Niger J Clin Pract
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Case Reports
Testicular torsion: Losses from missed diagnosis and delayed referral despite early presentation.
Testicular torsion leads to loss of blood supply to the testes due to the twisting of the spermatic cord and its contents, necessitating urgent surgical intervention to salvage the affected testis. Testicular loss from missed diagnosis and delayed referral is preventable, especially when patients present early to first contact health care workers. This makes having the correct diagnostic knowledge for testicular torsion by these first contact healthcare providers a very essential determinant of its overall outcome. ⋯ Their diagnoses were missed and referrals were delayed despite presenting within three hours of onset of symptoms. It led to the removal of the affected testis in both patients. This case series emphasizes the need to regard every testicular pain in children and young adults as testicular torsion until proven otherwise and highlights the importance of training the first contact health care providers on recognition and prompt intervention or referral of patients with testicular torsion.
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Case Reports
High-risk surgeries, anesthetic challenges, and real benefits of peripheral regional techniques revisited.
Patients with high-risk conditions for surgery may benefit from some form of regional block when neuroaxial regional blocks may be life threatening. Despite the increased use of ultrasound-guided peripheral regional blocks internationally, local infiltration and targeted nerve blocks aided by knowledge of anatomical landmarks remain helpful in these two patients presented. A 48-year old woman, presented with bleeding left breast mass, mild respiratory distress, and radiological features of lung metastases (Carcinoma of the breast stage 4). ⋯ The good outcomes in these two patients showed the benefit of peripheral regional blocks in high risk patients. Early recognition of high-risk patients and appropriate anesthetic and clinical assessment with the formulation of right techniques can help salvage lives. This thought is more apt in equipment challenged environments like ours in Nigeria, when resources for ultrasound assisted peripheral nerve blocks are not always available.
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The clinical diagnosis of chronic kidney disease (CKD) is based on estimated glomerular filtration rate (GFR) using serum creatinine-based equations. Many formulas are used in estimating GFR. ⋯ There is significant discordance in the eGFR obtained from the various serum creatinine-based GFR equations in our population suggesting the need to validate these equations and determine the best equation for our general population.
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Omphalitis is an important cause of neonatal sepsis (NNS) and mortality. Quantitative estimates of risk of omphalitis-related neonatal death is about 10%-19%. Topical applications of antiseptics have been shown to reduce this risk burden but has not been well investigated. ⋯ There is no evidence that 96% methylated spirit is inferior to 4% CHX gel in preventing neonatal omphalitis; hence, it may be considered a safe and effective alternative where CHX gel is unavailable.
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Using lasers for adhesive restoration removal can be practical and atraumatic. ⋯ Laser treatment can serve as a practical and effective method that eliminates the risk the enamel damage and restoration fracture.