Ciprofloxacin, among the many Fluoroquinolones, has been widely used as a broad‐spectrum antibiotic due to its wide range of action and relatively safe adverse effect profile. However, among the cutaneous adverse drug reactions due to Ciprofloxacin, toxic epidermal necrolysis occurring along with cholestatic hepatitis is a rare one. Here, we present a case of a 22‐year‐old male patient who was diagnosed with toxic epidermal necrolysis with cholestatic hepatitis secondary to Ciprofloxacin. Naranjo adverse drug reaction probability scale was used for the causal association.
Introduction and importance: Obturator hernia is an infrequent clinical entity of abdominal wall hernia, accounting for an incidence rate ranging from 0.073 to 2.2% of all hernias and being responsible for 0.2–1.6% of all cases of mechanical intestinal obstruction. The computed tomography (CT) scan, as an imaging modality, is critical in improving the diagnostic rate of obturator hernia. Case presentation: The authors herein report an 87-year-old thin male patient with a known history of chronic obstructive pulmonary disease who presenting with complaints of abdominal pain for 3 days and constipation for 2 days, as well as one episode of vomiting without any features of peritoneal irritation, which was diagnosed early as a right-sided obturator hernia via CT and managed with exploratory laparotomy with hernia reduction and polypropylene mesh repair. Discussion: Obturator hernia is a rare surgical phenomenon with a varied clinical spectrum, ranging from asymptomatic to presenting as intestinal obstruction. The CT scan plays a critical role in the detection of obturator hernias, which ameliorates the possible significant postoperative morbidity and mortality. Conclusion: This report demonstrates that a high index of suspicion combined with CT imaging aids in early diagnosis and management, thus overcoming the reluctant morbidity.
Purpose: Nepal's 2017 Disability Rights law provided a new national definition of disability consistent with the UN Convention on the Rights of Persons with Disabilities (CRPD). Updated measurement methods are now indicated to assess disability, suitable for use in populations where self-report tools may be sub-optimal. This study describes the development and field testing of a screening methodology using a clinical assessment conducted by trained nonprofessionals to score the ICF Minimal Generic Set (MGS). Method: A prospective, 2-stage assessment of disability was conducted over an eight-month period among a convenience sample of individuals aged ≥ 18, admitted to a rural District Hospital in Northeastern Nepal. After 30 hours of training, non-professional assessors completed Stage 1 screening during hospital admission, with positive screening thresholds set on the basis of MGS scores. A physiotherapist completed Stage 2 assessments in the homes of participants with long-term disability, after their hospital discharge.Results: Data from 161 participants was analysed, with 159 (98.8%) screening positive for either temporary or long-term disability. Stage 1 screening was completed independently by assessors in 8-12 minutes. Of the 35 participants (21.7%) with positive screening for long-term disability, 13 (37.1%) underwent Stage 2 detailed evaluation. Disability was confirmed in all Stage 2 assessments, indicating feasibility of the screening process.
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