A rare complication of ventriculoperitoneal (VP) shunt is presented. A 11-year old boy presented with a tube coming out of the mouth. He had multiple VP shunt done earlier. Clinical features, laboratory investigations and imaging studies showed that the peritoneal end had perforated the gastro-oesophageal junction and then prolapsed trans-orally. The shunt was removed and he made an uneventful recovery. Though migration of the peritoneal end of the shunt tube into various organs is known, to our knowledge, only six/seven cases have been reported in the English literature of a shunt tube coming out of the mouth and this is the next. The management of this very rare problem is discussed.DOI: http://dx.doi.org/10.3329/bjms.v13i4.20654Bangladesh Journal of Medical Science Vol.13(4) 2014 p.492-495
Background: Esophageal atresia (EA) encompasses a group of congenital anomalies (one in 2500 live births) comprising an interruption in the continuity of the esophagus combined with or without a persistent communication with the trachea. It is confirmed by passing no. 10 sterile, blunt‑tipped red rubber catheter into the esophagus, which gets failed to pass beyond 10 cm.
Case Series: We describe two male neonates in whom the infant feeding tube could be passed to 18-20 cm in the upper esophageal pouch. A babygram with a blunt-tipped soft red rubber catheter in situ confirmed the esophageal atresia (EA) with the long upper pouch in the first case and EA with obstruction at the gastroesophageal junction in the second one.
Conclusion: The importance of recognizing rare Kluth variants of EA is stressed. A low threshold for performing a red rubber catheter test is stressed.
A child with a foreign body lodged in the rectoaigmoid region resulting in colonic perforation and concurrent acute appendicitis is presented. During clinical evaluation, there were no signs of generalized peritonitis; abdominal sonography was performed to evaluate for acute appendicitis. An erect abdominal xray showed a radio opaque shadow in the right iliac fossa. At laparotomy, the tip of a pen was seen to perforate the sigmoid colon and impinge on the base of the appendix which was grossly inflamed. Subsequently, the pen was removed from within the colon and the colon was repaired in two layers. An appendicectomy was performed.
Background: Intensive care unit (ICU) acquired infections account for substantial morbidity and mortality. The study aimed to evaluate the
quality indicators and microbial ora and also healthcare professionals for applying the safe practices in the ICU of the cancer institute.
Patients andMethods:This prospective,observationalstudywas conductedina tertiarycare cancer hospitalfromSeptember2017toFebruary2018.
Results: Catheter-related blood-stream infections (CRBSI) -5.72% was the most frequently observed ICU-acquired infection, while the rates of
catheter-associated urinary tract infections (CAUTI) - 2.76% and surgical site infections (SSI) - 1.55% were lower than CRBSI. The percentage of
VAP was (1.14%), while bedsore was low (0.16%). There were only 6 cases of needle stick injury (NSI) with 0.02%. Out of all the microbial ora,
Gram-negative organisms were common with E. Coli constituting 27.33% followed by Klebsiella 12.17%. The result of the evaluation of the
healthcare professionals (nursing staff) for applying the safe practices in ICU through a structured questionnaire was 99%.
Conclusions: Among the quality indicators, CRBSI was the most frequently observed ICU-acquired infection followed by CAUTI. E. Coli
followed by Klebsiella was the most prevalent microbial ora. The application of safe practices by the healthcare professionals (nursing staff) in
the ICU of our cancer institute was 99%. Our recommendations would help HCP in other ICU facilities in improving quality indicators and
reducing ICU infections.
A blunt‑tipped red rubber catheter is used to confirm the presence of esophageal atresia in any newborn with drooling of saliva and frothing from the mouth. Failure to pass it beyond 10cms into the esophagus is considered diagnostic. We here in report an extremely rare case of broken tip of red rubber catheter lodged in the laryngopharynx of 2-day-old neonate of esophageal atresia with distal tracheoesophageal fistula. During endotracheal intubation foreign body was accidentally removed.
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