Ectopic Pregnancy (EP) is a serious emergency faced by physicians in obstetrics and gynaecology, and the identification of EP can be frequently missed. The common signs of ectopic pregnancy in fertile women are lower abdominal discomfort and vaginal hemorrhage. The aim of this paper was to study EP patients to determine the etiology and management of EP. This study aims to study the hazardous factors, types, and clinical complications associated with EP patients, as well as diagnostic methods and prognosis. This was a retrospective cohort study performed at King Khalid Hospital, Majmaah, Saudi Arabia. Patient demographic data were documented. These data included parity, hazardous factors, signs and symptoms, habits, occupation, past history of PID, ectopic pregnancy, pelvic surgery and management. The data were analyzed using statistical software in MS Windows. The data are presented as the mean plus standard deviation. In our study, most cases (83.3%) were managed surgically, which means that too few cases were given medical or conservative options; thus, medical staff training in how to apply medical or conservative management techniques according to guideline criteria can improve future outcomes.
A 51-year-old left-handed Caucasian female with no significant medical history presented with a two-week history of severe neck pain and bilateral upper limb weakness. Neurological examination revealed weakness and altered sensation in the C5-T1 distribution bilaterally, more severe on the left with Medical Research Council’s scale (MRC scale) of muscle power grade 3/5 and 4/5 on the right with upper motor neuron signs. Short-TI Inversion Recovery (STIR) and T2 weighted MRI imaging revealed increased signal at the C6-7 disc representing discitis, as well an anterior epidural collection from C5 to C7, with associated cord compression. The patient underwent an emergency anterior cervical corpectomy of C6, drainage of the epidural purulent collection, and insertion of a cage and plate. Some tissue and pus samples were sent to the microbiology laboratory for analysis, and the organism Pasteurella multocida was identified on all samples. The patient clinically and biochemically improved with operative management and a prolonged course of intravenous ceftriaxone. A peripherally inserted central catheter (PICC) line was placed and the patient was discharged on eight weeks of intravenous ceftriaxone and ongoing physical therapy.
BackgroundThere is ongoing controversy regarding the use of low-intensity pulsed ultrasound (LIPUS) therapy in patients with delayed union or non-union. Exogen (Bioventus, Durham, NC) is a well-known brand of LIPUS, and according to their data, 86% of non-union fractures will heal without the need for surgery. A few independent retrospective studies reported much lower healing rates. MethodA retrospective observational study was performed assessing all the patients who underwent Exogen therapy in a single centre. All patients who were initiated on Exogen after three months with radiographic signs of the delayed union were included in the study. Routine follow-up appointments were organised until clinical and radiological healing could be confirmed. Daily 20-minute Exogen sessions were continued until the fracture was healed or up to a maximum of four months as recommended by the manufacturer. ResultsA total of 37 patients received Exogen therapy from 2012 to 2021, of which only 28 patients met our inclusion criteria and were subsequently analysed. The mean age of the patients was 52.0 (SD ± 20.2) with a male to female ratio of 1.7:1. The average time to healing was 115 (±51.2) days with a success rate of 82.14%. The average interfragmentary gap was 7.5 mm (±5.8) for the fractures that healed whereas the failed treatment was 16.1 mm (±13.8). There was no obvious association between outcomes after Exogen therapy and the patient's age, sex, time to initiate Exogen, diabetes, and smoking status. ConclusionThis study demonstrated a high success rate of LIPUS therapy for patients with delayed union and nonunion. LIPUS represents a safe, non-invasive alternative to revision surgery. An independent risk factor for a potentially poor outcome is an increased interfragmentary gap.
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