Annual Congress and Medicare Expo on Trauma & Critical Care March 07-09, 2016 Madrid, Spain
Breast Cancer 2016, UK
Family Nursing 2016, USA
Psychiatry 2016, USA
Midwifery 2016, USA
Trauma 2016, Spain
Psychiatrists and Forensic Psychology 2016, Spain
Nurse Practitioners-2016, UAE
Stroke 2016, UAE
Clinical Nursing 2016, Australia
Neuroscience 2016, Australia
Surgical Nursing 2016, Malaysia
Healthcare AsiaPacific-2016, Australia
Day 1: March 7, 2016
Zaza Demetrashvili
Tbilisi State Medical University
Title: Damage Control Surgery in Abdominal Trauma
Biography Abstract
Zaza Demetrashvili was born in 1963, in Tbilisi. He got his MD status when he was 25 years old and completed his PhD at the age of 32 from a postdoctoral study in Tbilisi State Medical University. He is Associate Professor of Surgery, of Tbilisi State Medical University and Senior General Surgeon of Kipshidze Central University Hospital (Tbilisi, Georgia). He has published more than 80 scientific articles in international peer reviewed journals. He also is serving as an editorial board member and a reviewer of various international medical journals. He is member of several international surgical associates.
BACKGROUND Damage control surgery (DCS) is one of the major advances in surgical techniques used in polytrauma patients in the past 25 years. The central principle of DCS is that patients are more likely to die from the "lethal triad" of hypothermia, coagulopathy and metabolic acidosis than from a failure to complete operative repairs. The goals of the DCS are to identify injuries, control haemorrhage, and control contamination. In patients with major abdominal trauma DCS avoids extensive procedures on unstable patients, stabilizes potentially fatal problems at initial operation, and applies staged surgery after successful initial resuscitation. In this retrospective study we evaluate the results of DCS in patients with severe injury to the abdominal organs. MATERIAL AND METHODS The evaluated group included 20 patients with severe abdominal trauma who underwent damage control laparotomy in the 2008-2014 years. There were 17 men and 3 women; the age range was 21 to 62 years. DCS was indicated in the patients with blunt abdominal trauma (13 patients) or penetrating trauma (7 patients). DCS included simple surgery (rapid abdominal exploration with haemorrhage and contamination control, temporary abdominal wall closure without tension), resuscitation in the intensive care unit (correction of hypothermia, acidosis and coagulopathy) and definitive surgery. RESULTS DCS was most frequently performed for liver injury (11 patients), which was associated with multiple injury to the other abdominal organs and retroperitoneum in nine patients. Repeat surgery was carried out within 24 to 72 hours. Perioperative mortality was 15% (3/20). The reasons of death were progressive traumatic haemorrhagic shock in one case and brain oedema after concussion in two cases. The perioperative complication rate was 40% (8/20). The Complications were: biliary leakage and fistula formation in 3 cases, anastomotic leakage and fistula formation in 2 cases, rebleeding in abdominal cavity in 2 cases and intraabdominal abscess formation in 1 case. CONCLUSIONS: DCS is an effective method in the treatment of severe trauma to the abdominal organs in critically injured patients. With an organized approach, DCS can lead to improved patient survival.
ING HOW MOO
Changi General Hospital
Title: Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete
Dr. Ing How Moo has completed his MBBS at the age of 24 from University of New South Wales Sydney Australia and postgraduate MRCS (Ireland) at the age of 26. He is currently an Orthopaedic Surgery resident with an interest in trauma surgery. He has published 5 papers in reputed journals and has been invited to present at 4 international orthopaedic conferences held in Europe & Asia. He is active in research and currently conducting few trials.
Introduction: Compartment syndrome isolated to the anterior thigh is a rare complication of soccer injury. Previous reports in the English literature on sports trauma-related compartment syndrome of the thigh are vague in their description of the response of thigh musculature to blunt trauma, magnetic resonance imaging (MRI) findings of high-risk features of compartment syndrome, vascular injury in quadriceps trauma, and the role of vascular study in blunt thigh injury. Case Report: We present herein the rare case of a 30-year-old man who developed thigh compartment syndrome 8 days after soccer injury due to severe edema of vastus intermedius and large thigh hematoma secondary to rupture of the profunda femoris vein. MRI revealed "blow-out" rupture of the vastus lateralis. Decompressive fasciotomy and vein repair performed with subsequent split-skin grafting of the wound defect resulted in a good functional outcome at 2-years follow-up. Conclusion: A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and "blow-out" tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.
Sanja Masnec
University Hospital Center Zagreb, Croatia
Title: Pentadecapeptide BPC 157 and perforating corneal injury in rat
S Masnec is working as an Ophthalmologist in the Department of Anterior Segment of the Eye, at the University Hospital Centre Zagreb. Her special interests are anterior segment eye surgery, cataract surgery, corneal transplantation surgery, and oculoplastic and reconstructive surgery. She has completed her PhD from Zagreb University and Post-doctoral studies from Zagreb University School of Medicine. She has published 17 internationally indexed publications.
The effect of human gastric pentadecapeptide BPC-157 on healing of perforative corneal injury in rats was evaluated. The study included 100 male Wistar albino rats, 280-320 g body weight, divided in to 4 groups (n=25). The randomization protocol was generated by the Random Allocation Software Version 1.0, 2004. Penetrant linear incision 2 mm was performed under deep anesthesia with ketamine, 20 mg/kg i.p. and diazepam, 6 mg/kg , along with topical anesthetic oxibuprocaine 0.4%, 2 drops on left cornea paralimbal at 5 o'clock with incision knife 20 Gauge MVR (Bausch&Lomb) under 45º, under operating microscope. Left eye was operated in aseptic conditions by the same surgeon. Lesions were stained by standard 10% flourescein and photographed. Animals were medicated as follows: distilled water (control group) or BPC 157 2 pg/ml, 2 ng/ml, 2 µg/ml, 2 drops per rat's left eye started immediately after injury induction, every 8 hours up to 120 hours . Lesions were photographed before application or sacrifice (at 24, 48, 72, 96, 120 h). Healing process was analysed clinically using Fluorescein test, Seidel test, image analysis software SFORM software, slitlamp and pathohistologically using standard tissue analysis. Throughout 120 h-period a steady recovery is noted in controls. Healing was significantly accelerated in eyes on µg- or ng-topical regimen of BPC 157 (p<0.05) during all intervals. BPC 157 was shown to be effective in promoting healing of corneal layers in rats. Results were dose dependent.
Nilo Mercado Lapid
Angeles University Foundation
Title: Survival Analysis among Hemodialysis Patients in A Selected Tertiary Hospital in Pampanga
Nilo Mercado Lapid has completed his Masters degree with a merit of Benemeritus at the age of 29 years from Angeles University Foundation, Angeles City, Philippines. Finished his bachelors degree in Nursing in 2006 and licensed to practice by February 2007. In the same year clinical trainings were continuously attended. In particular, he continued his career in renal nursing as he attended further his knowledge and expertise through formal trainings, seminars and conventions in hemodialysis from 2007 to 2015. He solely earned his clinical nephrology practice in a private tertiary hospital in the Philippines from 2007 to 2015.
This retrospective cohort study aimed to determine factors associated to survival of hemodialysis patientsin the Selected Tertiary Hospital in Pampanga – Hemodialysis Unit and to estimate their mean and median survival time as well as their survival rates. The sample consisted of 200 patients who underwent hemodialysis treatment from 2007 to 2011. Patients aged below 18, those who underwent kidney transplant, and transient patients (those who went through dialysis only during the course of their short stay / vacation in Pampanga) were excluded. Kaplan-Meier Survival Analysis was used for examining the distribution of the survival time of the hemodialysis patients. Survival times were compared by levels of the various demographic, hemodialysis-related, and bio-chemical factors and diagnosis or cause of ESRD using log-rank tests. P-values less than 0.05 were considered significant. Results showed that about 3 out of every 4 hemodialysis patients in the Selected Tertiary Hospital in Pampanga started dialysis at more than 50 years of age while 3 out of every 5 of the hemodialysis patients are males. Half of the hemodialysis patients are prescribed twice a week hemodialysis sessions. Only 1 out of every 3 patients on hemodialysis for at least one year is compliant to the prescribed hemodialysis treatment. Most of the patients had hemoglobin, phosphate, BUN and creatinine and levels below the recommended range at baseline but these decreased during the course of their hemodialysis although there were several missing data on these bio-chemical factors during hemodialysis. Diabetes was found to be the leading cause of kidney disease leading to hemodialysis followed by chronic glomerulonephritis and then by hypertension. On the average, hemodialysis patients in the selected institution live up to about 2 and a half years after starting hemodialysis. After 5 years of hemodialysis approximately 1 out of every 3 hemodialysis patients in the selected institution would still be alive. The following hemodialysis patients were found to have a survival advantage: those who started dialysis between 18 to 40 years, males (who happened to be younger than females), baseline hemoglobin levels between 11 to 12 g/L, phosphate level more than 5.51 mg/dL during the course of dialysis, BUN level between 60 to 110 mg/dL during the course of dialysis, creatinine levels greater than 11.1 mg/dL during the course of dialysis, and with CGN as the cause of ESRD. In line with the results, the researcher recommends that the health care providers reiterate to the patients and their significant others to try to maintain during the course of hemodialysis the prescribed hemoglobin, phosphate, BUN and creatinine levels, which have been found in this study to be associated with greater survival. Incidentally, a more organized record keeping among hemodialysis patients is recommended to facilitate the development of a good database that may be used for research purposes. Since diabetes was found to be the leading cause of kidney disease leading to hemodialysis followed by chronic glomerulonephritis and then by hypertension, modifiable risk factors for these diseases have to be identified such that these factors could be modified as early as possible in the current study population. Lastly, the researcher recommends the implementation of the proposed series of seminars for hemodialysis nurses which will ultimately benefit hemodialysis patients and their significant others.
Aftab Ahmed
King Edward Medical University
Title: Head Injury in Children of Karachi: A Cross-sectional study
A cross-sectional study was conducted to evaluate the prevalence, causes and outcome of head injury in children at Neurosurgery Department, Jinnah Postgraduate Medical Centre, Karachi. The duration of study was from 1st December, 2013 to 1st February, 2014. A total of 37 patients under the age of 12 years, who presented with head injuries to the emergency department, were included in the study. A self-designed proforma was used to fill the detail involved in head injury including causes , clinical presentation along with X-Rays of skull and CT of brain. Result were analyzed by IBM, SPSS version 20.The mean age of patients was 6.93 years ± 3.02. Out of these 37 patients, 54.1% were boys and 45.9% were girls. Road traffic accidents accounted for most of cases (48.6%), with more boys than girls. Majority had a mild brain injury according to Glasgow Coma Scale (43.2%), whereas a depressed fracture was found to be the dominant feature (21.6%) on X-rays. Additionally, 29.7% of children had intracranial hemorrhage while 32.4% also acquired other injuries. There were (83.8%) admitted in neurosurgical ward, among them 29.7% had surgical intervention. Head injury in children is an important issue. Keeping in view the lack of preventive measures, we need to properly highlight the burden of such injuries on childhood so that all the concerned governing authorities should take every possible step in prevention and management of this devastating health concern