PubMed Health⌕ Search

Biomedical subjects

Z Mohyuddin

Publications and source records attributed to Z Mohyuddin.

8 recordsLinked to original sources
PubMed1998

Complications associated with different insertion techniques for Hickman catheters.

A dependable central venous access is an essential prerequisite for the delivery of care to the cancer patients. This has become easier since the introduction of indwelling central venous catheters. However, pancytopenia, often encountered in haematological malignancies, does influence the morbidity associated with these catheters. In this study the effects of two different placement techniques of Hickman catheters were evaluated. A total of 177 Hickman catheters were inserted in patients suffering from haematological malignancies. In 112 patients the catheters were placed percutaneously into subclavian veins without prior tunnelling; in the other 65 patients these were introduced, after having been tunnelled, into cephalic/external jugular veins by a cut-down technique. The catheters remained in use in each patient for between 18 and 253 days. Excessive bleeding and haematoma formation occurred in a significantly higher proportion of patients from the cut-down group (61% and 41%, respectively) compared to patients from the percutaneous group (8% and 0%, respectively). These in turn had a profound impact on the incidence of infective complications. Catheter exit site infection, tunnel infection and septicaemia were observed in 26%, 18%, and 41%, respectively, of the patients from the cut-down group, while in patients from the percutaneous group, skin exit site infection was noted only in 7% and septicaemia in 19% of patients. It was concluded that the placement technique of these catheters exerts a significant influence on the immediate as well as delayed complications. The results indicate that the insertion technique requiring minimal dissection is more beneficial. It is therefore recommended that percutaneous insertion without tunnelling should be the technique of choice for catheter placement.

Adolescent↗
PubMed1997

Complete gastric outlet obstruction following acid ingestion complicated by acute pancreatitis and disseminated intravascular coagulation.

A case is described where accidental acid ingestion resulted in the development of oesophageal stricture and complete gastric outlet obstruction. Following a smoothly conducted pre-surgery endoscopic examination the patient developed acute pancreatitis, which, on initial clinical examination, was diagnosed as a viscus perforation. The severity of pancreatitis was such as to lead to disseminated intravascular coagulopathy and ultimately death. The interest lies in the fact that pancreatitis was precipitated in a previously traumatised stomach by such an innocuous procedure as fibre-optic endoscopy.

Acids↗
PubMed1996

Deep vein thrombosis as a predictor of cancer.

An association between cancer and venous thrombosis has long been recognized. In an attempt to find whether venous thrombosis can serve as a reliable predictor of subsequent cancer, 196 cases of confirmed venous thrombosis treated over a seven-year period were reviewed. Of a total of 196 cases, 113 were found to suffer from primary type deep venous thrombosis (DVT), whereas 83 were allocated to secondary type DVT. Of 113 cases with primary DVT, 23 had suffered from recurrent episodes, whereas 90 had only a single episode. From the secondary DVT group of 83 patients, 14 suffered from recurrent episodes and 69 had a single episode. Of the patients in the primary DVT group, 2.65% (3/113) developed cancer subsequently, whereas none was detected among the group of 83 patients who had secondary DVT. In the group of 113 patients with primary DVT, the incidence was higher among those who had recurrent episodes (4.34%, 1/23) than among those who had a single episode (2.22%, 2/90). The overall incidence of cancer among 196 cases of DVT was found to be 1.53% (3/196). The findings do not support the routine screening of all DVT patients by expensive diagnostic modalities. These patients should rather be assessed by careful clinical examinations and baseline investigations. The detailed investigations should be resorted to if there is any suggestion of presence of occult malignancy by these simpler means. One should be more vigilant in case of patients suffering from primary type DVT, for the incidence in this group is significantly higher.

Adult↗
PubMed1995

Management of flail chest injury: internal fixation versus endotracheal intubation and ventilation.

A total of 427 patients with major chest trauma were treated in two major hospitals in Abu Dhabi, United Arab Emirates, during a 10-year period. In 64 of 426 patients, flail chest injury was the dominant factor among other injuries that were insignificant. Among 64 cases of flail chest injury, 25 were managed by internal fixation of ribs, whereas the remaining 38 were managed by endotracheal intubation and intermittent positive-pressure ventilation alone. Of the patients treated by internal fixation 80% (21/26) were weaned from the ventilator within an average of 1.3 days, whereas the remaining 20% (5/26) continued to need assisted ventilation for a longer duration; the total average duration of assisted ventilation for the whole group was 3.9 days. In comparison, among 38 patients with flail chest injury treated by endotracheal intubation and ventilation alone, the average duration of assisted ventilation was 15 days. In the group treated by internal fixation 11% (3/26) of the patients ultimately required a tracheotomy, whereas in the patients treated by intubation and ventilation alone tracheostomy was required in 37% (14/38) of the cases. In the group treated by internal fixation, chest infection was documented in 15% (4/26), septicemia in 4% (1/26), and barotrauma in 0%; in the other group these complications occurred in 50% (19/38), 24% (9/38), and 8% (3/38) of the cases, respectively. The mortality rate was 8% (2/26) in the surgically treated patients, whereas it was 29% (11/38) in the other group. All the deaths in both groups were ascribed to adult respiratory distress syndrome. Average stay in the intensive care unit was 9 days for the patients treated by internal fixation, whereas it was 21 days in the group treated by intubation and ventilation alone. The treatment of flail chest injury in our series by internal fixation resulted in speedy recovery, decreased complications, and better ultimate cosmetic and functional results and proved to be cost effective.

Adolescent↗
PubMed1990

Mycotic aneurysm.

Explore the source record for details and available documents.

Aneurysm, Infected↗
PubMedDate not supplied

Successful management of ruptured mycotic abdominal aortic aneurysm in a child.

Mycotic aneurysm of the abdominal aorta is a serious disorder that generally carries a grave prognosis. A few survivors have been reported in adults but none in children. This report describes the successful management of ruptured mycotic abdominal aneurysm in a 10-year-old girl. The entire aneurysm was excised, and aortic continuity restored with low porosity bifurcated Dacron graft. With no macroscopic suppuration, we believe aortic continuity is a logical way to deal with this grave situation in children. Antibiotic cover was given pre and postoperatively for a total of six weeks. To our knowledge, this is the only surviving case in children in the literature. The pathogenesis and diagnosis of mycotic and infected aneurysm is discussed, and the literature has been reviewed.

Aneurysm, Infected↗