RESUMO
Objective The objective of this audit was to find out whether brain CT scans performed on patients with head trauma in Basra Teaching Hospital (BTH) adhere to the 2023 National Institute of Excellence (NICE) guidance for head injury (NG232) and whether we can improve this with selected interventions. Methodology We performed a clinical audit in two cycles; in the first cycle, we collected data retrospectively over a month in February 2024. The data was sourced from the imaging request forms and patient records at BTH. We then analyzed the data and implemented four key interventions to improve the outcome. After that, we performed our second audit cycle over an additional 30-day period during April 2024. Results Cycle One involved 59 patients, while Cycle Two involved 46. There was a significant decrease in scans requested outside of the NICE guidance, from 59.3% in Cycle One to 17.4% in Cycle Two (p<0.05). We also noticed a significant increase in the one-hour indication scans, from 32% in Cycle One to 65.2% in Cycle Two (p<0.05). Conclusion Our study findings reveal that by following some simple interventions, we significantly improved the adherence of our emergency department to the 2023 NICE guidelines for head CT following head trauma.
RESUMO
The Morel-Lavallée lesion is a fluid collection resulting from the traumatic separation of the subcutaneous tissue from the underlying fascia. It frequently occurs over the trochanteric region but may also occur in the flank, lumbosacral region, and buttock. Morel-Lavallée lesions in the upper limb are rarely reported in the literature. In this report, we present a case of a 42-year-old male, not known to have any medical diseases, who suffered from a post-traumatic left elbow mass that had existed for seven months before his presentation to our clinic. It is worth reporting this case to increase the awareness of this little-known pathology among orthopedic surgeons. In addition, most of the Morel-Lavallée lesions mentioned in the literature are located in the lower limb. .
RESUMO
Desmoplastic fibroma (DF) is a non-metastatic primary bone tumor that is extremely rare with local aggressive behavior. To the best of our knowledge, only few cases were published discussing this type of tumor and its management. This case report aimed to discuss a novel case as well as its management scheme. We present a case of a 36-year-old male with DF lesion involving the proximal tibial who underwent an extended curettage, triple type of adjuvant thereby, and internal fixation.
RESUMO
BACKGROUND: Second-hand tobacco smoke is a serious health hazard. We tested the fidelity and feasibility of the Smoke-Free Homes (SFH) intervention and looked for preliminary evidence of its effectiveness in imposing smoking restrictions in homes in Pakistan. METHODS: SFH was piloted and adapted for Pakistan. The adapted SFH intervention was then delivered to primary schoolchildren, community leaders and health professionals in a semi-rural Union Council. We carried out a survey before and after the intervention to assess adult smoking behaviour and restrictions at homes. We also carried out focus group discussions with stakeholders to determine the appropriateness and acceptability of the intervention. RESULTS: We found the adapted SFH intervention feasible and appropriate in a typical semi-rural setting in Pakistan. The proportion of smoke-free homes increased from 43% (95%CI 37.4-48.2) to 85% (95%CI 80.9-89.2) after the intervention. The number of households with at least one smoker decreased from 57.5% (95%CI 52.1-62.9) to 38.4% (95%CI 32.7-44.1). There was a reduction in self-reported adult smoking prevalence from 44% (95%CI 39-48) to 28% (95%CI 24-33) in males. CONCLUSION: SFH has the potential to influence adult smoking behaviour in households. This approach needs to be further evaluated to establish its effectiveness and cost-effectiveness and to ascertain its long-term sustainability.