The efficacy of sodium bicarbonate for treatment of gout

Background: Sodium bicarbonate is highly alkaline and may be helpful in relieving symptoms of gout. Sodium bicarbonate helps to adjust your body's pH level, slightly creating an alkaline-forming state that lessens the likelihood of gout attacks. We can prepare sodium bicarbonate in several ways to treat gout symptoms. Objective: To examine the efficacy of sodium bicarbonate for treatment of gout. Subjects and method: A study was conducted in 54 patients with gout at Department of Rheumatology of Bach Mai hospital, from September 2006 to March 2007. Patients were divided into two groups, group 1 included 29 patients treated with intravenous sodium bicarbonate and group 2 included 25 patients treated with oral sodium bicarbonate. This was a descriptive, cross-sectional study. Results: No significant changes showed between serum uric acid level, 24-hour urine uric acid level at before and after treatment in 2 groups. Gout patients with renal failure had increased level of 24-hour urine uric acid after treatment (p < 0.05). There were significantly increased level of urine volume, urine pH and decreased level of urine specific gravity after treatment. The effect of sodium bicarbonate was not different between intravenous usage and oral usage. Conclusion: Sodium bicarbonate could change urine environment, limit crystallization of urine uric acid of gout patients.

Arm necrosis due to intra-arterial drug injection: report a case

Injection-related necrosis is a common pattern in the arterial injuries. But the acute embolization that led to extremity necrosis is very rare. Here we described a case of 43-year male patient with arm necrosis due to intra-arterial drug injection. The patient has addicted drug for 24 years and has injected opium for 18 years with dose of 2 ml self-prepared opium solution, 3-4 times daily. On April 2000, after second injection of a day, the patient felt burn and pain in his left hand. Then watery purples and necrotic papules appeared on the skin of left arm. He was treated by antibiotics, analgesics, and vasodilators, but the condition was not improved. The patients had to be amputated his left arm after 3 days of admission.

Role of surgery for diabetic foot

The ulcer lesion in diabetic foot is a major complication and usually leads to disability. Current treatments composed mostly of medication or amputation if required. After the conference of Vietnamese -American on diabetic foot care in June 2000, we have established a new plan of management, included early operation, proper debridement and appropriate blood sugar control. Method and material: retrospective and cross sectional study on 16 type II diabetics (5 males and 11 females) with foot infection. All these patients were operated to remove dead bones and necrotic tissues, sutured the wound in one layer and immobilized the pain leg within 21 days. They were also treated with insulin and investigated the arterial system by Doppler ultrasound. Results: average age of patients: 562 years. Average glycemia: 19020mg%. Left foot: 9. Right foot: 6. Both feet: 3. The duration from onset to ulcer: 60.2 years. Doppler ultrasonography showed the decrease flow pattern of lower limbs in 14 cases, atherosclerosis: 2. After surgery, 11 patients were healed completely within 21 days, 3 others within 30 days and 2 patients had to be amputated

Rupture of diaphragm

During 5 months from 1/2000 to 5/2000, at Nhan Dan Gia Dinh Hospital, we have operated 5 patients with post-traumatic rupture of diaphragm. Among them, three planned operations and two urgent operations. All cases were diagnosed by clinical findings associated with chest X ray and GI tract examinations. Only one case we had by thoracotomy, the rest had been performed by laparotomy. The realized target of this study is determining the typical semiology of diaphragmatic rupture and proposing the laparotomy access for delayed diaphragmatic rupture.