A Case of Cerebral Sinus Venous Thrombosis Resulting in Mortality in Severe Preeclamptic Pregnant Woman

Cerebral venous sinus thrombosis (CVST) is a rarely encountered condition during pregnancy. A 21-year-old pregnant woman with labour pains was hospitalized in our clinic. Diagnosis of severe preeclampsia was made based on her clinical and laboratory findings. She suffered from convulsive episodes during postpartum period which lead to initiation of treatment for eclampsia. However neurological and radiological examinations were performed after emergence of additional neurological symptoms disclosed the diagnosis of CVST. In this paper, we aimed to present a case with CVST which diagnosis was confused with eclampsia and resulting in maternal mortality

Revision of total hip arthroplasty using dual mobility acetabular cup as treatment of recurrent hip dislocation following total hip arthroplasty: a case report

One of the most common causes of revision surgery after total hip arthroplasty (THA) is dislocation. We present a recurrent case of hip dislocation following THA treated with dual mobility cup. Treated with total hip arthroplasty in another hospital in January 2024. Following the first surgery he suffered from a first event of hip dislocation in February 2024, managed with open reduction. One week following the open reduction, the hip became dislocated again and was treated with closed reduction. Two months later he was referred to our center with recurrent posterior right hip dislocation. Revision surgery was performed, using dual mobility acetabular cup. Intraoperative evaluation showed adequate stability and limb length was acceptable. Partial weight-bearing and active range of motion exercise was initiated following the surgery. Dual mobility acetabular cup reduces rate of dislocation and has satisfactory mid-term outcome

Evaluation of dyspnea severity and sleep quality in patients with novel coronavirus

Aim Dyspnea, a common symptom of novel coronavirus, can negatively affect sleep quality. The aim of this study was to evaluate the relationship between dyspnea severity and sleep quality in patients with COVID-19. Study Design A cross-sectional design was used. Methods Using the researcher's mobile phone, data were collected via an online questionnaire from patients (n = 100) who agreed to participate in the study. The data-collection form comprised three parts: a patient descriptive information form, the Dyspnea-12 Questionnaire, and the Richards-Campbell Sleep Questionnaire (RCSQ). Results The mean age of patients was 46.39 +/- 12.61 years and 66.0% were men. Patients who were treated in the intensive care unit had bachelor's degree or more and patients with comorbid diseases had low mean scores from the RCSQ and high mean scores from the Dyspnea-12 Questionnaire (P < .001, P P = .047, P P < .001, P < .001, respectively). Patients who were not receiving oxygen therapy had higher RCSQ mean scores and lower Dyspnea-12 Questionnaire scores (P < .001, P P < .001, P < .001, respectively). There was a strong negative relationship between the total scores obtained from the RCSQ and the Dyspnea-12 Questionnaire (r = -.701, P < .001). Conclusions Sleep quality is affected by dyspnea severity in patients with COVID-19. Sleep quality and dyspnea severity are also influenced by quite different factors, and these should be addressed and eliminated by nurses as part of a holistic approach. The results of this study will help nurses, especially those providing treatment and care for patients with COVID-19, to identify the factors affecting dyspnea and sleep quality and to plan, implement and evaluate nursing interventions that will reduce their workload

Facies, Sequence Stratigraphy and Reservoir Heterogeneity of the Upper Wolfcampian Group (Wolfcamp A Equivalent): Glass Mountains of West Texas

The Latest Artinskian to Early Kungurian Upper Wolfcamp (Skinner Ranch) Formation is exposed in the Lenox Hills of the Glass Mountains in Brewster County, Texas. These outcrops provide geoscientists and engineers a window to examine strata equivalent to the Wolfcamp A unconventional reservoirs in the southern Delaware Basin. This study provides an outcrop-based sequence stratigraphic analysis to identify distinct chemo/litho facies within a regionally correlative framework for improved reservoir characterization of organic-rich, mudrock-dominated successions. We use modern advances in Energy-Dispersive X-Ray Fluorescence (ED-XRF) chemostratigraphy to better understand depositional constraints on reservoir quantity (spatio-temporal variations) and quality (compositional, TOC richness) within a mixed carbonate-siliciclastic system. Within the Lenox Hills, the Upper Wolfcamp Formation consists from the base up of the: 1) carbonate conglomerate-prone Decie Ranch Member,2) organic rich, mudstone-prone Poplar Tank Member, 3) mixed carbonate-siliciclastic conglomerate-prone Sullivan Peak Member, and (4) the organic poor, mudstone-prone Dugout Mountain Member. The lowermost three members of the Upper Wolfcamp Formation, especially the mudstone-prone Poplar Tank Member, were the focus of this study. Five facies were identified within the Poplar Tank Member: 1) Facies 1a (skeletal packstone/grainstone) and 1b (skeletal wackestone), Facies 2 (calcareous silty mudstone), Facies 3 (argillaceous shale/mudstone), Facies 4 (siliceous mudstone/siltstone), and Facies 5 (siliceous shale/siltstone).Within the Poplar Tank Member, the heterogeneity of the observed facies and elemental proxies throughout the lower depositional sequence of the Upper Wolfcamp Formation suggest strong depositional cyclicity. Detrital and paleo-redox proxies indicate increase in siliciclastic deposition occurred during the interpreted TST and early HST, and carbonate deposition occurring during the interpreted late TST and HST. Comparison of reservoir quality between the Upper Wolfcamp mudstone in outcrop and core studies indicate an equivalence of strata to the informal “Wolfcamp A” reservoirs in the subsurface of the Delaware Basin. Likewise, preliminary analysis of the shale/siltstone at the base of the Dugout Mountain Member indicate a correlation to the X, Y, and Z Sands of the Wolfcamp A. These findings, coupled with complete sedimentary and geochemical analysis of the type Upper Wolfcamp (Skinner Ranch) Formation provides chronostratigraphic insights for the surface to subsurface correlations. This work indicates that to make the Wolfcamp Group in outcrop coeval to the Wolfcamp Group in the subsurface, the base of the Leonard Group (Bone Springs) should be placed at the base of the Wedin Member of the overlying Cathedral Mountain Formation

Comparison outcome in management of femoral neck fracture using multiple cancellous screws with and without fibular graft

Multiple cancellous cannulated screw is preferred method in fresh cases of fracture neck of femur in young patients. Fibular strut graft is sometimes used along with multiple cancellous cannulated screws to enhance union and early restoration of function. We conducted a retrospective study to patients aged between 20-50 years old with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft between the period of January 2016 to January 2018. We obtained total of six patients (five males and one female) with femoral neck fracture treated with multiple cancellous screws either with or without fibular graft. All fractures were garden type II-IV fresh femoral neck fractures. The functional outcome based on Harris hip score was excellent for all patients. The mean time of full weight bearing was 16±8 weeks in both multiple cancellous screws without fibular group and multiple cancellous screws with fibular group. The mean time of union was also 16±8 weeks in both groups. There is no complication such as non-union, avascular necrosis of femoral head and/or broken fibular graft in both the groups occurrences. Fixation with cancellous screws and fibular strut grafts for femoral neck fractures is cost effective and technically less demanding and associated with good outcomes. There is no added advantage of non-vascularized fibular grafting with multiple hip screw fixation in fresh femoral neck fractures in young adults over multiple hip screw fixation alone

Persistent headache in a postpartum patient: the investigation and management

Postdural puncture headache (PDPH) is the most common complication of obstetric regional anaesthesia and the most likely cause of headache in a woman who underwent epidural anaesthesia during delivery. Cerebral venous sinus thrombosis (CVST) is an uncommon cause of postpartum headache. Anaesthesia in obstetrics may lead to long-lasting intracranial hypotension resulting in CVST. CVST is a serious pathology with high mortality if misdiagnosed, but its correct and rapid diagnosis offers the opportunity for early treatment. Cranial magnetic resonance imaging (MRI) is an important modality in the diagnosis of both CVST and intracranial hypotension. The latter condition may be treated either by an epidural blood patch or bed rest and hydration. We report a case of a 36-year-old woman who developed CVST and multiple venous infarcts after an attempted epidural procedure during delivery. She was treated conservatively with bed rest, hydration and low-molecular-weight heparin and the patient recovered completely. Copyright 2013 BMJ Publishing Group. All rights reserved

The predictive performance of commodity futures risk factors

This paper investigates the time-series predictability of commodity futures excess returns from factor models that exploit two risk factors – the equally weighted average excess return on long positions in a universe of futures contracts and the return difference between the high- and low-basis portfolios. Adopting a standard set of statistical evaluation metrics, we find weak evidence that the factor models provide out-of-sample forecasts of monthly excess returns significantly better than the benchmark of random walk with drift model. We also show, in a dynamic asset allocation environment, that the information contained in the commodity-based risk factors does not generate systematic economic value to risk-averse investors pursuing a commodity stand-alone strategy or a diversification strategy

Local injection of leukocyte rich platelet rich plasma produced higher radius union scoring system than local injection of pure platelet rich plasma in conservative therapy of intra-articular closed distal radius fractures

Background: Distal radius fracture often occurs both extra-articular and intra-articular, covering all ages. The use of autologous platelet rich plasma (PRP) consisting of leucocytes rich-PRP (L-PRP) and pure-PRP (P-PRP) thought can help in bone healing process. This study aimed to determine that the administration of L-PRP provides a better healing rate than P-PRP in intra-articular closed distal radius fractures after conservative treatment.Methods: This was a single-blinded experimental study with stratified randomized post-test only group design involving 51 patients with closed distal fractures undergoing closed reduction, consisting of 17 patients per study group. Group 1 received placebo, group 2 received P-PRP, and group 3 with L-PRP. Each group was then re-evaluated using x-ray at week 2, 3, and 6. RUSS score was then measured. Data was analysed using descriptive statistics and normality test, homogeneity test and inferential test were performed to determine the effect of L-PRP, P-PRP on the union rate of fracture distal radius. All obtained data was analysed using SPSS statistics 22 software.Results: Between control and P-PRP group, there was significant difference in mean RUSS with p value of 0.012. Between control and L-PRP injection group, there was a significant difference in mean RUSS with p value of 0.000. Between P-PRP and L-PRP group, there was also significant mean RUSS difference with p value of 0.003.Conclusions: There was a significant difference between the control group given placebo and the group P-PRP and L-PRP in closed fractures of the intraarticular radius after conservative therapy

Profile of total knee replacement patients and short term outcome in the sanglah public hospital 2018: a case reports

Total knee replacement (TKR) is considered to be among the most successful type of orthopedic surgery, with 15-year-survival-rate of implant exceeding 95%; furthermore, the improvement in quality of life is very significant. This study aims to describe the demographics, length of hospitalization and short-term outcome observed in patients undergoing TKR at Sanglah Hospital in 2018. All patients undergoing TKR at Sanglah Hospital in 2018 have been prospectively entered into our database. A total of 59 patients were recorded on 2018 for this study and 1 revision TKR patient and 2 patients with incomplete data were excluded. At baseline, 78.6% patients were female, 72.3% were Balinese and 84.1% were housewives. The mean age of patients was 63 years old. Authors also record that 44 (78.6%) patients are Overweight patients (BMI 25.00-29.99 kg/m2), 11 (19.6%) patients are at Obese Class I (30.00-34.99 kg/ m2) range, and only 1 (1.8%) patients have normal weight (18.50-24.99 kg/m2). As many as 51.8% patients had right TKR and 49.2% left TKR. The modus of patient’s length of stay is 7 days with 27 (48.2%) patients started to walk on the 4th day. VAS was recorded at level 4/10 on 92.9% patient. Drain was removed after 3 days on 42 (75%) patients. 15 patients (26.8%) had PRC transfusion due to anemia after operation