Evaluation of the opportunities for and contraindications to immunization in a tropical paediatric clinic.
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The immunization status and frequency of contraindications to immunization were studied in 446 children attending the paediatric clinic of a teaching hospital in south India. In all, 27% of the children were up to date in their immunizations, 19% had a contraindication, and 57% required and could safely be given immunizations. A policy of offering immunizations in paediatric clinics to all who require them and who do not have a contraindication would result in protection of a significant number of unimmunized children.Keywords:
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Objective To study characteristics of clinical manifestation of patients with acute myocardial infarction(AMI) .Methods From 2000 to 2004,the risk factor,symptoms,signs,and results of assistant check 96 patients with AMI were analyzed.They were divided into thrombolytic treatment group and control group.Results(1) The main risk factor were hypertention,smoking and diabetes.(2) There was no difference in complication of AMI about two groups.(3) Group of thrombolytic was cured easier.Conclusion AMI patients without contraindication must be treated by thrombolytic earlier.
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Objective To evaluate the clinical efficacy and safety of TURP on patients with BPH.Methods 34 high-risk patients with BPH were treated by TURP and have been follow up for an average of 1~3 months.Results Satisfactory result has been achieved in all.only one patient needed a second surgical procedure.Conclusions The high-risk patients with BPH are not on absolute contraindication.
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Abstract In the Royal New Zealand Plunket Society's 1990‐91 cohort study, of 3902 children, 985 (25.2%) had fallen behind the immunization schedule by 6 months of age. These children were more likely to be from lower socio‐economic groups or to have mothers who were older, with high or low education, or of higher parity. The infants were also more likely to be from non‐European families, or to have unemployed fathers. Eight hundred and ten (82.2%) of the incompletely immunized children at that age could be brought up‐to‐date with their immunizations by a single visit to the doctor. The most common reason for delaying immunization was that the baby was sick. This was a false contraindication in 69.2, 79.0 and 78.4% of these children at the 6 week, 3 month and 5 month immunization, respectively.
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Objective To investigate the perioperative management of laparoscopic cholecystectomy(LC) in patients aged 80 and over. Methods Thirty-four patients over 80 years old who received LC in general anaesthesia and CO2 pneumoperitoneum in this hospital between June 2001 and June 2006 were analysed retrospectively. Results Of the patients, 76.5%(26/34) had different kinds of concomitant diseases and all received LC. The length of hospital stay was(13.3±5.3)days,operating time was (28.4±8.6)min. Three patients had postoperative complications, including aucte atrial fibrillation with aucte heart failure, pulmonary infection and delayed healing of incisional wound. Conclusion Advanced age is not an operative contraindication, perfect perioperative management, reasonable choice of operation time and skilled surgical manipulation are the key factors for the successful cure.
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objective To review the surgical operation indication and the diagnosis of reoperation for recurrent carcinoma of the esophagus. Methods 48 patients with local recurrence of esophageal cancer were reoperated and analysed retrospectively. Results The resectability rate was 75%(36/48) and the hospital mortality rate was 8.3%(3/48). Postoperative complications occurred in 8 patients with a morbidity of 22.2%. pathologically, previous anastomotic relapse was seen in 28 patients, recurrent lesion of residual esophagus in 6, and recurrent cancerous residue at the esophageal bed in 2. Curative resection was performed for 28 patients and palliative resection for 8 patients. Follow-up showed that 8 patients survived for 5 years, 10 for 3 years, and 7 for 1 year. 8 patients died within one year after reoperation. Conclusions The recurrence of esophageal cancer after first operation is not a contraindication to reoperation, but careful preoperative assessment and patients' selection should become an integral part of the evaluation of these patients. Reoperation is the first choice for patients with local recurrence of esophogeal cancer.
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Anticoagulant therapy for lower extremity deep-vein thrombosis (DVT) has been shown to reduce mortality from pulmonary embolism, but subsequent morbidity from the postthrombotic syndrome remains high. Thrombolytic therapy produces higher lysis rates of venous thrombi than heparin alone. Some studies suggest a lower incidence of postthrombotic sequelae after early use of streptokinase. These potential benefits are limited to those patients without contraindications for this therapy.For the past 3 years we have prospectively studied patients with DVT documented by duplex scanning. The records of these patients were reviewed to determine what proportion of this population would have been candidates for thrombolytic therapy. For this analysis, contraindications to the use of thrombolytic agents included: (1) recent surgery (less than 1 month); (2) recent major trauma; (3) active or recent bleeding; (4) brain disease (cerebrovascular accident, brain tumor, arteriovenous malformation); (5) pregnancy; and (6) bleeding diathesis. Also, patients with prior ipsilateral DVT and those with acute symptoms present for 7 or more days were not considered to be candidates for thrombolytic therapy.A contraindication to thrombolytic therapy was present in 194 (93%) of 209 patients with a diagnosis of DVT, including four patients with a relative contraindication. Two or more contraindications were present in 65 cases (31%). Recent surgery was the most frequent factor precluding therapy, being present in 71 patients. A history of DVT in the affected leg was present in 45 patients.Only 15 (7%) of 209 patients with DVT exhibited no contraindications for thrombolytic treatment. Only a small fraction of patients with venous thrombosis will be potential candidates for this therapy.
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The study objective was to determine the rate of failures to present for routine childhood immunization due to either parental vaccine refusal, failure to comply with the immunization schedule and real or false contraindications. The rate of use of alternative vaccines which can be provided within the routine immunization schedule either on parental request or when recommended by the physician was also determined. We analyzed records of 5,038 children born between January 1, 2000 and December 31, 2004 and registered with a sample of general practitioners. We identified 1,284 cases (25.5 %) of no, incomplete or alternative vaccination. Failure to present for immunization with at least one vaccine as scheduled due to contraindication was stated in 291 (5.8 %) children; a total of 436 contraindications were reported (more than 1 contraindication in some children). The most common contraindication was a CNS disorder (171 cases) such as encephalopathy, epilepsy or unspecified conditions. Sixty-nine children (1.4 %) remained nonvaccinated against at least one disease (due to parental vaccine refusal or failure to comply with the immunization schedule). Alternative vaccines were administered to 936 (18.5 %) children for the following reasons: contraindication in 275 (5.5 %) children and on parental request in 716 (14.2 %) children (cost incurred by parents), with 55 (1.1 %) children given alternative vaccines for both reasons. These results suggest that contraindications and the use of alternative vaccines are quite common and need to be monitored.
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• The Beck operation, which consists of procedures to effect intercoronary blood-flow communications, has been performed on 185 patients in Cleveland. The operation relieves ischemic areas of the heart muscle, responsible for pain, and can prevent dangerous oxygen differentials that cause death; however, it cannot stop occlusive disease in the coronary arteries, nor restore degenerated myocardium. A positive diagnosis of coronary disease is the indication for operation (unless there is some specific contraindication), and the protection afforded by the operation need not be withheld until the patient has had at least one myocardial infarction. On 137 follow-up studies the long-term mortality has been reduced over one-half from what would be expected, and 90% of those patients still being followed have definite amelioration of previous symptoms. The low operative mortality is attested to by a series of 100 consecutive patients operated on, of which only one died prior to discharge from the hospital.
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