Lack Of Early Treatment Research Articles

Vesicoureteral Reflux and Renal Scarring in Infants after the First Febrile Urinary Tract Infection.

Urinary tract infection (UTI) is common in children. It is caused by bacteria and can lead to complications such as renal scarring in cases of late diagnosis and a lack of early treatment. Vesicoureteral reflux (VUR) occurs when urine flows from the bladder to the ureter and kidney, and is more common in children with UTI. VUR predisposes patients to pyelonephritis and can cause renal scarring. This retrospective study aimed to determine whether VUR was associated with the evolution to renal scarring in 132 infants aged 9 days to 24 months admitted to a tertiary care hospital in Jeddah, Saudi Arabia, with the first episode of febrile UTI (mean age = 4.48 months [standard deviation = 5.48]; 82 [62.1%] males; 50 [37.9%] females). Data from their medical records were investigated[INLINE:1]for VUR and renal scarring. The VUR was related to renal scarring (P = 0.001). C-reactive protein (CRP) levels were significantly higher in patients with VUR (P = 0.027) and renal scars (P = 0.05). There was a statistically significant difference between VUR and renal scarring with the first UTI (P = 0.001). In conclusion, our study revealed a significant association of CRP with renal scarring (P = 0.05) and VUR and (P = 0.027).

Promoting Access to Children’s Mental Health Care Services: Strategy and Policy Implications

In recent years, children’s mental illness has become a major problem; but little is known about the problems and the available literature does not address this issue properly. The present study was meant to examine the current mental health care situations to promote access to services for children in Addis Ababa. The data have been cautiously collected through multiple data collection tools such as semi-structured interviews, focus group discussions, and questionnaires. The data analysed and interpreted from wider perspectives. The study result indicated insufficient mental health policies, limited access to specialized treatment, shortage of human resources, lack of early treatment, and preventive programs/education. There is a need for the comprehensive strategies and mechanisms which take the relevant variables into account to strengthen specialized care and awareness among society via integrating the study evidence into practices. The authors described very significant implications for future actions such as conducting further empirical studies, regular discussions with responsible stakeholders, etc.

Status epilepticus: Having treatment paradigms in place in Neurosurgical settings

Status epilepticus (SE) is an emergency situation, which needs immediate and prompt treatment. Lack of early treatment often leads to permanent neuronal damage and poor long-term neurological outcome. Among the known neurosurgical causes of SE are central nervous system (CNS) tumors, subarachnoid and intracerebral hemorrhage (ICH), head trauma and post-operative states. Given the frequency of SE events in neurosurgical wards, it is essential that the neurosurgical teams and intensive care unit staff are adequately sensitized to the prompt detection and management of SE. Uniform, easily understandable and logical algorithms are needed as part of care pathways to enable satisfactory management. Such measures are imperative in improving long-term patient outcome.

Early Return to Function in Young Adults with Neglected Femoral Neck Fractures

Neglected femoral fractures in young adults are a challenge to the orthopaedic surgeon, requiring prolonged treatment and with attendant risks of nonunion. We postulated treatment in this group by accurate reduction, two cannulated screws, and whole free fibular autograft would allow early mobilization and provide good bony union. Thirty-two patients aged 18 to 50 years were treated at our center in this manner. They presented to our center 3 to 6 months after injury, and had Garden's Grade III/IV fractures with varying degrees of neck resorption, but no avascular necrosis. No plaster was applied, and early return to function was encouraged. Bony union was achieved in 29 (90.6%) patients at a mean of 19.2 weeks (range, 16-24 weeks). All patients with union had good function at long-term followup at an average of 6.1 years postoperatively (range, 2-12 years), and the average Harris hip score was 87.1 points (range, 74.5-94 points). Our procedure allows early return of function in young, active patients disabled by old femoral neck fractures compounded by lack of early treatment.

ERASION, EXCISION AND AMPUTATION IN JOINT DISEASE.

From failure of early diagnosis, from lack of early treatment, and from the neglect of early protection and fixation of inflamed joint surfaces, or on account of the intensity of the tubercular process, a large number of cases of tubercular joint disease still require operative procedures for the safety of the limb or the life of the affected individual. Fortunately, owing to a better appreciation of the conditions, these cases are becoming rare; it being more generally recognized that destructive results are preventable by early treatment; that is, by long-continued protection secured by rest and by effective mechanical devices. Proper management of these cases will result in the saving of a large number of these joints, even if the tubercular bacillus has secured a foothold in the osseous structures adjacent to the joint itself. Much will depend upon the joint invaded; but the same principles of treatment will apply to