The West Virginia medical journal
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Randomized Controlled Trial
Glove perforations with blunt versus sharp surgical needles in caesarean delivery: a randomized trial.
To compare the rate of glove perforations and surgeon satisfaction when utilizing blunt surgical needles compared to conventional sharp surgical needles. ⋯ A total 240 patients were enrolled into the study. There was no statistically significant difference in the rate of glove perforation per case between groups assigned to sharp (24%) or blunt surgical needles (26%). (RR 1.05, 95% CI 0.68-1.63). There were significant differences in the surgeon satisfaction surveys, with surgeons in the sharp needle group being more satisfied with the tissue penetration of the needle (p < .001), needle integrity (p = .01), force to penetrate tissue (p < .001) and control of bleeding at the needle insertion site (p = .001). Surveys from surgeons in the blunt needle group showed a statistically significant improvement in the perceived safety profile of the blunt needles (p < .001) CONCLUSIONS: There was no significant difference in the rate of glove perforation between blunt and sharp surgical needles during Caesarean delivery. Overall surgeons were more satisfied with the sharp surgical needles.
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Review Case Reports
Cetacaine induced methemoglobinemia: overview of analysis and treatment strategies.
Methemoglobin is formed upon iron oxidation of the heme molecule from ferrous (Fe2+) to its ferric (Fe3+) state. Normal methemoglobin levels in the body vary between 1-2% of the total hemoglobin. ⋯ Herein, we present to you a case of methemoglobinemia after Cetacaine (a benzocaine based topical anesthetic) utilization during a transesophageal echocardiography. Some of the other common potential inciting agents are also discussed here along with an overview of treatment strategies.
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Rectus sheath hematoma (RSH) is uncommon and is often reported in the setting of anticoagulation or trauma. Typically RSH presents with localized or diffuse abdominal pain and a fixed abdominal wall mass, however, various presentations and complications have been reported depending on the setting and extent of the hematoma. We report a case of a rapidly expanding RSH causing obstructive anuria and hydronephrosis in addition to a review of literature on this rare presentation of RSH.
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Texting has become popular, particularly among young adults. Texting while driving has been identified as a factor in accidents. Literature is lacking about the overall attitudes and utilization of texting. ⋯ Texting is commonly used by young adults, though many believe texting while driving decreases concentration and is unsafe. A majority report to texting while driving. Injury prevention and awareness programs are needed to decrease this behavior.
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Marijuana induced hyperemesis is a syndrome manifested by intractable nausea, vomiting and abdominal pain in someone who chronically uses marijuana with relief obtained from excessive bathing. This case report documents the exhaustive and costly work-up that has been performed in the case of one patient presenting to our facility with these complaints. It will also discuss marijuana induced hyperemesis syndrome in an effort to increase awareness of this under-diagnosed condition allowing for a more thorough history-taking and reduce unnecessary testing and radiologic examinations.