Stephy Publishers

  SOJ Medical and Clinical Case Reports  - (SOJMCCR) |  Stephy Publishers Abstract Emergency Treatment Unit of a hospital is the place where, acutely unwell patients admitted to the hospital, are given the immediate treatment in the critical stage. DGH – Gampaha – Sri Lanka is a tertiary care hospital with a bed strength of 795 with a well - recognized Emergency Treatment Unit. Objective of this study was to evaluate the Emergency Treatment Unit of District General Hospital, Gampaha, Sri Lanka. Data was collected through oobservations, key informant interviews and reviewing registers and records. Findings were subjected to SWOT analysis. 1) Identified strengths included accessibility, Infrastructure, ETU concept, 24 hour service, competent staff, availability of equipment and investigation facilities and Information management. 2) Some weaknesses identified were; shortage of staff, absenteeism, gaps in competency, shortage of equipment and inadequate quality management s...

  SOJ Medical and Clinical Case Reports  - (SOJMCCR) |  Stephy Publishers Abstract Background:  Spontaneous intracranial hypotension (SIH) is a relatively rare but known pathology that results in brain herniation or sagging due to CSF hypovolemia. SIH can commonly be misdiagnosed when occurring with other pathologies including chronic subdural hematoma (CSDH). Neurological decline caused by SIH is rare, but is often rapid and much more severe. Case description:  A 69-year-old man was delivered to the emergency department for loss of consciousness and mild left hemiparesis. Brain computed tomography (CT) revealed increased density over basal cisterns suggestive of subarachnoid hemorrhage (SAH), and CSDH. Cerebral angiography showed dural arteriovenous fistula, but there was no apparent cerebral aneurysm. We first performed trans-arterial embolization using n-butyl cyanoacrylate, followed by bilateral hematoma evacuation. A postoperative CT showed that CSDH wa...