Concerns, coping and quality of life in head and neck cancer patients

This study was conducted to explore the concerns and coping mechanisms used by patients with head and neck cancer and assess their quality of life. A group of 50 consecutive patients with oral and laryngeal cancers were interviewed using a coping and concerns checklist and a semistructured interview proforma to elicit the common concerns in relation to head and neck cancers and their surgical treatment. The Hospital Anxiety and Depression Scale was used to detect anxiety and depression. Concerns were compared between oral and laryngeal cancers and between preoperative and postoperative patients. Commonest concerns were about the future (64%), subjective physical evaluation (60%), finances (56%), being upset (54%), communication (54%), current illness (52%) and inability to do things (50%). The commonest coping mechanisms used were helplessness and fatalism. Resolution was noted in less than 40% of the frequent concerns. As compared to laryngeal cancer patients, those with oral cancer significantly more often had concerns about current illness, subjective evaluation of health, eating and chewing, social interactions, pain and disfigurement (P < 0.05). Most subjects had numerous unresolved concerns. Mainly ineffective coping mechanisms such as helplessness and fatalism were employed leading to incomplete resolution. Interventions to minimise these concerns and to handle associated anxiety and depression would improve their quality of life.

Salmonella infections in Asir region, southern Saudi Arabia: Expatriated implications

One hundred forty-two cases of salmonella infection seen in Asir region, Southern Saudi Arabia, during the period of 1989-1991 inclusive, were analyzed. Ninety-four cases were found to have enteric fever and 48 cases were found to have, Salmonella enteritidis gastroenteritis. Enteric fever is more common in non-Saudis (64%) than in the indigenous Saudi population (34%). Salmonella enteriditis gastroenteritis is more common among the Saudi population (75%) than non-Saudis (25%). The clinical presentation of both types of salmonella infection is outlined. Enteric fever is more common among expatriates who recently came from India (40.5%), Egypt (10.6%), Pakistan (6.4%), and Syria (4.3%). Salmonella typhi resistant to tetracycline, ampicillin, and chloramphenicol are more common among Indian patients (75% of resistant cases) and Syrian patients (12.5-28% of resistant cases). Resistance to cotrimoxazole is commonly encountered in Indians (50% of resistant cases) and Egyptians (33.3%). Salmonella enteriditis resistant to tetracycline, ampicillin, and chloramphenicol is more common among Saudis (66.7% of resistant cases) and Filipinos (16.7-33.3% of resistant cases). Recommendations regarding screening of expatriates for enteric fever and proper drug therapy of possible resistant cases are outlined.

Cladosporium bantianum (trichoides) infection of the brain

A 32 yr old male patient with history of convulsion and bitemporal headache was diagnosed as suffering from tuberculoma based on CT Scan. He worsened after anti-tuberculous therapy. The patient underwent parieto-occipital craniotomy with drainage of abscess. The histopathological examination of brain abscess revealed the infection with cladosporium bantianum. The details of this rare case of opportunist fungal cerebral lesions in healthy individual are reported.

Hydatid cyst of the tibia

A case of hydatid cyst of the tibia, which manifested as a pathologic fracture is being reported. Pain and swelling of left lower limb with inability to bear the weight were the main features. Tender swelling was also noted at the upper and middle third of tibia. Open biopsy revealed the hydatid cyst wall and scolices of Echinococcus granulosus. Albendazole treatment was followed by curettage and bone grafting.

Wolf blade plate ankle arthrodesis

Fifteen patients, each of whom had a Wolf blade plate ankle arthrodesis, were followed for a mean of 56 months. The mean age at the time of operation was 46.7 years. The preoperative diagnosis was posttraumatic arthritis in 16 cases and one each of degenerative arthritis, rheumatoid arthritis, and avascular necrosis of the talus. Eighteen of the 19 cases fused for a fusion rate of 94.7%. The average fusion position was 2.9 degrees of plantar flexion and 5 degrees of valgus. All patients whose ankle fused were satisfied with their results. The average Mazur postoperative score was 75 (range, 33-91). Five patients had delayed wound healing. The Wolf blade plate is a simple and easy method to fuse the ankle. Minimal dissection is required and a fusion rate of 95% is obtainable.