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Ayoub K, Alibraheem A, Masri E, Kazan A, Basha SR, Hamoud M, Mahli N. Trichobezoar from bristles brush and Carpet yarn requiring emergency laparotomy. Case report. Ann Med Surg (Lond) 2021; 63:102192. [PMID: 33680452 PMCID: PMC7930585 DOI: 10.1016/j.amsu.2021.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction and importance When hair accumulates inside the stomach, it causes what is called a Trichobezoar, which leads to a stomach blockage, this condition is rare and more common in women and in patients with psychiatric disorders. Case presentation The authors report an unusual case of a 16-year-old girl who has trichobezoar not only by ingestion of hair, it is also by bristle clothes brush and Carpet yarn. she presented with acute abdominal pain and gastrointestinal symptoms-like watery diarrhea, vomiting, hypercoria and weight loss attributed to Anorexia. With an upper gastroscopy, the condition was diagnosed as a huge Trichobezoar that occupied the stomach. The patient was managed by surgical removal of the intra gastric mass. Clinical discussion Affected patients infrequently remain asymptomatic for several years. Symptoms begin while the bezoar increases in size to the point of obstruction, these symptoms are nonspecific like vomiting, nausea, anorexia, asymptomatic abdominal mass and digestive bleeding. Conclusion Trichobezoar considers as a differential diagnosis for any patient with psychological disorders, like trichotillomania and trichophagia and has gastrointestinal symptoms. Trichobezoar considers as a differential diagnosis for any patient with psychological disorders, like trichotillomania and trichophagia and has gastrointestinal symptoms. Trichobezoar is caused by chronic ingestion of hair; Small trichobezoars may be extracted by endoscopic fragmentation, huge trichobezoar, on the other hand need surgical removal. Early diagnosis and an appropriate therapy can reduce morbidity and mortality. Psychological counselling plays a pivotal role in order to prevent bezoar recurrence
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Affiliation(s)
- Kusay Ayoub
- PHD, Department of Surgery, Faculty of Medicine, University of Aleppo, Syria
| | | | - Esraa Masri
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Amira Kazan
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Mahmoud Hamoud
- MD, Department of Surgery, Faculty of Medicine, University of Aleppo, Syria
| | - Nihad Mahli
- Professor of surgery, Department of Surgery, Faculty of Medicine, University of Aleppo, Syria
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Alibraheem A, Danial A, Kazan A, Masri E, Obari MY, Basha SR. Rapunzel Syndrome in Congenital Mental Retardation Patient Requiring Emergency Laparotomy. Case report. Ann Med Surg (Lond) 2020; 58:99-101. [PMID: 32963774 PMCID: PMC7490442 DOI: 10.1016/j.amsu.2020.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction When hair accumulates inside the stomach, it causes what is called a Trichobezoar, which leads to a stomach blockage. When the accumulated hair extends into the small intestine, it causes a rare disturbance called Rapunzel syndrome (RS). Discussion Affected patients infrequently remain asymptomatic for several years. Symptoms begin while the bezoar increases in size to the point of obstruction, these symptoms are nonspecific like vomiting, nausea, anorexia, asymptomatic abdominal mass and digestive bleeding. Presentation of case The authors report an unusual case of a 25 years old young woman who presented with acute abdominal pain and gastrointestinal symptoms. With an upper gastroscopy, the condition was first diagnosed as a Trichobezoar that occupied the stomach. A decision to perform a surgical procedure was taken, only to discover, during the procedure, that the mass was extended to the duodenum and jejunum, thus diagnosing the condition as Rapunzel syndrome. The patient was managed by surgical removal of the huge mass. Conclusion Trichobezoar considers as a differential diagnosis for any patient with mental retardation and has gastrointestinal symptoms.
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Affiliation(s)
| | - Aghyad Danial
- MD, Department of Surgery, Faculty of Medicine, University of Aleppo, Syria
| | - Amira Kazan
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Esraa Masri
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
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Yamini TR, Nichter M, Nichter M, Sairu P, Aswathy S, Leelamoni K, Unnikrishnan B, P PM, Thapar R, Basha SR, Jayasree AK, Mayamol TR, Muramoto M, Mini GK, Thankappan KR. Developing a fully integrated tobacco curriculum in medical colleges in India. BMC Med Educ 2015; 15:90. [PMID: 25990861 PMCID: PMC4455282 DOI: 10.1186/s12909-015-0369-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 05/01/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND This paper describes a pioneering effort to introduce tobacco cessation into India's undergraduate medical college curriculum. This is the first ever attempt to fully integrate tobacco control across all years of medical college in any low and middle income country. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as challenges that face implementation and steps taken to address them and to advocate for adoption by the Medical Council of India. METHODS In-depth interviews were conducted with administrators and faculty in five medical colleges to determine interest in and willingness to fully integrate smoking cessation into the college curriculum. Current curriculum was reviewed for present exposure to information about tobacco and cessation skill training. A modular tobacco curriculum was developed, pretested, modified, piloted, and evaluated by faculty and students. Qualitative research was conducted to identify challenges to future curriculum implementation. RESULTS Fifteen modules were successfully developed focusing on the public health importance of tobacco control, the relationship between tobacco and specific organ systems, diseases related to smoking and chewing tobacco, and the impact of tobacco on medication effectiveness. Culturally sensitive illness specific cessation training videos were developed. Faculty and students positively evaluated the curriculum as increasing their competency to support cessation during illness as a teachable moment. Students conducted illness centered cessation interviews with patients as a mandated part of their coursework. Systemic challenges to implementing the curriculum were identified and addressed. CONCLUSIONS A fully integrated tobacco curriculum for medical colleges was piloted in 5 colleges and is now freely available online. The curriculum has been adopted by the state of Kerala as a first step to gaining Medical Council of India review and possible recognition.
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Affiliation(s)
- T R Yamini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, Kerala, India.
| | - Mark Nichter
- University of Arizona, School of Anthropology, 85721, Tucson, AZ, USA.
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA.
| | - Mimi Nichter
- University of Arizona, School of Anthropology, 85721, Tucson, AZ, USA.
| | - P Sairu
- Department of Community Medicine, T.D. Medical College, Alappuzha, Kerala, India.
| | - S Aswathy
- Department of Community Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
| | - K Leelamoni
- Department of Community Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
| | - B Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
| | - Prasanna Mithra P
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
| | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
| | - S R Basha
- Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
| | - A K Jayasree
- Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
| | - T R Mayamol
- Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
| | - Myra Muramoto
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA.
| | - G K Mini
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, Kerala, India.
| | - K R Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, Kerala, India.
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Thankappan KR, Yamini TR, Mini GK, Arthur C, Sairu P, Leelamoni K, Sani M, Unnikrishnan B, Basha SR, Nichter M. Assessing the readiness to integrate tobacco control in medical curriculum: experiences from five medical colleges in Southern India. Natl Med J India 2013; 26:18-23. [PMID: 24066988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Making tobacco cessation a normative part of all clinical practice is the only way to substantially reduce tobacco-related deaths and the burden of tobacco-related morbidity in the short term. This study was undertaken because information on receptivity to integrate tobacco control education in the medical curriculum is extremely limited in low- and middle-income countries. METHODS From five medical colleges (two government) in southern India, 713 (men 59%) faculty and 2585 (men 48%) students participated in our cross-sectional survey. Information on self-reported tobacco use and readiness to integrate tobacco control education in the medical curriculum was collected from both the faculty and students using a pretested structured questionnaire. Multiple logistic regression analysis was done to find the associated factors. RESULTS Current smoking was reported by 9.0% (95% CI 6.6-12.1) of men faculty and 13.7% (CI 11.8-15.9) by men students. Faculty who were teaching tobacco-related topics [odds ratio (OR) 2.29; 95% CI 1.65-3.20] compared to those who were not, faculty in government colleges (OR 1.69; CI 1.22-2.35) compared to those in private colleges and medical pecialists (OR 1.79; CI 1.23-2.59) compared to surgical and non-clinical specialists were more likely to be ready to integrate tobacco control education in the medical curriculum. Non-smoking students (OR 2.58; CI 2.01-3.33) compared to smokers, and women students (OR 1.80; CI 1.50-2.17) compared to men were more likely to be ready to integrate a tobacco control education in the curriculum. CONCLUSION Faculty and students are receptive to introduce tobacco control in the medical curriculum. Government faculty, medical specialists and faculty who already teach tobacco-related topics are likely to be early introducers of this new curriculum.
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Affiliation(s)
- K R Thankappan
- Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Science and Technology (SCTIMST), Thiruvananthapuram 695011, Kerala, India. Quit Tobacco India Project
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