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Biomedical subjects

P Barss

Publications and source records attributed to P Barss.

35 records · Page 2Linked to original sources
PubMed1984

Ulnar compression neuropathy due to an occult post-traumatic synovial cyst.

A patient presented with an ulnar nerve palsy which developed some time after minimal trauma to the arm. It was thought that the paralysis was possibly caused by leprosy, but because of doubt about the diagnosis, biopsy of the nerve was advised. At operation, it was found that there was nerve compression by a slowly developing occult synovial cyst of the elbow joint, which had tracked down the tight confines of the cubital tunnel. If there is doubt as to whether an isolated ulnar palsy is caused by leprosy, it may be reasonable to explore the nerve at the level of the cubital tunnel. If compression is found, it can be relieved. If the nerve itself appears abnormal, the epineurium can be biopsied.

Adult↗
PubMed1984

Injuries due to falling coconuts.

Falling coconuts can cause injury to the head, back, and shoulders. A 4-year review of trauma admissions to the Provincial Hospital, Alotau, Milne Bay Province, Papua New Guinea, revealed that 2.5% of such admissions were due to being struck by falling coconuts. Since mature coconut palms may have a height of 24 up to 35 meters and an unhusked coconut may weigh 1 to 4 kg, blows to the head of a force exceeding 1 metric ton are possible. Four patients with head injuries due to falling coconuts are described. Two required craniotomy. Two others died instantly in the village after being struck by dropping nuts.

Child↗
PubMed1983

Grass-skirt burns in Papua New Guinea.

A retrospective survey of burn cases admitted to Alotau Hospital, Papua New Guinea, over a four-year period showed that 48% were due to grass-skirt burns. Most of these occurred in young girls and usually caused full-thickness burns of the buttocks and thigh. The commonest long-term complications were contractures of the hips and knees. The next most common cause of burns was a fall into a fire during an epileptic fit (24%). None of the patients were on anticonvulsants. The population needs to be informed of the dangers of leaving children near open fires, of the value of bundling up children whose grass-skirts catch fire to smother the flames, of the importance of anticonvulsants to chronic epileptics, and of the advantages of seeking medical treatment when burns occur.

Accidents, Home↗
PubMed1976

Diagnosis and management of onyalai.

Onyalai is diagnosed by finding the combination of haemorrhagic blisters in the mouth and severe thrombocytopenia, and by excluding other possible causes of thrombocytopenia. Patients improve rapidly with appropriate therapy. Haemorrhagic shock should be corrected with intravenous fluid and blood transfusion. Corticosteroids should be given in large doses initially, then tapered off and stopped over a period of several weeks. Occasional patients may require more prolonged steroid therapy.

Adult↗
PubMedDate not supplied

Falls from trees and tree associated injuries in rural Melanesians.

Falls from trees and other tree related injuries are the most common cause of trauma in some parts of rural Melanesia. A four year review of all admissions for trauma to the Provincial Hospital at Alotau, Milne Bay Province, Papua New Guinea, showed that 27% were due to falls from trees, and a further 10% were due to related injuries, such as being struck by a falling branch or a coconut. A questionnaire distributed to rural health centres showed that during the study period at least 28 villagers died from falls from trees before reaching hospital. Head and chest trauma were common causes of death. Many injured patients were boys. Forearm fractures were the most common injuries, but more serious injuries were also frequently encountered. Trees responsible for most deaths and injuries included the coconut palm, betel palm, mango, and breadfruit. There are many strategies for preventing such injuries; perhaps the most important is to stop small boys climbing tall trees. Such falls are a serious occupational hazard for many subsistence farmers.

Adolescent↗
PubMedDate not supplied

Wound necrosis caused by the venom of stingrays. Pathological findings and surgical management.

Two cases of stingray injury which caused extensive tissue necrosis are reported. In one patient, the wound was allegedly inflicted by Dasyatis kuhlii, the blue-spotted stingray; in the other, by D. sephen, the cowtail ray. After excision of necrotic tissue, the wounds healed rapidly and without complications. Wound exploration and debridement of dead tissue are indicated in at least some stingray injuries, particularly when first-aid measures, such as early immersion in hot water or irrigation of the wound have not been carried out.

Adolescent↗
PubMedDate not supplied

Injuries caused by pigs in Papua New Guinea.

Pigs are intelligent animals that can be formidable adversaries to humans because of their sharp tusks and their ability to attack swiftly. Domestic and feral pigs have an important role in the ecology of village life in Melanesia. A six-year review of all injuries that were caused by pigs that were referred from the villages in Milne Bay Province, Papua New Guinea, to the Provincial Hospital was completed. Some of the injuries that were seen among the 20 patients who were studied included: three penetrating abdominal injuries with prolapse and strangulation of the intestine; a "sucking" chest wound; bilateral pneumothoraces; two infected open fractures of the radius and the ulna; a perforating injury of the knee with septic arthritis; a hand injury with laceration of multiple tendons; an arterial injury of the wrist; injury of a tibial nerve with foot drop; and a severe scrotal injury with exposure of the testicles. Most injuries resulted from the hunting of feral pigs. Adult male hunters who used dogs and carried only one spear were injured most frequently. Wounds from injuries by pigs are deep, often involve multiple critical structures, and are grossly contaminated. Resuscitation requires the administration of fluid and often blood. Treatment includes irrigation, debridement and closure of the wound. The principles of managing such injuries, the prevention of injuries, the ecology of pigs and humans, human infections originating from pigs, and safer methods of hunting pigs are discussed.

Adult↗
PubMedDate not supplied

Renal failure and death after multiple stings in Papua New Guinea. Ecology, prevention and management of attacks by vespid wasps.

Although most species of wasps are solitary and no hazard to humans, attacks by colonies of large social wasps of the family Vespidae, which commonly are known as hornets, can result in envenomation with severe toxicity. The effects of such envenomation on six persons from Papua New Guinea are described and discussed in the light of other published reports from Melanesia, Asia, Europe and America. Four deaths and at least four cases of acute renal failure occurred. Vespa affinis (L.), 1764 was responsible for at least two deaths and Vespa tropica (L.), 1764 for one death. The ecology of vespids in Asia and the Pacific is reviewed and guide-lines for the prevention of wasp attacks are outlined, including appropriate clothing, and the recognition, avoidance and selective destruction of nests. A description is helpful in the identification of the species of insect that was responsible for clinical cases. Management includes hospitalization for victims of multiple stings, with careful monitoring for early and late damage to kidneys, blood, liver and muscle.

Acute Kidney Injury↗
PubMedDate not supplied

Tubal ligation in Milne Bay Province, Papua New Guinea.

Milne Bay Province, Papua New Guinea, with a scattered population of 130,000 suffers from irregular health patrols in remote areas, and often inadequate supplies of contraceptive agents. A total of 694 tubal ligations were performed by hospital staff under local anaesthesia between 1978 and 1982 in the province, the number increasing each year. Detailed analysis of 324 operations from 1979 to 1981 showed an average age of 34, average parity of 7 (84% of women had five or more children) and the presence of one or more high risk factors other than multiparity in half the women operated upon. Tubal ligation decreases maternal mortality, and has proven to be a useful method of family planning for multiparous women living in remote villages in Milne Bay Province.

Adult↗
PubMedDate not supplied

Medical emergency flights in remote areas: experience in Milne Bay Province, Papua New Guinea.

Light aircraft can be valuable for transfer of emergency patients from remote island health centres to a central hospital. A two-year experience of 92 such flights in Milne Bay Province, Papua New Guinea was reviewed. 50% of air charter evacuations were for obstetric or gynaecological patients, 35% for surgical, and 15% for medical cases. 63 of the patients might have died and another nine might have been left with a serious disability without the emergency air transfer. The average cost per life saved was approximately Kina 461 (360 pounds; US$520) and the average cost of providing the emergency service per head of population per year was about Kina 0.10 (0.08 pounds; US$0.12).

Aircraft↗