When no evidence of infection developed, she was taken to the operating theatre for delayed primary repair of her skin. The patient had an uneventful recovery and was discharged one week post-operatively. Crocodile A 40-year-old male was fishing on a small handmade boat in Lake Tanganyika when a crocodile attacked and pulled him into the water. The crocodile partially swallowed the patient, crushing his left forearm and biting his chest and right shoulder region. The patient used his fishing knife to stab the crocodile and break free from its grasp. His family members rescued him from the water and transported him to a district hospital. When the district hospital determined that the patient needed surgery for

his left upper extremity, https://www.selleckchem.com/products/BKM-120.html they transferred him one day later to BMC. On trauma survey at BMC, the patient was tachycardiac to 110 beats per minute, hypotensive to 100/60 mmHg, and tachypneic to 35. Pulse oximetry was not available. He had dullness to percussion and decreased breath sounds on the left side. He had an obviously

deformed crush injury of his left forearm with devitalized tissue, and his right shoulder had superficial to deep bite marks. His abdomen was non-tender. His hemoglobin level was 7.0. A chest x-ray showed left lung field homogenous opacity and four broken ribs. A left FK228 ic50 chest tube returned 400 cc of fresh red blood. He received 2 liters of normal saline and one unit of whole blood through a large bore peripheral intravenous line. He was administered intravenous metronidazole, ceftriaxone, and tetanus vaccine. He was taken to the operating theatre the

day of his admission to BMC for debridement of his left forearm and exam under anesthesia of his chest and right shoulder wounds. His wounds were irrigated with betadine and left open for three days; he then returned to the operating theatre for delayed primary closure of his right shoulder wound and further debridement of his left forearm wound. His chest tube was removed one week after injury. Given the extensive crush injury to his left extremity and neurovascular disruption, the patient was taken to the operating theatre three week after injury for completion amputation. His recovery was uneventful and he was discharged home Tacrolimus (FK506) two weeks post-operatively. Elephant A 43-year-old man was guarding his crops when a group of elephants entered his farm. One elephant attacked him from behind, hitting him with its trunk and trampling with its feet, then lifting and dropping him from the air with its tusks. Due to his rural location and poor emergency SB202190 in vitro transport to a tertiary care center at the time of the attack, the patient presented first to a district hospital and several hours later was transported to our Casualty Ward. On arrival, the patient denied loss of consciousness but described shortness of breath and pain in his left leg. The patient was alert and oriented but dyspneic. He was tachycardic to 120 and his blood pressure was 130/80.