Normative Hand Strength Values for the Healthy Adult Trinbagonian Population and Comparison to International Data.

Introduction: It has been well established that grip strength measurements can be useful as a benchmark for comparing the efficacy of different treatment modalities as well as an aid in the assessment of the progress of disease and rehabilitation. Grip strength has also been shown to be a representative marker for sociodemographic factors.

Methods: Participants were selected from five different regions in a cross-sectional manner from the streets of Trinidad and Tobago, and a Jamar hand dynamometer was used to assess the metrics of hand grip, palmar grip, tip pinch, and key pinch across both hands.

Endovascular Biopsy of an Inferior Vena Cava Mass: A Case Report.

We describe the case of an 82-year-old female referred to the vascular clinic for further evaluation and management of suspected inferior vena cava (IVC) thrombosis. She had previously presented to the general practitioner with a one-week history of vague abdominal pain in the right and left loins. Contrast-enhanced magnetic resonance imaging (MRI) of the abdomen and magnetic resonance angiography/magnetic resonance venography (MRA/MRV) revealed a 10 cm filling defect in the IVC, with the inferior margin of ≈5.

Heterogeneity in the guidelines for the management of diabetic foot disease in the Caribbean.

The prevalence of diabetes mellitus, diabetic foot (DF) disease and, as a result, lower extremity amputation rates remain high in the Caribbean. This study was undertaken to determine whether Caribbean countries have designated individuals that monitor DF disease and whether there are DF protocols consistent with the International Working Group on the Diabetic Foot (IWGDF) guidance documents. Relevant DF health care personnel(s) from the CARICOM and Dutch Caribbean countries were called or sent questionnaires regarding the presence of structured programs to monitor and manage DF problems in the population.

Collateral damage: a case report of vertebral artery dissection and stroke in the young with persistent primitive trigeminal artery.

Stroke in the young is an uncommon condition resulting in significant morbidity and as result trammels the integrity of healthcare systems [1]. We present an unusual case of a 37-year-old male presenting with neurologic signs of right parietal lobe infarction with evidence of vertebral artery dissection and persistent carotid-vertebrobasilar anastomosis as a conduit for thromboembolism.

Breast Carcinoma Receptor Expression in a Caribbean Population.

Trinidad and Tobago are islands in the Southern Caribbean with a unique mix of races within the population consisting of East Indian (EI) (37.6%), Afro-Caribbean (AC) (36.3%), mixed (24.

Conservative therapy significantly reduces patients' chronic venous disease symptoms: A Caribbean insight into the VEIN Act Program.

Objectives: We sought to determine the baseline demographic and clinical characteristics of patients with Chronic Venous Disease (CVD) across the Caribbean, and to evaluate patients' compliance to conservative therapy and the effectiveness of such therapy in reducing patients' CVD symptoms.

Method: Patients were enrolled into the VEIN Act Program, and their demographic data, CVD symptoms (and their intensity) and CEAP C-classification was recorded at the first visit. Patients were prescribed conservative therapy, and symptom intensity and patient compliance and satisfaction evaluated at a follow-up visit.

Thyroid Hemiagenesis: Narrative Review and Clinical Implications.

Thyroid Hemiagenesis (THA) is an uncommon, congenital anomaly defined by the absence of one thyroid lobe with or without the isthmus. Reports suggest it may be found more often in regions endemic for hypothyroidism. Genetic abnormalities are thought to have a role based on findings in monozygotic twins.

An "Occult" Popliteal Vein Aneurysm Causing Pulmonary Embolism.

Popliteal vein aneurysm (PVAs), though uncommon, can be a cause of pulmonary emboli. They can also result in pulmonary vein embolism despite the use of anticoagulation therapy. We report the case of an otherwise fit, 64-year-old male who had a history of sudden onset of dyspnea on exercise with near syncope.

Safety and Cost-Savings of Same-Day Discharge Trans-Radial Percutaneous Coronary Intervention in Trinidad and Tobago.

Introduction: Same-day discharge percutaneous coronary interventions (SDD-PCI) may be quite impactful on healthcare burden for small island developing states (SIDS) such as Trinidad and Tobago.

Methods: From June 2012 to November 2014, 11 patients underwent SDD trans-radial PCI and followed up at one-month and three months. Data was retrospectively reviewed from a prospectively entered unit-maintained cardiology database.

Distal-to-Snuffbox Arteriovenous Fistula.

The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF.

Compulsive showering and marijuana use - the cannabis hyperemisis syndrome.

Patient: Male, 26 FINAL DIAGNOSIS: Marihuana addiction Symptoms: Compulsive showering • nausea • vomiting

Medication: - Clinical Procedure: - Specialty: Toxicology.

Objective: Unexpected drug reaction.

Background: The use or misuse of Cannabis is well recognized in the Caribbean region.

Charcot-Marie-Tooth disease presenting as a nonhealing ulcer in a 26-year-old man.

A 26-year-old man presented with a nonhealing ulcer on the plantar aspect of the left foot of five years duration. Initial investigations were unremarkable. It was only after careful neurological examination that an inherited neuropathy was suspected.

A male patient from the West Indies with invasive ductal carcinoma in the right breast: a case report and literature review.

Background: Men with breast carcinoma have a poor prognosis, especially in the younger age group (30-40 years of age), because most breast enlargements in young men are dismissed as gynecomastia, resulting in an unnecessary delay in treatment.

Objective: We describe the case of a young male patient with invasive ductal breast carcinoma.

Case Summary: In November 2005, a 30-year-old Afro-Caribbean man presented at St.

Wound healing activity of Carica papaya L. in experimentally induced diabetic rats.

The aqueous extract of C. papaya fruit (100 mg kg(-1) day(-1) for 10 days) was evaluated for its wound healing activity in streptozotocin-induced diabetic rats using excision and dead space wound models. Extract-treated animals exhibited 77% reduction in the wound area when compared to controls which was 59%.

Sepsis and the scalpel: anatomic compartments and the diabetic foot.

The foot comprises 3 compartments bounded by bone and fascia, each compartment containing muscle and vascular and nervous structures. Infection leading to an increase in pressures in the compartments results in rapid necrosis, a pathologic process characteristic of diabetic feet. Treatment involves fasciotomy and complete debridement of devitalized tissue with possible amputation of the involved digits.

Upper extremity bypass grafting for limb salvage in end-stage renal failure.

Objective: Patients with end-stage renal failure and upper-extremity arterial occlusive disease sometimes have painful digital ulceration. We evaluated the efficacy of distal bypass grafting from the brachial artery for limb salvage in this setting.

Methods: All patients with end-stage renal disease with painful digital ulceration or gangrene of the hand seen from 1992 to 2002 were evaluated with clinical examination and noninvasive studies.

Should ruptured abdominal aortic aneurysms be repaired in the octogenarian?

Purpose: Several investigators have suggested a dismal prognosis of ruptured abdominal aortic aneurysm (rAAA) repair in the elderly. The purpose of this study is to evaluate the morbidity and mortality of rAAA repair in octogenarians and compare it to that of a younger population.

Methods: From 1980 to 2000, all patients undergoing emergent rAAA repair were divided into two groups based on their age; Group I: age <80, Group II: > or =80 years.