ABSTRACT
To present our experience of post-transplant infections in allogeneic stem cell transplants at Sheikha Badryia Stem Cell Transplant Centre, Kuwait. Retrospective analysis of 21 consecutive patients with malignant and non-malignant hematological disorders who received a transplant of an unmanipulated bone marrow graft from an HLA-I identical sibling donor from November 2011 to December 2013. Pre-transplant infection surveillance was carried out, and strict prophylaxis against infection was observed. Bone marrow stem | cells were used as the stem cell source. Cyclosporin and methotrexate with or without mycophenolate mofetil / methylprednisolone were used as graft-versus-host disease [GVHD] prophylaxis. The engraftment was monitored with molecular analysis. Survival was calculated from the date of transplant to death or last follow-up. Twenty-one patients received allogeneic stem cell transplants from HLA- matched siblings for various hematological disorders. Twelve patients were female. The median age of the patient cohort was 34 years [range 3-41 years]. All patients and donors were cytomegalovirus [CMV] IgG-positive. Seventeen patients [80.95%] developed febrile episodes in different phases of post-transplant recovery. Post-transplant infections were confirmed in 20 patients [90.2%] on the basis of clinical assessment and microbiological, virological, and histopathological examination. Mortality related to infections and chronic graft versus host disease was one patient [4.8%]. 90% of our patients developed febrile episodes with relatively low culture yield. The majority of infections were treated effectively
ABSTRACT
Postoperative pain for anal surgery is a concern. Intrathecal morphine is effective and simple method for postoperative analgesia. The aim of this study is to compare the efficacy of 50 ug intrathecal morphine in low dilute bupivacaine 0.125% to 100 ug morphine in low dilute bupivacaine 0.125% and to compare the advantage and disadvantage in each group. Sixty patients of ASA grade I and II scheduled for anal surgery were randomly allocated to receive saddle block in setting position either lml of 0.25% hyperbaric bupivacaine with 1ml saline 0.9% [total volume 2ml to give concentration of 0.125%] [Group I n=20] or 1ml of hyperbaric bupivacaine 0.25% with 1ml of morphine 50 micro g [group II n=20] or 1ml hyperbaric bupivacaine 0.25% with 1ml of morphine 100 ug [group III n=20]. The duration of analgesia in the groups I, H, III were 2.8 +/- 0.55 hr, 6.4 +/- 0.8 hr and 11.2 +/- 1.2 hr respectively which was highly significant. Postoperative nausea and vomiting occurred at overall highly significant incidence during the first 24 hours, in group II, III, while there was no nausea and vomiting in group I. Urinary retention was also significant between group I, II and III with mean 3.95, 6.82 and 9.12 hours, in group II eight patients need catheter while in group Ill fourteen patients need catheter. As regard pruntus no patients in group I, while in group II one patients complaining of sever pruritus, in group Ill five patients complaining of sever pruritus and need treatment. A transient respirator depression with respiratory rate<8 pen minute and SPO2<90% occurred in one patients only in group III. No homodynamic changes
Subject(s)
Humans , Male , Female , Pain, Postoperative/drug therapy , Morphine/administration & dosage , Injections, Spinal/methods , Bupivacaine , Drug CombinationsABSTRACT
To determine the prevalence of asymptomatic bacteriuria in pregnancy, midstream urine samples from 505 pregnant women in Sharjah, United Arab Emirates, were screened using urine culture and urinalysis. Urine cultures showed heavy growth [>/= 10[5] colony forming units/mL] in 4.8% [24/505] of the samples; 16/24 [66.7%] of these isolates were Escherichia coli. Microscopic examination had the highest sensitivity [67%], while nitrite dipstick testing showed the highest specificity and positive predictive value [99% and 57% respectively]. Antibiotic sensitivity tests carried out on the positive culture samples showed high sensitivity to gentamicin, amoxicillin-clavulanic acid and fosfomycin