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Abstract Introduction Septorhinoplasty operates on the nose's bone and cartilage and is ensued by severe postoperative pain. Objective The objective of this study is to evaluate the effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty. Methods A total of 150 patients undergoing septorhinoplasty were randomly assigned into 3 groups with 50 patients in each group. The control group (group A) was administered 100 ml saline solution; the paracetamol group (group B) was administered 1,000 mg of IV paracetamol in 100 ml of saline solution; and the ibuprofen group (group C) was administered 800 mg of IV ibuprofen in 100 ml of saline solution before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using the visual analogue scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient. Results In comparison with group A, the score in the VAS of groups B and C was statistically lower in all the time intervals (p < 0.05). In the 1st and 6th hours postoperatively, group C's score in the VAS in was lower than that of group B (p < 0.05). In the control group, total opioid consumption was highest in all time intervals (p < 0.05). In group C, total opioid consumption was significantly lower than in group B in the 0 to 6 and 6 to 12 hours intervals. (p < 0.05). Conclusion The single-dose preemptive administration of ibuprofen has a more profound postoperative analgesic effect than paracetamol in the first 6 hours after septorhinoplasty. After the first 6 hours postsurgery, there is no difference between ibuprofen and paracetamol in terms of analgesic effect.
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Background: The fast-growing demand for platelet concentrates (PC) necessitates the storage of these blood products before transfusion. Platelets are prepared as concentrates from the whole blood or by plateletpheresis. Qualitative and quantitative assessment of these PCs is an important issue in transfusion medicine. To assess the qualitative, quantitative changes and bacteriological safety of 5 days of stored platelet concentrates (PC).Material & Methods:This prospective study was conducted at the department of Clinical Pathology in collaboration with the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2008 to April 2009. A total of 65 healthy donors were included in the study as per the inclusion and exclusion criteria. Therefore, 65 platelet concentrates (bags/units) were prepared from the donors. Purposive sampling of the units was done. pH and platelet indices (PLT, MPV, PDW and P-LCR) were measured and Gram staining of PCs was performed on days 0 and 5. Statistical significant tests were done at a 95% confidence interval using the statistical package for social science (SPSS).Results:The mean (±SD) pH was 7.18±0.07 ranging from 7.0 to 7.3 during day 0. On day 5 the mean (±SD) pH was 6.77±0.11 and their range was from 6.5 to 7. The mean pH difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) PLT/unit was 70.56±15.56 x109/unit and it ranged from 38.01 to 110.6 x109/unit during day 0. On day 5 the mean (±SD) PLT/unit level was 68.46±15.52 x109/unit and it ranged from 36.82 to 107.2 x109/unit. The mean PLT/unit difference was statistically significant (p<0.05) between day 0 and day 5. The mean (±SD) MPV was 9.34±0.92 fl and it ranged from 7.5 to 11.5 fl during day 0. During day 5 the mean (±SD) MPV was 9.27±0.99 fl ranging from 7.0 to 11.2 fl. The mean (±SD) PDW was 10.07±1.61 fl and which ranged from 7.4 to 14.4 fl during day 0. During day 5 the mean (±SD) PDW was 10.72±1.71 fl ranging from 7.0 to 15.4 fl. The mean (±SD) PLCR was 18.28±5.67 % and it ranged from 8.0 to 32.5 % during day 0. During day 5 the mean (±SD) PLCR was 21.18±5.91 % and it ranged from 10.0 to 36.3 %. The mean PLT, PDW and PLCR differences were statistically significant (p<0.05) between day 0 and day 5 in the unpaired t-test, however, the mean MPV difference was not statistically significant (p<0.05) between day 0 and day 5. Gram staining of platelet concentrates on day 0 and day 5 found no bacteria.Conclusions:Storage-induced lesions take place in PCs when stored for 5 days in second-generation storage containers under the currently recommended conditions, but how far these changes are clinically relevant needs to be investigated.
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Purpose@#This study presents our initial experience with endoscopic combined intrarenal surgery (ECIRS) for large renal stones and compares the results of a propensity score-matched cohort of patients undergoing shock-wave lithotripsy (SWL). @*Materials and Methods@#A total of 100 adults underwent ECIRS for renal stones between August 2017 and January 2019. For comparison, 2172 patients who underwent a first session of SWL between January 2005 and May 2018 were included in the SWL cohort.Propensity score matching was performed using maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) scores. Stone-free rate (SFR) and success rate were compared between ECIRS and SWL. @*Results@#In the ECIRS group, the mean MSL, mean MSD, and mean SHI were 28.7±15.2 mm, 1013.9±360.0 Hounsfield units (HU), 209.4±104.0 HU, respectively. The SFR was 70%, and the success rate was 82.0% in this group. Although the ECIRS group had larger, harder, and more homogeneous stones than the SWL group, ECIRS showed a higher SFR and success rate than SWL. After propensity-score matching, SFR and success rate remained higher with ECIRS than with SWL (both, p<0.001). In multivariate logistic regression, smaller stone size [odds ratio (OR): 0.947, 95% confidence interval (CI): 0.913–0.979, p=0.002] and lower Seoul National University Renal Stone Complexity score (OR: 0.759, 95% CI: 0.610–0.935, p=0.011) were independent predictors of successful ECIRS. @*Conclusion@#ECIRS showed a higher SFR and success rate than SWL for large renal stones. Smaller stone size and lower complexity of stones were associated with a higher likelihood of successful ECIRS.
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Obesity is a modifiable risk factor for the development and progression of kidney disease. Obesity may harm kidneys in individuals without hypertension, diabetes, or pre-existing renal disease. Ginger, Zingiber officinale, has many beneficial pharmaceutical benefits. This study aimed to evaluate the Zingiber officinale protective effect against obesity complications which induced by high fat diet and caused renal dysfunctions. The study period was two months, and the experimental animals' groups were four, 80 Wistar rats were appropriated similarly 20 animals/group: control group; ginger extract group (GE); high-fat diet (HFD); and GE+HFD group. Body and fat weight, creatinine, leptin, TNF-α, total antioxidants, renal histopathological and ultrastructure were investigated. Rats in group of HFD showed a significant increase (P<0.05) in the body and fat weights, creatinine, leptin and TNF-α, and significant decrease (P<0.05) in total antioxidants (TAS). Ginger administration significantly showed the protective restoring the altered parameters. Furthermore, rats co-treated with ginger extract improved the histopathological and ultrastructural renal injury induced by obesity. The study concluded that the ginger extract used could suppress and decrease the renal damage induced by high-fat diet as it possesses potential medicinal values.
La obesidad es un factor de riesgo modificable para el desarrollo y la progresión de la enfermedad renal. La obesidad puede dañar los riñones en personas sin hipertensión, diabetes o enfermedad renal preexistente. El jengibre, Zingiber officinale, tiene muchos beneficios farmacéuticos. Este estudio tuvo como objetivo evaluar el efecto protector de Zingiber officinale en las complicaciones de la obesidad inducida por una dieta alta en grasas y las enfermedad renal. El período de estudio fue de dos meses, y los grupos de animales experimentales fueron cuatro, se asignaron 80 ratas Wistar de manera similar, 20 animales por grupo: grupo de control; grupo de extracto de jengibre (GE); dieta alta en grasas (DAG); y el grupo GE + DAG. Se evaluó el peso corporal y la grasa, creatinina, leptina, TNF-α, antioxidantes totales, histopatología renal y ultraestructura. Las ratas en el grupo de DAG mostraron un aumento significativo (P<0,05) en el peso corporal y de grasa, creatinina, leptina y TNF-a, y una disminución significativa (P<0,05) en los antioxidantes totales. La administración de jengibre mostró una protección significativa restaurando los parámetros alterados. Además, las ratas tratadas conjuntamente con extracto de jengibre mejoraron la lesión renal histopatológica y ultraestructural inducida por la obesidad. El estudio concluyó que el extracto de jengibre podría suprimir y disminuir el daño renal inducido por la dieta alta en grasas, ya que posee potenciales valores medicinales.
Subject(s)
Animals , Rats , Plant Extracts/pharmacology , Zingiber officinale/chemistry , Diet, High-Fat/adverse effects , Kidney Diseases/drug therapy , Obesity/complications , Body Weight , Tumor Necrosis Factor-alpha/analysis , Rats, Sprague-Dawley , Creatinine/analysis , Leptin/analysis , Microscopy, Electron, Transmission , Kidney/pathology , Kidney Diseases/pathologyABSTRACT
Objective: To assess the ameliorative properties of Iranian Trigonella foenum-graecum L. (T. foenum-graecum) seeds and Punica granatum L. (P. granatum) peel extracts against streptozotocin-induced diabetes in male guinea pigs. Methods: Sixty guinea pigs were divided into six groups (10 guinea pigs per group). Group 1 consisted of normal animals. Groups 2 and 3 were treated with Iranian T. foenum-graecum seeds and P. granatum peel extract alone, respectively. Group 4 was treated with streptozotocin only; whereas Groups 5 and 6 receiving streptozotocin were treated with Iranian T. foenum-graecum seeds and P. granatum peel extract, respectively. All animals were treated for 30 days, and the body weight, blood and liver biochemical parameters were measured. Results: Guinea pigs exposed to streptozotocin showed an alteration in body weight gain, fasting glucose level, kidney function parameters (blood urea nitrogen and creati-nine) as well as decreased serum and hepatic total protein level. In addition, it increased the cholesterol and triglyceride level, while decreasing the hepatic glucose-6 phosphate dehydrogenase activity, glycogen, glutathione content and hepatic catalase activity. Oral treatment with T. foenum-graecum seeds and P. granatum peel extracts revealed sig-nificant protective properties with respect to body weight gain and other biochemical parameters studied. Conclusions: The Iranian T. foenum-graecum seeds and P. granatum peel extracts are significantly potent in ameliorating diabetic condition induced by streptozotocin and improving various biochemical parameters in serum and liver of guinea pigs.
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Background: Helicobacter pylori [H. pylori], is a common infection in pregnant women accompanied by variations in the levels of the IgM, IgA and IgG antibody isotypes. The variations of anti-H. pylori antibodies during and after pregnancy, and the extent of protection they provide to the mother and the fetus are not completely understood
Objectives: To investigate the changes of the anti-H. pylori IgM, IgA and IgG levels in healthy Omani pregnant women during pregnancy and 3 months after delivery
Methods: Serum samples obtained from 70 Omani healthy pregnant women, with no history of autoimmune diseases, were tested for anti-H. pylori IgM, IgA and IgG in the first trimester of pregnancy and 3 months after delivery. In parallel and as a control group, sera obtained from a group of 70 healthy non-pregnant Omani women were tested. The levels of anti-H. pylori IgM, IgA and IgG were measured using standard Enzyme Linked Immunosorbent Assays [ELISAs]
Results: Anti-H. pylori IgA levels were found to be significantly higher during pregnancy [p=0.046] and after delivery [p=0.02] when compared to the control group. Moreover, a significant increase in the levels of anti-H. pylori IgM, IgA and IgG was detected after delivery [p=0.002] when compared to the levels during pregnancy
Conclusion: Pregnancy is associated with an increase in the levels of anti-H. pylori IgA antibodies. In addition, anti-H. pylori IgM, IgG and IgA antibody levels increase after delivery
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Background and study aims: Prognosis for patients with cirrhosis admitted to a medical intensive care unit [MICU] is poor and no previous studies have been published from Qatar or other countries in the region to investigate this issue. The objective of this study was to assess the predictors for in-hospital mortality and admission of cirrhotic patients to MICU in a single tertiary hospital in Qatar
Patients and methods: All adult cirrhotic MICU patients hospitalized from 2007 through 2012 to Hamad General Hospital-Qatar were included. We compared them to cirrhotic patients admitted to medical wards during same period of time. All data were recorded and analyzed with respect to demographic parameters, clinical features and laboratory as well as radiology characteristics on day one of admission to MICU. Cirrhosis diagnosis was established either with a liver biopsy or the combination of physical, laboratory and radiologic findings. Predictors of mortality were defined by logistic regression analysis
Results: The cohort comprised 109 cirrhotic MICU patients [86.2% males], and their mean age +/- SD was 51.6 +/- 11.5. MICU-cirrhotic patients had longer hospital stays than medical wards-cirrhotic patients [p = 0.01]. Admission with severe hepatic encephalopathy, upper gastrointestinal bleeding and SOFA [Sepsis Related Organ Failure Assessment] score were the independent predicting factors for MICU admission. Mortality was higher for the MICU-cirrhotic group than medical wards group [27 [24.8%] deaths vs. 12 [5.3%] deaths, respectively, p = 0.001]. In multivariate logistic regression analyses, older age > 60 years [p = 0.04], APACH-II score [p = 0.001] and MELD score [p = 0.02] were independent predicting factors for overall mortality
Conclusion: Severe hepatic encephalopathy, upper gastrointestinal bleeding and SOFA score predict MICU admission of cirrhotic patients. Among MICU cirrhotic patients, older age, APACH-II score and MELD score predict mortality
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Objective: To investigate the levels of zinc-α-2-glycoprotein (ZAG) among Omani AIDS patients receiving combined antiretroviral therapy (cART). Methods: A total of 80 Omani AIDS patients (45 males and 35 females), average age of 36 years, who were receiving cART at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, were tested for the levels of ZAG. In addition, 80 healthy blood donors (46 males and 34 females), average age of 26 years, attending the SQUH Blood Bank, were tested in parallel as a control group. Measurement of the ZAG levels was performed using a competitive enzyme-linked immunosorbent assay and in accordance with the manufacturer's instructions. Results: The ZAG levels were found to be significantly higher among AIDS patients compared to the healthy individuals (P=0.033). A total of 56 (70%) of the AIDS patients were found to have higher levels of ZAG and 16 (20%) AIDS patients were found to have high ZAG levels, which are significantly (P > 0.031) associated with weight loss. Conclusions: ZAG levels are high among Omani AIDS patients on cART and this necessitates the measurement of ZAG on routine basis, as it is associated with weight loss.
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<p><b>OBJECTIVE</b>To investigate the levels of zinc-α-2-glycoprotein (ZAG) among Omani AIDS patients receiving combined antiretroviral therapy (cART).</p><p><b>METHODS</b>A total of 80 Omani AIDS patients (45 males and 35 females), average age of 36 years, who were receiving cART at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, were tested for the levels of ZAG. In addition, 80 healthy blood donors (46 males and 34 females), average age of 26 years, attending the SQUH Blood Bank, were tested in parallel as a control group. Measurement of the ZAG levels was performed using a competitive enzyme-linked immunosorbent assay and in accordance with the manufacturer's instructions.</p><p><b>RESULTS</b>The ZAG levels were found to be significantly higher among AIDS patients compared to the healthy individuals (P=0.033). A total of 56 (70%) of the AIDS patients were found to have higher levels of ZAG and 16 (20%) AIDS patients were found to have high ZAG levels, which are significantly (P>0.031) associated with weight loss.</p><p><b>CONCLUSIONS</b>ZAG levels are high among Omani AIDS patients on cART and this necessitates the measurement of ZAG on routine basis, as it is associated with weight loss.</p>
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To estimate the prevalence of pre-hypertension and its association with some selected cardiovascular risk factors among the Omani adult population in the primary healthcare setting. A cross-sectional study involving a sample taken from a National Screening Program of chronic non-communicable diseases in primary healthcare institutions, Sohar city, Sultanate of Oman [July 2006 - December 2007]. Inclusion criteria included Omanis aged 40 years or above residents of Sohar city attending primary healthcare institutions not previously diagnosed with diabetes mellitus, hypertension, or chronic kidney diseases. Descriptive statistics were used to describe the demographic, physical and metabolic characteristics. Univariate analysis was used to identify the significant association between the characteristics and normal blood pressure, pre-hypertension and hypertension. Chi-squared test was used for categorical variables analysis and independent t-test was used for continuous variables analysis. In order to examine the strength of significant associations, the multinomial logistic regression analysis was used. There were 1498 participants, 41% were males and 59% were females. Overall, pre-hypertension was observed in 45% of the total study population [95% CI: 0.422 - 0.473]. There were more males affected than females [46% versus 44%]. About 34% of the total study population was hypertensive. The multinomial logistic regression analysis revealed that an increase of one unit of age, body mass index, fasting blood glucose and total blood cholesterol, were significantly associated with higher risk in both pre-hypertension and hypertension. High odds ratio of pre-hypertension and hypertension was found with the total blood cholesterol. The prevalence of pre-hypertension was high among the Omani adult population. The determinants of pre-hypertension in this research age, body mass index, fasting blood glucose and total blood cholesterol. A cost-effectiveness study about the management of pre-hypertension within primary healthcare is significant in the future health system service strategies.
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Exudative pleural effusion represents a common diagnostic task to the clinician. The two commonest causes of exudative pleural effusion are parapneumonic followed by malignant ones. However, obtaining a definite diagnosis is essential for proper management of the effusion. The aim of this work was to evaluate the role of the fiberoptic bronchoscope used as a thoracoscope in management of exudative pleural effusion. Eighty-four patients with exudative pleural effusion of undetermined etiology were enrolled in this study. All patients were subjected to full history taking, thorough clinical examination, pleural fluid aspiration and analysis, computed tomography of the chest and ultrasound examination of the pleural cavity. Under conscious sedation and local anaesthesia, fiberoptic thoracoscopy was then carried out using fiberoptic bronchoscope inserted through a rigid large siliconized chest tube. After drainage of the pleural fluid, the pleural cavity was carefully explored and multiple forceps biopsies were taken and sent for histopathological examination. Pleurodesis was then done using iodopovidone in patients with apparent pleural pathology. After lung expansion and pleural fluid drainage of less than 100 cc/day, the chest tube was removed. Successful histopathological diagnosis was achieved in all patients. It revealed that 63 [75%] cases had malignant pathology and 21 [25%] cases had inflammatory pathology. The malignant pathology was caused by: bronchogenic carcinoma in 28 [33.3%] cases, malignant mesothelioma in 2 [2.38%] cases and metastatic malignant deposits from other organs in 33 [39.28%] cases. The inflammatory pathology was tuberculosis in 16 [19%] cases and non-specific pleurisy in 5 [5.95%] cases. Pleurodesis was performed and was successful in all the patients. Two [2.38%] patients developed empyema after the procedure and they were successfully managed by intercostals tube drainage and anitibiotic therapy. Other complications encountered included local wound infection in 3 [3.57%] cases, subcutaneous emphysema in 3 [3.57%] cases and chest pain following pleurodesis in 15 [17.85%] cases. Thoracoscopy using the fibroptic bronchoscope is safe and effective. It is an alternative technique to rigid thoracoscopy with some advantages as it allows better exploration of the pleura. It is equally as efficient as the rigid thoracoscope and hardly more time consuming. With proper handling, there will not be any damage or abuse of the fibroptic bronchoscope
Subject(s)
Humans , Male , Female , Diagnostic Techniques and Procedures/statistics & numerical data , Bronchoscopy/statistics & numerical data , Pleural Effusion/diagnosis , Povidone-Iodine , Treatment Outcome , Hospitals, UniversityABSTRACT
Invasive pneumococcal disease [IPD] is associated with high case-fatality rates and serious chronic sequelae. The objective of this study was to assess the magnitude of invasive pneumococcal infections in a pediatric population without universal vaccination during childhood in a single hospital. Retrospective review of all pediatric cases of invasive pneumococcal infection during a 7-year period. We reviewed the microbiological and clinical records of cases of IPD in children <13 years of age admitted to the Armed Forces Hospital, Southern Region, Saudi Arabia. We identified 41 patients with IPD; 27 [66%] were <2 years of age. Four [50%] of those with pneumoccal meningitis were <2 years of age. The case fatality was 3 of 41 [7.3%] due to meningitis and 2 of 41 [5%] due to sepsis, with a case fatality of 5 [12%] due to meningitis and sepsis. Nine patients developed sequelae; of those with meningitis, 5 [73%] developed sequelae. Only 15 [41%] patients had predisposing medical conditions. The overall intermediate and high levels of pneumococcal resistance to penicillin and ceftriaxone were found to be 48.5%, 2.4% and 2.4%, 0%, respectively. None of the pneumococcal isolates were serotyped, and none of the patients had been vaccinated against pneumococcal infections in our hospital. Despite the presence of a targeted immunization program, a considerable number of cases of invasive pneumococcal infections were reported among our pediatric population over a period of 7 years. Prospective studies in serotypes and antibiotic resistance from the southern region are needed to provide baseline information for the formulation and evaluation of a national prevention and control program
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Schwartz-Jampel syndrome is a rare autosomal recessive disorder in which the patient had short stature, myotonia with paucity of facial expression, blepharophimosis, pectus carinatum, and contractures. It is a muscle-joint anomaly with prominent facial characteristics and ocular defects. There is a typical facial appearance due to myotonia of the muscles of expression; the skin appears to be pursed and stretched tightly over the face and mouth. Joint limitations are part of the syndrome. The face appears somewhat expressionless, and the few patients who have been identified to have a remarkably consistent appearance. Blepharophimosis is a consistent feature. We report the occurrence of the classic Schwartz-Jampel syndrome in two boys of two consanguineous families in Jordan with bilateral congenital nasolacrimal duct obstruction in one of them. Their main facial manifestations are highlighted