outcome of severe traumatic brain injury in children in Qatar: six year study

Traumatic brain injuries [TBI] are important public health problem resulting in short-term or permanent disability and death. To determine the extent and outcome of severe TBI amongst children in Qatar medical records were reviewed retrospectively of all cases of severe TBI in children aged 1 4 years or less who attended the Children Rehabilitation Unit, Hamad General Hospital, Qatar, between January 2002 to December 2008. The severity of TBI was assessed by the Glasgow Coma Scale [GCS]. Of 65 children with severe TBI, most were male [73.8%] and 91% were older than five years of age. The leading causes of injury were road traffic accident [84.6%] and falls [10.8%]. Other causes included trauma by ceiling fan blades [4.6%], sports and recreation injuries. Early sequelae included spasticity [43.1%] and posttraumatic epilepsy [33.8%]; both were significantly associated with the increased severity and need for intracranial surgery. Almost a quarter of the children had communication disorders, 17 [26.2%] had poor cognition, 16 [24.6%] had hemiplegia and 12 [18.5%] had abnormal behaviour. Twelve [18.5%] children died within the first month of admission to hospital. It is clear that severe TBI results in significant morbidity and mortality among children in Qatar and special efforts are needed to reduce the causes especially motor vehicle crashes and injuries. Rehabilitation programs are also needed to limit the extent of long-term complications associated with TBI

Serum adiponectin levels in coronary artery disease

Coronary artery disease [CAD] refers to a lack of oxygen due to inadequate perfusion of the myocardium, which causes an imbalance between oxygen supply and demand. Many generalized or systemic risk factors predispose to development of atherosclerosis. Atherosclerosis of the coronary arteries commonly causes acute coronary syndromes. Adiponectin is one of the adipokines secreted by adipocytes. Adiponectin may play anti-atherogenic and anti-inflammatory roles. The aim of this study is to investigate whether concentrations of serum adiponectin constitute a significant coronary risk factor. Serum adiponectin was measured in 50 patients with CAD and in 20 control subjects. Patients were divided into three groups according to condition type: Acute myocardial infarction [AMI] group [n=20], unstable angina pectoris [UAP] group [n=15], and stable angina pectoris [SAP] group [n=15]. Serum concentrations of adiponectin in patients with CAD were significantly lower than in control subjects [p<0.000]. There was a significant negative correlation between adiponectin and triglyceride and significant positive correlation with HDL in patients. The findings suggest that measurement of serum concentrations of adiponectin may become a predictor risk factor for CAD and may be related to the development of acute coronary syndromes

Risk factors and laboratory diagnostics for post renal transplant tuberculosis: a case-controlled, country-wide study on definitive cases

Tuberculosis [TB] is a common cause of morbidity and mortality in renal transplant recipients. It is usually misdiagnosed because of lack of medical awareness and its infrequency in renal transplant recipients. 44 cases [0.3%] with post-transplant TB out of 12820 patients who had renal transplants performed between 1984 to 2003 were found from the hospital records of 12 major kidney transplantation centers in Iran. These cases were compared with 184 healthy transplant subjects whose transplants were performed by the same surgical team as the controls. The mean age of cases and controls was 37.7 [13-63] and 35.6 [8-67] years [p=0.3], respectively. The mean duration of pre-transplantation hemodialysis was 30.3 [3-168] months in cases and 18.2[1-180] months in controls [p=0.03]. A past history of tuberculosis was detected in 2 cases and 1 control [p=0.3]. The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases [56.8%] and 60[32.6%] controls had rejection prior to diagnosis of TB [p=0.004; OR=2.7, CI95%: 1. 3-5.6]. To our knowledge, this is the first study that demonstrated increasing risk of post-transplant TB by extending the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes. Further study is needed to clarify our new findings specifically in respect of different immunosuppressive regimens

Presence of panic disorder among medical patient referred to psychiatry

A retrospective application of the panic questionnaire and the life stressors questionnaire on 50 patients with unexplained somatic symptoms referred for psychiatric consultation by other medical disciplines. The most common presenting symptoms were related to, head, chest, heart, and abdomen. Analysis revealed two groups of patients, panic disorder patients [N = 32] and non - panic patients [N = 18]. Panic group presented more frequent and severe somatic symptoms and they were associated with different life stressors. The results also indicate that the panic patients had utilized more frequently the health services

Wilson's disease in Saudi Arabia: report of a Saudi Arab family

A Saudi family with Wilson's disease [hepatolenticular degeneration] is described. The index case presented with anicteric hepatitis and hydrops of the gallbladder. Neurological involvement appeared later. The diagnosis of Wilson's disease was based on the presence of Kayser-Fleischer rings, a low serum ceruloplasmin level, and an elevated urinary copper concentration. Histological examination of the liver biopsy specimen revealed active cirrhosis. Acute hepatic failure developed during D-penicillamine therapy. Continuation of the drug at a lower dose, along with other supportive measures, was successful in reversing this. After three years of therapy, the index patient's neurological signs disappeared, and liver function and gallbladder size and function returned to normal. Family screening revealed that three other siblings have the disease, and all have been treated with D-penicillamine. The parents are related but are asymptomatic. An unusual feature of the index case was the presence of a distended nonfunctioning gallbladder that reverted to normal with decoppering. Although D-penicillamine treatment possibly precipitated the acute hepatic failure, paradoxically it was also successful in treating it