ABSTRACT
Objective: the hyoscine-n-butylbromide [Buscopan] is ought to be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, nonetheless, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment [if spotted early]. Openangle glaucoma is not affected by hyoscine
Purpose: the purpose of this study was to evaluate the use of hyoscine amid colonoscopists, with certain reference to glaucoma
Materials and Methods: a short questionnaire was electronically managed to members of the Saudi Society of Gastroenterology and the Association of Coloproctology of KSA. The use of Hyoscine among colonoscopists and the effect of glaucoma history upon the prescribing practice
Results: sixty-three colonoscopists responded to some or all of the questions. 41/61 [67.2%] of respondents claimed they were aware of the guidelines. 53/62 [85.5%] sometimes or always use hyoscine, while 9/62 [14.5%] never do. 45/59 [76.3%] always enquire about glaucoma history prior to administration, even though 48/58 [82.8%] make no differentiation between open-angle or angle-closure forms. 42/59 [71.2%] would [incorrectly] withhold hyoscine if the patient declares a history of any form of glaucoma. 46/59 [78.2%] do not substitute glucagon as an antispasmodic. 2/60 [3.3%] had encountered ophthalmic complications postadministration
Conclusions: current guidelines pertaining to hyoscine use and glaucoma are inappropriate. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms
ABSTRACT
Objectives: To estimate the prevalence and risk factors for obstetric anal sphincter injuries [OASIS] in Saudi Arabia using data in a tertiary care University Center
Design: A retrospective case-control study
Setting: King Khalid University Hospital, Kingdom of Saudi Arabia
Subjects: All women with third and fourth degree perineal tears over a 10-year period
Interventions: We conducted this study by creating an obstetric database compiled over a period of 10 years [2002-2012] screening all for third and fourth degree perineal tears and too control matched by the time of delivery and delivery team [midwife and obstetrician]
Main Outcome Measures: The prevalence of perineal injuries was calculated in cases and controls. Maternal and obstetric parameters were analyzed and compared between the two groups
Results: Of 31,665 vaginal deliveries, seventy-three patients [0.23 %, 95% Cl by the adjusted wald method: 0.18%-0.29%] had a recognized third [n=66] or fourth-degree [n=7] perineal tear. The following three variables were independently associated with OASIS on multivariate logistic regression models adjusting for potential confounders: primiparity [OR 3.32] instrumental delivery [OR 7.19] and episiotomy [OR 4.92]
Conclusion: The overall prevalence of third- and fourth-degree perineal tears in our population is low; avoidance of certain obstetric interventions including instrumental delivery and episiotomy may decrease such complications