Association between stroke and hypertension and deep vein thrombosis in Northern Saudi Arabia: community-based study

Background: Deep venous thrombosis [DVT] is a serious complication of various medical conditions including acute stroke

Objectives: We aimed to analyze the association between stroke toward hypertension [HP] and deep vein thrombosis [DVT] in northern Saudi palpitations

Methods: Cross-sectional study was performed, all incident stroke events during follow?up were identified by searching the hospital discharge diagnosis registry, and previous patient's medical records. Also, we conducted a questionnaire survey among population of North Saudi Arabia including 15 cities

Results: Our study showed that HP, and DVT which is definitely associated with stroke occurs only in approximately 5% of patients and significantly affects mortality among population from northern Saudi

Conclusion: Severe HP events with no stroke incidence is associated with increased risk of DVT especially in Male and age group above 55 years. Therefore, it may be reasonable to provide this group of patients with additional care and proper DVT prophylaxis in order to minimize the risk of stroke. Also, those patients with HP should be managed and followed regularly especially elderly patients who are at risk

uncommon diagnosis of Windsock deformity for a common presentation

We report a two-year-old Indonesian female who presented with vomiting and weight loss for more than one month and was ultimately diagnosed with duodenal obstruction due to a windsock deformity. This is a rare and intrinsic congenital anomaly of the duodenum. The diagnosis as well as immediate and conclusive surgical management is discussed

Surgical management of Necrotizing Enterocolitis following Congenital Diaphragmatic Hernia Repair

Necrotizing Enterocolitis [NEC] is a significant cause of in-hospital mortality. The pathogenesis remains unclear, but may be associated with Staphylococcus epidermidis related sepsis, hypertonic feeds or other stress. It is also associated with Abdominal Compartment Syndrome [ACS] as documented after complete closure of gastroschisis. While the incidence of NEC is rare, the associated mortality is significant. We report a case of NEC following the repair of a congenital diaphragmatic hernia [CDH]; an unusual yet serious complication. A literature search revealed only one similar case which resulted in mortality. The possibility of serious postoperative complications following the repair of CDH must be considered in any neonate who exhibits deterioration in their general condition

Smoking status effects on common carotid arteries resistivity and pulsatility indices in current Sudanese smokers

Many different indices have been used to describe the shape of the flow waveforms but commonly used indices available on most commercial scanners are: resistance index [RI] and pulsatility index [PI]. This study intended to evaluate the effects of smoking in common carotid arteries Doppler RI and PI, according to smoking status [number of cigarettes smoked per day] in current Sudanese smokers. 1752 Sudanese subjects with 440 of them were non smokers. Female's distribution in the total number of subjects is 161 while males are 1591 with mean age of 28 +/- 11.8 years. a percentage of 49.32% of male subjects were current smokers but there was no female found to be a smoker. Ultrasound examination was established within each vascular laboratory to ensure that common carotid arteries sonography is performed consistently, comprehensively and accurately. These techniques may be modified to match the needs of specific patients or vascular laboratories. In all cases, however, the protocol should meet or exceed the standards established by the American Institute of Ultrasound in Medicine [AIUM] or the Intersocietal Commission for the Accreditation of Vascular Laboratories [ICAVL]. The standards of these two agencies are substantially the same which was our guide for sonographic scanning in the study. Smoking status in current smokers effectively increases the RI and the PI than their normal ranges with a positive linear correlation manner. Findings of this study reported that smoking status effectively increase common carotid arteries Doppler RI and PI in a positive manner were the effect noticed to be in the left common carotid artery more than that of the right one

Fetal femoral length as a parameter for estimation of fetal weight using ultrasound

The fetal femoral length [FFL] can be a factor in calculating the fetal weight [FW] via ultrasound. Its size and ease of measurement makes the femur the long bone of choice in predicting fetal weight. This study was designed to find a simplified and accurate method to estimate FW in Sudanese ladies with healthy and singleton pregnancy. A total of 230 healthy pregnant ladies with an age that ranged between 18 to 42 years with normal and well being, singleton pregnancy, had transabdominal ultrasound in order to estimate FW using Shephard equation. FW can be estimated accurately and easily by using the following formula that use a single biometric measure which is [FW [g] = 14.714 x FFL[cm] - 188.56] with a correlation factor R[2]=0.9587 that indicates a positive linear correlation between FW in grams and FFL in centimeters. Obtained equation is an accurate and simplified method when compare to other complicated equations used in estimation of fetal weight

Transvaginal scan versus transabdominal scan for gestational sac detection in the early first trimester of pregnancy in Sudanese Ladies

Since ectopic pregnancy is the leading cause of maternal death in the first trimester, the clear identification of a normal intra-uterine pregnancy by ultrasonography is vital as these pregnancies have a good prognosis. Modern ultrasound technology, especially transvaginal, has improved the assessment of early pregnancy development. The use of diagnostic ultrasound during pregnancy is considered to be safe for both mother and feotus, even in critical periods of development the using high-frequency transvaginal transducers, has no adverse bioeffects been demonstrated. Ultrasound provides reassurance, charts normal development, and identifies women with abnormal or high risk pregnancies. This study was designed to compare the efficiency between transvaginal scan [TVS] over transabdominal scan [TAS] in the early detection for the presence of gestational sac in the first trimester of pregnancy. A total of 100 women with an age that ranged between 15 to 45 years old and showed a positive pregnancy test during first trimester of pregnancy, had transvaginal and transabdominal ultrasound in order to compare the value of these two techniques for the detection of gestational sac. TVS found to be significant and superior when compared with TAS in detection for the presence of gestational sac, where Pearson Chi-Square value=32.727 and P value=.000; [Pearson Chi-Square=32.727 and P=.000]. Despite of this fact, knowledge of the finding on TAS made it easier to interpret the transvaginal findings. Although TVS have limitations such as locate lesions outside the pelvis and needs further counseling and education. TVS is more efficient in accessing the presence of gestational sac in early first trimester of pregnancy rather than the TAS

Effect of an anti-thyroid drug, 2,8-Dimercapto-6-hydroxy purine on reproduction in male rats

This histomorphological study is designed to evaluate the peripheral action of 2,8-Dimercapto-6-hydroxypurine [an antithyroid drug] on male reproductive system. The drug was administered as i.p. injection for 21 days to investigate its role on morphology of intratesticular cells and plasma testosterone level. Adult male rats [n=12], divided into three groups i.e. control, dimethylsulphoxide [DMSO] and 2,8-Dimercapto-6-hydroxypurine treated groups and treated with saline, DMSO and 2,8-Dimercapto-6-hydroxypurine for 21 consecutive days respectively. Blood samples were collected at day 1, 7, 14 and 21 and analyzed by using EIA systems. All the animals were scarified on 22nd day and testicular tissues were studied by histomorphpological assesment. 2,8-Dimercapto-6-hydroxypurine caused a significant decrease [P<0.0001] in mean testicular cell population, testicular cell diameter and resulted in arrested spermatogenesis. A significant decrease [P<0.0001] was observed in mean Sertoli and Leydig cell population and diameter in treated group. Similarly a significant decrease was observed in plasma testosterone levels at days 1, 7 and 14 [P<0.05] and further decrease by day 21 [P<0.01] of drug treatment. The present study suggests that 2,8-Dimercapto-6-hydroxypurine is a negative modulator of reproductive system as it suppressed the plasma testosterone level and proliferation of different testicular cell types in adult male rats

Surgical management and outcome in achalasia cardia

The objective of the evidence based clinical report was to assess the outcome of exramucosal modified Heller's cardiomyotomy in terms of effective palliation of dysphagia with minimum complications. Ten patients were included after exclusion of four patients due to poor follow-up. Due to the non-availability of manometry, barium swallow and endoscopy had to be relied upon for the definitive diagnosis. All patients underwent transabdominal modified Heller's myotomy coupled with anterior partial fundoplication [Dor Patch]. Median age of the patients treated was 42.5 years. Seven patients had grade III dysphagia, 2 had grade IV and one patient, an 8 years old child was having grade II dysphagia. In one patient, [10%], mucosa was perforated iatrogenically followed by wound infection. Another patient developed acute coronary syndrome on first postoperative day. In the rest of patients recovery was uneventful. Mean hospital stay was 7.1 days. Immediate relief of dysphagia was noted in all the patients. Mean follow-up was 7.2 months. There was significant improvement in dysphagia following surgery. Outcome was assessed devising a scoring system. Excellent outcome was observed in 80% of cases, good in 10% and fair in 10% of cases