ABSTRACT
We aimed to perform a systematic review and meta-analysis of all randomized placebo-controlled trials (RCTs) that examined the analgesic benefits of preemptive pregabalin among patients undergoing minimally invasive hysterectomy. Five major databases were systematically screened from inception until August 29, 2021 Relevant studies were evaluated for risk of bias. Endpoints were analyzed using the random-effects model and pooled as the mean difference or risk ratio with a 95% confidence interval. Four studies with seven treatment arms met the inclusion criteria. The total sample size was 304 patients: 193 and 111 patients were allocated to the pregabalin and placebo groups, respectively. Overall, the included studies revealed a low risk of bias. The summary results revealed that the mean postoperative pain scores at rest were significantly lower in the pregabalin group than in the control group at 0, 2, 4, 6, 12, and 24 hours. Moreover, the mean postoperative pain scores on movement/coughing were significantly lower in the pregabalin group than in the control group at 12 and 24 hours. The rate of patients who were opioid-free postoperatively was significantly higher in the pregabalin group than in the control group. There was no significant difference between the groups in terms of the mean postoperative time to first rescue analgesic and the rates of adverse events. Compared with placebo, preemptive pregabalin was largely safe, and was correlated with superior analgesic effects in terms of lower postoperative pain scores and higher opioid-sparing effects. Additional RCTs are needed to confirm these findings.
ABSTRACT
Background: bronchial asthma is a common chronic respiratory disease affecting adolescents and young adults nationality and worldwide and its prevalence has increased in developed and developing countries over the last three decades
Aim of the Work: to establish the prevalence of bronchial asthma among medical students in Saudi Arabia and the relationship between asthma and some associated risk factors
Patients and Methods: a descriptive cross-sectional study. Data were collected from randomly selected undergraduate medical students of 6 universities, during the academic year 2017-2018. A predesigned questionnaire was disseminated to the targeted population to complete it
Results: the prevalence of physician-diagnosed bronchial asthma in our participants was 19.2%. Males reported insignificant higher prevalence of bronchial asthma compared to females [P= 0.195]. Bronchial asthma was significantly associated with skin allergy 32.9% [P= 0.001], allergic rhinitis 61.6% [P=0.001], hay fever 12.3 %[P=0.001] and obesity 28.8% [P0.009]. While it was insignificantly associated with smoking [P=0.428], passive smoking [P=0.561], diabetes [P=0.254] and performing muscular exercise [P=0.322]. Precipitating factors to bronchospasm was dust in 43.8%, certain foods in 1.4%, hot weather in 2.7% and multiple factors in 52.1%. Herbal treatment was tried in 34.2%; desensitization in 6.8% and 68.5% needed emergency treatment. Response to medical treatment was good in 89.1% of cases
Conclusion: the prevalence of physician-diagnosed bronchial asthma in our participants was 19.2%. Males reported insignificant higher prevalence of bronchial asthma than females. Bronchial asthma was significantly associated with skin allergy, allergic rhinitis, hay fever and obesity. While it was insignificantly associated with active smoking or passive smoking
ABSTRACT
Accurate evaluation of firearm related injury is essential for medicolegal aspects of incident. In this study, the records of thirty living cases of gunshot skeletal injuries were reviewed and analyzed to determine the adequacy of description of important forensic aspects of the injuries. The cases were collected from a busy trauma center in the Republic of Yemen. Emphasis was put on the description of inlet and exit wounds, estimation of distance and direction of firing. Revision of the patients and their x rays was done to investigate the accuracy of clinical description documented by the trauma surgeons who treated the patients. The records of the cases revealed 52 bullet wounds. Entrance versus exit was described in 39 wounds [75%]. The size and shape was described in only 5 wounds [10%]. The site of wound was assessed by region in 46 wounds [88%], by diagram in 29 [56%] or measurement from fixed point in 12 [23%]. The direction was determined only in 7 [13%] of the examined wounds. After forensic assessment of the cases and their comparison with medical records written by trauma surgeons, inadequate information and insufficient comparison were seen in two cases who were avoided. In 13 cases that had one wound, only one case [8%] was adequately and correctly identified. Of 8 cases with two wounds, only 2 cases [25%] were equal to forensic examination. In all 7 cases that had more than 2 wounds, the surgeon records had discrepancies with forensic examination. This study revealed that the trauma specialists responsible for treating firearm injuries do not adequately nor correctly analyze and interpret these wounds
ABSTRACT
We reviewed the results of twenty patients [twenty-five hips] who had operative treatment for correction of neglected developmental dislocation of the hip. We had special interest in the study of acetabular remodeling potential after open reduction and femoral osteotomy. Marked spontaneous correction of the acetabular index was observed in all but one hip and only one pelvic osteotomy was needed for full correction of this hip. The average follow-up was five years and three months [2-6 years]. At the end of follow up the acetabular index improved from an average of 34 degrees preoperatively [range 30 degrees to 40 degrees] to 18 degrees postoperatively [range 12 degrees to 22 degrees]
Subject(s)
Humans , Male , Female , Acetabulum , Osteotomy , Treatment Outcome , Follow-Up Studies , ChildABSTRACT
Deficiency of the anterior cruciate ligament [ACL] is a common disorder which can lead to changes in Iifestyle [1]. We followed 32 patients who had arthroscopic reconstruction of the anterior cruciate ligament using a central-third of patelIer- tendon autograft and interference screws fixation for 2 years to assess the results of reconstruction of the ACL with the use of this technique. Our patients were 26 males and 6 females with an average age of 26 years [range 19 - 46 years], the average time between injury and operation was 13 weeks [range 3-24 weeks]. The data that were analysed included the mechanism of injury, the interval between injury and operation, the pre-operative subjective findings, the clinical examination included bilateral assessment of the range of motion, Lachman and Pivot shift tests, and information obtained with use of the knee rating scale of Lysholm and Gillquist. At the latest folIow-up evaluation of 2 years the mean Lysholm and Gillquist score increased from a mean of 60 points pre-operatively to a mean of 92 points post-operatively. All of our patients were satisfied with the results of the operation except one patient [3%] who was complaining of recurrent attacks of anterior knee pain and effusion. There were no infection in any of our patients