2009 H1N1 influenza A in children: a descriptive clinical study

The 2009 H1N1 was a new influenza virus causing illness in people. Especially those younger than 5 years of age and those who have high-risk medical conditions are at increased risk for influenza-related complications. In the present study, we describe the clinical presentation of the H1N1 cases attending Jeddah Clinic Hospital-Al Kandarah [JCH-K] in the time period from October 2009 to January 2010, and identified the high-risk age groups. Prospective study at JCH-K from October 2009 through January 2010. All pediatric patients [up to 15 years old] presenting with influenza-like illnesses in the clinics during the specified period were clinically examined and tested using reverse transcriptase polymerase chain reaction. Only confirmed H1 N1 cases were included in the study. Over a 4-month period, 89 cases of laboratory-confirmed H1N1 were reported in JCH-K. Thirty-four patients [38.2%] were younger than 5 years of age. Forty-six [51.6%] cases were males. Thirty-three cases were Saudis [37.1%]. The most commonly reported symptom was fever, which was noted in all cases. Twenty-eight cases [31.5%] had pneumonia. Fourteen cases [15.7%] were known asthmatics. Fifty-two [58.4%] cases were lymphopenic and 32 [35.9%] cases were leucopenic. Sixty-five [73%] patients were hospitalized, and five of them were treated in the intensive care unit. Even though the majority of cases of the 2009 pandemic influenza A H1N1 were mild, a severe disease does occur in children. In view of delayed PCR results, clinical presentation and lymphopenia were used as diagnostic criteria to start antiviral treatment as early as possible. No deaths were attributed to the 2009 pandemic

value of ultrasonography and fluorescein fundus angiography in the differential diagnosis of optic nerve head oedema

Fifty six eyes with optic nerve head oedema were studied. Since all cases had clear media, fluorescein fundus angiography and coloured fundus pictures were taken; ultrasonography as well as performed. Cases included pleuro-cephalic oedema, acute anterior ischemic optic neuropathy, acute hypotony due to trauma or uveitis, acute papilHtis and giant drusen. Ultrasonography could only confirm the clinical differential diagnosis in cases with giant drusen while could not differentiate between other cases which gave same pictures. On the other hand, fluorescein fundus angiography differentiated only acute anterior ischaemic optic neuropathy from other lesions

Evaluation of adhesive N-butyl-2-cyanoacrylate for recurrent pterygium

The study was carried on 40 surgeries which were done for recurrent pterygium. The following different techniques of N-butyle-2-cyanoacrylate application were used a. Limbo-scleral for 15 eyes b. scleral application for 15 eyes. C. No adhesive substance was used in the last 10 eyes as a control. The recurrence rate was high in the cases in which we did not use the adhesive substance. With the adhesive substance the incidence of recurrence was less with the cases of multiple application technique and for 14 days duration

Corneal astigmatism after glaucoma surgery

Different techniques of subscleral trabeculectomies were done, using different shapes of scleral flaps, in comparison with peripheral iridectomy, and iridenecliesis to study the incidence of postoperative astigmatism, in glaucoma surgery. The incidence of corneal astigmatism was lower in peripheral iridectomy and subscleral trabecuIectomies, specially triangular flaps, in comparison with iridencleisis

Tarsal reconstruction

A new operation for vertically short upper lid is dissuced. Twenty one upper lids from 16 patients were operated upon, five were bilateral and 11 unilateral. All lids showed marked vertical shortening, 17 had acccompanying ectropion trichiasis which becomes worst on looking upward, 5 had moreover notching of lid margin. All cases had been subjected previously to surgical interferences, before presentation with heir conditions. The cause of this lid disorder is fully discussed. Its repair was achieved by tarsal reconstruction using cartilage grafts, fresh and stored. The technique of surgical proceedure is explained and results are discussed

Superficial scleral flaps in subscleral trabeculectomy

Different shapes of the scleral flaps were used for 60 trabeculictomies; It was triangular in 20, rectangular in 20 and semicircular in 20 eyes. We have obtained favourable results with triangular and rectangular flaps, however the triangular design of the flaps may assist more the good alignment, formation of a posterior diffuse bleb, which is less liable to complications as delayed anterior chamber formation, infection, and perforation