Fulminant hepatic failure

Fulminant hepatic failure is a devastating disease occurring as a complication of various forms of liver diseases in both children and adults. The objectives of this article is to update the knowledge of physicians, on the most important and recent advances related to this condition with the ultimate goal of improving patient care

Chronic diarrhea in children part I Physiology, pathophysiology, etiology

Chronic diarrhea is an important cause of morbidity and mortality in children. Although the pattern of the problem is well established in Western countries, limited data are available from Saudi Arabia. The purpose of this review is to provide an updated overview of the physiology of digestion, pathophysiology and etiology of diarrhea with particular emphasis on patterns prevalent in Saudi Arabia

Chronic diarrhea in children part2 clinical approach and management

Chronic diarrhea is a complex symptom. The clinical approach and management should be based on pathophysiologic considerations and stepwise laboratory investigations. In infants with severe malnutrition, nutritional support is a priority in the management of this condition

Gastroesophageal reflux in infants and children

Gastroesophageal reflux is a common disorder in infants and children worldwide. This paper is intended to provide updated information on various aspects of the disease. It is hoped that this review will increase awareness and stimulate research in this field

Chronic constipation in children in the Eastern Province

This paper reports on 42 children presenting with chronic constipation during a 5-year period. The majority of the patients [90%] were Saudi nationals, and the male-to-female ratio was 1.6 to 1. This symptom started in the first year of life in 86% of the patients, and the duration ranged from 1 month to 7 years. Functional constipation was the most common diagnosis [64%], followed by aganglionosis of the colon, congenital anal stenosis and anal ectopia. Barium enema was not found helpful in screening for aganglionosis. The results of treatment were excellent in nine patients [21.4%], good in 21 [50%], poor in six [14.3%], and six patients [14.3%] were lost to follow-up. This report emphasizes the need for further prospective studies of all aspects of chronic constipation in childhood

Problems in organizing therapeutic drug monitoring: a practical experience in the Eastern Province

A therapeutic drug monitoring [TDM] service was organized and conducted on an experimental basis between February 1984 and April 1985 to identify practical problems and pitfalls associated with the implementation of such services. Six drugs were selected for monitoring and 433 samples were received and analysed. Analysis of drug assay requests shows that information related to drugs and to patients was frequently not recorded by the requesting physicians thus interfering with the accurate interpretation of results. A high percentage of subtherapeutic theophylline levels [87.1%] was found but there was no relationship between the reasons for requesting blood levels for digoxin and Phenobarbital and the actual levels of these drugs. For digoxin and Phenobarbital selective monitoring identified 32.8% and 29.1% abnormal results respectively. We conclude that TDM in practice is a complex task requiring a multidisciplinary approach. Involvement of clinical pharmacologists or clinical pharmacists as part of the medical team should help avoid many of the problems reported in this study