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Objectives@#Fatigue is the most frequently reported symptom experienced by cancer patients and has a profound effect on their quality of life (QOL). The study aimed to determine the impact of fatigue on QOL among breast cancer patients receiving chemotherapy and to identify the risk factors associated with severe fatigue incidence. @*Methods@#This was an observational prospective study carried out at multiple centers. In total, 172 breast cancer patients were included. The Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire was used to measure QOL, while the Brief Fatigue Inventory (BFI) was used to assess the severity of fatigue. @*Results@#The total average mean and standard deviation of QOL were 84.58±18.07 and 4.65±1.14 for BFI scores, respectively. A significant association between fatigue and QOL was found in linear and multiple regression analyses. The relationships between fatigue severity and cancer stage, chemotherapy dose delay, dose reduction, chemotherapy regimen, and ethnicity were determined using binary logistic regression analysis. @*Conclusion@#The findings of this study are believed to be useful for helping oncologists effectively evaluate, monitor, and treat fatigue related to QOL changes.
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Objectives@#Fatigue is the most frequently reported symptom experienced by cancer patients and has a profound effect on their quality of life (QOL). The study aimed to determine the impact of fatigue on QOL among breast cancer patients receiving chemotherapy and to identify the risk factors associated with severe fatigue incidence. @*Methods@#This was an observational prospective study carried out at multiple centers. In total, 172 breast cancer patients were included. The Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire was used to measure QOL, while the Brief Fatigue Inventory (BFI) was used to assess the severity of fatigue. @*Results@#The total average mean and standard deviation of QOL were 84.58±18.07 and 4.65±1.14 for BFI scores, respectively. A significant association between fatigue and QOL was found in linear and multiple regression analyses. The relationships between fatigue severity and cancer stage, chemotherapy dose delay, dose reduction, chemotherapy regimen, and ethnicity were determined using binary logistic regression analysis. @*Conclusion@#The findings of this study are believed to be useful for helping oncologists effectively evaluate, monitor, and treat fatigue related to QOL changes.
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Objective: The purpose of this study was to evaluate the knowledge among dental students at King Khalid University, Jazan University, and Najran University in the kingdom of Saudi Arabia about when to repair or replace defective direct composite restoration. Materials and Methods: A questionnaire-based survey was formulated, pursuing the information about management (repair/replacement) of defective composite restorations and distributed among 200 dental students of three universities in the southern region of the kingdom of Saudi Arabia. The data were collected with the help of an online questionnaire. Data entry and the analysis were done using the statistical software package SPSS version 20.0. It was presented using descriptive statistics in the form of frequencies and percentages for qualitative variables, and range means and standard deviations for age, quantitative variable. Analytic statistics were done using Chi-Square tests (χ2) to test the significant difference between categorical variables. The level of significance, the p-value was 0.01(p<0.01). Results: The decision to choose between composite repair or replacement was influenced by whether this topic was taught to them at various undergraduate levels during Bachelor of Dental Surgery. The reason associated with the decision to repair defective composite restorations, 76% reported as cost-effective followed by Increased longevity (71%), the permanent filling (70%), patient's preference for repair (65%), and least time consuming (50%). 67% participants preferred significantly (p<0.001) repair due to secondary caries in the previously restored tooth with composite, followed by the small surface defect in a composite restoration (65%), risk of pulpal damage significantly (p<0.001) in a defective composite restoration (62.5%) and more invasive and destructive treatment option (35%). More than half of respondents 123 (61.5%) reported that they were not taught about composite repair during the Bachelor of Dental Surgery. Conclusion: It is suggested with the help of our study that didactic and clinical training components regarding composite repair should be seriously included in the teaching curriculum of dental institutions as it is in the best interest of the patient. Dental students should be provided with clinical training on this topic so that they can follow proper decision-making protocols available during repair or replacement of defective resin composite restorations. Other researches in the future can be carried out for refining the guidelines and techniques utilized for composite repair. (AU)
Objetivo: O objetivo deste estudo foi avaliar o conhecimento entre estudantes de odontologia da King Khalid University, Jazan University e Najran University, no reino da Arábia Saudita, sobre quando reparar ou substituir restaurações de resina composta direta defeituosas. Material e Métodos: Foi formulada uma pesquisa baseada em questionário, buscando informações sobre o manejo (reparo / substituição) de restaurações de resina composta e distribuída entre 200 estudantes de odontologia de três universidades da região sul do reino da Arábia Saudita. Os dados foram coletados com o auxílio de um questionário online. A entrada e análise dos dados foram feitas com o software estatístico SPSS versão 20.0. Foi apresentado por meio de estatística descritiva na forma de frequências e percentuais para as variáveis qualitativas, e amplitude de médias e desvios-padrão para a idade, variável quantitativa. A estatística analítica foi feita usando testes de qui-quadrado (χ2) para testar a diferença significativa entre as variáveis categóricas. Ao nível de significância, o valor de p foi de 0,01 (p <0,01). Resultados: A decisão de escolher entre o reparo ou substituição do compósito foi influenciada pelo fato de este tópico ter sido ensinado a eles em vários níveis de graduação durante o Bacharelado em Odontologia. O motivo associado à decisão de reparar restaurações de resina composta defeituosas, 76% relataram como custo-benefício seguido por maior longevidade (71%), restauração definitva (70%), preferência do paciente para reparo (65%) e menos demorado ( 50%). Sessenta e sete por cento dos participantes preferiram o reparo significativamente (p <0,001) devido a cárie secundária no dente previamente restaurado com resina composta, seguido pelo pequeno defeito de superfície em uma restauração composta (65%), risco de dano pulpar significativamente (p <0,001) em um restauração de resina composta com defeito (62,5%) e opção de tratamento mais invasiva e destrutiva (35%). Mais da metade dos entrevistados, 123 (61,5%) relataram que não foram ensinados sobre reparo de resina composta durante o Bacharelado em Odonotlogia. Conclusão: É sugerido com a ajuda de nosso estudo que os componentes do treinamento didático e clínico sobre reparo de resina composta devem ser seriamente incluídos no currículo de ensino de instituições odontológicas, pois é do interesse do paciente. Os estudantes de odontologia devem receber treinamento clínico sobre este tópico para que possam seguir os protocolos de tomada de decisão adequados disponíveis durante o reparo ou substituição de restaurações de resina composta com defeito. Outras pesquisas no futuro podem ser realizadas para refinar as diretrizes e técnicas utilizadas para reparo de resina (AU)
Subject(s)
Humans , Composite Resins , Dental Caries , PolymerizationABSTRACT
Introduction: Colorectal cancer (CRC) is one of the most common causes of cancer-related mortality. Previous studies conducted in Saudi Arabia and provided information about the current situation regarding CRC but still, no enough data was found about the elderly population. Objectives: We aim to evaluate the overall survival of advanced CRC patients in the elderly population and to assess treatment tolerance. Methods: We conducted a retrospective analysis for the medical records department at Princess Norah Oncology Center (PNOC), King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included patients treated at PNOC in the period between 2010 and 2015. Only patients aged above 70 years old with the advanced colon. Results: We included 57 cases with advanced colon cancer in our final analysis. For all the patients in this cohort study, the average age of diagnosis was 76.51 ± 9.28 years, and 71.93% were males. Overall 1-year, 2-year, and 5-year survival rates were 84.3%, 72%, and 54%, respectively. Survival analysis suggested surgical treatment, local radiation, younger ages, recurrent patients, female patients, and Non-mucinous Adenocarcinoma were associated with better survival. Multivariate Cox regression analysis showed that younger age (HR: 1.05, 95%CI=1.00-1.11, p-value=0.050), surgical treatment (HR: 0.15, 95%CI=0.04-0.60, p-value=0.007) and local radiotherapy (HR: 0.04, 95%CI=0.00-0.70, p-value=0.027) were significantly associated with longer survival. Newly diagnosed patients, males and mucinous adenocarcinoma were associated with shorter survival with no statistically significant difference. Conclusion: Survival rates among outpatients were higher than previous local studies. 5-year survival rate was 54%. Survival and regression analysis showed younger age, surgical treatment and local radiotherapy were significantly associated with longer survival.
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The main objective of the article is to provide the necessary awareness on decision making in order to support better patient care. The awareness is through advisory technique with more emphasis on practical application. The article has analysis of the opinions from experts on synthesis. More so, there is provision of better ways to clinical data feasibility, open forum consultations and surveys from experts on anesthesia. The main emphasize of the article is decision making in improvement of the patient care. Although advisories are important, the aim should always be decision making and the article focuses on practice in order to improve medical knowledge. The article gives an outline on additional measures to be taken to improve the medical practice according to Anesthesiology. The article emphasizes the advisory from the anesthesiologists and all the supporting physicians. In addition, there is also provision of advisory to individuals who administer general anesthesia. Review of the article on Metal-Analysis study has identified many characteristics of patients who have been associated with the risk of little awareness. The review has explained the procedures to be followed when dealing with situations of higher risks on intraoperative awareness. The anesthetic techniques on intraoperative awareness are also included in the preoperative awareness
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Background: In most developing countries, nutritional rickets is a major health problem. The aim of this study was to explore the magnitude of nutritional rickets among Saudi infants, and the various clinical presentations, as well as to address the possible operating risk factors behind the disease
Methods: Cross sectional study has been conducted among Infants, aged 4 - 24 months, who were seen and evaluated, at King Abdulaziz Hospital and Oncology center, pediatrics endocrine clinic in Jeddah - Saudi Arabia, during the period from January 2015 to December 2016, and confirmed to have rickets were included
Conclusion: Infants under 2 years of age are liable to have vitamin D deficiency and rickets, if they are exclusively breast fed and having inadequate exposure to sunlight. Delayed introduction of complementary foods and malnutrition are also important contributing factors in nutritional rickets. Vitamin D deficiency can present with variety of symptoms other than musculoskeletal symptoms like recurrent acute respiratory, diarrhea and seizures
Subject(s)
Humans , Male , Female , Infant , Infant , Cross-Sectional Studies , Vitamin D DeficiencyABSTRACT
Background: Obstructive Sleep Apnea [OS A] is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients' case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR. Methods: a systematic search in the scientific database [Medline, EMBASE, Google Scholer and Ovid] from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-control studies were analyzed and included based on the preset inclusion and exclusion criteria
Results: the search has yielded twelve studies to be included in the present SR [n = 206 patients, 34.4+/- 10.0 years and body mass index: 29.3 +/- 9.6 kg/m2] met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% [from 43.73 +/- 21.7 /hour to 13.7 3 +/- 12.7 /hour] [n - 198]. The AHI mean difference [MD] was -30.2 per hour [95% confidence interval [CI] -39.3, -21.1] [P value < 0.00001]
The AHI SMD was -1.37 [-1.65, -1.09] [large effect]. Lowest oxygen saturation improved from 77.7 3 +/- 11.9% to 85.5 3 +/- 8.2% [n = 186]. Lowest oxygen saturation MD was 8.5% [95% CI 5.2, 11.8] [P value < 0.00001]
The Epworth Sleepiness Scale decreased from 11.6 3 +/- 3.7 to 6.1 3 +/- 3.9 [n = 125]. Individual patient outcomes [n = 52] demonstrated an 85.2% success rate [AHI < 20/hour and > 50% reduction] and a 57.4% cure rate. Conclusion: tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity
Subject(s)
Humans , Female , Male , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Tonsillectomy , Airway Obstruction , Databases as Topic , Review Literature as Topic , Retrospective StudiesABSTRACT
BackgroundiDiabetic Ketoacidosis [DKA] is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided
Aim of the Study: was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department
Methods:A literature search was carried out on MEDLINE [including MEDLINE in-process], CINAHL,Embase and the Cochrane Library. Databases using [diabetic ketoacidosis] as a MeSH heading and as textword. High yield journals were also hand searched
Findings: The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment
Conclusion: Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It's therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit
Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition
Subject(s)
Humans , Adult , Diabetes Mellitus , Diabetes Complications/therapy , Insulin/therapeutic use , Hyperglycemia , Patient Outcome Assessment , Review Literature as TopicABSTRACT
Objective: The study seeks checking out the effectiveness of the proposed program for developing skill of leadership after being applied on students of preparatory stage
Method: It uses the experimental method by applying activities of a program for leadership skill
Sample: It consists of 20 [Male/ Female] students in preparatory schools, aged [13-15] year olds, divided equally into the control and the experimental groups, selected from Future Experimental Languages School, in Zaytoun district, Cairo governorate
Tools: IQ Pictured Test [1974] by Ahmed ZakiSaieh, The Socio-economic and Cultural Level Form, by Abdel Aziz El-Shakhs, Scale of Leadership Skill, by researcher, and Program of Developing Leadership Skill, by researcher
Results: The study checked hypotheses and extracted results which most important are: There are no significant statistical differences between average scores of males and females of the experimental groups regarding the post-application of the proposed program; while there are significant statistical differences between the two groups, the control and the experimental post-application of the proposed program, in favor of the experimental group
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Objective: To investigate the levels of zinc-α-2-glycoprotein (ZAG) among Omani AIDS patients receiving combined antiretroviral therapy (cART). Methods: A total of 80 Omani AIDS patients (45 males and 35 females), average age of 36 years, who were receiving cART at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, were tested for the levels of ZAG. In addition, 80 healthy blood donors (46 males and 34 females), average age of 26 years, attending the SQUH Blood Bank, were tested in parallel as a control group. Measurement of the ZAG levels was performed using a competitive enzyme-linked immunosorbent assay and in accordance with the manufacturer's instructions. Results: The ZAG levels were found to be significantly higher among AIDS patients compared to the healthy individuals (P=0.033). A total of 56 (70%) of the AIDS patients were found to have higher levels of ZAG and 16 (20%) AIDS patients were found to have high ZAG levels, which are significantly (P > 0.031) associated with weight loss. Conclusions: ZAG levels are high among Omani AIDS patients on cART and this necessitates the measurement of ZAG on routine basis, as it is associated with weight loss.
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Background: Hyperuricemia as an independent risk factor of cardiovascular disease or not is debated for years
Objective: To determine the association of high serum uric acid level with acute coronary syndrome [ACS]
Subjects and Methods: This was a case control study, conducted from 1[st] January to 31[st] August, 2014, in Department of Cardiology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. A total of 367 study subjects, with 193 patients taken as cases, having acute coronary syndrome [ACS], diagnosed and labeled after thorough relevant investigations and 174 controls do not having acute coronary syndrome, selected from accompanying attendants, were included in study. The variables included in study were age, sex, BMI, hypertension, smoking, serum cholesterol, HDL, LDL, triglyceride, serum uric acid level and disease status of ACS. Serum uric acid >7mg/dl in males and >6mg/dl in female was taken as high. Informed verbal consent was taken from all the cases and controls before including them in study. The data was entered and analyzed in SPSS version 16
Results: A total of 367 study subjects, with 193 patients having coronary heart disease and 174 controls do not having coronary heart disease, were included in study. The mean age of patients of ACS was 52 +/- 11 years, versus controls 47 +/- 15 years, 84% among patients of ACS versus 75% among control were male, BMI was 27 +/- 3 among patients of ACS versus 25 +/- 6 among control, HDL was 41.92 +/- 8mg/dl among patients of ACS versus 43 +/- 6mg/dl in controls, triglyceride was 172.68 +/- 98mg/dl among patients versus 168 +/- 78mg/dl in controls, LDL was 119 +/- 37mg/dl among patients versus 118 +/- 32mg/dl in controls, and serum uric acid was 6.1 +/- 1.2mg/dl among patients versus 5.1 +/- 0.3mg/dl in controls. Those who have ACS, 37.3% have high serum uric acid as compared to 24% among Non CHD subjects. [p-value 0.00]
Conclusion: This study showed that elevated serum uric acid level was statistically significantly associated with Acute Coronary Syndrome
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<p><b>OBJECTIVE</b>To investigate the levels of zinc-α-2-glycoprotein (ZAG) among Omani AIDS patients receiving combined antiretroviral therapy (cART).</p><p><b>METHODS</b>A total of 80 Omani AIDS patients (45 males and 35 females), average age of 36 years, who were receiving cART at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, were tested for the levels of ZAG. In addition, 80 healthy blood donors (46 males and 34 females), average age of 26 years, attending the SQUH Blood Bank, were tested in parallel as a control group. Measurement of the ZAG levels was performed using a competitive enzyme-linked immunosorbent assay and in accordance with the manufacturer's instructions.</p><p><b>RESULTS</b>The ZAG levels were found to be significantly higher among AIDS patients compared to the healthy individuals (P=0.033). A total of 56 (70%) of the AIDS patients were found to have higher levels of ZAG and 16 (20%) AIDS patients were found to have high ZAG levels, which are significantly (P>0.031) associated with weight loss.</p><p><b>CONCLUSIONS</b>ZAG levels are high among Omani AIDS patients on cART and this necessitates the measurement of ZAG on routine basis, as it is associated with weight loss.</p>
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Invasive pneumococcal disease [IPD] is associated with high case-fatality rates and serious chronic sequelae. The objective of this study was to assess the magnitude of invasive pneumococcal infections in a pediatric population without universal vaccination during childhood in a single hospital. Retrospective review of all pediatric cases of invasive pneumococcal infection during a 7-year period. We reviewed the microbiological and clinical records of cases of IPD in children <13 years of age admitted to the Armed Forces Hospital, Southern Region, Saudi Arabia. We identified 41 patients with IPD; 27 [66%] were <2 years of age. Four [50%] of those with pneumoccal meningitis were <2 years of age. The case fatality was 3 of 41 [7.3%] due to meningitis and 2 of 41 [5%] due to sepsis, with a case fatality of 5 [12%] due to meningitis and sepsis. Nine patients developed sequelae; of those with meningitis, 5 [73%] developed sequelae. Only 15 [41%] patients had predisposing medical conditions. The overall intermediate and high levels of pneumococcal resistance to penicillin and ceftriaxone were found to be 48.5%, 2.4% and 2.4%, 0%, respectively. None of the pneumococcal isolates were serotyped, and none of the patients had been vaccinated against pneumococcal infections in our hospital. Despite the presence of a targeted immunization program, a considerable number of cases of invasive pneumococcal infections were reported among our pediatric population over a period of 7 years. Prospective studies in serotypes and antibiotic resistance from the southern region are needed to provide baseline information for the formulation and evaluation of a national prevention and control program
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To evaluate the effectiveness of capsule endoscopy in the management of patients with obscure gastrointestinal bleeding. A prospective descriptive study was conducted at surgical unit IV, Civil Hospital Karachi over a period of 2 years from December 2007 to November 2009. Twenty eight consecutive patients presenting with obscure gastrointestinal bleeding were included in the study. Patients having history of acute intestinal obstruction were excluded. Study was approved by the hospital ethical committee. Informed and written consent was taken from all the patients included in the study. The procedure was performed as day case. Patients were asked to swallow a capsule with a glass of water after an overnight fast and bowel preparation. Endocapsule [Olympus MAJ-1469] was used in the study. Examination was termed as complete when the capsule reached the caecum or incomplete if capsule failed to enter the caecum or the battery life was exhausted. Computer recordings were read by two examiners and finally results were interpreted. Follow up was done on telephone every 24 hours till the passage of capsule and then monthly for 4 months. In case of failure to pass the capsule after 14 days or adverse effects like vomiting, abdominal pain, an abdominal radiograph was obtained and decision regarding surgical intervention was made. A total of twenty eight patients were included in this study, 15 [53.6%] males and 13 [46.4%] females. Age of the patients ranged from 15-85 years [mean 56.25 +/- 19.6 years]. There were 8[28.6%] diabetics, 8[28.6%] hypertensives and 5[17.9%] hepatitis C positive patients. The indication for the capsule endoscopy was malena in 9 [32.1%], occult bleed in 18 [64.3%] and non specific abdominal pain in 1[3.6%]. Examination was completed in 22/28 [78.6%] patients while 6 [21.4%] patients had incomplete examination. In 2/28 [7.1%] patients endoscopic assistance was required to push the capsule through the pylorus. There was history of abdominal surgery in 3/28 [10.7%] patients prior to capsule endoscopy. Capsule entrapment occurred in 2/28 [7.1%] patients who were subjected to surgery. The results of capsule endoscopy showed ulceration and bleeding in distal ileum in 7 patients followed by Arterio Venous Malformation in 6 patients. The management and follow up was done accordingly. The diagnostic yield of CE in this study was 64.28% [18/28 patients].In a total of 28 patients referred for capsule endoscopy, bleeding was resolved in 13 patients [46.42%]. Capsule endoscopy is a well tolerated and safe examination of the small bowel with a diagnostic yield superior to radiological investigations
Subject(s)
Humans , Male , Female , Aged , Adolescent , Adult , Middle Aged , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/therapy , Prospective StudiesABSTRACT
To evaluate the effectiveness of endoscopic balloon sphincteroplasty as an adjunct to endoscopic sphincterotomy in removing large and difficult bile duct stones. A prospective non-randomized descriptive study was conducted at the Endoscopic Service of Surgical Unit 4, Civil Hospital Karachi over a period of 2 years from February 2007 to January 2009. A total of 84 patients where the biliary calculus was either greater than 15mm or difficult to remove with standard techniques underwent ERCP with endoscopic sphincterotomy and balloon sphincteroplasty. Patients with diagnosis of cholangitis or "pancreatitis were excluded from the study. Endoscopic balloon dilatation was performed after standard sphincterotomy by using standard 15-18mm Controlled Radial Expansion [CRE] balloons. All procedures were done as day case under conscious sedation. There were 18 [21.4%] male and 66 [78.6%] females. Age of the study population ranged from 16-85 years with a mean of 48.38 +/- 17.07 years. The size of the stone ranged from 10-32mm with a mean of 14.7 +/- 0.44mm. Stones were removed with sphincteroplasty in first session in 52/84 [61.9%] patients, 11/17 [64.4%] patients in the second session and 4/4 [100%] in the third session. Patients who were lost to follow up were 14[16.7%]. Surgery was advised for 2 [2.4%] patients because of failure to remove stones by sphincteroplasty. Overall success of endoscopic sphincterotomy and large balloon dilatation in our study was 79.76%. Complications were seen in seven patients [8.3%] while one [1.2%] died. Bleeding was encountered in 3 [3.6%] patients which was controlled by adrenaline injection in 2 patients while one patient died due to severe haemorrhage before any surgical intervention could be undertaken. Moderate pancreatitis necessitating admission was seen in 3 patients [3.6%]. None of the patients had severe pancreatitis or perforation secondary to the procedure. Large balloon dilatation along with endoscopic sphincterotomy is a simple, safe and effective technique in removing large bile duct stones, in patients with distal common bile duct narrowing or in whom the size of stone is greater than the size of common bile duct with a complication rate if not less equal to that of endoscopic sphincterotomy alone
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Sphincterotomy, Transduodenal , Sphincterotomy, Endoscopic , Treatment Outcome , Prospective StudiesABSTRACT
Hypertension is common chronic disease, its prevalence increases with age, the goal of treating hypertension is to control blood pressure below the target level [140/90 mm Hg]. Poor or non compliance is one of the biggest and modifiable obstacles in controlling high blood pressure. Descriptive study was conducted on a 418 hypertensive patients at Ali Kamal consultation clinics in Suliamania city, from 3[rd] May 2008 to 2[nf] July 2008. During interview questionnaires were used to evaluate patient's compliance. SPSS version 13 was used for analysis. In studied sample [30.4%] were males and [69.6%] were females, the mean age +/- SD [58 +/- 10]. Compliance to antihypertensive treatments was [58%], Fair compliance [30%], and poor compliance [12%]. Significant association [P<0.05] were found between good compliance and older age, Unemployed 353 [84.4%], longer duration of hypertension 221[52.9%], doing follow up in private clinics 37[69.8%], Depending on both Governmental and private pharmacy to get medications 206[52.4%], knowledge of patient and home blood pressure checking 90[73.2%]. While gender, illiterate 263[62.9], medium economic state 294 [70.3], positive family history of hypertension 250[59.8], No previous hospital admission 261 [62.4] and number of prescribed drugs do not affect compliance [P>0.05]. Younger age, poor hypertension awareness and employment adversely affect compliance to antihypertensive medication. Regular blood pressure checking in-creases compliance, while numbers of drugs and gender not affect compliance rate
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Cytomeglovirus [CMV] is a common viral infection globally. Although most infections are subclinical; infection during pregnancy may be associated with serious outcome such as abortion, stillbirth and congenitally malformed child. During the period from June to July 2003, 250 subjects [150 blood donors and 100 women presenting to Khartoum Teaching Hospital's and Omdurman Maternity Hospital respectively] had their blood tested for IgG antibodies against Cytomegalovirus using ELISA test. Of these 84% were found to harbor Cytomegalovirus antibodies. The seroprevalence of the virus was higher in the antenatal women [95%] compared to the blood donors [77%]. The study revealed insignificant association between infection with the virus and both history of previous surgical operation and blood transfusion [p > 0.05]. CMV infection was found to be associated with increased risk of abortion in women under study
Subject(s)
Humans , Female , Cytomegalovirus Infections , Prevalence , Blood Donors , Seroepidemiologic Studies , Immunoglobulin G , Enzyme-Linked Immunosorbent Assay , Pregnancy Complications, Infectious , Pregnant Women , Prenatal Care , Congenital Abnormalities , Abortion, Spontaneous/etiologyABSTRACT
A14 years old child with the diagnosis of [PAR] was followed for one year in a primary care setting at the periphery of Makah holy city. [PAR] mini-clinic was prepared and the staffs were trained on the use of communication and education skills [CES] on [PAR] patients. The team diagnosed [PAR] depending on the presence of four cardinal symptoms which are [sneezing, nasal itching, rhinorrhea and blocked stuffy nose] plus the chronicity of the problem. The child and his parents [CHP] concerns, misbelieves plus the cost of the drugs and mite covers were the main areas of visits. [PAR] management outcomes were the clinical improvement in the child four cardinal symptoms, the triggers avoidance, the nasal spray compliance and technique and the [CHP] knowledge. These outcomes were followed in each visit which has improved a lot at the end of the year. The aim of this case report is to show the beneficial effects of using [CES] on [PAR] management outcomes. To my knowledge this is the first case report in the literature
Subject(s)
Humans , Male , Test Taking Skills , Chronic Disease , CommunicationABSTRACT
Ventricular arrhythmias [VAS], including ventricular tachycardia [VT], ventricular fibrillation [VF] and Brady-arrhythmias, are life-threatening complications of acute myocardial infarction [MI]. To study the incidence of ventricular arrhythmias, brady-arrhythmias and Sudden Cardiac Death [SCD] in Sudanese patients with acute MI. This is a prospective cross sectional, hospital based study, conducted at Elshaab Teaching Hospital Khartoum Sudan. One Hundred Sudanese patients with acute MI were enrolled in the study in the period between August 2006 and December 2006. A questionnaire was constructed in sections to address the different aspect of the study group. ECG Monitor was used to confirm the complication in every patient. Of the study group forty seven [47%] patients were 55-65 years old, twenty eight [28%] were more than 65 years old and twenty five [25%] were less than 55 years old. Sixty nine [69%] were males. Twenty patients [20%] developed complications [ventricular arrhythmias [VAS], Brady-arrhythmias and SCD]. The incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death following acute myocardial infarction were significantly high in Sudanese patients. The increased incidence is even in all age groups. DM, smoking and past history of IHD are the commonest associated risk factors. Thrombolysis is under used and had no significant impact
Subject(s)
Humans , Male , Female , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires/statistics & numerical data , Electrocardiography/statistics & numerical data , Thrombolytic Therapy/statistics & numerical data , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/epidemiology , Bradycardia/etiology , Bradycardia/epidemiology , Ventricular Fibrillation/etiology , Ventricular Fibrillation/epidemiology , Tachycardia, Ventricular/etiology , Tachycardia, Ventricular/epidemiology , Smoking/complications , IncidenceABSTRACT
To evaluate the presentation, staging and histology of carcinoma breast patients admitted over a period of five years A retrospective analytical study was conducted at surgical unit two, Civil Hospital Karachi over a period of five years from October 2001 to October 2006. Eighty five female patients with biopsy proven carcinoma breast admitted and operated, were included in the study. 43.5% patients were under the age of 45 years. 4.7%had family history, 49.4%were premenopausal, none had history of oral contraceptive intake. 84.7% had breast fed their siblings, 12% were nulliparous. 29.4% had skin involvement at presentation; nipple retraction was seen in 23.5%. 90.5% had infiltrating ductal carcinoma with 58.8% having histological involvement of axillary lymph nodes. 50% had stage 3 and 41% stage 2 cancers. The risk / predisposing factors for carcinoma breast were not significantly present in our study population. Most of the patients at presentation had stage two and three carcinoma, with the predominant cancer type being infiltrating ductal carcinoma