Evaluation of inhaler use techniques among asthmatic patients in King Faisal medical complex, Taif, Saudi Arabia

Background: Bronchial asthma is a prevalent health problem globally. Inhaled route is commonly used over other routes to manage asthmatic patients. Despite the efficacy of inhalers, the poor inhaler technique used by asthmatic patients leads to decrease drug delivery to lungs and poor asthma control

Objective: The main objective of this study was to evaluate the proper use of inhaler devices by asthmatic patients according to the standard recommended steps and to identify the factors related to the inaccurate or poor inhaler use among asthmatic patients at King Faisal Hospital in Taif, Saudi Arabia

Methods and Materials: This was a cross-sectional observational study conducted among Saudi asthmatic patients using inhaler devices and visiting out-patient's respiratory clinic. Patients were asked to use their inhaler devices and their inhaler technique and using a validated checklist. MDI, TurboHaler and Handihaler were the most commonly used whether alone or in combinations

Results: Around 74% and 92% responded to receive any education for asthma and asthma devices respectively. Of those who received any education, mostly reported that they received education about asthma and/or devices from their physicians. Breathing out, breath holding pattern and position of head during inhaling condition were three critical steps that led to improper use

Conclusion recommendation: Inhalation technique in asthma patients was unsatisfactory and was accompanied with errors, especially in patients with low education levels. This study suggested prioritizing and establishing the proper practice of inhaling devices to better manage asthmatic patients and quality of life

Cystic adenomatoid malformation in a young male adult with recurrent respiratory tract infections

We present a case of 26-year-old male with congenital cystic adenomatoid malformation. His medical history started after birth as recurrent respiratory tract infections and breathlessness during his infancy which persisted even after continued medical treatment. Cystic bronchiectasis of right lower lobe was suspected. On cross-sectional imaging at our hospital, congenital cystic adenomatoid malformation of right lower lobe was diagnosed. The clinical features, radiological characteristics, differential diagnosis and prognosis of the disease are discussed

Radiological feature of hepatic cirrhosis hepatitis "c" in Pakistan our experience at department of radiology, services institute of medical sciences

Objects: to evaluate the accuracy of liver fibrosis stage by utilizing the techniques of advanced ultrasound performance in patients with chronic liver disease with Hepatitis C

Material and Method: this cross-sectional study was prospectively designed by including 101 consecutive patients with a diagnosis of chronic liver disease including liver cirrhosis between January and December 2010. The ultrasound score was determined from both hepatic lobes and the average scoring was calculated for liver edge, liver surface and liver parenchymal texture. A score of O was given when no abnormality was observed; score 1 for mild abnormality; score of 2 for moderate abnormality; and a score of 3 for severe abnormality. Scoring was given for a blunted edge and severe irregular surface or a highly coarse texture only when these characteristics were clearly confirmed by the low frequency probe

Results: out of 101 subjects, 63.4 % were male and 36.6 % were female with age range of.23-70 years [mean age 50.73 years SD+/- 10]. 17.8 % subjects were between age group 20-40 years, 67 .3 % between age group 41- 60 years and 14.9 % between 61 years and above. Mean duration of illness was 2.86 years [minimum 1 year and maximum 15 years]. Mean liver size was 12.261 with SD+ 2.7145. Mean portal vein size was 1.662 SD+ 2.3247. Mean spleen size was 71.71 SD+ 32.226. 62.4 % had splenomegaly, 66.3 % had ascites, 56.4 % had bruising and bleeding, 62.4% had varices. 20.8 % had sharp edge 48.5 % had mildly blunted edge and 30.7 % had blunt edge, '11.9% had smooth edge. 33.7% had mildly irregular edge, 39.6 % had irregular edge and 14.9 % had highly irregular edge. Regarding liver parenchymal structure 13.9 % had fine, 22.8 % had mildly coarse, 48.5 had coarse and 14.9 % had highly coarse liver parenchymal. structure.15.8 % of subjects had mild fibrosis [score 0-2], 55.4 % had moderate fibrosis [score 3-5], 28.7 % had severe fibrosis [score 6-8]

Conclusion: US scoring system is clinically useful for differentiating patients with minimal or no fibrosis from those with mild to severe fibrosis. This is also useful for prognostic information and determining the optimal therapeutic options during the follow-up of chronic liver disease

CT findings of a giant retroperitoneal liposarcoma; our experience at services hospital, Lahore

Liposarcoma is the most common primary neoplasm of mesodermal origin derived from adipose tissue. It is a slow-growing tumor with a propensity to displace rather than invade adjacent structures. This article reports the CT findings of retroperitoneal liposarcoma in one patient. CT scan revealed a huge hypodense expansile mass lesion with multiple hyperdense septation inside it, giving a whorly appearance to the mass. The mass was having mainly fat [attenuation. The mass appeared to be extending from the under surface of right hemidiaphragm to the right iliac fossa. The mass displaced all the abdominal viscerae and major vessels to the left side of the abdominal cavity, origin being retroperitoneum with most probable epicenter in right renal fossa

Dysphagia as an unusual complication of pleural mesothelioma

Dysphagia is an unusual presentation of pleural mesothelioma and carries a grim prognosis. A case of an elderly patient is presented herein, in whom the diagnosis was confirmed histologically, and the patient was still surviving 6 months after palliation