Medicinal and biological values of Callistemon viminalis extracts: History, current situation and prospects

Callistemon viminalis (C. viminalis) is a plant that has been reported to have various medicinal values such as antibacterial, antifungal, antioxidant activities and other pharmaceutical and insecticidal properties. This review covers the potentials, applications and properties of different extracts from different parts (branches, flowers, fruits, bark, leaves) of C. viminalis. Furthermore, the chemical structures of the bioactive compounds were reported for biological activities. All the results supported the traditional uses of C. viminalis in folk medicine. In addition, some researches supported the use of C. viminalis extracts for the preparation of metal oxide nanoparticles.

Medicinal and biological values of Callistemon viminalis extracts: History, current situation and prospects

Callistemon viminalis (C. viminalis) is a plant that has been reported to have various medicinal values such as antibacterial, antifungal, antioxidant activities and other pharmaceutical and insecticidal properties. This review covers the potentials, applications and properties of different extracts from different parts (branches, flowers, fruits, bark, leaves) of C. viminalis. Furthermore, the chemical structures of the bioactive compounds were reported for biological activities. All the results supported the traditional uses of C. viminalis in folk medicine. In addition, some researches supported the use of C. viminalis extracts for the preparation of metal oxide nanoparticles.

Some studies on heavy metal affecting wild catfish in different regions in Egypt

Fish is considered one of the most important sources of animal protein in I3gypt due to the extreme need for sources of animal proteins particularly with the gradual increase of the population. In this sjudy about 200 catfish were collected from four different canals [El Maruttia, Hi Mansouria, El Ismailia and El Khanater] of the metropolitan area of Cairo include [Cairo - Giza - Kalyobia] in Egypt. The results of this study point to the existence of a significant differences in the concentrations of copper, iron, zinc, chromium, nickel, lead, cadmium and mercury in the muscles of catfish among all the groups of the study. In a comparison between all the groups of the study for iron [Fe] levels in muscles of the catfish [males and females] it was found that 100% of the fish in El Maryottia canal have concentrations of iron higher than allowed levels, with regard to the copper [Cu] it was found that its levels in the muscles of fish collected from El Maruttia [males and females] were higher than admissible limits us the following [19.16, 21.28] microg / g, respectively, while samples from all the other places such as El Mansouria, El Ismailia, El Khanater were contain different concentrations of copper, but within the permissible levels either in males or females .With reference to lead [Pb] it was found in all the muscles of catfish from all canals with rate 100% higher than the permitted level? except for El Khanater its levels in muscles were within the permissible limits, but lead was found in the liver samples of all groups from all canals. For mercury [Hg] it was noticed that the muscles of catfish collected from El Maruttia canal and El Mansouria contain a higher concentrations than the allowed levels. Also the results of this study refer to presence of significant differences in the concentrations of [iron, copper, lead and mercury] in between the liver samples of catfish from different groups of the study

incidence of a fourth canal in maxillary and mandibular first molars in a group of Jordanians: a clinical study

The aim of this study was to clinically investigate the incidence of a fourth canal in maxillary and mandibular first molars in a group of Jordanians while carrying out routine endodontic practice without using any magnification or special lighting conditions. Three hundred ninety nine patients were referred to the conservative clinic at Princess Aysha Bint Al-Hussein Medical Complex for endodontic treatment of maxillary or mandibular first molars from November 2008 till May 2009. Preoperative radiographs were taken for evaluation. The teeth included in the study were both clinically and radiographically examined for the number of root canals. A total of 399 patients [216 female and 183 male] were treated at the conservative clinic. The mean age of patients was 28.23 years, ranging from 13.0 to 66.0 years. Out of 399 teeth treated endodontically, 195 [48.9%] were maxillary first molars and 204 [51.1%] were mandibular first molars. Forty five teeth [23.08%] out of the 195 treated maxillary first molars had second canal [Mb2] in the mesiobuccal root; all the distobuccal and palatal roots had a single canal. Regarding the mandibular first molars out of the 204 treated teeth, 99 teeth [48.5%] had 4 canals; two mesial and two distal canals.A fourth canal was found in about 23% of maxillary first molars and in about 49% of mandibular first molars. There is no consistency in the incidence of extra canals. This may be due many variations including the study design, the method of canal identification and the racial variations

Role of novel cardiac biomarkers in prediction, diagnosis, and severity assessment of atherosclerotic coronary artery disease

Atherosclerotic cardiovascular disease is a major health problem around the world. Insulin resistance assessed by homeostatic model assessment of insulin resistance [HOMA-IR], triglyceride/ HDL, serum high sensitive C-reactive protein [hs-CRP], and HbA1c are probably associated with atherosclerosis. The aim of this study was to find if there was an association between HOMA-IR, triglyceride/ HDL ratio and their product as well as hs-CRP and HbA1c with the presence and the severity of coronary artery disease and to find the best cut off value for clinical practice. The study involved 170 consecutive patients with suspected or known CAD referred for coronary angiography divided into two groups; CAD group [Group I] and non CAD group [Group II] based on coronary angiography. The blood samples including HbA1c, hs-c-reactive protein, fasting blood glucose creatinine, urea, insulin and lipid spectrum were obtained after overnight fasting. Patients with CAD had higher HOMA-IR than those no CAD [4.47 +/- 4.26 vs. 2.49 +/- 1.99, p=0.002]. Stepwise multiple logistic regression analysis demonstrated that HOMA-IR > 2.66 was independently associated with CAD [odds ratio: 3.057 ; 95% confidence interval: 1.211-7.717; p=0.018] after adjustment for age, male sex, diabetes and waist circumference. HOMA-IR correlates positively with BMI [p=0.008 and r=0.227], waist circumference [p=0.002 and r=0.267] and HbA1c [p=0.015 and r=0.213]. Also HOMA-IRxTG/HDL was higher in patients with CAD compared to those no CAD [18.35 +/- 22.72 vs, 9.50 +/- 10.50, p=0.018]. However there were insignificant differences in levels of triglyceride/HDL, HbA1c, and hs-CRP among both groups [p= 0.124, 0.523, 0.250 and 0.764 respectively]. HOMI-IR was significantly higher in patients with DVD [Double-vessel Disease] and MVD [Milti-vessel Disease] compared to patients with no CAD [p=0.002 and 0.000 respectively]. Moreover HOMA-IR was significantly higher in patients with DVD and MVD compared to patients with SVD [Single-vessel Disease] [P=0.035, 0.001 respectively]. HOMA-IR x TG/HDL was significantly increased in DVD and MVD patients [P=0.012 and 0.001 respectively] compared to patients with no CAD and also when compared to patients with SVD [P=0.005 and 0.000 respectively]. HOMA-IR is considered as a marker for prediction of CAD and severity assessment

Immunohistochemical expression of endothelin protein in oral squamous cell carcinoma.

Context: Endothelin-1 (ET-1) plays a signifi cant role in cancer biology and is considered as a potential target for molecular therapy. Alteration of ET-1 was detected in oral squamous cell carcinoma (OSCC). Aim: To evaluate the immunohistochemical expression and distribution of ET-1 in OSCC and to correlate its expression with the degree of histopathologic differentiation as well as the regional metastatic status of OSCC. Materials and Methods: The immunohistochemical expression and distribution of ET-1 was evaluated in total number of 30 cases of OSCC. The specimens were retrieved as formalin-fi xed, paraffi n-embedded blocks from the archival fi les. Detection of ET-1 expression in different grades of metastatic and non-metastatic OSCC was quantifi ed using an image analyzer computer system. Statistical Analysis Used: Statistical software package SPSS v. 19. Results: ET-1 immunoreactivity was observed in all studied specimens. On comparing optical density values for ET-1 expression in different grades of OSCC, poorly differentiated OSCC showed a signifi cantly greater expression than moderately differentiated OSCC, which was also signifi cantly greater than well-differentiated OSCC (P0.001). Moreover, ET-1 expression was higher in metastatic OSCC than that in non-metastatic OSCC (P0.018). Conclusions: Increased ET-1 expression could enhance the aggressive behavior of poorly differentiated OSCC, especially metastasis. Accordingly, ET-1 could be a therapeutic target in OSCC.

Evaluation of extracts and essential oil from Callistemon viminalis leaves: antibacterial and antioxidant activities, total phenolic and flavonoid contents

OBJECTIVE@#To investigate antioxidant and antibacterial activities of Callistemon viminalis (C. viminalis) leaves.@*METHODS@#The essential oil of C. viminalis leaves obtained by hydro-distillation was analyzed by GC/MS. Different extracts were tested for total phenolic and flavonoid contents and in vitro antioxidant (DPPH assay) and antibacterial (agar disc diffusion and 96-well micro-plates methods) actives.@*RESULTS@#Fourteen components were identified in the essential oil, representing 98.94% of the total oil. The major components were 1,8-cineole (64.53%) and α-pinene (9.69%). Leaf essential oil exhibited the highest antioxidant activity of (88.60±1.51)% comparable to gallic acid, a standard compound [(80.00±2.12)%]. Additionally, the biggest zone of inhibitions against the studied bacterial strains was observed by the essential oil when compared to the standard antibiotic (tetracycline). The crude methanol extract and ethyl acetate fraction had a significant antibacterial activity against the tested bacterial strains.@*CONCLUSIONS@#It can be suggested that C. viminalis is a great potential source of antibacterial and antioxidant compounds useful for new antimicrobial drugs from the natural basis. The present study revealed that the essential oil as well as the methanol extracts and ethyl acetate fraction of C. viminalis leaves exhibited highly significant antibacterial activity against the tested bacterial strains.

Reasons for extraction of primary teeth in Jordan -a study

The purpose of this study was to identify the causes of primary teeth extraction, and the most frequently extracted tooth among Jordanian children who were seen at pedodontic clinic at King Hussein Medical Center [KHMC] in Amman - Jordan. Two hundard fifty pediatric patients formed the study group. Their ages ranged from 3 to 13 years. They had one primary tooth extracted under local anesthesia. The reasons for extraction of teeth in these children seen over a period of 2 months and their ages, gender and the tooth extracted were recorded. The results revealed that the most common cause of primary tooth extraction was dental caries [57%] and the first primary molars were the most commonly extracted teeth [40%]. No gender, differences were noticed but there were obvious difference in age. In subjects [3-6] years, primary central incisors were the most common teeth extracted [54%], while in patients [7-9] and [10-13] years the first primary molars were the most common extracted [52% and 43%] respectively. The results of this survey indicated that dental caries was the leading cause of extraction of primary teeth in Amman - Jordan

Prevalence of new carious lesions among patients undergoing orthodontic treatment with fixed appliances

The development of new carious lesions is a significant clinical problem during orthodontic treatment. The aim of this study was to evaluate the prevalence of carious lesions, commonly presented as white spots [WSLs] on banded molars among patients undergoing orthodontic treatment with fixed appliances. In addition, the relation between prevalence and treatment duration was evaluated. Another aim was to investigate the relation between severities of detected WSLs and treatment durations. A study group of randomly selected 100 patients undergoing orthodontic treatment with fixed orthodontic appliances were examined for the presence of white spot lesions on banded molars. The examination was performed after removal of cemented bands. Direct visual examination was the detection method used. The study group patients were divided into three groups according to treatment duration. The detected white spot lesions were given four scores according to severity; zero, one, two and three. A control group of 100 patients who were referred for orthodontic treatment, but no treatment had started yet, were also examined for the presence of white spot lesions on molars to be banded. The results show that the overall prevalence of white spot lesions in the test group patients was 87%, while it was 18% in control group. Studying the relation between prevalence of WSLs and treatment duration show that prevalence was 74% for the first group with treatment durations less than one year, 85% for second group with treatment durations between one and two years, and 100% for the third group with treatment durations more than two years. A scoring system which consisted of 4 scores [from 0-3] was designed for the study according to white spot lesions depth. Score 0 was given when no WSL was detected, score 1 for detected WSLs with no hard tissue disintegration, score 2 for lesions with disintegration of enamel surface, and score 3 for lesions extending into Dentin. In the first group of the study group patients, 47% of the detected lesions had score of 1, 47% had score of 2 and 6% had score 3. In the second group: 63% of lesions had score of 1, 37% of the lesions had score of 2. In the third group 48% had score of one, 52% had score of two. Despite preventive measures improvements, development of white spot lesions is still a side effect that can't be ignored and should always be kept in mind by orthodontist before, during and after initiating orthodontic treatment with fixed appliances. Prevalence of WSLs on banded molars increased significantly among patients undergoing orthodontic treatment with fixed orthodontic appliances compared to control group. Prevalence of WSLs was highest when treatment duration increased for more than two years. No relation was found between severity or depth of WSLs and treatment duration

Comparison between blood smear, histidine-rich protein-2 immunochromatographic test [HRP2-ICT] and nested PCR in malaria diagnosis of clinically suspected cases, Jazan, KSA

Malaria is a major health problem. The efficacy of treatment depends on its early diagnosis using rapid effective diagnostic tests. Correct diagnosis is urgently needed to reduce mortality and morbidity and also to reduce wastage of costly drugs. Comparison of microscopic blood smear examination, with the P. falciparum histidine rich protein 2 immunochromatographic test [HRP2-ICT] and the nested polymerase chain reaction [PCR] in detection of malarial infection in clinically suspected patients. A total of 91 patients attending Jazan General Hospital, Jazan KSA, complaining of a short febrile illness or prolonged undiagnosed pyrexia were investigated for harboring malaria parasites by microscopic Giemsa- stained blood smears, HRP2-ICT and nested PCR. The diagnostic performance of these methods was calculated. Out of the 91 clinically suspected malarial cases, 23 [25.3%] were positive for Plasmodium infection using microscopy, while HRP2-ICT and PCR detected 25 [27.5%] and 29 [31.9%] positive cases, respectively. Patients diagnosed by PCR proved to be 27 [93.1%] P. falciparum-infected and 2 [6.9%] P. vivax-infected. The differences in detection rates of these diagnostic tests were statistically significant [P<0.001]. Sensitivities of PCR, HRP2-ICT and blood smears were 97%, 83% and 77%, respectively. The three methods gave a specificity of 100%. Additionally, HRP2-ICT proved to be more in accord with PCR [K;= 0.8 versus 0.7] than the blood smear. Clinical diagnosis of malaria should not be relied on. Using antigen detection tests and PCR techniques in addition to microscopic blood examination will help to diagnose malaria cases accurately

Congenital lobar emphysema: peri-operative evaluation and management

Congenital lobar emphysema [CLE] is one of congenital lung malformations and is characterized by overdistension and airtrapping in the affected lobe. It is one of the causes of neonatal and infantile respiratory distress. This study was performed on 10 children with congenital lobar emphysema with a age range from 2 days to 7 months. The age of the first presentation was the neonatal period. It is frequently diagnosed in males. Tachypnea and dyspnea were present in all cases. The diagnosis was confirmed by Chest x-ray and computed tomography of the chest. All patients underwent total lobectomy or segmental resection. All cases survived after operation without early or late post operative complication

Renewing of Ravitch approach for repair of pectus excavatum deformity: Surgical and anesthetic implications

Pectus excavatum is the most common chest wall deformity referred for surgical correction. As a congenital lesion, it is a highly visible anomaly and is easily diagnosed. Its anatomic severity can be readily assessed by visual measurement. Repair is undertaken to alleviate symptoms of pain, cardiac or respiratory compromise, as well as to diminish significant psychosocial consequences to a child or adolescent. Was to study results of renewing the standard surgical approach to the pectus repair based on the technique described by Ravitch. Several technical modifications in the operative procedure and perioperative management strategy were added. Two post-operative pain management techniques were used following the Ravitch repair of pectus excavatum: continuous intravenous opioid analgesia, and thoracic epidural analgesia using opioid and local anesthetic combination. This study included 15 patients [nine females 60% and six males 40%], their ages ranged from 8-13 years old with a mean of 10.6 +/- 2.7 subjected to pectus excavatum repair in the cardio-thoracic surgery department between 2001 and 2006. A limited transverse submamary skin incision with generous subcutaneous flap over the muscle fascia. Three to four sets of costal cartilages were removed to get optimal remodeling. The xiphoid process was detached from the sternum. An anterior wedge osteotomy was done using the redo sternal saw leaving the posterior table intact. Final stabilization was done using Kirshner wires mounted on drill, passing transversely under the lower segment of the sternum. Asymmetry can be easily dealt with by adjusting the angle of the osteotomy. Thoracic epidural catheter was routinely placed preoperatively by the anesthesiologist at the most appropriate level between T3 and T8, after induction of general anesthesia. No operative mortality or significant infra-operative morbidities were reported. Blood loss was minimal. Two children developed ileus. One patient had a wound infection that required incision and drainage. Seromas developed after discharge in two patients. All patients had extubated before leaving the operating room and were sent to the thoracic surgery ward after leaving the recovery room. Both regimens provided effective analgesia. A low morbidity with excellent short- and long-term results combined with a high level of patient satisfaction were achieved and should be the standard against which the Nuss procedure is compared. Indwelling epidural catheters placed at the time of surgery lead to smooth postoperative course. This strategy has greatly reduced the amount of narcotics required and allowed for more rapid mobilization

role of the subperiosteal hematoma in the management outcome of traumatic fractures of the nasal bone

The aim of this study is to show the importance of addressing the associated sub-periosteal hematoma in the management of acute nasal bone fractures whether or not associated with bone deformity. The goal in management is to perform a proper reduction early and right from the first time, and to prevent a residual SPH from organisation and resulting in nasal bone deformity. This is hoped to improve the results of management of acute nasal traumatic deformities avoid the need for a revision septo-rhinoplasty. A prospective study was none on a group of patients from the Hearing and Speech Institute where upon a technique was adopted to evacuate associated SPH with bone reduction of the fracture displacements. A control group of similsr cases was studies retrospectively from the patient records and the results were compared to the former group

Foreign body ingestion, an etiology for retropharyngeal abscess in diabetic patients

Pharyngeal abscess including Para and regtorpharyngeal abscess are potentially life-threatening conditions. A review in literature reveals that these infections are more prevalent and more complicated in patients with diabetes rnellitus and their management is more difficult with higher rate of mortality and morbidity. A prospective study on 4 cases during a 21 month period in Imam Khorneini Hospital in the Ahwaz city. Materials and methods: All diabetic patients suspected for retropharyngeal abscess were chosen and history, physical examination, type of antibiotics used, methods for surgery, and outcome were studied thoroughly. Foreign body ingestion is a common etiology for retropharyngeal abscess formation in diabetic patients. Vigorous antibiotic therapy with surgical drainage along with control of glycemic state is essential for successful treatment

role of bronchoscopy versus fluoroscopy in diagnosing persistent stridor in infants and children

Stridor is a high pitched respiratory sound usually inspiratory, but may be expiratory or biphasic produced by turbulent airflow due to partial airway obstruction at the level of the pharynx, larynx and/or trachea. Stridor can be classified into two types: acute stridor and persistent or chronic stridor. Evaluation of child with persistent stridor includes radiological assessment mainly plain X-ray and fluoroscopy. Direct visualization of the airway is often necessary to confirm the diagnosis and is essential in children with persistent stridor. The aim of this study was to determine the role of flexible fiberoptic and rigid bronchoscopy in comparison with fluoroscopy in diagnosing the site of partial upper airway obstruction in infants and children with persistent stridor. The study was conducted on 35 infants and children presented by persistent stridor. Fluroscopy and bronchoscopy [Flexible or rigid] were done for all the cases. The results obtained from fluoroscopy were compared to those obtained from bronchoscopy. The most common type of stridor was inspiratory in 80% of cases followed by biphasic stridor [11.4%], and lastly, the expiratory stridor [8.6%]. The most common cause of stridor in the studied group was Laryngomalacia in 17 cases [48.6%]. Flexible and rigid endoscopy were able to diagnose the site as well as the pathology in 35/35 of studied cases [100%]. Fluoroscopy delineated the site of obstruction in 4/35 cases [11.4%], two cases had external compression by vascular ring, one case of subglottic stenosis and one case with congenital tracheal stenosis. This study demonstrated the usefulness and safety of bronchoscope either flexible or rigid, in infants and children with persistent stridor. It usually provides rapid and precise diagnosis without significant complications. Diagnostic radiological modality as fluoroscopy needs more improvement. It may serve as a cost-effective screening tool in the evaluation of stridor in children, especially for lesions of the lower airway

Effect of three different methods in rewarming hypothermic postoperative patients

Hypothermia refers to core body temperature less than 36°C. It was reported that 60 to 80% of all postoperative patients suffered from hypothermia. Hypothermia has a profound effect on every body system and may result in life threatening problems if not recognized and treated promptly. The nurse has an important role in rewarming surgical patients immediately postoperatively. Many researchers found that there are different methods to warm surgical patients immediately postoperatively as radiation using infrared lamps, forced air warmer, and warmed blanket. Comparing between three different nursing methods in rewarming patients after major abdominal surgery. The study was carried out in surgical wards and recovery rooms at Alexandria Main University Hospital. A convenient sample of 60 adult patients was selected and assigned randomly to one of three experimental warming methods. Group I was assigned to extrablanket, group II was assigned to radiation, and group III was assigned to forced air warmer. In postoperative period, all patients in the three different groups were assessed every 5 minutes for core body temperature using tympanic thermometer until return to baseline temperature. The study revealed that the patients warmed with forced air warmer returned to baseline temperature in a shorter period than those who were warmed by the use of radiation or extrablanket. Statistically significant difference was found between the three groups. Rewarming is a priority in the immediate care of postoperative surgical patients because hypothermia may augment the risk of adverse outcome. Therefore, the importance of the use of forced air warmer, radiation using infrared heat lamps, or extrablanket should be emphasized in the postoperative period

Cervical lympho-venous shunt versus denver shunt in management of intractable ascites [analysis of 170 cases]

The present study was conducted on 170 patients with intractable ascites secondary to liver cirrhosis. The present study showed that both peritoneo-venous and lympho-venous shunts are technically simple procedures that could be done under local anesthesia in nearly similar time duration. However, Denver shunt is expensive, it costs between LE 4000-6000. Lympho-venous shunt is a biological cheap procedure. It can be concluded from this study that patients with intractable ascites could be offered surgical therapy with either shunts with a high success rate. Cervical lympho-venous shunt appears to be a simple, safe, cheap and effective method for achieving a long-term control of refractory ascites. The use of a biological shunt is an added advantage over prosthetic shunts for drainage of ascetic fluid with almost negligible complications. Failure does not interfere with the future use of the expensive peritoneo-venous Denver shunt. Denver peritoneo-venous shunt is a good device to relieve ascites, thereby reducing the risk of complications and the number of hospital admissions due to repeated paracentesis and consequently improving the quality of life. However, its high cost limits its wide scale application. A careful patient selection is mandatory for optimal results

Efficacy of preemptive, continuous, thoracic paravertebral nerves block with ropivacaine 0.5% in relieving post-thoracotomy pain

The purpose of our study was to evaluate the efficacy of preemptive, continuous paravertebral block to relief post-thoracotomy pain after open heart surgery. to help weaning from mechanical ventilation. Also, to study its effect on pulmonary function tests postoperatively, and any complication that occurs. Patients were classified into two groups, 20 patients each In the paravertebral group, 20 patients with paravertebral catheter inserted at the 4th thoracic space before induction of anesthesia. Postoperative pain relief was achieved by preemptive injection of 20 ml of 0.5% ropivacaine through the paravertebral catheter, followed by continuous infusion at a rate of 0.1 ml /kg/ hr of ropivacaine 0.5% during the perioperative period and 5 days postoperatively. In the control group, 20 patients were the postoperative analgesia was achieved by IM injection of 5 mg morphine 6 hrs starting at the end of the surgery and for 5 days postoperatively. In both groups, 20 mg pethidine was injected IV. if pain scoring was 3. postoperative data collected: time to extuhatlon when criteria for extubation were fulfilled. pain score [VAS] at rest, on coughing, respiratory rate. FVC. PEFR/6 hrs for 48 hours postoperatively, total dose of pethidine used and any untoward effects. Both groups were comparable as regard age, duration of CPB and duration of surgery, but the time from admission to ICU till extubation was significantly shorter in the paravertebral group than in the control group [4.8 +/- 3.3 hours vs 6.3 +/- 4.5 hours]. The visual analogue pain scores were significantly lower in both groups at all time of measurements compared to full recovery score both at rest and on coughing. The paravertebral group has significant lower VAS pain score when compared to the control group at all time of measurements. The pethidine consumption was significantly less in the paruvertehrul group throughout all the study period. The respiratory rate decrease insignificantly in paravertebral group compared to preoperative value. In contrast, the decrease in respiratory rate was significant in the control group. There was significant difference between groups with lower rate in the control group at 12 hours till 36 hours postoperatively. The FVC and PEFR decreased significantly at recovery when compared with the preoperative value in both groups and then gradually increased during the 48 hours postoperatively. After recovery which was comparble in both groups, both had significantly lower values in the control group compared to the paravertebral group. Oxmietre recordings were significantly better in the paravertebral group throughout the 5 days study period compared with the control group. After full recovery, no patient in either group had a sedation score >2 throughout the study time, although patients in the control group were significantly more sedated till the 4th day postoperatively than in the paravertebral group. Nausea and vomiting occurred more frequently in the control group [8/5 vs 2/2] [P< 0.05]. Hypotension, after weaning from inotropes occurred only in 2 patients in the control group [P> 0.05]. Urinary retention after removal of urinary catheter occurred more frequently in the control group [11 vs 2] [P<0.001].There was no difference between group in the duration of ICU stay [3.9 vs 3.1 days]. We concluded that continuous paravertebral block, beginning before operation was highly effective for post-thoracotomy pain. In this study, we found that paravertebral analgesia was superior in terms of analgesia, pulmonary function and side effects then IM morphine

Clinicopathological patterns and distribution of schistosomiasis in Asir Region

The objective of this study is to report, for the first time, the histopathologic pattern of Schistosomiasis from the Asir Region and to compare it to patterns reported from other regions of the Kingdom of Saudi Arabia. Several studies have reported the patterns of Schistosomiasis in other regions of the Kingdom of Saudi Arabia and other countries where Schistosomiasis is endemic. Schistosomiasis is endemic in certain areas of Asir region, however no data is available concerning the clinicopathological pattern of Schistosomiasis in the Asir Region. This is a retrospective analysis of 217 cases of Schistosomiasis from surgical and biopsy files of Asir Central Hospital during a period from January 1990 to October 1999. Our study revealed that Schistosomiasis was more common among the expatriate population of Asir Region than Saudi nationals residing in this area. The urinary tract was most commonly involved, and then in descending frequency came the vermiform appendix, liver and large bowel. These findings are somewhat different from those observed in the Riyadh Region where the vermiform appendix was the most commonly affected organ. Based on the histopathologic pattern, our study describes the pattern of Schistosomiasis in the Asir Region and may serve as a base-line for future research work