comparison of using ketamine versus combination of ketamine and thiopentone in short painful procedures in pediatrics

Short painful procedures in pediatric age group like bone marrow aspiration [BMA] and biopsy taking are day case operations which demand rapid recovery and minimal incidence of postoperative complication. Objective: To compare between intra and prospective complications and the time of stay in recovery room for pediatrics undergoing short painful procedures under general anesthesia with either "ketamine and thiopental" or "ketamine alone" Patients and methods: This is a prespective randomized clinical trial done in children welfare hospital in medical city, Baghdad, Iraq, from august – November 2010 on 89 children patients who were scheduled for short painful procedures. All patients allocated randomly into 2 groups: the 1st group [KT] received I.V ketamine 1% [1mg/kg] plus I.V thiopental 1% 3-5 mg/kg [anesthetizing doze] on induction and maintained on intermittent I.V doses of thiopental 1% in case of need. While the 2nd group[K] received I.V ketamine 1% [1.5mg/kg] alone on induction and maintained on intermittent I.V doses of ketamine 1% [0.5 mg/kg] in case of need. any intra or postoperative complications and duration of recovery for all patients were recorded.Results: It was found that intraoperative complications [temporary and mild decrease in atrial O2 saturation and its associated breath holding and cough] occurred more in the KT group, while the occurrence of [mild involuntary movements and verbal responses] occurred more frequently in the K group the postoperative complications [nausea, vomiting, verbal hallucinations and dizziness] occurred only in the K group. The duration of recovery is more prolonged in the [KT] group. Conclusion: The use of combination of thiopentone and ketmaine is associated with more mold and temporary

role of intramuscular injection of methotrexate in the treatment of chronic idiopathic urticaria

Chronic idiopathic urticaria can be extremely disabling in it's severe form and may respond poorly to antihistamines or systemic corticosteroids, so immunomodulatory treatment had been tried for those severe cases. To determine the beneficial effect and safety of methotrexate in Chronic idiopathic urticaria patients compared with loratadine. Forty patients with severe Chronic idiopathic urticaria were included in this study. Twenty of these patients received methotrexate in a dose of 12 mg once a day/week IM injection, after performing baseline investigations. The other 20 patients received loratadine 10 mg orally once daily. Both groups were treated for 8 weeks and were followed up for 8 weeks after treatment. After 8 weeks of treatment there was a significant improvement in both frequency of episodes and duration of episodes in patients treated with methotrexate. At the end of treatment and after 8 weeks follow up assessment, patients treated with methotrexate showed a significant improvement regarding frequency of episodes [P value <0.0001] and duration of episodes [P value<0.0001] compared with those treated with loratadine. It is concluded that methotrexate was not only significantly more effective than loratadine in the treatment of chronic idiopathic urticaria but also had a significantly sustained effect after discontinuation of therapy

Coronary artery connection: cone trunk sharks varieties anatomy study (Selachians) / Conexión de la arteria coronaria: estudio de las variedades anatómicas del cono tronco en tiburones (Selachians)

Due to our interest in clarifying the congenic problems at the origin of the coronary arteries, we have published in the early 70´s a theory (Borges et al., 1974) in which the coronary arteries would be the last pair of aortic arches that, at the beginning of the embryogenesis, would be connected with the previous arch, trunk of the lung's artery through a duct which we named "ductus coronarius".

Debido a nuestro interés en aclarar los problemas congénicos en el origen de las arterias coronarias, hemos publicado a principios de los años 70 una teoría (Borges et al., 1974) en que las arterias coronarias serían el último par de arcos aórticos que, en el comienzo de la embriogénesis, estarían conectadas con el arco anterior, tronco de la arteria pulmonar a través de un conducto que hemos llamado "conducto coronario".

Sexually transmitted disease prevalence in brothel-based commercial sex workers in Chiang Mai, Thailand: impact of the condom use campaign.

One hundred and ninety five (195) brothel-based commercial sex workers (CSW) in Chiang Mai, Thailand, were screened for sexually transmitted disease (STD) between October 1994 and April 1995, prior to their enrollment in a multi-center comparative trial of the effectiveness of two strategies using male and female condoms. These CSW had a mean age of 22.2 (SD 4.3) years. Forty-seven per cent were Thai and 57.4 per cent had no formal education. Median duration of prostitution was 16 months and median cost for sexual service was 50 baht (US$ 2) per client. Ninety-four per cent of CSW reported always using condoms with clients. There were 63 (32.3%) CSW infected with at least one type of the STD screened. The prevalence of STD included chlamydial infection (16.9%), gonococcal infection (14.4%), condyloma accuminata (4.6%), moluscum contagiosum (2.6%) and trichomoniasis (1.0%). There was no statistically significant risk factor for STD found in this study. Despite an active programme for prevention of STD in CSW and the provision of free condoms, STD were diagnosed in one-third of the screened CSW in Chiang Mai. The programme needs to be strengthened by more intensive education and practice in the correct and consistent use of condoms and integrated with other STD prevention programmes.