ABSTRACT
Objective: the hyoscine-n-butylbromide [Buscopan] is ought to be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, nonetheless, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment [if spotted early]. Openangle glaucoma is not affected by hyoscine
Purpose: the purpose of this study was to evaluate the use of hyoscine amid colonoscopists, with certain reference to glaucoma
Materials and Methods: a short questionnaire was electronically managed to members of the Saudi Society of Gastroenterology and the Association of Coloproctology of KSA. The use of Hyoscine among colonoscopists and the effect of glaucoma history upon the prescribing practice
Results: sixty-three colonoscopists responded to some or all of the questions. 41/61 [67.2%] of respondents claimed they were aware of the guidelines. 53/62 [85.5%] sometimes or always use hyoscine, while 9/62 [14.5%] never do. 45/59 [76.3%] always enquire about glaucoma history prior to administration, even though 48/58 [82.8%] make no differentiation between open-angle or angle-closure forms. 42/59 [71.2%] would [incorrectly] withhold hyoscine if the patient declares a history of any form of glaucoma. 46/59 [78.2%] do not substitute glucagon as an antispasmodic. 2/60 [3.3%] had encountered ophthalmic complications postadministration
Conclusions: current guidelines pertaining to hyoscine use and glaucoma are inappropriate. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms
ABSTRACT
Background: Management of small aneurysms regularly poses a therapeutic problem and surgical treatment or coiling can be considered as therapeutic choices. In the current study, we reviewed our series of ruptured small cerebral aneurysm preserved surgically
Materials and Methods:A total of 53 consecutive patients with ruptured small aneurysm were surgically treated between November 2014 and November 2016. Data were retrospectively collected. Procedure-related death and complications were systematically reviewed. Clinical outcomes were evaluated utilizing the Modified Ranking Scale. Neuroradiological follow-up was performed to evaluate aneurysmal occlusion and recanalization rate
Results: The mean aneurysm size was 2 mm +/- 0.7 mm. All the patients were operated and the aneurysm clipped. Clinical outcomes were as expected on the basis of the presenting Hunt and Hess grade. Generally, major and minor neurological deficit related to clipping were 5% and 3%, respectively. At the time of discharge, 85% of the patients presented with a favorable outcome, while 15% had poor clinical outcome. Aneurysm occlusion was achieved in all the cases. Neither recanalization nor re-aneurysmal rupture was observed in the clinical follow-up
Conclusion: Aneurysms, 3 mm in diameter or smaller, represent a therapeutic challenge. Given the proven role of microsurgery in small aneurysms and the perceived challenges with endovascular therapy, surgical clipping still can be considered an effective treatment modality in this setting