Aspirin resistance in patients undergoing coronary artery bypass grafting

Aspirin is a very common drug used after coronary artery bypass grafting. Significantly it is known to reduce mortality and the rate of ischemic complications after CABG. Resistance to Aspirin is a well known entity and has a great influence on clinical outcome. Our study will investigate the phenomenon of aspirin resistance in our patients that underwent coronary artery bypass surgery. In a prospective controlled study 100 patients undergoing coronary artery bypass grafting [CABG] were included to investigate their sensitivity to Aspirin using platelets aggregometry study. Patients were followed up after one year to show their clinical outcome. 25 patients [25%] showed normal reaction to Aspirin [sensitive to treatment]. 24 patients [24%] were preoperatively resistance to Aspirin and 51 patients [51%] developed this resistance postoperatively. The use of cardiopulmonary bypass, pump time and type of procedure showed no influence on the resistance rate. The one year follow up showed 5 deaths in the group of patients that developed the resistance preoperatively whereas resistance disappeared completely after one year in the perioperative resistant group. Aspirin resistance occurs in a large portion of patients that undergo open heart surgery for coronary artery bypass grafting. It doesn't appear to last permanently but rather for a brief period. The worse outcome for patients with Aspirin resistance could be assumpted by the increase mortality in this group

Use of neck advancement techniques for reconstruction of mild to moderate neck and lower face post-burn scars

To investigate our experience with "Neck Advancement" as a useful technique in late reconstruction of some neck and lower face post-bum scars in addition to evaluate the limitations and complications of this technique. During the period between 1999-2006. A total of 110 "Neck Advancement" procedures were performed on 57 patients with mild to moderate neck and lower face scars at the Royal Jordanian Rehabilitation Center. Forty one of these 57 patients had previous scar revisions or serial excisions ranging from 1-6 procedures per patient prior to the neck advancement. The medical records, pre- and postoperative photographs of these patients were retrospectively studied in terms of age, gender, cause of bum, duration since the acute burn, previous attempts at reconstruction, indications for surgery, results, and postoperative complications. The range of neck advancements was 1-4 procedures per patient. The overall post operative improvement was good in 45 [79%] patients, satisfactory in 9 [16%] patients, and poor in only 3 [5%] patients. There were a total of 13 complications among our group of patients. Apart from simple wound problems related to this technique, the main complication was facial or neck asymmetry, a pseudo-torticollis that tends to occur with unilateral advancements. We found this technique useful in the late reconstruction of a large number of patients with mild to moderate facial and neck bums. It is easy, quick, repeatable and convenient to the patient with a low frequency of complications. It is an additional technique to the armamentarium of the reconstructive surgeon to deal with such difficult burns. It has limitations and is not suitable for the more extensive neck bums

Cutaneous myiasis among Jordanian soldiers in Sierra Leone

To highlight the routes of infection for cutaneaus myiasis in order to prevent it among Jordanian soldiers in Sierra Leone. A prospective study of 793 Jordanian soldiers among the United Nations Mission in Sierra Leone was conducted, over a five-month period [May-September 2000]. A questionnaire outlining the major predisposing factors for cutaneous myiasis [an endemic tropical disease] was filled in by all soldiers. A total of 87 patients out of the 793 soldiers were infested with cutaneous myiasis [11%]. The major predisposing factors for cutaneous myiasis were: Drying clothes on sandy ground and tents keeping them exposed for a long time, wearing incompletely dried clothes, not ironing clothes before wearing them, hanging clothes in shaded areas not exposed to bright sunlight properly and wearing them immediately within 24 hours of drying. Cutaneous myiasis is a communicable tropical disease. It could be easily prevented without systemic consequences