Management for abdominal pregnancy at Dhaka: A case report

Pregnancy in abdominal cavity is an unusual type of ectopic pregnancy having excessive illness as well as death for the mother and the unborn baby. Identification and management may present several complications, particularly in low-resource centers. A higher level of doubt is crucial in making a timely diagnosis in these cases. A 25-year-old third gravida patient was shifted to a tertiary care center in the city on the advice of failed induction. Her previous attempt of abortion procedure failed. It was observed from her ultrasonography that her right lower abdominal cavity contained single deformed fetus with no cardiac activity. After successful laparotomy, the mass was removed from in between uterus and urinary bladder. This situation shows that several pregnancies of abdomen could be supervised properly. A case is presented here where a pregnancy in abdomen was productively taken care of by operational laparotomy. The patient had a healthy recovery. This occurrence shows that operative laparotomy is a secure substitute for the supervision of appropriately designated patients in midtrimester pregnancy in abdomen.

Incidence of endophthalmitis following intravitreal bevacizumab injection at a tertiary care hospital in eastern province of Saudi Arabia

The aim of this communication is to report the incidence of endophthalmitis following the use of intravitreal Bevacizumab [IVB] at a tertiary care hospital in the Eastern province of Saudi Arabia. A total of 2769 intravitreal Bevacizumab injections were carried out between January 2009 and April 2014. During this period, one case of endophthalmitis following IVB injection occurred. The overall incidence of clinical endophthalmitis was 0.036% [1/2769; 95% confidence interval: 0.0001-0.002%]. This compares favorably with studies reported from other parts of the world

Corneal collagen crosslinking for progressive keratoconus in Saudi Arabia: one-year controlled clinical trial analysis

Aims: To determine the short-term efficacy of corneal collagen crosslinking [CXL] treatment in patients with progressive Keratoconus [KCN] in comparison with no treatment

Settings and design: This controlled clinical trial study was carried out at a tertiary eye hospital, Eastern Province, Saudi Arabia

Methods and material: A prospective controlled clinical study of patients being treated for Keratoconus at a tertiary eye care hospital in the Eastern province of Saudi Arabia. 51 eyes of 43 patients with progressive KCN who received corneal collagen crosslinking [treatment group] and 50 eyes of 34 patients with KCN and no treatment [control group] were included in our study.A one year clinical data were collected preoperatively as well as at 1, 3, 6 and 12 months postoperatively for the treatment group patients. A baseline and 1 year clinical data were collected for the control group patients. The short-term efficacy of the treatment in preventing progression of KCN in comparison with no treatment was analysed at one year

Results: At one year after crosslinking, there was significant flattening of the average keratometry by 0.61 D [p = 0.001] [95% CI: 0.25, 0.97] compared to 0.40 D [p = 0.210] steepening in the control group; difference between treatment and control was 1.01 D [p = 0.006] [95%CI: 0.29, 1.72]. Pachymetry in treatment group thinned by 20.21 microm [p < 0.0001] [95% CI: 12.77, 27.66] compared to 0.32 microm [p = 0.912] in the control group. Visual acuity remained stable at the preoperative level of 20/30 [p = 0.397] in the treatment group and 20/40 [p = 0.553] in the control group at one year

Conclusions: Corneal CXL is an effective treatment for halting the progression of KCN as shown by reduced keratometry and stability of vision

Frequency of genodermatoses among Iraqi patients

Genodermatoses are hereditary skin disorders or anomalies which can be grouped into three categories: chromosomal, single gene and multifactorial. Most genodermatoses show single gene or Mendelian inheritance [autosomal dominant, autosomal recessive or X-linked recessive genes]. To asses the frequency of genodermatoses among Iraqi patients in outpatients Dermatology and Venereology comparison with other countries. This case series descriptive epidemiological study included eighty three patients [57males and 26 females] with genodermatoses. They consulted the out patient clinic/ Department of Dermatology and Venereology Baghdad Teaching Hospital from April 2005 through April 2006. Their ages ranged from 2months-60 years [Median 10 years],With various genetic diseases. Full history, dermatological and clinical examinations were done to establish the clinical diagnosis of genodermatoses regarding all demographic points related to these disorders. The frequency of genodermatoses among outpatient attendant in Dermatology and Venereology Department was 837 20000 [0.42%]. This study had shown that the most common genodermatoses were; ichthyosis: 21 [25.3%] patients and epidermolysis bullosa which contain 16 [19.3%] patients when taken together they constituted 37 [44.6%] patients of the total, neurofibromatosis 8 [9.6%], hereditary palmoplantar keratoderma 6 [7.2%], darier's disease 5 [6%] and xeroderma pigmentosa 4 [4.8%]. Positive family history of the same disease was obtained in;8 [38.1%] patients with ichthyosis, 4 [66.6%] in hereditary palmoplantar keratoderma, 2 [12.5%] in epidermolysis bullosa and all patients with Hailey-Hailey disease had positive family history of the same condition. Consanguinity was positive in; 13 [61.9%] patients of ichthyosis, 12 [75%] epidermolysis bullosa, 2 [33.3%] hereditary palmoplantar keratoderma and [100%] patients with xeroderma pigmentosa Genodermatoses are frequently encountered among Iraqi dermatological outpatients and more common in families with positive consanguinity and were comparable to other countries

Neonatal diarrhea in a diarrhea treatment center in Bangladesh: clinical presentation, breastfeeding management and outcome.

OBJECTIVE: To study the clinical presentation and outcome of neonates admitted with diarrhea, and effect of counseling their mothers for exclusive breastfeeding. DESIGN: Prospective study. SETTING: Inpatient unit. RESULTS: Two hundred and forty-four neonates were studied during 1994-95. Their mean (SD) age was 18 (6.2) days, and body weight and length were 2.18 (0.52) kg and 47.5 (3.2) cm, respectively. More neonates had some dehydration than severe dehydration (78% vs. 11%), with mean (SD) serum bicarbonate values 9.6 (5.1) mmol/1. V. cholerae was isolated from 25 (12%), Shigella spp. from 8 (3%), and Salmonella spp. from 3 (1%) of the patients who had rectal swab cultures. Mean (SD) hospital stay was 3.6 (2.1) days, during which the majority (80%) recovered fully, but 29 (13%) left earlier. Eleven (4%) of the neonates had to be referred elsewhere for treatment of other problems and 7 (3%) died. None of the neonates were exclusively breastfed on admission. Excluding mothers of adopted neonates, breastfeeding counseling enabled 64% of the mothers to convert to exclusive breastfeeding during the hospital stay. CONCLUSIONS: Most of the neonates admitted with diarrhea were small and underweight, and had poor feeding practices. The majority of neonates recovered soon, and were exclusively breastfeeding when discharged from the hospital. Breastfeeding counseling should be included as an integral part of case management at all health facilities.

Orientación sobre la lactancia materna en un hospital para enfermedades diarréicas / Breast-feeding counseling in a diarrhoeal disease hospital

Se adiestró a consejeras en materia de lactancia materna para que dieran asesoramiento a las madres de lactantes parcialmente amamantados y hospitalizados por diarrea, con el fin de lograr que las madres iniciaran la lactancia materna exclusiva durante su permanencia en el hospital. Se asignó de forma aleatoria a lactantes (n = 250) de 12 meses de edad o menos a un grupo de intervención y a un grupo testigo. Las madres del grupo de intervención fueron asesoradas individualmente por las consejeras, mientras que las madres del grupo testigo recibieron solo la educación sanitaria impartida en grupo rutinariamente. Durante el seguimiento que hicieron las consejeras en el hogar una semana más tarde, solo las madres del grupo de intervención fueron asesoradas. A las 2 semanas de su egreso, todas las madres fueron evaluadas en términos de sus prácticas de amamantamiento en el hogar. En cuanto a los 125 pares de madres e hijos que había en cada grupo, 60% de las madres del grupo de intervención alimentaban a sus hijos al pecho exclusivamente en el momento del egreso, en comparación con solo 6% de las madres del grupo testigo (P < 0,001); 2 semanas más tarde, estos porcentajes subieron a 75 y 8 en el grupo de intervención y en el grupo testigo, respectivamente (P < 0,001). Sin embargo, 49% de las madres del grupo testigo volvieron a alimentar a sus hijos con biberón, en comparación con 12% de las madres del grupo de intervención (P < 0,001). Por consiguiente, la orientación individual tuvo un efecto favorable en las madres, ya que hizo que iniciaran la lactancia materna exclusiva durante la hospitalización y que la siguieran practicando en el hogar. Los centros de salud maternoinfantil deben incluir la orientación sobre lactancia materna como parte integral de sus programas para mejorar las prácticas de alimentación de los lactantes.

Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea, so that they could start exclusive breast-feeding during their hospital stay. Infants (n = 250) up to 12 weeks of age were randomized to intervention and control groups. Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education. During follow-up at home by the counsellors a week later, only the mothers in the intervention group were counselled. All the mothers were evaluated for infant feeding practices at home two weeks after discharge. Among the 125 mother­infant pairs in each group, 60% of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6% in the control group (P < 0.001); two weeks later, these rates rose to 75% and 8% in the intervention and control groups, respectively (P < 0.001). However, 49% of mothers in the control group reverted back to bottle-feeding compared with 12% in the intervention group (P < 0.001). Thus, individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home. Maternal and child health facilities should include lactation counselling as an integral part of their programmes to improve infant feeding practices.