effectiveness of using modified transcutaneous spinal electroanalgesia on patients with acute sickle cell painful episode

To evaluate the effectiveness of modified Transcutaneous Spinal Electroanalgesia [mTSE] on acute painful episode in sickle cell disease [SCD]. Prospective Non-Randomized Experimental Study. Pediatric and Medical Ward, Qatif Central Hospital, Eastern Province of Saudi Arabia. A prospective study conducted between April to July 2004. It included all SCD patients admitted in pediatric and medical wards with moderate/severe acute pain involving lower back and/or lower limbs, not responding to the initial management over the first four hours of presentation. Modified Transcutaneous Spinal Electroanalgesia [mTSE] was used for 90 minutes. Data entry and analysis were done by Epi-Info software [Version 3.2.2]. One hundred seven patients were included in the study. Age ranged between 5 and 50 years. Males were 57 [53.27%]; 50 [51.10%] of the females were adults and 32 [56.14%] of the males were pediatrics. The mTSE had lowered the pain level to mild in 20 [38.46%] adults, compared to 32 [58.18%] children. Twenty-eight [49.12%] males showed improvement, compared to 28 [56%] females. Post-mTSE pain score was 3.6 +/- 2.5, compared to 7.5 +/- 2.1 pre-mTSE, [p-value<0.01]. The response to mTSE was more apparent in pediatrics [3.1 +/- 2.7] compared to adults [4.1 +/- 2.2], P-value=0.01. Pediatric male patients responded better to mTSE [2.8 +/- 2.6] compared to adult male patients [4.1 +/- 1.8], P-value=0.005. Our preliminary study reveals the efficacy of mTSE in controlling bony pain of acute painful episodes in SCD patients

Sensorineural hearing loss in homozygous sickle cell disease in Qatif, Saudi Arabia

Sensorineural hearing loss [SNHL] is a known complication of sickle cell disease [SCD]. There is a paucity -of information on this problem in Saudi SCD patients. A prospective controlled study was conducted over 27 months in Qatif Central Hospital. One hundred patients with sickle cell anemia [SCA], aged five to 40 years, were studied. The control group consisted of 100 healthy individuals. A detailed history, otologic and audiologic examinations were carried out on both groups. Further investigations to rule out local retrocochlear pathology were performed on those having unilateral SNHL. No case of SNHL was detected in the control group, while it was recorded in 19 [19%] of SCA patients, 13 males and six females. There was a significant association between the SNHL and the onset of first vaso-occlusive crisis at six years of age or less. There was no significant difference in the frequency of SNHL between children and adults. Twenty-one percent of patients who had SNHL completely recovered. Patients with SCD need a careful regular hearing assessment. Those detected to have SNHL need a careful plan implemented by both the clinician and otolaryngologist for proper care of this important complication

patterns of oropharyngeal microflora in patients with homozygous sickle cell disease

A controlled prospective study was carried out between 16 July 1991 and 31 January 1992 to evaluate the oropharyngeal flora in homozygous sickle cell disease [SS]. Throat swabs for cultures were taken from 163 asymptomatic SS patients attending sickle cell clinics [90 children and 73 adults]. Throat swabs were also taken from 84 asymptomatic healthy individuals as a control group [44 children and 40 adults]. Group A beta hemolytic Streptococci were isolated from 16.6% of children with SS compared to 4.5% of children without SS [P<0.05]. Staphylococcus aureus was isolated from 16.4% of adults with SS compared to 0% of adults without SS [P<0.0001]. Group G beta hemolytic Streptococci and nongroupable Streptococci were also isolated from 11% and 13.7% of adults with SS compared to 0% and 2.5% of adults without SS respectively. Several other organisms were isolated only from SS patients. We conclude that the oropharyngeal flora of patients with SS is disturbed. This disturbance may contribute to morbidity of these patients

Ocular manifestations of homozygous sickle cell disease in Qatif, Saudi Arabia: a preliminary report

To determine the frequency of ocular manifestations in Saudi homozygous sickle cell disease patients [SSD].A prospective study.Paediatric and adult sickle cell clinics at Qatif Central Hospital, Eastern Province, Saudi Arabia.The subjects were 51 consecutive patients with confirmed SSD: 31 males and 20 females [M:F ratio 1.6:1]. Mean age 18.6 years [range 5-38 years].Detailed ocular examination during steady state, including indirect ophthalmoscopic retinal examination. Presence of SCO-related ocular manifestations in the conjunctiva, sclera, anterior segment and retina.Ocular abnormalities were found in 13 patients [25.5%]. Conjunctival abnormalities in ten patients [19.6%],and peripheral retinal abnormalities in six patients [11.8%]. No proliferative retinal abnormalities were found.The frequency of ocular manifestations is much lower in our patients compared with SSD patients of African descent

Pattern of admissions of children with sickle cell disease in Qateef central hospital, Saudi Arabia

Sickle Cell Disease [SCD] in the Eastern Province of Saudi Arabia is thought to be a benign form of disease. This is not true for all patients and it contradicts our clinical observation. Therefore, we conducted this study to look at the patterns of different presentations of SCD patients who required admission to Qateef Central Hospital [QCH]. The study was conducted prospectively between March 1990 and July 1991. All SCD patients less than 13 years were included. The total number of patients admitted to the paediatric medical ward during the study period was 2886, out of which 561 were SCD patients [19.4%]. Out of these, painful crises were responsible for 298 admissions [53%], anaemic episodes for 204 admissions [36.4%], infection for 83 admissions [15%], acute chest syndrome for 28 admissions [5%] and others for 20 admissions [3.6%]. The SCD patients form a large proportion of paediatric admissions. They present with various complications of the disease

Acute abdominal pain in sickle cell disease

A prospective study of paediatric patients with sickle cell disease [SCD] admitted to Qateef Central Hospital [QCH] because of abdominal pain was carried out between July 1990 and October 1992. Out of 59 admissions, 53 had acute abdominal painful crises [APC] and 6 patients had acute surgical abdomen [ASA]. History of abdominal pain was found in 66% of APC. Vomiting was found in 66.7% of ASA and 26% of APC. Diffuse abdominal pain was found in all ASA and 11.3% of APC. Rigidity, involuntary guarding and decreased bowel sounds were found in 66.7% of ASA and 9.4% of APC. Rebound tenderness and increased bowel sounds were found only in ASA [33.4%]. Accompanying painful bone crises was found in 56.6% of APC and in 33.3% of ASA. Past history of abdominal pain, diffuse abdominal pain and accompanying painful bone crises were features of APC. On the other hand, signs of peritoneal irritation were features of ASA

Priapism in two children with sickle cell disease at Qateef Central Hospital

Two Saudi children with sickle cell disease were admitted at Qateef Central Hospital with sickle cell crises. The first patient from south-west of Saudi Arabia, was admitted with severe abdominal crisis. The second patient was from Eastern Province, was admitted with major sequestration crisis. Priapism was diagnosed in both patients after admission. Both of them were successfully treated conservatively. The possibility of this complication should be borne in mind when a child with sickle cell disease is presented in a crisis