Splenectomy in thalassemia

The aims of our study were to illustrate the most common indications for splenectomy in patients with beta thalassemia and to clarify the effect of splenectomy on blood transfusion requirements in our patients. This is a retrospective study of 36 patients with B thalassemia who underwent splenectomy in Prince Rashed Ben Al-Hassan Hospital in Irbid in the northern area of Jordan over a period of 10 years, from January 1993 to January 2003. Case histories were reviewed with regard to age, sex, indication for splenectomy, blood transfusion requirements [both amount and frequency], hematocrit level [pre and post splenectomy], hepatitis C virus [HCV] antibodies, preparations made for surgery, and post-operative complications. Increased transfusion requirements, hypersplenism, and massive splenomegaly were the most common indications for splenectomy in beta thalassemia patients. For 6-12 preoperative months, the frequency of blood transfusion had increased from nearly monthly intervals [10-12 times per year] up to more than 20 to 24 times per year. The amount of blood required had increased from a mean of 150 cc /kg/year to more than a mean of 280cc/kg/year during the same period of preoperative time. Post splenectomy, patients with beta thalassemia major returned to a monthly transfusion regimen [15-28 months, mean 21.5 months]. In patients with beta thalassemia intermedia, the effect of splenectomy was longer lasting [36-48 months, mean 42 months]. Hepatitis C infection was seen in 20 beta thalassemia patients [56%] before splenectomy. Splenectomy is beneficial for children with beta thalassemia and hypersplenism because it reduces blood transfusion requirements even if only for a temporary period. Polyvalent vaccines should be given to all patients before splenectomy to reduce complications

Effect of diazepam on prevention of recurrences of febrile seizures

The objective of this study was to evaluate the efficacy of intermittent oral diazepam for reducing the recurrence of febrile seizures.Prince Rushed military hospital north of Jordan. Prospective controlled study of 280 patients, who were admitted to pediatric ward with first febrile seizures and were r and omized into two groups, one group received short-term prophylaxis for 12 months with oral diazepam 2.5Mg for children less than 7Kg, 5Mg for children weighing 7-15Kg and 10mg diazepam for children weighing more than 15kg and then continued after the temperature >38.5c, the control group received no prophylaxis Short-term diazepam prophylaxis reduces the recurrence rate of febrile seizures to one fifth that is from 43% to 8.2 [p<0.003] when the first febrile seizures are simple and to one-fourth that from 62% to 16% when the first febrile seizures are complex, with mild side effects of diazepam. Short-term prophylaxis with oral diazepam is effective in prevention of recurrence of febrile seizures, with mild side effects