Oral midazolam in pediatric dentistry

The study aimed at abserving the changes in cooperation level of children undergoing dental procedures following the administration of a single oral dose of 7.5 mg of Midazolam. Children were multinational, and ranged in age between 24 to 59 months. All subjects were considered to be resistant to routine behavioural management techniques. There was a 77.8% treatment visit success. The success rate was statistically insignificant between the sexes. Due to the small population, differences could not be elicited based on nationality and age group of subjects. There were however noticeable differences in behaviour based on the dental procedure being performed. Dental extraction had the poorest cooperation followed by cavity preparation. Cooperation improved significantly when the rubber dam was removed [where applied]. Midazolam was found to increase treatment visit success rates in the present study

Modified laryngeal mask airway

Modified Laryngeal Mask [MLMA] aided fiberoptic intubation [FOI] using larger than 6mm ID endotracheal tube was studied in 25 adult patients and compared to unaided FOI in another 25 patients. MLMA aided FOI was successful in 96% cases compared to 56% in the unaided group. Furthermore, the time to successful intubation was increased by 67.1% when FOI was attempted without MLMA aid which was statistically significant [P < 0.001]. However, maximum fluctuations in the heart rate and mean arterial pressure in the immediate post-intubation period were statistically insignificant between the groups. We conclude that MLMA not only adds to success rate of FOI but also significantly reduces the FOI time in adult patients

Calculation of infant mortality rate in the sultanate of Oman

Infant mortality rate [IMR], despite its unique importance, is always estimated. The estimation of IMR of 23 per 1,000 live births in the Sultanate of Oman seems to be high. This rate has been estimated from the child health surveys, 1988. With the rapid growth of health services, the health status of Omanis have improved. Thus the estimation of IMR in the Sultanate on past surveys cannot provide the real value of IMR. It has been shown in this paper how to calculate the actual lMR. Our computation of IMR gives the value of 13.0 per 1,000 live birth in the north Batinah region for the year 1993, and 12.8 for 1994

Interrelationship of minerals in pregnant women and their neonates

Serum ionized calcium, total calcium, management, inorganic phosphorus, total protein, albumin and alkaline phosphates were determined in 30 non pregnant [controls] and 30 pregnant women delivering full term, full term low birth weight and preterm neonates [n=30 each]. Comparison of control non-pregnant with pregnant groups show significant differences. A statistically significant difference was observed in serum mineral levels of term neonates when compared with preterm neonates

Dietary management of surgical patients: effects on incisional wound healing

A study of 38 patients was undertaken at the main University Hospital in Alexandria. The sample was divided into a control group and an experimental group. Findings show statistically significant differences between the two groups in the level of education, but no difference in blood picture, body mass index or nutritional status. There was a difference in the rate of wound healing in the two groups, and a relationship between the nutritional status and wound healing in the control group. Total hospital stays for the control group were longer than those for the experimental group. The nutritional status of surgical patients, as well as their food intake, should be evaluated at short intervals before and after surgery

Underestimation of malnutrition among Pakistani infants weighed with clothes on

Many growth monitoring programmes at health facilities and in communities in Pakistan weigh children with their clothes on. The nutritional status of infants at the Rawalpindi General Hospital was estimated from weight without clothes on and showed that about 8% of malnourished children were being missed. This underestimation mostly affected children with grade II and grade III malnutrition. Generally, more boys have normal nutritional status than girls. Accordingly, weight with clothes on was found to underestimate the malnutrition status of girls more than that of boys. Children should be weighed without clothes on so as estimate their nutritional status and risk accurately

Risk factors of persistent diarrhoea in children below five years of age

Persistent diarrhoea has been identified as a major source of morbidity in the developing world. This study was conducted to evaluate the risk factors of persistent diarrhoea in children below five years of age. The data used is from a prospective analytical case control study carried out in the Department of Pediatrics, Dow Medical College and Civil Hospital, Karachi, during 1993-94. A total of 50 cases of persistent diarrhoea and 50 acute diarrhoeal controls [matched for age and sex] under 5 comprised the study subjects in this analysis. The maximum incidence of persistent diarrhoeal episodes occurred in children below one year of age. Male to female ratio was 3:2. The seasonal variation showed a peak incidence in summer rainy season. Risk factors for persistent diarrhoea recorded were young age, poor nutritional status, irrational use of antibiotics during acute diarrhoea, lack of exclusive breast feeding, incomplete vaccination, lack of tap water supply and sanitation facility at home and income < Rupees 2000/month of the earning members of the family. Thus, it is concluded that discouraging the irrational use of antibiotics and other drugs for the treatment of diarrhoea, promotion of breast feeding and Expanded Programme of Immunization [EPI], Standard Diarrhoea Case Management courses for doctors, medical students and paramedical staff and provision of safe drinking water and sanitation facility are important for the prevention of persistent diarrhoea

Cholera admissions in adult 1989-1994: a hospital based study

In order to gain insight into the distribution of cholera over the years and proportion of monthly admissions under our adult medical services, we scrutinized our records of hospital discharges between 1989 and 1994. Only culture positive cases were included. Each year most of the cases of cholera are admitted between May and November with almost disease free interval from December to April. In 1992 admission rate was 4.24/1000 medical admissions which increased to 12.65 in 1993 and 13.73 in 1994. Though the Vibrio cholerae 01 Ogawa was the major isolate upto May, 1993, Vibrio cholerae non-01 serogroup 0139 dominated between June and August, 1993. Ogawa strain re-established itself in October, 1993. In August, 1994, non-01 strain reappeared and became the major isolate in September. Cholera has caused multiple epidemics throughout the Indian subcontinent. Since 1800, there have been seven pandemics of cholera. The seventh pandemic originated in Indonesia and continues today

Setting health care priorities in Pakistan

To describe a health priority setting exercise in Pakistan and its relevance to traditional medical care and care providers. Literature search of local and regional data was performed to identify priority health problems, those with high disease burden and with cost-effective interventions. Major causes of ill-health were communicable [diarrhoca, respiratory infections, childhood immunizable diseases, malaria, tuberculosis] and pregnancy related diseases. Factors that contributed to these disorders included malnutrition, anemia, poor sanitation and water supply, low level of education, high fertility rates and proverty. For these conditions, cost-effective interventions for prevention included environmental control [provision of clean water and sanitation], education programmes, expanded programme of immunization and family planning and those for treatment included case management of diarrhoea, respiratory infections, tuberculosis and complications of pregnancy and childbirth. Priority health problems include factors outside the domain of traditional medical care. Their definition is important for directing policy reform, medical curricula and health research

Intraoperative radiation therapy for gastric adenocarcinoma

Intraoperative radiation therapy [IORT] is a multidisciplinary approach in which residual tumors or tumor beds are directly irradiated during a surgical procedure. To evaluate its efficacy, from 1985, we conducted a prospective study including non-metastatic gastric adenocarcinoma treated by surgery, IORT [15 Grays] and postoperative external beam radiotherapy [44 Grays]. Up to 1993, 51 cases of gastric adenocarcinoma [20 pN[0] and 31 pN[1-2]] have been included in the study. Mortality and morbidity rates were not different from those of surgery alone. The overall 5 year survival rate was 59.1%, and the pN[1] N[2] 5 year survival rate was 50.6%. These promising results are comparable with those of Asian randomized studies which demonstrate the possible value of IORT in the treatment of gastric adenocarcinoma

Changes of haptoglobin and free hemoglobin due to blood transfusion

Serum total haptoglobin and free hemoglobin levels during blood transfusion were investigated in 17 elective surgeries. Total haptoglobin and free hemoglobin levels in 73 stored whole blood were also investigated for different storage periods. Free hemoglobin was detected in serum when total haptoglobin level became 130 mg/dl or less and a mean storage period of transfused bloods were 11 days or longer. Total haptoglobin level became 130 mg/dl or less at a transfusion volume of 600 ml or more. No constant relationship was recognized between transfusion speed and total haptoglobin or free hemoglobin levels. In the stored whole blood, free hemoglobin level increased in accordance with an increase of storage period and it reached significant increase on 7-9 storage period against 1-3 storage period. The detection rate of free hemoglobin increased significantly when it was stored for 7 days or longer. It was concluded that 7 days or more stored whole bloods had free hemoglobin, but serum free hemoglobin was detected when 600ml or more of 11 days or longer whole bloods were transfused

Rhegmatogenous retinal detachment in young adults

Purpose: A retrospective study was conducted to assess the etiological factors for rhegmatogenous retinal detachment [RRD] and the visual and anatomical outcome of treatment in a group of young Saudi adults.Methods The records were retrieved of all patients aged between 14 and 40 years who had been treated by the authors for RRD from October 1991 to October 1994 to at the King Abdul Aziz University Hospital in Riyadh, Saudi Arabia. All patients aged between 14 and 40 years who had attended at least two postoperative follow-up visits were included in the study. The etiology, treatment, and visual and anatomic outcome of treatment were recorded Fellow eye pathology and management were also evaluated. The final study group comprised 74 patients [63 males and 11 females] aged from 14 to4O years [mean, 31.8 +/- 5.4 years]. Twenty-three patients [31.1%] presented with RRD secondary to retinal breaks associated with lattice degeneration; retinal detachment [RD] was bilateral in seven of these patients. All patients were myopic before treatment, ranging from -1.0 to -12.0 diopters [D] [mean -7.4 +/- 3.2 D]. The fellow eye needed prophylactic treatment. Twenty-one patients [28.4%] had trauma-related detachments. RRD due to atrophic holes without other pathology was noted in 13 patients [17.6%]. Refraction ranged from +0.5 to -19.0 D [mean, -90 +/- 7.4 D]. RRD due to horseshoe tears was found in seven patients [9.5%]. Their refraction ranged from -43.5 to -23.0 D [mean -9.9 +/- 8.2 D]. Five patients [6.7%] were found to have RRD secondary to giant breaks. The refraction s between -8.0 to -14.0 D [mean -11.2 +/- 2.04 D]. Two patients [2.7%] had aphakic RRD following surgery for congenital cataract. Another two patients [2.7%] had rhegmatogenous retinal detachment following pars planavitrectomy. Choroidal colohoma was found in one patient [1.3%]. In all groups there was a male predominance. Conclusion Lattice degeneration and trauma were the most important causes of RRD in young Saudi adults. Patients with lattice degeneration-related RRD had the most favorable surgical and functional outcome. RRD is frequently a bilateral disease in all etiologie groups except trauma