Predictors of outcome for non-traumatic intracerebral hemorrhage

To evaluate the prognosis, neurologic outcome, and predictors of survival in patients with non-traumatic intracerebral hemorrhage. We evaluated prospectively a cohort of 96 Saudi adult males and females with stroke during the month of July 2005 at Arar Central Hospital, Riyadh, Kingdom of Saudi Arabia. Out of 103 patients, 96 patients, who were diagnosed as having intracerebral hemorrhage [ICH] presenting to the emergency department for initial evaluation, were included, except those with recurrent intracerebral hemorrhage, arteriovenous malformation, subarachnoid hemorrhage, traumatic brain injury, hemorrhagic infarctions, and patients receiving anticoagulant therapy. No patient underwent any neurosurgical procedure. The results of 96 patients were analyzed. The mean age at ICH was 67.2 [ +/- 14.7] years [range, 30-100 years], and mean Glasgow coma scale [GCS] score on admission was 8.42 [ +/- 1.73] and [range, 4-13]. Mean ICH volume on initial CT scan was 10.61 [ +/- 14.01] ml3 [range, 1-63]. Mean pulse pressure on hospital arrival was 81.9 [ +/- 22.8] mm Hg [range, 70-120 mm Hg]. In uni-variate analysis, GCS score [p = 0.0005], ICH volume [p = 0.001], mass effect [p = 0.001], and presence of intraventricular hemorrhage [p = 0.0005] were all associated with 30-days mortality, while in multivariable analysis, the most significant independent predictors of 30-day mortality were, GCS score and the intraventricular extension of hemorrhage. This model may aid in making decisions quickly and easily regarding the appropriate level of care for such patients with intracerebral hemorrhage

Intensive behavioral therapy for primary enuresis

To assess the effect of intensive behavioral therapy on Saudi children with primary enuresis. Twenty-six children, aged 6-14-years, presented with complains of bed wetting during a 12-months period from January 2001 through to January 2002, ArAr Central Hospital, Kingdom of Saudi Arabia were studied in an interventional, non-randomized trial without control. After complete verbal autopsy, physical examination and laboratory investigation, they were offered intensive behavioral therapy. They were evaluated for response, regularity, esteem and recurrence of enuresis. Mean age of the study group was 9.6-years [SD = +/- 2.6] and boys were affected almost twice of girls [P<0.05]. Family history, social history and school performance did not show any significant [P>0.05] association with enuresis. Sixty point five% were regular and out of those 27.9% never missed any visits. 91.7% were completely dry out of regular patients. There was 75% success rate in those, who visited 4-8 times while 25% in those, who visited 1-3 times. Ninety-six% of the parents and 80.7% of the children were fully satisfied with this therapy. Socio-economic status seems to play a significant [P<0.05] role in regularity of follow up and response to behavioral therapy. This result shows an excellent response to intensive behavioral therapy in primary enuresis if the follow up is regular