Subarachnoid lavage following inadvertent intrathecal injection of tranexamic acid

Tranexamic acid (TXA) is a commonly used antifibrinolytic drug during surgical procedures to reduce blood loss. An Inadvertent intrathecal injection of TXAmay lead to serious side effects including seizures and ventricular fibrillation with reported fatalities. We report a case of an inadvertentintrathecal injection of TXAwhich occurred as a result of similarities in appearance between TXAand heavy bupivacaine ampoules. The patient had subarachnoid lavage after experiencing back pain, systemic hypertension followed by generalized tonic clonic seizures

Periodontal status of adult subjects in relation to other local factors in Jazan region, Saudi Arabia

Background: Information about the distribution patterns of periodontal disease and the possible existence ofhigh-risk groups among adult population in Jazan region is scarce. Aims: This study was designed to explorethe periodontal status and the effects of socio-demographic characteristics and habits among adult populationliving in Jazan region, Saudi Arabia (SA). Materials and methods: This work was a cross-sectional studyconducted among 204 individuals. This population was composed of 172 males and 32 females with a mean ageof 43.9 years. Structured questionnaire, which included general health status and possible risk factors forperiodontal disease, was used for sampling. Clinical periodontal examination was carried out using the schemeused by the National Institute of Dental and Craniofacial Research. Data was analyzed using Statistical Packagefor Social Sciences software version 20. Results: Approximately 46.1% of population presented moderatepocket depths. The clinical attachment loss of ≤4 mm was 57.8%, and the fair oral hygiene was 40.2%. Theeffects of khat chewing, shammah dipping, and smoking on moderate pocketing were 50%, 47.7%, and 41.9%,respectively. The attachment losses of ≤4 mm were high in khat chewers, shammah dippers, and smokers at63.1%, 68.8%, and 50.1%, respectively. The average poor oral hygiene among groups was high at 53.3%.Severe pocket depth and poor oral hygiene were significantly high among old age groups at 22.2% and 66.7%,respectively. Females showed significantly (p=0.05) higher mild gingivitis and better oral hygiene of 65.7% and68.8%, respectively, compared with those of males. Conclusion: The prevalence of periodontal disease is highdue to associated risk factors, including khat chewing, smoking, and poor oral hygiene. The elderly age groupshowed high levels of periodontal pocketing, attachment loss, and poor oral hygiene. Females also presentedbetter oral hygiene and periodontal health than those of males.

Magnitude and risk factors of occupational injuries among workers involved in petroleum and mining industries in Kingdom Saudi Arabia

While Kingdom of Saudi Arabia is a rapidly growing mining and petroleum production country, a little was known about the magnitude and risk factors of occupational injuries in this field. The purpose of this study was to identify the magnitude and main risk factors of occupational injuries [OIS] among workers involved in mining and petroleum industries. Using a carefully structured format, the data were collected from files of all occupationally injured workers of one year [2007] from all offices [20] concerned with OIS compensation. OIS were classified according to ILO. The incidence rate and relative risk as well as the total cost of OIS were calculated. The total detected number of OIS were 417 injuries with total incidence rate of 56.73/10000 full-time workers [ftw] costing 11.676.000$. A significantly higher occurrence of OIS was associated with Saudi nationality, decreased duration of experience and working in oil production and transport processes. A decreasing trend on OIS along the months of the year and the days of the week was detected. Less serious injuries were the most common types [contusions and bruises] [33.09%]. The highest proportion of OIS was due to struck against objects [42.21%] and falls [20.86%]. OIS commonly occur during dealing with manual tools [31.41%] and conveying and transporting [11.51%]. Upper and lower Extremities were the most common affected -body part [34.05% and 25.90% respectively]. The incidence rate of OIS in petroleum and mining industries in Saudi Arabia were lower than that detected for many industrialized countries but still higher than that detected for other national economic activities. Less serious injuries were the most common types [contusions and bruises]. Safety education and some human and organizational modifications were recommended

Task - based learning: polishing of an old method of learning

Task-based learning [TBL] is a method for direct acquisition of knowledge, skills and attitude under direct supervision in an adaptable workplace. In contrast to didactic teaching that explore a tremendous volume of knowledge, TBL focuses on points of learning needed to be transferred at a particular point in time. These learning foci are used to train learners in analytical cognitive functions such as diagnostic capabilities, manual skill performance and explanation of symptoms, signs or results of investigation. TBL is motivating for all levels of learners. At the low level of poorly educated societies hand dexterities are taught to the subordinate by the learner's senior person or direct boss. This is particularly true among carpenters, ironmongers, tailors and jobs that require handcrafting

Histological study on the human gubernaculums in descended and undescended testis

The gubernaculum is a fibrous cord connecting the caudal pole of the testis with the scrotum. The regression of the extra-abdominal part of the gubernaculum in prenatal and early stage of postnatal life plays an integral role in testicular descent. Researchers claim that the undescended testis is a condition caused by failure of the gubernaculum to function, particularly in infants suffering from neuromuscular diseases and myopathies. To provide more information on the role of the gubernaculum in testicular descent, the structure of the gubernaculum was examined in cases of descended and undescended testis. The study was performed at both the light and electron microscopic levels. The gubernaculum biopsies were taken from 20 children with undescended testis, the control biopsies were obtained from 5 children [3 and 5 years old] who suffered from inguinal hernia but with descended testis. The specimens were prepared for light and electron microscopic examination. The histological examination revealed that the gubernaculum in 75% of undescended testis contained large amount of fat cells, a small amount of collagen fibers, and wide interstitial spaces, compared to the control group. The results suggest that the lack of testicular descent is probably caused by loss of retractibility of the gubernaculum

Effect of acute antioxidant overdose on blood hemostasis: experimental study

The current study was carried out to investigate the effects of the excessive use of large doses of the most widely used antioxidants, d-alpha-tocopherol [vitamin E], retinol acetate [vitamin A], and l-ascorbic acid [vitamin C], on the blood hemostasis. 140 albino rats were divided into 4 experimental groups of 40 animals each as follows: Group I: A control group [negative and positive]; Group II: Each animal of this group received a daily oral dose of 24 mg of d-alpha-tocopherol; Group III: Each animal of this group received a daily oral dose of 1mg of Trans-retinol acetate, and; Group IV: Each animal of this group received a daily oral dose of 20 mg of l-ascorbic acid. The results of the current study have revealed that both d-alpha-tocopherol and retinol acetate produced a significant prolongation of prothrombin time [PT] and activated partial thromboplastine time [PTT] with a significant reduction of factor X activity. On the contrary, l-ascorbic acid produced no significant effect on these parameters. Histopathological examination of liver, kidney, and brain specimens of the different treated animal groups revealed the presence of significant hemorrhages in most samples of both d-alpha-tocopherol- and retinol acetate-treated animals, while the specimens of l-ascorbic acid-treated animals showed no hemorrhage in nearly all samples. These histopathological changes were confirmatory to the biochemical ones. It could be concluded that the excessive use of large doses both d-alpha-tocopherol and retinol acetate alters the blood hemostasis with increased bleeding tendencies, while l-ascorbic acid doesn't. In fact, l-ascorbic acid could be considered a safe drug even in excessive doses for long periods

Neurotoxicity of the commenest volatile substances abused in El-Minia Governorate: clinical and experimental study

The current study was. performed to investigate the possible neurotoxic effects of chronic solvent abuse of some of the commonest abused substances in El-Minia governorate, namely, acetone and diethyl ether, and whether these changes, if present, are reversible or not. It was carried out as 2 parts: 1[st] part; 50 male persons aging between 20-45 were divided into 5 groups of 10 subjects each: group I; a normal volunteer control group, group II exposed daily to acetone for 1-2 year[s], group III: exposed daily to acetone for 8-10 year[s], group IV: exposed daily to diethyl ether for 1-2 year[s], group IV: exposed daily to diethyl ether for 8-10 year[s]. All subjects were examined thoroughly for any neuropsychiatric disorders 3 times 3 months apart. The 2[nd] part; 180 albino rats divided into 9 groups of 20 rats each as follows: group I: a control group received a daily oral dose of 1.5 ml of physiological saline for 1 month, group II: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 1 month, then examined immediately, group III: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 1 month, left for 1 month without any medical intervention, then examined, group IV: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 3 months, then examined immediately, group V: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 3 months, left for 1 month without any medical intervention, then examined, group VI: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] 1 month, then examined immediately, group VII: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] 1 month, left for I month without any medical intervention, then examined, group VIII: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] for 3 months, then examined immediately, and group IX: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] for 3 months, left without any medical intervention for 1 month, then examined. The results of the 1[st] part of the current study revealed that persons of the groups II and IV had mild neuropsychyatric disorders and that these changes were much more severe in the persons of group III and V as well as the appearance of another serious disorders including parkinsonism, cerebellar dysfunction, and cranial nerve affection. The results of the 2[nd] part revealed that animals of groups II and VI showed profound pathological changes of the cerebral cortex and cerebellum ranging from mild to moderate degrees with higher incidence towards the mild one. In addition, the animals of groups IV and VIII showed similar changes with increased incidence of the moderate degree. Moreover, animals of groups III and VII showed a mild improvement of the reported pathological changes when compared to those examined immediately after the last dose. On the other hand, animals of groups V and IX showed no improvement and nearly were the same when compared to those of groups IV and VIII. It could be concluded that volatile substance abuse induces serious neuropsychiatric and pathological changes, and that severity of the pathological changes increases with the increase of period of abuse, while reversibility becomes less likely

Evaluation of the role of ancylostoma caninum in human as a cause of acute and recurrent abdominal pain

Ninety-five patients with obscure acute or recurrent abdominal pain and ten asymptomatic healthy parasite free cases were subjected to thorough history taking, clinical examination, sonography, routine laboratory investigations and sero-testing by IgG ELISA to detect antibodies to excretory/secretory [ES] antigens of adult A. caninum and by IgG and IgG4 Western blot [WB] to detect antibodies to Ac68 antigen. Eleven male patients [5 with acute abdomen, 3 diagnosed as appendicitis and 3 had recurrent mild to moderate abdominal pain] fulfilled the criteria of case definition of human enteric infection with A. Caninum [GI]. The study also detected human hookworm infection in 14 patients [G.IIb], other parasites in 34 patients [GIIc] and 36 patients had no parasite [G.IIa]. Although 3 patients from group I were diagnosed as appendicitis and were dealt with surgically, the pain recurred and mebendazole only ameliorated the patients complaints. The obtained appendices of these operated cases showed marked eosinophilic infiltration, but no adult canine hookworms were detected. IgG ELISA was positive in 72.7%, 8.3%, 100%, 23.5% and 0% in groups and control, respectively

Clinical application of serum bile acid measurement

The diagnostic usefulness of fasting total serum bile acids [SBA] in assessment of hepatic function alterations were evaluated in 30 healthy subjects and 57 patients with obstructive jaundice. The values of SBA were compared with standard liver function tests. SBA can be used as an additional liver function test

Transplantation immunity and isograft size of spontaneous mammary carcinomata in mice

A method was described for determining the size of palpable mammary tumors in a mice without removing the tumor or killing the host. A formula was worked out and nomographs were made for simple and direct use employing only 2 diameters, bisecting the palpable growth at right angles to each other. Small tumor implants [0.05 to 5 cu mm in size] of C 3H spontaneous mammary carcinomas developed palpable tumors with same growth rates and same times of appearance in young syngeneic hosts of C 3H virgin females irrespective of the initial implant size. On the other hand, large implants [25 and 50 cu mm in size] of same carcinomas underwent necrosis and/or regression after an initial retarded growth and delayed appearance in syngeneic hosts.However, animals with regressing tumors from large implants remained refractory to a second challenge implant [0.5 cu mm in size], those with progressing growing tumors from small implants developed large tumors at challenge site.Resistance to challenge implants apparently immunologic in nature could be passively transferred to normal syngeneic hosts by lymph node cells and peritoneal washing cells

Modified allogeneic immunity to Ehrlich ascites tumor with bacterial endotoxin [boivin's antigen] in mice

Allogenic immunity of young adult Swiss albino mice to their residual intraperitoneal tumors after aspiration of their initial ehrlich ascites tumor allografts 12 days post-implantation maintained these mice in complete remission for the rest of their lives.Yet, this solid resistance was depressed when 100 nanogram [ng] amounts of an endotoxinpreparation[Boivin'santigen] wasadministrated subcutaneously three times per week post-aspiration. Ascites tumors relapsed and developed rapidly in the allogenic hosts treated with endotoxin.On the other hand,administration of the endotoxin subcutaneously in ng amounts three times per week starting 24hours after intraperitoneal implantation of the ascites tumor heightened the resistance of the host to its tumor allograft for a week. This was marked by a delayed onset [seven days] and a slower growth rate than the controls.Such resistance was not observed when endotoxin was administrated in higher [10 and 100 ng] or lower [0.1 ng] doses. When endotoxin was administrated subcutaneously in amounts of 0.1 or 100 ng three times per week starting 12 days prior to the intraperitoneal implantation of the tumor allograft, no resistance was observed.The highest dose [100 ng] of the endotoxin had practically no effect on ehrlich ascites tumor cells after an in vitro incubation for one hour when the cells were inoculated back into normal young adult mice, except for a delay of 48 hours in the onset of the ascites tumor. The possibleuseofsystemicadjuvants of immunity in clinical immunotherapy of cancer patients conditioned by such factors as the dose and time of administration in relation to the amount of residual cancer left from a previous treatment was discussed

Australia antigen and anti-australia antibody in lymphomas, leukemias and breast cancer

The sera of 90 lymphoma and 60 leukemic patients were studied for the presence of either HBsAg or anti-HBs using counter-electrophoresis. In addition, the study included 40 breast cancer patients and 20 normal healthy subjects as controls. The findings indicated a close and specific association between hepatitis B infection and leukemia. The frequency of exposure in leukemia patients was 17% compared to 5% in the other groups. Acute leukemia cases with positive HBsAg or anti-HBs reactions indicated a group with very bad prognosis. The causal relationship of hepatitis B virus to certain types of leukemias was discussed