[A] massive tuberculosis abscess at the erector spinae muscles and subcutaneous tissues in a young man

Tuberculosis [TB] is a chronic granulomatous infection which can present in an atypical form. Isolated muscle involvement is very rare. We report a 25-year-old man who presented with a massive cystic swelling on the right side of his back, extending from the lower thoracic to the gluteal region. He had a history of contact with a friend who was suspected of having TB. Magnetic resonance imaging [MRI] showed that the origin of the cyst was from the erector spinae muscles. The result of a fluid aspirate showed acid fast bacilli. The swelling disappeared after treatment with anti-tuberculous medications. Muscular involvement in TB is very rare. In our patient, the reports of an ultrasound and MRI confirmed isolated muscle and subcutaneous involvement without bony lesions. This case is reported to increase physician awareness regarding soft tissue TB. Although it is rare, similar cases may be seen in the future

Successful resuscitation of prolonged hyperkalemic cardiac arrest following succinylcholine administration in possibly undiagnosed myopathy

We report a 3 years old male with undiagnosed myopathy, who developed cardiac arrest secondary to hyperkalemia following succinylcholine administration.The patient underwent prolonged cardiopulmonary resuscitation [CPR], which ended successfully after applying external pace maker. He was discharged home eleven days after the cardiac arrest for follow up of his myopathy

Powered endoscopic inferior turbinoplasty versus conventional partial inferior turbinectomy for hypertrophic inferior turbinate

Chronic nasal obstruction due to hypertrophic inferior turbinates is a common disorder. A variety of surgical procedures are performed for treatment of hypertrophic inferior turbinates. We evaluated objectively [by postoperative endoseopy] and subjectively [by questionnaire] 60 patients who underwent one of two procedures; Conventional partial inferior turbinectomy [Conventional PIT] and Powered Endoscopic partial inferior turbinoplasty [Powered Endoscopic PIT]. The CPIT and PEPIT showed good functional results for long term effectiveness [80% and 86.7% respectively]. Long term follow up revealed high level of satisfaction of both techniques. Less morbidity [less bleeding, synaechae, crusts and fewer days of hospital stay] was recorded with PEPIT. Thus powered endoscopic inferior partial turbinoplasty offers an excellent method of correction of turbinate hypertrophy with minimal intraoperative and postoperative complications and significant long term improvement

Factors influencing the success of family planning services in El Menia and Assuit governorates Egypt

Family planning is an added value to the health and weli-being of women, children, families, and communities and a key component of reproductive health services. The objectives of this study are to identify the cultural, social and environmental determinants associated with under utility of family planning services and assess women satisfaction towards the quality of family planning services. The study was carried out in two governorates El Menia and Assuit, in each governorate 10 primary health care units were selected, live of them have already got the golden star in quality of family planning service recently. The study was conducted during the period January 2004 to May 2004. The subjects of this study included; 300 women who attended the family planning services during the study period, 20 physicians, 20 nurses and 20 social workers [Raedat], who are working in the selected 20 primary health care units. The result revealed that there were no significant differences between the two groups as regards duration of marriage and the number of living children. The rate of illiteracy was around 54% in both groups. Considering the educational status of the husbands there was a significant difference between the two groups. 64% of physicians in PHCs with golden star used explanatory tools during discussion with clients compared to 43.3% in the second group. This difference was statistically significant [p<0.01]. The results pointed out that physicians were the first contact as mentioned by 20.7% of women in the first group compared to 10% in the second group this difference was statistically significant [p<0.05]. General examination was performed in 91.3% for women in the first group compared to 73.3% for women in the second group this difference was statistically significant [p<0.01]. The overall patient satisfaction rate was the same in both groups [87.8% per patient in the first group and 87.3% in the second group]. The study concluded from the results of interview and focus group discussions that reasons for distinguishing PHCs with golden stars relatively to those without golden stars may be attributed to many factors including the lower illiteracy rate of the husbands, the relatively lack of desire of the women to have more children in the next two years, the near distance of the PHCs to the houses, seeing the physicians on the first contact to the PHCs and using tools for explaining the contraceptive methods

Anaesthetic management of an epidermolysis bullosa patient undergoing cricopharyngeoesophagoscopy

In this case report, we are describing a young boy with known epidermolysis bullosa who was admitted to the hospital for foreign body removal by cricopharyngeoesphagoscopy. This patient is liable to get bullae formations with any trauma to the skin and mucous membrane, and to avoid this problem we will describe the precautions taken during anaesthetizing this case

Non invasive evaluation of patients with ventricular septal defect after surgical correction

The present work is planned to study the cause of any residual cardiac murmur after surgical closure of ventricular septal defect and to evaluate cardiac function using Doppler echocardiography. Twenty cases of isolated VSD who underwent trans-atrial surgical closure of VSD were studied. They were 14 males and 6 females. Their age ranged between 3 and 20 years with a mean of 8. 5 +/- 4 years. Preoperative data were collected from patients files as cardiac catheterization data. Operative details were recorded during operation. Post operative study was also conducted and included clinical examination for any residual cardiac murmur. ECG, chest X-ray and Doppler echocardiography were performed to assess closure of the defect. Patients were classified into two groups. Group I included 8 patients with RV pressure < 50 mm Hg. Group 2: included 12 patients with RV pressure > 50 mm Hg. Doppler examination revealed 14 cases of 20 [70%] proved to have no residual shunt. 4 cases had mild shunt [20%], 2 cases had moderate shunt [10%] and no case showed large shunt. The shunt occurred along the suture line. Left ventricular function was assessed by the EF% which ranged between 47% and 63%. RV pressure decreased significantly in both groups postoperatively, post operative echo evaluation has also showed that 9 patients had TR 45%, 1 patient had pericardial effusion [5%], 1 showed vegetation on the patch [5%] and I patient had right atrial thrombus [5%]. We conclude that Doppler echocardiography is highly sensitive in the early post operative detection of VSD shunt, as well as other postoperative complications as pericardial effusion, vegetation on the patch and myocardial dysfunction. Results showed also that RV pressure decreased significantly after closure of the defect in both groups, however, in patients with VSD and at least moderate pulmonary hypertension, pulmonary artery pressure was not returning to normal therefore, it is advisable to operate on individuals with VSD and moderate pulmonary hypertension before there is the any increase of pulmonary vascular resistance