RESUMO
Obesity leads to several changes in both airway and drug metabolism. The problems are compounded in cases of super super morbid obesity. Gastric banding surgery for weight loss was planned for a 47 year old, super-super morbidly obese female patient [164 kg and 151 cm, BMI: 72 kg/m[2] On pre-operative examination, patient had a short thick neck and grade 4 Mallampatti class. Induction of anesthesia was done in the sitting / semi-sitting position Maintenance was provided with 6% desflurane and O[2]/air mixture. Remifentanil infusion of 0.05 [xg/kg was administered during surgery. Patient had an uneventful recovery. The use of short acting drugs and appropriate monitoring provided hemodynamic stability and a fast and smooth recovery
RESUMO
To determine the corrected perinatal mortality rate [PMR] in a single tertiary care center, and to test the effect of unbooked pregnancies on the PMR, and amalgamate the 2 to develop a new terminology known as the extended corrected PMR. We conducted a retrospective cohort study of all women who delivered at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January 2000 and December 2010. We recorded all cases of perinatal death and calculated the PMR per annum. The PMR was corrected for extreme prematurity and congenital anomalies. The unbooked cases were reported, and the PMR was further corrected for booking status. For statistical analyses, the Statistical Package for Social Sciences was used for descriptive analysis and tests of significance. The total number of births was 46,677. Seven hundred and seventy-one perinatal deaths were reported, giving a PMR of 16.5 per 1000 per year. The corrected perinatal mortality was 11.0 per 1000. The PMR decreased significantly to 6.4 per 1000 [odds ratio 2.6, 95% confidence interval 1.2-2.4, p=0.001] after correction for booking status. The PMR in our study population is higher than those in developed countries, and when corrected for congenital anomalies and extreme prematurity, it is marginally higher. It was then considerably reduced after correction for booking status.
RESUMO
To study pathological mucosal changes, gut bacteriological spectrum [bacterial overgrowth] and some pancreatic exocrine function in Giardiasis. 50 Patients having Giardia lamblia infection proved by stool examination beside, 20 healthy controls of matched age, sex and socioeconomic status. All patients and controls were subjected to thorough history and clinical examinations. Stool examination for diagnosis of giardia and study of fat contents, liver function tests, renal function tests, glucose tolerance curve, plain x-ray abdomen and abdominal ultrasonographly. Pancreatic function tests in the form of trypsin and amylase activities in duodenal aspirate, besides serum amylase and trypsin concentrations Upper GIT endoscopy for taking duodenal biopsy Also, parsitological and bacteriological examination for the duodenal aspirates. Both amylase and trypsin activities were lowered in patients than controls [t = 9.256] [t =7.284] and in patients with severe mucosal abnormalities than in patients with minor or no abnormalities [t = 7.462] and [t = 6.567] respectively. On the other hand, both serum amylase and trypsin concentrations showed significant elevation in patients than controls [t = 8.676] and [t= 7.827] and in patients with severe mucosal abnormalities than in patients with minor or no abnormalities [t =7.541] and [t = 7.623] respectively Giardia infection leads to a state of pancreatic exocrine insufficiency which resulted mainly from duodenal mucosal changes rather than bacterial overgrowth