Prevalence and risk factors of gallstone disease in a high altitude Saudi population

To study the prevalence of gallstone disease and related risk factors in a Saudi Arabian population a cross-sectional community-based study was made of 291 people from Abha district, Asir region. A structured interview collected background data and all participants had upper abdominal ultrasonography to detect gallstones. The overall prevalence of gallstone disease was 11.7%. Using logistic regression multivariate analysis, the following were significant risk factors for gallstone disease: female sex, family history of gallstone disease and past history of pancreatitis. Age, education, blood pressure, smoking, coffee intake, overweight, diabetes mellitus, number of pregnancies and use of oral contraceptives were not significant risk factors. Discriminant analysis of symptoms showed that only right hypochondrium pain was significantly associated with gallstone disease

Remifentanil by patient controlled analgesia compared with epidural analgesia for pain relief in labour

Epidural analgesia has been established as the gold standard for labour analgesia. However, clinical contraindications and personnel or institutional limitations preclude some parturients from receiving an epidural. Remifentanil has been suggested as an ideal opioid for patient controlled analgesia [PCA] in labour. In our study we compared the use of PCA remifentanil to epidural analgesia in labour as regard pain relief, safety of the mother and the fetus, side effects, and overall parturient's satisfaction. After ethical committee approval and informed written consent 30 healthy pregnant women ASA I or II, with no obstetric complications or contraindication to remifentanil or epidural analgesia were included in the study randomly allocated into one of two equal groups, in [Group EP] epidural infusion of bupivacain 1% plus 2 micro g/ml of fentanyl was given and in [Group R] the women received PCA remifentanil with a bolus of 0.4 micro g kg[-1] over 20 seconds and a lockout period of 1 min as an analgesia for labour. There was significant decrease in [VAS] of pain in both groups with significantly more decrease in [Group EP]. There were no significant difference between both groups as regard arterial blood pressure, heart rate, oxygen saturation, nausea, and overall patient's satisfaction. Sedation scores were significantly higher in [Group R], there were no serious bradycardia, hypotension, or desaturation, and all the parturients were easily arousable. There were no fetal heart rate changes that required interference. The median 1 and 5 minutes Apgar scores were 9 in both groups, and the mean umbilical cord gases, and lactate levels were within normal limits with no difference between both groups. Our study demonstrated that epidural infusion gives superior analgesia for labour than PCA remifentanil, however PCA remifentanil is a good, safe, and could be an alternative method of analgesia for labour