Behavioral and emotional effects of repeated general anesthesia in young children

Preclinical and clinical data suggest the possibility of neurotoxicity following exposure of young children to general anesthetics with subsequent behavioral disturbances. The aim of the study was to determine the overall effect of repeated general anesthesia on behavior and emotions of young children aged 1½-5 years old, compared to healthy children. Thirty-five children underwent repeated anesthesia and surgery were matched with the same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist [CBCL] 1½-5 years and Diagnostic and Statistical Manual of Mental Disorders [DSM] oriented scale. Behavior data were collected through a semi-structured questionnaire. The CBCL score revealed that children with repeated anesthesia were at risk to become anxious or depressed [relative risk [RR]; 95% confidence interval [CI] = 11 [1.5-80.7]], to have sleep [RR; 95% CI = 4.5 [1.1-19.4]], and attention problems [RR; 95% CI = 8 [1.1-60.6]]. There was no difference in the risk between the two groups regarding emotionally reactive, somatic complaints, withdrawn problems, aggressive behavior, internalizing or externalizing problems. On DSM scale, children with repeated anesthesia were at risk to develop anxiety problems [RR; 95% CI = 3.7 [1.1-12.0]], and attention deficit/hyperactivity problems [RR; 95% CI = 3 [1.1-8.4]]. There was no difference in the risk between the two groups regarding affective, pervasive developmental and oppositional defiant problems. Young children who undergone repeated surgical procedures under general anesthesia were at risk for subsequent behavioral and emotional disturbances. Proper perioperative pain management, social support, and avoidance of unpleasant surgical experiences could minimize these untoward consequences

Correlation between the RhD genotyping and RhD serotyping in isoimmunized pregnancies

Alloimmunisation was one of the most important causes of perinatal mortality and morbidity by the middle of the last century. The objective of the present study was to investigate the presence of the RHD gene in fetal cells [amniocytes] obtained from amniotic fluid by genotyping to compare it with the RhD serotyping. Also to correlate the presence of RhD gene with the neonatal outcome. This work was carried out at Maternity hospital and Medical Genetics center, while PCR testing was done at the Medical Research center, Faculty of Medicine, Ain Shams University in the period from 2008 to 2010. The present study included recruiting of 20 RhD negative [sensitized to the RhD antigen] pregnant mothers. The entire study group was subjected to complete general, obstetric and a detailed obstetric ultrasonographic examination. Rh typing and indirect Coomb's test were also done. Amniocentesis was performed with a 20-gauge needle under continuous ultrasound guidance. RhD serotyping of the fetuses showed that, 14 fetuses [70%] were positive and six fetuses [30%] were negative. While using RhD gentyping 13 cases [65%] were positive and seven cases [35%] were negative [P value = 0.002]. Among fetuses positive for RhD genotyping six fetuses [46%] had received postnatal treatment, while among fetuses negative for RhD genotyping, neither of them had received postnatal treatment [P value = 0.032], which is statistically significant. From the present study we can conclude that, the identification of an antigen-negative fetus on the basis of the blood group genotype provides significant advantages in managing the pregnancy at risk for HDFN

In vitro processing of donors' blood with quinine for elimination of malaria parasites

To eliminate malaria parasites in donors' blood in vitro for eradication of transfusion-induced malaria. We conducted the study at Ahmed Gasim Hospital in Khartoum, Sudan, between January 2005 and January 2006. Out of 4484 blood samples screened for malaria parasite microscopically, only 30 [200 ml each] satisfied the inclusion criteria of this study. The samples were subdivided equally into 4 portions. Three concentrations of quinine were separately added to 3 specimens while the fourth left without quinine [control]. Blood specimens were tested on the day of collection by hematological and biochemical techniques simultaneously, and after 24 and 48 hours at 4-6 degrees celcius by the same techniques. The number of malaria parasites killed were found to be proportional to the concentrations of quinine and to the storage period, while donors' blood samples without quinine revealed a stable number of the viable parasites during the storage. Quinine was highly effective within 24 hours storage. The detected lethal dose of the applied drug to malaria parasites was generally safe to all constituents of the stored blood. Our study shows that quinine could be used for the eradication of transfusion-induced malaria by in vitro processing of donors blood. The optimal doses could be added to bags' blood post phlebotomy

Endoscopic transcanal tympanoplasty

The authors report their experience with the use of otoendoscope in the reconstruction of the tympanic membrane. Studyed design: Case review study Methods Charts were reviewed for all patients who underwent endoscopic transcanal tympanoplasty between November 2002 and November 2004. Autograft temporalis fascia was used in all cases. There were 24 patients with uncomplicated central perforation. Success was defined as complete graft taking and hearing improvement. Results graft taking success rate was 87.5% and hearing improvement was achieved in all, except one who had developed serous otitis media and required a myringotomy tube in the postoperative period

Arterial hypertension in Saudi Arabia

Across-sectional population-based survey employing a cluster sampling method and household visits by trained health teams investigated hypertension prevalence in the Kingdom among 13, 700 individuals of both sexes in all age groups. The World Health Organization [WHO] definition of hypertension of 160/95 mmHg was used; it was found that 9.1% and 8.7% of the total sample investigated were systolic and diastolic hypertensive, respectively. However, 12.4% and 7.9% of children younger than 18 years were systolic and diastolic hypertensive. Among adults aged 18 years and above, 5.3% were systolic and 7.3% were diastolic hypertensive; 87.5% of systolic and 79.4% of diastolic hypertensive were aged 40 years and over. Females had statistically significant elevated systolic hypertension compared with males [P< 0.01]. However, if blood pressure 140/90 mmHg is used as a criterion for hypertension definition, the prevalence among the latter age groups would be 20.4% for systolic and 25.9% for diastolic hypertension. The prevalence of Isolated Systolic Hypertension [ISH], Isolated Diastolic Hypertension [IDH] and Systolic Hypertension [SDH] among adults above 18 years was 1.8%, 3.8% and 3.5% respectively. ISH was higher among females compared with males [2% vs 1.4%], while IDH was higher among males than females [4.4% vs 3.4%]. There is a need for tracking childhood hypertension, which could provide long-term analysis for risk adult hypertension