Prevalence of and Reasons for Patients Leaving Against Medical Advice from Paediatric Wards in Oman.

The objective of this study was to determine the prevalence of and reasons for patients leaving against medical advice (LAMA) in a paediatric setting in Oman. This retrospective study was carried out between January 2007 and December 2009 and assessed patients who left the paediatric wards at the Royal Hospital, Muscat, Oman, against medical advice. Of 11,482 regular discharges, there were 183 cases of LAMA (prevalence: 1.6%). Dissatisfaction with treatment and a desire to seek a second opinion were collectively the most cited reasons for LAMA according to data from the hospital's electronic system (27.9%) and telephone conversations with patients' parents (55.0%). No reasons for LAMA were documented in the hospital's electronic system for 109 patients (59.6%). The low observed prevalence of LAMA suggests good medical practice at the Royal Hospital. This study indicates the need for thorough documentation of all LAMA cases to ensure the availability of high-quality data for healthcare workers involved in preventing LAMA.

The role of antioxidant enzymes in TCDD-induced oxidative stress in various brain regions of rats after subchronic exposure.

The induction of oxidative stress by TCDD in various brain regions of rats has been investigated after subchronic exposure. TCDD was administered by gavage to female Sprague-Dawley rats at daily doses of 0, 10, 22, and 46 ng/kg for 13 weeks. The brains were dissected to cerebral cortex (Cc), hippocampus (H), cerebellum (C), and brain stem (Bs); the production of superoxide anion (SA) and lipid peroxides and the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) were determined in those regions. TCDD caused dose-dependent increases in the production of SA and lipid peroxidation in Cc and H and those were associated with dose-dependent suppressions of SOD. While a TCDD dose of 10 ng/kg/d resulted in significant increases in catalase and GSH-Px activities in Cc and H, doses of 22 and 46 ng/kg/d resulted in dose-dependent suppressions of these two enzymes in the same regions. In the C and Bs, TCDD treatment did not result in significant production of SA and lipid peroxidation but it resulted in dose-dependent increases in the activities of various antioxidant enzymes. These results suggest that Cc and H are vulnerable to TCDD-induced oxidative stress after subchronic exposure, and that C and Bs are protected against that effect.