ABSTRACT
OBJECTIVE: To evaluate the outcome of primary versus secondary ureteroscopy for pediatric ureteral stones. PATIENTS AND METHODS: A retrospective chart review study that included 66 children aged less than 12 years, who were subdivided into two groups: Group A, which included 42 children who had undergone primary ureteroscopy without pre-stenting; and Group B, which included 24 children who had undergone ureteroscopy after ureteric stenting. Kidneys, ureters and bladder radiographs were done on the first postoperative day to assess the degree of stone clearance and stent position. RESULTS: Age, gender, stone location and stone size were not significantly different between both groups. In Group A, 31 (73.8%) children required ureteric dilation, 13 (31%) had a tight ureter that failed to respond to dilation, 25 (59.5%) displayed complete stone clearance, and of these, 13 (52%) needed postoperative stenting. One child experienced ureteric injury during stone disintegration and was stented for two weeks. Children in Group B experienced a 95.8% complete stone clearance rate, with no ureteric injury reported; postoperative stenting was performed in three (12.5%) children.. CONCLUSION: Secondary ureteroscopy is preferable over primary ureteroscopy in pediatric populations because of a significantly lower need for ureteric dilation, shorter procedure time and better stone clearance rate..
Subject(s)
Ureteroscopy , Algorithms , Child , Child, Preschool , Dilatation , Female , Humans , Male , Retrospective Studies , Treatment Outcome , Ureteral CalculiABSTRACT
We studied 21 patients with Sanjad-Sakati syndrome (SSS) from 16 families. Parental consanguinity was recorded in 2 families (12.5%). All patients had severe intrauterine growth retardation, short stature, small hands and feet, blue sclera, deep-set eyes, microcephaly, persistent hypocalcaemia and hypoparathyroidism. Medullary stenosis was detected in 2 patients. Cytogenetic and fluorescent in situ hybridization studies were normal. All affected persons had homozygous deletion of 12 bp (155-166del) in exon 3 of the TBCE gene. All of the parents were heterozygous carriers of this mutation. The high frequency of SSS and low frequency of consanguineous marriages in this study may reflect a high rate of heterozygous carriers.
Subject(s)
Abnormalities, Multiple/genetics , Fetal Growth Retardation/genetics , Hypocalcemia/genetics , Hypoparathyroidism/genetics , Intellectual Disability/genetics , Microcephaly/genetics , Abnormalities, Multiple/epidemiology , Chromosome Deletion , Consanguinity , Cytogenetic Analysis , Fetal Growth Retardation/epidemiology , Genes, Recessive/genetics , Heterozygote , Homozygote , Humans , Hypocalcemia/epidemiology , Hypoparathyroidism/epidemiology , In Situ Hybridization, Fluorescence , Infant, Newborn , Intellectual Disability/epidemiology , Kuwait/epidemiology , Microcephaly/epidemiology , Molecular Chaperones/genetics , Mutation/genetics , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , SyndromeABSTRACT
We studied 21 patients with Sanjad-Sakati syndrome [SSS] from 16 families. Parental consanguinity was recorded in 2 families [12.5%]. All patients had severe intrauterine growth retardation, short stature, small hands and feet, blue sclera, deep-set eyes, microcephaly, persistent hypocalcaemia and hypoparathyroidism. Medullary stenosis was detected in 2 patients. Cytogenetic and fluorescent in situ hybridization studies were normal. All affected persons had homozygous deletion of 12 bp [155-166del] in exon 3 of the TBCE gene. All of the parents were heterozygous carriers of this mutation. The high frequency of SSS and low frequency of consanguineous marriages in this study may reflect a high rate of heterozygous carriers
Subject(s)
Hyperostosis, Cortical, Congenital , Polymerase Chain Reaction , Mutation , Parents , Consanguinity , Syndrome , Hypoparathyroidism , Intellectual DisabilitySubject(s)
Abnormalities, Multiple/genetics , Face/abnormalities , Growth Disorders/genetics , Intellectual Disability/genetics , Language Development Disorders/genetics , Abnormalities, Multiple/epidemiology , Child , Female , Genes, Dominant/genetics , Growth Disorders/epidemiology , Humans , Intellectual Disability/epidemiology , Kuwait/epidemiology , Language Development Disorders/epidemiology , Microcephaly/epidemiology , Microcephaly/genetics , Pedigree , Rare Diseases , Syndactyly/epidemiology , Syndactyly/genetics , SyndromeABSTRACT
In a prospective study in Kuwait, 182 mentally retarded male patients who fulfilled 5 or more clinical criteria of fragile X syndrome were screened using polymerase chain reaction (PCR) testing. Twenty patients (11%) were highly suspected of having fragile X syndrome due to mutation at the FRAXA locus; none had mutation at the FRAXE locus. Of these, 11 (55%) were confirmed fragile-X-positive by both cytogenetic and PCR techniques. The most frequent clinical features were: prominent forehead, high arched palate, hyperextensible joints, long ears, prominent jaw, height > 10th centile and attention-deficit hyperactivity. Less common were avoidance of eye contact (45%), autism (45%) and seizures (30%). Large testes were found in 55% of cases. Pre-pubertal and post-pubertal clinical criteria were different.
Subject(s)
Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Intellectual Disability/etiology , Age Factors , Blotting, Southern , Cytogenetics/methods , Fragile X Mental Retardation Protein , Fragile X Syndrome/complications , Fragile X Syndrome/epidemiology , Genetic Testing/methods , Humans , Incidence , Intellectual Disability/diagnosis , Kuwait/epidemiology , Male , Nerve Tissue Proteins/genetics , Pedigree , Polymerase Chain Reaction/methods , Prevalence , Prospective Studies , Puberty , RNA-Binding Proteins/genetics , Sensitivity and Specificity , Severity of Illness Index , Time Factors , Wechsler ScalesABSTRACT
In a prospective study in Kuwait, 182 mentally retarded male patients who fulfilled 5 or more clinical criteria of fragile X syndrome were screened using polymerase chain reaction [PCR] testing. Twenty patients [11%] were highly suspected of having fragile X syndrome due to mutation at the FRAXA locus; none had mutation at the FRAXE locus. Of these, 11 [55%] were confirmed fragile-X-positive by both cytogenetic and PCR techniques. The most frequent clinical features were: prominent forehead, high arched palate, hyperextensible joints, long ears, prominent jaw, height > 10th centile and attention-deficit hyperactivity. Less common were avoidance of eye contact [45%], autism [45%] and seizures [30%]. Large testes were found in 55% of cases. Pre-pubertal and post-pubertal clinical criteria were different
Subject(s)
Blotting, Southern , Cytogenetics , Fragile X Mental Retardation Protein , Genetic Testing , Incidence , Intellectual Disability , Nerve Tissue Proteins , Puberty , Fragile X SyndromeABSTRACT
OBJECTIVE: This study was carried out to assess control of blood glucose among diabetic patients attending Primary Health Care Centers in Riyadh. METHODS: It is a retrospective study where fasting blood glucose reading for all diabetic patients attending 3 randomly selected Primary Health Care Centers in Riyadh was taken during the months of March and April 2000. The patients were divided into 3 categories: those with excellent, those with acceptable and those with poor glycemic control (Fasting blood sugar 4-7, 7-10 and more than 10 mmol/litres). RESULTS: A total of 991 diabetic patients were involved in the study (83% men and 62% women). Those with excellent glycemic control represent 21% of patients in the first reading and 25% of the patients in the second readings, while those with poor control represent 49% and 44% of the patients in the two readings. The remaining are in the acceptable category. CONCLUSION: Diabetes mellitus is poorly controlled in a large proportion of diabetic patients attending Primary Health Care Centers in Riyadh. Public education and awareness programs should be encouraged. Such programs must include the importance of appropriate life style changes and of self monitoring of blood glucose at home.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus/blood , Diabetes Mellitus/prevention & control , Blood Glucose Self-Monitoring , Diabetes Mellitus/economics , Diabetes Mellitus/epidemiology , Fasting , Female , Humans , Life Style , Male , Needs Assessment , Patient Education as Topic , Primary Health Care , Retrospective Studies , Saudi Arabia/epidemiologySubject(s)
Anti-Bacterial Agents/therapeutic use , Attitude to Health , Drug Utilization/statistics & numerical data , Health Knowledge, Attitudes, Practice , Urban Health/statistics & numerical data , Drug and Narcotic Control , Health Services Misuse/statistics & numerical data , Humans , Patient Selection , Saudi Arabia , Self Medication/psychology , Self Medication/statistics & numerical data , Surveys and QuestionnairesABSTRACT
A simple, safe technique for complete excision of pilonidal pathology and immediate fasciocutaneous rhomboid flap closure is presented. Twenty-five patients were treated. All wounds healed by first intention, with no patient remaining in the hospital for more than 10 days. Earlier cases were followed up for 2 years. No recurrence has yet been encountered.
Subject(s)
Pilonidal Sinus/surgery , Surgical Flaps , Adolescent , Adult , Female , Humans , Male , Methods , Recurrence , Wound HealingSubject(s)
Dermatologic Surgical Procedures , Surgical Instruments , Suture Techniques , Humans , NeedlesABSTRACT
A new operation for pilonidal sinus is described. This utilizes a rhomboid transposition flap to cover the defect left after radical excision. The results show healing by first intention in 29 out of 30 patients. No patient remained in hospital for more than ten days. Minor infection took place in five cases and major infection in one case. Patients have been followed for up to three years. No recurrence has yet been encountered. The reasons for the success of this operation are discussed.
Subject(s)
Pilonidal Sinus/surgery , Surgical Flaps , Adult , Humans , MaleABSTRACT
Cutaneous leishmaniasis, treated or untreated, is known to leave disfiguring scars. These scars are usually on exposed parts, for which plastic surgery may be required. The present work deals with the treatment of cutaneous leishmaniasis using surgical techniques from the onset. In 20 patients, 35 lesions were excised down to the deep fascia. To cover the resulting defect, subcuticular sutures were used in 7 small lesions. Dufourmental (LLL flap) and Limberg flaps were used in 23 lesions of moderate size. Free grafting was resorted to in five large lesions. Using these techniques, morbidity was reduced and cosmetic results were satisfactory.
Subject(s)
Leishmaniasis/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Methods , Middle Aged , Skin Transplantation , Surgical FlapsABSTRACT
We report 20 chronic leg ulcers successfully treated by rotating an anterior tibial flap, which is a modification of the dorsalis pedis flap. The sizes of the flaps ranged from 6 x 6 cm up to 15 x 13 cm; the largest ones are not recommended, for fear of development of persistent lymphedema of the foot. These flaps are dissected upward through the leg and pedicled on the anterior tibial vessels, so they can be rotated to any site on the anterior, lateral, or medial side of the leg.
