Vitamin D Deficiency and Its Associated Factors among Female Migrants in the United Arab Emirates.

Vitamin D is important for bone health, and vitamin D deficiency could be linked to noncommunicable diseases, including cardiovascular disease. The purpose of this study was to determine the prevalence of vitamin D deficiency and its associated risk factors among female migrants from Philippines, Arab, and South Asian countries residing in the United Arab Emirates (UAE). We used a cross-sectional study to recruit a random sample (N = 550) of female migrants aged 18 years and over in the city of Al Ain, UAE. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentrations ≤20 ng/mL (50 nmol/L). We used multivariable logistic regression analysis to identify risk factors associated with vitamin D deficiency. The mean age of participants was 35 years (SD ± 10). The overall prevalence rate of vitamin D deficiency was 67% (95% CI 60-73%), with the highest rate seen in Arabs (87%), followed by South Asians (83%) and the lowest in Filipinas (15%). Multivariate analyses showed that low physical activity (adjusted odds ratio (aOR) = 4.59; 95% CI 1.98, 10.63), having more than 5 years duration of residence in the UAE (aOR = 4.65; 95% CI: 1.31, 16.53) and being obese (aOR = 3.56; 95% CI 1.04, 12.20) were independently associated with vitamin D deficiency, after controlling for age and nationality. In summary, vitamin D deficiency was highly prevalent among female migrants, especially Arabs and South Asians. It is crucial that health professionals in the UAE become aware of this situation among this vulnerable subpopulation and provide intervention strategies aiming to rectify vitamin D deficiency by focusing more on sun exposure, physical activity, and supplementation.

Pediatric Liver Transplantation for Alagille Syndrome: Anesthetic Evaluation and Perioperative Management.

BACKGROUND Alagille syndrome (AGS) is an autosomal dominant hereditary disorder characterized by identifiable abnormalities in the liver, heart, face, skeleton, and eyes. Recently, liver transplantation (LT) has been proposed as a therapeutic strategy for patients with AGS complicated by end-stage liver disease, but clinical experience in performing anesthesia in LT for AGS is still scarce. We aimed to summarize our preliminary experience in the anesthetic management of LT for AGS in this study. MATERIAL AND METHODS We reviewed the cases of 11 patients with AGS who underwent LT from September 2017 to April 2019. Preoperative multi-system comorbidities, intraoperative details, and postoperative outcomes were retrospectively collected and summarized. RESULTS Cardiopulmonary abnormalities were common (81.8%) in AGS patients before LT, and the most frequent comorbidity was pulmonary artery stenosis. After careful anesthetic evaluation and perioperative management, all patients survived during the perioperative period without significant cardiovascular complications. However, there was an unexpectedly high prevalence of surgical complications and re-operations in AGS patients compared to biliary atresia recipients (54.5% vs. 22.4%, P=0.031; and 45.5% vs. 15.3%, P=0.028, respectively). CONCLUSIONS Perioperative management of LT for AGS patients can be particularly challenging, requiring a full understanding of the pathophysiology, as well as a careful preoperative evaluation of the multi-system comorbidities. The high prevalence of postoperative surgical complications should be a matter of concern.

Ultrasound guided internal jugular venous cannulation: comparison with land-mark technique.

OBJECTIVE: To compare real-time ultrasonography-guided technique versus the traditional land-mark technique for internal Jugular venous cannulation. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Department of Anaesthesia, Combined Military Hospital, Rawalpindi, from September 2013 to July 2014. METHODOLOGY: A total of 200 patients who required internal jugular vein cannulation were randomly assigned using either real-time ultrasound-guided technique or land-mark technique. Access time, number of attempts until successful cannulation, complications and the demographics of each patient were recorded. RESULTS: Access time was significantly less in real-time ultrasound group (34.95 ± 11.47 vs. 146.59 ± 40.20 seconds, p < 0.001). Cannulation was performed in first attempt in 99% of patients in ultrasound group as compared to 89% of landmark group. Complication rate was significantly higher in the land-mark group than in the ultrasound-guided group. Carotid artery puncture rate (9% vs. 1%) and haematoma formation (7% vs. 0%) were more frequent in the land-mark group than in the ultrasound-guided group. Brachial plexus irritation was also more in land-mark group (6% vs. 0%). CONCLUSION: Access time, failure rate and procedure related complications are reduced when real-time ultrasonography is used to cannulate internal Jugular vein.

Anaesthetic risks in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy.

OBJECTIVE: To determine the frequency of anaesthetic risks in children having Obstructive Sleep Apnea Syndrome (OSAS), undergoing adenotonsillectomy. STUDY DESIGN: A case-control study. PLACE AND DURATION OF STUDY: Department of Anaesthesiology, Armed Forces Hospital, Najran, Saudi Arabia from November 2006 to January 2008. METHODOLOGY: The study was carried out in 60 children scheduled to undergo adenotonsillectomy and divided into two equal groups of 30 each. Group-1 had obstructive sleep apnoea syndrome and group-2 had children without it. Both groups were given a standard general anaesthesia and frequency and rate of complications and medical interventions taken in such children were studied. P-value and odds ratio were determined. RESULTS: The age ranged from 3 to 10 years. The frequency of difficult intubation was higher in the group-1 than in the control group (16.6 vs. 3.3%, odds ratio 5.8). At the time of induction of anaesthesia desaturation was higher in group-1 (33.3 vs. 6.6%, p=0.021, odds ratio 7). At the time of extubation, desaturation was significantly higher in group-1 (43.3 vs. 6.6%, p=0.002, odds ratio 10.70). The complications at extubation, for example cough, laryngospasm and postoperative nausea and vomiting were higher in group-1 but not statistically significant. In the postanaesthesia care unit, the frequency of complications and medical interventions were also higher in group-1. More patients of group-1 required oxygen (63.3 vs. 10%, p < 0.001, odds ratio 15.54) and insertion of an oropharyngeal airway (20% vs. nil, p=0.023) respectively. CONCLUSION: Children with OSAS, operated for adenotonsillectomy, are at significant risk of certain life-threatening perioperative anaesthetic complications. These results may be used as a guideline for safe and successful anaesthetic management of these children.