Staphylococcus aureus bacteremia.

OBJECTIVES: To study the episodes of Staph.aureus bacteremia diagnosed at King Abdulaziz University Hospital, to determine the source of infection, risk factors, the outcome of treatment and to compare our results with those reported in the literature. METHODS: A retrospective study in which the episodes of Staph.aureus bacteremia diagnosed at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia in the period from June 1996 to December 1998 were analyzed. RESULTS: A total of 103 episodes of Staph.aureus bacteremia were diagnosed in 95 patients with a mean age of 33.61 years (range 2 months to 90 years) and male:female ratio of 1.9:1. More than 50% of patients were Saudi nationals. Hospital-acquired infection was detected in 74% of the episodes versus 25% community-acquired. Methicillin resistant Staph.aureus was found in 29% of the episodes. Intravenous catheters and wounds were the main sources of bacteremic episodes (29% and 21%). The overall mortality was 32% with significant association with old age, diabetes mellitus and hemodialysis for renal failure. Risk factors such as surgical wounds, diabetes mellitus and malignancy, were more frequently associated with hospital-acquired than community-acquired bacteremia. Infective endocarditis was higher in patients with community-acquired bacteremia who had unknown source of infection. CONCLUSIONS: As discussed in the text, our results are comparable with those reported in the literature. Insertion of intravenous catheters under aseptic precaution, better care and judicious limitation of patients length of exposure to central line, in addition to proper wound dressings could reduce the frequency of blood stream infections.

Surgery in Egypt.

The history of medicine can never be complete without referral to ancient Egyptian medicine. Imhotep has been identified as the god of medicine. There are 13 faculties of medicine in Egypt; the oldest is the Kasr El Aini Faculty, which started in 1925. We review undergraduate and postgraduate education in Egypt. The Egyptian Society of Surgeons organizes the scientific surgical activities. Schistosomiasis is a national health problem. Health care is provided by many types of hospitals, including university, teaching, Ministry of Public Health, military, and private hospitals.

Visual laser ablation of the prostate (VLAP) with bare fiber in conjunction with laser bladder neck incision in the treatment of patients with benign prostatic hyperplasia (BPH).

The objective of this paper was to assess the effectiveness of visual laser ablation of the prostate (VLAP) using a bare fiber with simultaneous laser incision of the bladder neck for patients with symptomatic benign prostatic hyperplasia. Sixty-seven patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were entered into a prospective trial where VLAP was done with neodymium:YAG laser, while the bladder neck incision was done with KTP laser. The laser was delivered using a bare fiber. There was marked improvement demonstrated at three months post-lasing in symptom score and flow rate. No significant changes were noticed in the subsequent follow-up. However, the addition of the bladder neck incision increased the rate of retrograde ejaculation without appreciable improvement in symptom score or flow rate when compared to other published data. None of the patients developed bladder neck contracture. VLAP, using a bare fiber, in conjunction with laser bladder neck incision, produces durable improvement in urine flow rate and symptom score in patients with symptomatic benign prostatic hyperplasia without the development of bladder neck contracture. This method will reduce the costs of laser prostatectomy.