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2004| September-December | Volume 10 | Issue 3
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The completeness rate of colonoscopy in a cohort of unsedated patients
Abdulrahman Mohammed Aljebreen
September-December 2004, 10(3):150-154
Colonoscopy is considered a painful procedure requiring routine intravenous sedation, however there are number of potential advantages to performing colonoscopy without sedation. The aim of this study was to determine the effect of unsedated colonoscopy on the success rate of caecal intubation.
Patients and methods:
All charts of patients who had unsedated colonoscopy from January 2002 to September 2003 were reviewed. Patient characteristics including age, gender, and mode of presentation were collected. The success rate of unsedated colonoscopy was compared with the standard success rate of sedated colonoscopy in the literature. The reasons for incomplete colonoscopy and sites reached were recorded.
During the study period, 503 examinations were performed. Patients mean age was 48.5 years, 55.9 % of them were males. Colonic polyps were the predominant abnormal endoscopic finding; occurring in 21.3%. The completion rate in the study population excluding patients with obstructive disease and patients with inadequate preparation was only 67%.
In this cohort studiy, sedation probably affects the overall success rate of cecal intubation. A large prospective randomized study comparing sedated with unsedated colonoscopy in terms of completion rate and patient satisfaction is needed
carriers among expatriate workers in Al-Qatif area
Hassan Mohammed Albreiki, Amein Kadhem Al-Ali, Arputhasamy Joseph Rayan
September-December 2004, 10(3):140-143
Salmonella infection and diarrhoeal diseases are major causes of morbidity and mortality in the developing world. All expatriates applying for work permits in the Kingdom of Saudi Arabia (KSA) have to undergo a governmental compulsory health check program.
Aim of the study:
To estimate the number of salmonella carriers who had previously been diagnosed as free of infection.
Subjects and methods:
Over a period of two years, a total of 17, 918 workers in Al-Qatif area, in the Eastern Province were tested for salmonella on stool samples.
Three hundred and twenty eight were found to be asymptomatic carriers of salmonella. The highest frequency was found among workers from Egypt (13.1 %) while Filipinos and Indians were the lowest carriers (1.2%). Salmonella serogroups E, C 1 and C2 were most common ( 29%, 29% and 23.5% respectively) followed by serogroups B, D and C (13%, 3.7% and 1% respectively). No Shigella species were isolated. All carriers were given antibiotics and were instructed in prophylactic hygiene measures. After completing the course of antibiotics, they were retested and found to be clear of infection.
The health check system in this area will contribute towards the prevention of outbreaks of infection by salmonella
Outcome of pancreaticoduodenectomy: Comparing the classic whipple with pyloric preservation
Mohammed Reza Kohsari, Hedayat Riazi, Manzar Hussein Akbar
September-December 2004, 10(3):144-149
The majority of patients presenting with periampullary neoplasms are operative candidates and are treated surgically.
Aim of the study:
To assess the complications, morbidity, mortality and 2-year survival rates, and safety of pancreaticoduodenectomy for periampullary carcinomas in a non-oncology surgical set-up.
Patients and methods:
Records of 23 patients underwent pancreaticoduodenectomy for periampullary cancers between July 1995 and April 2001 in Guilan, Iran, were reviewed.
Among 23 consecutive patients who underwent pancreaticoduodenectomy, 16 were men and 7 were women, and the mean age was 58 +/-10.2years. All the patients had a malignant neoplasm. Mean operative time was 7.3 hours. The surgical procedure was pylorus-preserving pancreaticoduodenectomy (PPPD) in 65%. The median intraoperative blood loss was 625 ml and no transfusion was required. There was no intraoperative mortality, and the overall 30-day postoperative mortality rate was 4.5%. Delayed gastric emptying was the most common postoperative complication. The 2-year survival rates for periampullary cancers were 93% in PPPD and 62.5% in classic Whipple procedure.
Pancreaticoduodenectomy for periampullary tumors remains a formidable procedure in our set-up. It can be performed safely with low mortality and morbidity rates
Gallbladder perforation: A case report and review of the literature
Amit Goel, P Kumar Ganguly
September-December 2004, 10(3):155-156
Omental infection secondary to blunt trauma in a child
Asal Izzidien Al-Samarrai, Jenny Almond, Ayodele Kolawole Adebanjo
September-December 2004, 10(3):157-159
Hepatitis C virus infection in Saudi Arabia
Hisham Osman Akbar
September-December 2004, 10(3):127-131
Infection with hepatitis C virus (HCV) is a common global cause of chronic liver disease, which is also true in Saudi Arabia. HCV prevalence in Saudi Arabia varies in different provinces being highest in the Western and Southern provinces. Most of the studies among blood donors documented a decrease in HCV prevalence, probably due to increase awareness and improved socioeconomic status. Genotype 4 is the commonest genotype in Saudi patients infected with HCV which unfortunately is least likely to respond to the standard interferon therapy though recent studies using pegylated interferon demonstrated promising results. Liver transplantation for patients with end stage liver disease was started in 1994 but the cases currently done are still less than that required
The association of helicobacter pylori infection with coronary artery disease: Fact or fiction?
Mohamed Zakaria Khalil
September-December 2004, 10(3):132-139
Helicobacter pylori (H. pylori) infection is an important cause of peptic ulcer disease and other gastrointestinal disorders. Since its discovery, a number of extra-gastrointestinal diseases have been reported to be associated with H. pylori infection. Recently, several epidemiological and clinical studies suggested that H. pylori infection has been associated with an increased risk of developing coronary artery disease (CAD). Evidence from animal studies showed that H. pylori plays an important role in the acute phase of myocardial infarction by causing platelet aggregation and inducing pro-coagulant activity in experimentally infected mice. However, results from human studies are conflicting in providing clear evidence for an association between H. pylori and CAD. Therefore, the aim of this article is to critically analyze the available evidence to prove or refute such an association
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