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1998| January-April | Volume 4 | Issue 1
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Treatment of acute pancreatitis
Ibrahim Abdulkarim Al-Mofleh
January-April 1998, 4(1):1-7
There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future.
Helicobacter pylori in the dental plaque of healthy Saudis
Qais Qutub Contractor, Mohammed Yasin Tahir, Shahzad Naseem, Shamweel Ahmad
January-April 1998, 4(1):13-16
The objective of this study is to determine the presence of Helicobacter pylori in the dental plaque of healthy Saudis and its relation to dental care. One hundred randomly selected healthy Saudis attending the dental clinic were assessed for oral hygiene and periodontal disease by dental examination. Information about the use of toothpaste, chewing stick, smoking and dentures was obtained. Samples of dental plaque were collected after scoring it according to the plaque index. Presence of H. pylori in the plaque was sought by a commercially available rapid urease test with a sensitivity of 94% and a specificity of 100%. The presence of H. pylori was indicated by a positive rapid urease test in 81 %. There was significant correlation of heavy dental plaque (plaque index score 3) with presence of H. pylori (p=0.03). We conclude that H. pylori is present in the dental plaque of most Saudis and this is due to poor oral hygiene.
Seasonal variation in the incidence of endoscopically diagnosed duodenal ulcer in Sudan
Musa Mohamed Kheir, Sulieman Salih Fedail, Abdel Gadir El Kadrou
January-April 1998, 4(1):17-19
The seasonal pattern of endoscopically diagnosed duodenal ulcer disease in an endoscopy unit in Suba University Hospital and Ibn Sina Hospital, Sudan, was evaluated retrospectively for the period 1980-1988. We reviewed all the 12443 endoscopy records and found 1348 cases of duodenal ulcers. The incidence of duodenal ulcer was then calculated for each month separately. We found that in Sudan the frequency of duodenal ulcer is significantly higher during winter (January-February), and significantly lower during summer (May-August).
Doxycline-induced esophageal ulcerations
Mohammad Abdullah Al Mofarreh, Ibrahim Abdulkarim Al Mofleh
January-April 1998, 4(1):20-24
Over a period of six years 16 patients presented to Dr. Al Mofarreh's polyclinic with drug-induced esophageal ulcerations. One patient had esophagitis without ulcerations and two patients, who declined endoscopy were not included in this analyzis. The mean age of the remaining 13 patients was 28.92 ± 10.39 years. The mean ulcers number was 3.69 ± 2.76. The ulcers were located at the mid-esophagus, 29.23 ± 3.94 cm from the incisors teeth. Odynophagea, retrosternal pain and dysphagea in 13 (100%), 12 (92%) and 9 (69%) patients, respectively, were the most frequent presenting symptoms. All patients took a doxycycline preparation at bed time with little water. The mean elapse between the drug intake and endoscopy was 7.85 ± 9.96 days. The symptoms resolved within a maximum of one week of antireflux treatment despite the continuation of doxycycline therapy in three patients with brucellosis. The current data confirmed the role of oral doxycycline intake, the timing and the amount of concurrent fluid in the etiology of esophageal ulcerations.
Foods and food allergy: The prevalence of IgE antibodies specific for food allergens in Saudi patients
Mohamad Osman Gad El-Rab
January-April 1998, 4(1):25-29
Objective: The intent of this study is to determine the prevalence and pattern of sensitivity to food allergens in Saudi patients. Subjects: The subjects included in this study were 58 patients with asthma, 47 patients with rhinitis and 112 patients with urticaria. They all gave clinical history suspecting food as causing or aggravating their symptoms. Methods: Specific IgE antibodies to different food allergens were measured in the patients serum by using the Pharmacia CAP Radioaller gosorbent (RAST) Fluoroimmunoassay (FEIA) test. Results: IgE-antibodies specific for different foods were detected in 38 (17.5%) out of 217 patients. Most positive reactions were detected in urticaria patients (9.7%) followed by asthmatic patients (5.5%) and allergic rhinitis (2.3%). Reactions to peanut (22.6%), egg white (14.5) and cow's milk (12.9%) were very prominent. Conclusion: The prevalence rate of food allergy seems to be high in Saudi patients when compared to studies from other regions. The pattern of food reactions, detected in this study, can be utilized in diagnosis of patients with suspected food allergy. Further studies will be required to obtain more information about the prevalence and incidence rates among different patient groups.
Hepatobiliary scintigraphy in the distinction between biliary hypoplasia and biliary atresia
Mahmoud El-Desouki, Mohammed Mohamadiyah, Abdullah Al Rabeeah, Saleh Othman, Nasir Al Jurayyan
January-April 1998, 4(1):8-12
The aim of this work is to see whether distinction between biliary atresia and biliary hypoplasia is possible or not and to present the value and usefulness of hepatobiliary scintigraphy in the investigation of infants with persistent hyperbilirubinemia. Seventy-seven patients of the age between five days and six months (average 62 days), 43 females and 34 males of which 65 Saudi, and 12 non-Saudis were investigated. Laboratory tests, abdominal ultrasound, hepatobiliary scintigraphy, liver biopsy, explorative laparatomy and intraoperative cholangiography were performed whenever indicated. The findings on hepatobiliary scintigraphy of nonvisualization of the gallbladder and no activity in the bowel upto 24 hours post injection were considered consistent with the diagnosis of biliary atresia. Minimal bowel activity, or visualization of the gallbladder where consistent with biliary hypoplasia. In addition, the liver in the two entities appeared in a different shape and can be used as an additional distinctive feature. Thirty-four infants were diagnosed by hepatobiliary scintigraphy as having biliary atresia. Only 3 of the 34 were false positives as compared to cholangiogram and liver biopsy results. Five cases were biliary hypoplasia. Hepatobiliary scintigraphy in infants with persistent hyperbilirubinemia can be distinguished between BA and BH in a simple and noninvasive approach.
Appendiceal adenocarcinoma simulating primary bladder carcinoma: A case report and review of the literature
Mahmoud S Tarsin, Atilio Baez Giangreco, Mohammad Afzal
January-April 1998, 4(1):31-33
Cerebral venous thrombosis as a complication of ulcerative colitis associated with protein-s deficiency: Case report and review of literature
Abdulrahman Al Tahan, Salah A Mageed, Abdulkareem Al Momen, Radwan Zaidan, Abdulkader Daif, Fatina Al Tahan
January-April 1998, 4(1):34-37
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