M. Chandrashekaraiah, B. Almoallem, Danalakshmee Curpanen
57 Succinylcholine apnea is one of the known documented adverse events following suxamethonium use for securing the airway. Although the documented duration of action of the drug is 5 to 13 minutes, it may cause an apnea up to several hours in individuals with reduced pseudocholinesterase activity. It is metabolized in the bloodstream by the enzyme pseudocholinesterase (PChE), which is produced by the liver1. Patients with an abnormal PChE level are incapable of metabolizing suxamethonium, resulting in prolonged muscle paralysis2. The causes of suxamethonium apnea are either hereditary from an autosomal recessive disorder or acquired through various diseases and drugs.
{"title":"Suxamethonium Apnoea : The Forgotten Episode in Current Practice","authors":"M. Chandrashekaraiah, B. Almoallem, Danalakshmee Curpanen","doi":"10.12816/0047479","DOIUrl":"https://doi.org/10.12816/0047479","url":null,"abstract":"57 Succinylcholine apnea is one of the known documented adverse events following suxamethonium use for securing the airway. Although the documented duration of action of the drug is 5 to 13 minutes, it may cause an apnea up to several hours in individuals with reduced pseudocholinesterase activity. It is metabolized in the bloodstream by the enzyme pseudocholinesterase (PChE), which is produced by the liver1. Patients with an abnormal PChE level are incapable of metabolizing suxamethonium, resulting in prolonged muscle paralysis2. The causes of suxamethonium apnea are either hereditary from an autosomal recessive disorder or acquired through various diseases and drugs.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"57-59"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44486504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
60 Constipation is very common in children1,2. The estimated prevalence of functional constipation in children is 4% to 36%1,2. The complaint of constipation accounts for 3% of children visits to primary physicians and 25% of visits to pediatric gastroenterologist1,2. In spite of its prevalence, it rarely causes serious complications in children, such as sigmoid colon volvulus3. The volvulus of the sigmoid colon is believed to be caused by a twist of the mesentery of the redundant colon3. An abdominal radiograph is helpful in diagnosing the presence of sigmoid volvulus. There are a few specific radiographic signs for sigmoid volvulus, including the dilated ahaustral loops. Rectal tube reduction is very successful in reducing sigmoid volvulus; however, ultimately, most patients require sigmoidectomy4,5.
{"title":"Chronic Constipation Leading to Sigmoid Colon Volvulus in an Adolescent","authors":"Saeed Alhindi, Manal D. Shihadeh","doi":"10.12816/0047445","DOIUrl":"https://doi.org/10.12816/0047445","url":null,"abstract":"60 Constipation is very common in children1,2. The estimated prevalence of functional constipation in children is 4% to 36%1,2. The complaint of constipation accounts for 3% of children visits to primary physicians and 25% of visits to pediatric gastroenterologist1,2. In spite of its prevalence, it rarely causes serious complications in children, such as sigmoid colon volvulus3. The volvulus of the sigmoid colon is believed to be caused by a twist of the mesentery of the redundant colon3. An abdominal radiograph is helpful in diagnosing the presence of sigmoid volvulus. There are a few specific radiographic signs for sigmoid volvulus, including the dilated ahaustral loops. Rectal tube reduction is very successful in reducing sigmoid volvulus; however, ultimately, most patients require sigmoidectomy4,5.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"60-61"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42585987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research and Ethics for the Medical Profession Book","authors":"M. Corbally","doi":"10.12816/0047433","DOIUrl":"https://doi.org/10.12816/0047433","url":null,"abstract":"","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"7-10"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42077314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HTG is defined as fasting serum triglyceride more than 1.7 mmol/L. It is classified as mild (1.7-2.2 mmol/L), moderate (2.3-11.2 mmol/L), severe (11.2-22.4 mmol/L) and very severe (>22.4 mmol/L)4. There is a five percent risk of developing acute pancreatitis with severe HTG and 10% to 20% risk with very severe HTG5. Although patients with HTG-P present with similar complaints to other etiologies inducing pancreatitis, studies suggest that the risk of complications are more severe with HTG-P3,6. The exact mechanism and pathophysiology of HTG inducing pancreatitis is still not clearly established; yet, several medical treatment modalities such as plasmapheresis, apolipoprotein CII infusion and intensive insulin therapy and heparin infusion were reported7-11.
{"title":"Effectiveness of Intensive Insulin Therapy in the Management of Acute Necrotizing Pancreatitis Induced by Very Severe Hypertriglyceridemia","authors":"E. Hamza, K. Hakim, K. Bousselmi","doi":"10.12816/0047446","DOIUrl":"https://doi.org/10.12816/0047446","url":null,"abstract":"HTG is defined as fasting serum triglyceride more than 1.7 mmol/L. It is classified as mild (1.7-2.2 mmol/L), moderate (2.3-11.2 mmol/L), severe (11.2-22.4 mmol/L) and very severe (>22.4 mmol/L)4. There is a five percent risk of developing acute pancreatitis with severe HTG and 10% to 20% risk with very severe HTG5. Although patients with HTG-P present with similar complaints to other etiologies inducing pancreatitis, studies suggest that the risk of complications are more severe with HTG-P3,6. The exact mechanism and pathophysiology of HTG inducing pancreatitis is still not clearly established; yet, several medical treatment modalities such as plasmapheresis, apolipoprotein CII infusion and intensive insulin therapy and heparin infusion were reported7-11.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"62-65"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45774518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Common site to harvest the full thickness skin graft for facial and cervical coverage is the upper arm and post auricular area. Compared to split thickness graft, full thickness graft is superior in skin elasticity, recurrence of scar and matching of normal skin4. The full thickness skin graft harvested from the donor area to fit the defect should be closed in an aesthetic tension free method to preserve valuable tissue.
{"title":"Post-Auricular Full Thickness Skin Graft by M-Plasty Technique : An Alternative to Classical Elliptical Technique","authors":"F. Abdulkarim, N. Louri, Pradeoth Mukandan","doi":"10.12816/0047481","DOIUrl":"https://doi.org/10.12816/0047481","url":null,"abstract":"Common site to harvest the full thickness skin graft for facial and cervical coverage is the upper arm and post auricular area. Compared to split thickness graft, full thickness graft is superior in skin elasticity, recurrence of scar and matching of normal skin4. The full thickness skin graft harvested from the donor area to fit the defect should be closed in an aesthetic tension free method to preserve valuable tissue.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"66-68"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47581503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
50 A virtual autopsy employs CT and MRI to replace a traditional autopsy to investigate the cause of death. Blood analyses, biopsies and needle aspiration of tissues might be a part of the virtual autopsy. It has been argued that virtual autopsy provides better delineation of pathology within a smaller time frame, while at the same time, respects various cultures and beliefs and reduces the risks of infection associated with a traditional autopsy1. It has also gained value in the practice of forensic medicine2.
{"title":"The Role of Virtual Autopsy in Uncertain Clinical Scenarios","authors":"Taha Mallick, Muneera J. Alhammadi, M. Elbahr","doi":"10.12816/0047444","DOIUrl":"https://doi.org/10.12816/0047444","url":null,"abstract":"50 A virtual autopsy employs CT and MRI to replace a traditional autopsy to investigate the cause of death. Blood analyses, biopsies and needle aspiration of tissues might be a part of the virtual autopsy. It has been argued that virtual autopsy provides better delineation of pathology within a smaller time frame, while at the same time, respects various cultures and beliefs and reduces the risks of infection associated with a traditional autopsy1. It has also gained value in the practice of forensic medicine2.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"50-53"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49074291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The first published case of confirmed AK was in 1974. The incidence of the disease increased during the 1980s, corresponding to the widespread use of soft contact lenses. Several studies have shown that Acanthamoeba cysts and trophozoites adhere to several types of contact lenses, suggesting that these lenses may act as a vector for disease transmission. Other documented risk factors include poor lens hygiene, contact lens use while swimming, and water source contamination1,2.
{"title":"Unilateral Acanthamoeba Keratitis Following the Use of Cosmetic Contact Lens","authors":"G. Ali, A. W. Agab, Abdulrahman Albuainain","doi":"10.12816/0047447","DOIUrl":"https://doi.org/10.12816/0047447","url":null,"abstract":"The first published case of confirmed AK was in 1974. The incidence of the disease increased during the 1980s, corresponding to the widespread use of soft contact lenses. Several studies have shown that Acanthamoeba cysts and trophozoites adhere to several types of contact lenses, suggesting that these lenses may act as a vector for disease transmission. Other documented risk factors include poor lens hygiene, contact lens use while swimming, and water source contamination1,2.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"69-71"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42278811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-Traumatic Left Thigh Seroma","authors":"A. E. Shayeb, Yousif Salem","doi":"10.12816/0047442","DOIUrl":"https://doi.org/10.12816/0047442","url":null,"abstract":"","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"44-46"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47820873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Result: A total of 239 patients were included in the study; 83 (34.7%) were males, 75 (31.4%) were pregnant females and 81 (33.9%) were non-pregnant females, the mean age was 37.56 years. One hundred forty-five (60.7%) patients had complicated UTI. The most prescribed antibiotics were cefuroxime and ciprofloxacin. Seventy-two (30.1%) of inappropriate antibiotics prescription were mostly due to improper duration.
{"title":"Antibiotic Appropriateness for Urinary Tract Infection in the Emergency Room","authors":"J. A. Salman, S. Alawi, Ebtihal Y. Alyusuf","doi":"10.12816/0047440","DOIUrl":"https://doi.org/10.12816/0047440","url":null,"abstract":"Result: A total of 239 patients were included in the study; 83 (34.7%) were males, 75 (31.4%) were pregnant females and 81 (33.9%) were non-pregnant females, the mean age was 37.56 years. One hundred forty-five (60.7%) patients had complicated UTI. The most prescribed antibiotics were cefuroxime and ciprofloxacin. Seventy-two (30.1%) of inappropriate antibiotics prescription were mostly due to improper duration.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"38-42"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46494200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
29 Epilepsy is considered one of the major public health problems and could have serious psychological and physical consequences, including mental health disorders, traumatic injury and premature death1. Epilepsy is a chronic and disabling neurologic disorder and affects approximately 1% of the population globally, especially in developing countries1,2. Although good prognosis has been seen in most patients with epilepsy, approximately 20% to 30% of patients with epilepsy do not remain seizure free despite the intervention of multiple antiepileptic drugs (AEDs)3,4,5.
{"title":"MDR1 Gene Polymorphism and Phenytoin Pharmacokinetics in Epilepsy","authors":"A. Alhazzani, Murali Munisamy, G. Karunakaran","doi":"10.12816/0047438","DOIUrl":"https://doi.org/10.12816/0047438","url":null,"abstract":"29 Epilepsy is considered one of the major public health problems and could have serious psychological and physical consequences, including mental health disorders, traumatic injury and premature death1. Epilepsy is a chronic and disabling neurologic disorder and affects approximately 1% of the population globally, especially in developing countries1,2. Although good prognosis has been seen in most patients with epilepsy, approximately 20% to 30% of patients with epilepsy do not remain seizure free despite the intervention of multiple antiepileptic drugs (AEDs)3,4,5.","PeriodicalId":43814,"journal":{"name":"Bahrain Medical Bulletin","volume":"39 1","pages":"29-32"},"PeriodicalIF":0.4,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44739878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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