This study aimed at evaluating the usefulness of a structured patient counseling program on clinical outcomes of asthma patients in Saudi Arabia. This cross sectional study enrolled 10 asthma patients and all were evaluated for their baseline knowledge on asthma, quality of life, compliance, patient satisfaction and drug related problems among randomly selected 5 (of the total 10) patients. The median (IQR) age of the patients was 46 (33.5-56.2) years. The baseline knowledge scores was 9 (8-11), the maximum possible scores to be 21. Cronbach alpha of the KQ was 0.65. The overall total median (IQR) compliance (Morisky) score was 4 (3-5), the maximum possible score was 5. The patient satisfaction median (IQR) score was 35.5 (32-46.25), the maximum possible score was 70. Of the total patients 3 (30%) had a history of allergy. There were total 18 allergens observed in these patients. There has been no drug-drug or drug-food interactions observed between among the prescribed drugs of the patients. Altogether 2 patients reported a total of 2 ADRs. The knowledge of the asthma patients was found to be poor. Missing the dose was the most commonly encountered drug taking behavior. The compliance was found to be good and the patient satisfaction was average.
Clomiphene is a widely prescribed drug for the treatment of infertility. Visual symptoms that occur as a side effect of this drug are uncommon. Some doctors may neglect to mention this side effect when prescribing clomiphene. Thus these visual disturbances can be very alarming to the patient and may also pose a hazard if the patient is doing activities such as driving or operating machinery. The patient should be told to stop taking clomiphene and ophthalmologic evaluation should be performed. Although visual disturbances generally cease on stopping clomiphene, some women may experience persistent visual disturbances.
A patient who presented with massive upper gastrointestinal hemorrhage underwent a Billroth II partial gastrectomy. He developed efferent loop obstruction due to a retained abdominal drain. Relaparotomy for removal of drain was performed. Retained drains are known complications but rarely, it is cause of efferent loop obstruction.
The management of the clinician who generates complaints and claims on a regular basis, raises issues of professional responsibility and presents ethical challenges for the defence team, in addition to the immediate practical need for advice and representation. This short session examines some of these issues and suggests some ways that are already being used to address them.
A case report of adenoid cystic carcinoma of the trachea is presented. A high index of suspicion is required to make the diagnosis of tracheal tumours early since the patients tend to have normal chest radiographs which on closer examination may show an abnormality of the tracheal column. Adenoid cystic carcinoma is the most common malignant tumour of the trachea. Locoregional control of this disease is achieved by a combined modality therapy of surgery and postoperative radiotherapy. Despite this, it still has a prolonged clinical course and the tendency for delayed onset of distant metastases.
One of the problems faced by manufacturers is the difficulty in constructing a robust and reliable, angled applicator tip. This can be overcome by handmaking your own retrograde carrier. The applicator tip may be bent to about 50 degrees and, if a kink occurs while bending the tip, it can be replaced easily by a new modified needle. Because the wire used is flexible, it can adapt to the bend without a problem. Narrower carriers can also be made using a 20-G needle, perhaps more suitable for retrograde fillings of molar apices. Because the carrier is designed to be used once only, the problems of it being difficult to load and liable to blockages should not arise.
A mass CPR (cardio-pulmonary resuscitation) teaching programme, believed to be the first in Malaysia, was held at the Dewan Tunku Canselor, University of Malaya (UM) on Saturday, 13th July 1996. Organised by the Resuscitation Committee of University Hospital, Kuala Lumpur, this programme was conducted for 200 first year UM students. We describe the organisation of this non-traditional and non-threatening, new CPR teaching programme and propose that this be further developed for the dissemination of CPR skills to our Malaysian public.
The year under review has seen a remarkable proliferation of papers on dengue. Four prospective studies have been carried out across the dengue belt, many groups have been pushing at the question of pathogenesis of dengue haemorrhagic fever, and a breakthrough has been achieved in the development of a mouse model for human dengue haemorrhagic fever.
This female Asian (Malay) baby had clinical features of Proteus syndrome. She had a large right facial lipolymphangioma with hyperpigmentation of the overlying skin. There was a smaller lymphangioma over the left side of her neck with excess nuchal folds, macrodactyly and bilateral talipes equinovarus. Despite the extensive hemifacial swelling, there was no evidence of upper respiratory tract obstruction. Generalized seizures developed on the sixth day of life which were controlled with phenobarbital. The lymphangiomas were excised without recurrence.
Modified subtotal cholecystectomy involves removal of the gall bladder after circumferential division of the neck. Either the impacted stone or the surgeons finger was used as a guide to identify the neck. The stump cavity in the neck is obliterated with interrupted sutures to prevent recurrent stone formation. Indications for this procedure are obscure anatomy, due either to the severe inflammation in acute cholecystitis or dense adhesions in the small fibrosed gall bladder. The decision to perform modified subtotal cholecystectomy is taken during the operation. Forty three patients (14%) underwent this procedure during the period between August 85 and April 90. Out of 289 cholecystectomies performed seven were emergency and thirty-six were early cholecystectomies. With the increasing trend towards urgent and early cholecystectomy in acute cholecystitis the author has found this to be a safe and definitive procedure.