Saudi Med J
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To test the reliability and validity of an Arabic version of the modified dental anxiety scale (MDAS), and to correlate it with other demographic data. ⋯ The Arabic version of the MDAS presented adequate internal consistency reliability, allowing its safe use to assess levels of dental anxiety in Arabic-speaking populations.
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To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed. ⋯ This study confirms the importance of evaluating the frequency and efficiency of various fumigation techniques as an ambulance is a potential reservoir for microbial transmission to patients and staff.
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Case Reports
Toxic epidermal necrolysis in a patient receiving concurrent phenytoin and whole brain and thoracic radiotherapy.
Toxic epidermal necrolysis (TEN) is a severe drug induced type IV hypersensitivity syndrome that can be caused by anticonvulsant drugs, especially the aromatic anticonvulsants such as phenytoin. Most patients with brain metastasis receive whole brain radiotherapy along with anti-edema measures and anticonvulsants either as prophylactic or for symptom control; phenytoin being the most commonly used drug. ⋯ We report a 54-year-old patient with metastatic non-small cell lung cancer treated with palliative whole brain and mediastinal radiotherapy with concurrent phenytoin-developing TEN, which started within the radiation portals with subsequent generalization. Though a rare, but serious complication, avoidance of the use of phenytoin concurrent with radiotherapy, replacing phenytoin with newer anticonvulsants, early recognition, aggressive management and awareness of this possible complication has been implied upon in this report.