Saudi Med J
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Case Reports
Hemobilia due to liver abscess. A rare cause of massive upper gastrointestinal bleeding.
Massive hemobilia is a rare complication of liver abscess. A 48-year-old male presented with massive hemobilia due to liver abscess. He had been complaining of right upper quadrant abdominal pain, fever, and jaundice for 10 days. ⋯ Drainage of the large liver abscesses was achieved under ultrasound guidance. Diagnostic modalities and management of hemobilia are discussed along with a review of the literature. A high index of suspicion, and the use of appropriate diagnostic tools can help diagnose and treat this rare cause of upper gastrointestinal bleeding.
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To determine factors affecting smoking cessation success in different age groups. ⋯ Different variables in different age groups may affect successful smoking cessation. These should be taken into consideration in efforts at smoking cessation.
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Adefovir dipivoxil (ADV) at a low-dose (10 mg daily), which was previously considered not nephrotoxic, was reported to have induced acquired Fanconi syndrome (FS). We report one 64-year-old Chinese woman and 2 Chinese men (ages 45 and 63 years) with bone pain, and/or muscle weakness on ADV therapy were diagnosed with low-dose ADV-induced FS. ⋯ Regular monitoring of urine and serum phosphate is necessary during therapy with ADV. Prognosis was favorable, however, tenofovir is not a suitable replacement for ADV.
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To compare the diagnostic accuracy of stroke volume variation (SVV) and pulse pressure variation (PPV) in studies that examined both parameters in the same patient population. ⋯ Both SVV and PPV exhibit a high degree of diagnostic accuracy in predicting the success or failure of a fluid challenge in hemodynamically unstable critically ill patients under controlled mechanical ventilation.
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Randomized Controlled Trial
Chloral hydrate versus midazolam as sedative agents for diagnostic procedures in children.
To compare sedation outcomes for chloral hydrate (CH) and midazolam (MD) as sedative agents for diagnostic procedures in children. ⋯ Chloral hydrate compared to MD, had a shorter time to achieve sedation, a higher success rate, less need for a second dose, and decreased the time spent in the DCU. Older and heavier patients are more likely to require a second dose of the study drug to be sedated.