Saudi Med J
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Randomized Controlled Trial
Hemodynamic effects, recovery profiles, and costs of remifentanil-based anesthesia with propofol or desflurane for septorhinoplasty.
To compare hemodynamics, recovery profiles, postoperative side effects and costs of desflurane-remifentanil and propofol-remifentanil anesthesia for septorhinoplasty operations. ⋯ Both desflurane-remifentanil and TIVA provide perioperative hemodynamic stability, early and easy recovery with similar cost profiles for septorhinoplasty operations.
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Randomized Controlled Trial Comparative Study
Comparison of propofol/fentanyl and ketamine anesthesia in children during extracorporeal shockwave lithotripsy.
Extracorporeal Shockwave Lithotripsy (ESWL) is an effective and safe way for treatment of upper urinary system stones. For pediatric patients, throughout ESWL, sufficient sedation and analgesia is needed to cope with the procedural pain. In this study, our goal was to compare 2 methods of intravenous anesthesia, applied to pediatric patients during ESWL. ⋯ Although both protocols do not differ much according to ease of application and efficacy in providing sufficient analgesia for ESWL, they have their corresponding side effects and they can only be practiced safely by experienced anesthesiologists in a monitorized and well equipped setting.
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Organophosphate compounds (OP) are usual insecticides and may poison human beings in a suicide attempt or accidental exposure. They inhibit activity of cholinesterase. Poisoning may be enough sever for intensive care support. In this paper, we study the prevalence and management of sever cases as well. ⋯ Organophosphate compounds poisoning is a serious and lethal condition and needs early diagnosis and appropriate treatment. In patients with respiratory failure the mortality is very high; therefore we recommended early diagnosis, careful monitoring and appropriate management of complications in reducing the mortality rate.
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Quality assurance (QA) is an increasingly important element in the administrative management of Intensive Care Unit (ICU). This is not only to improve clinical practices and patient's outcome, but also helps in proper resource utilization. We introduced a comprehensive quality assurance program in ICU at King Abdulaziz National Guard Hospital, Alhasa, Saudi Arabia, based on the existing medical evidence. ⋯ Implementation of QA program is practical in an ICU. Disseminating the quality monitoring information at national level can lead to a broad data base, which can identify the best performing ICUs, thus, leading to bench marking and creating risk adjusted models applicable to local population.
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To determine the frequency, etiology (viral infection or vaccination), presenting signs and symptoms, response to therapy, complication and course of acute disseminated encephalomyelitis (ADEM) in our hospitals. ⋯ Acute disseminated encephalomyelitis is common in our children, possibly because of the high prevalence of causative infections. Due to advances in control of traditional exanthematous diseases such as measle, rubella and so forth, most cases of ADEM in this study followed non-specific upper respiratory infections. Differentiation of ADEM from a single episode of multiple sclerosis is difficult. Diagnosis of multiple sclerosis should be carried out if new symptoms and signs or imaging abnormalities appear, more than 3 months after the onset of clinical symptoms in ADEM cases.