Saudi Med J
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Comparative Study
Comparison of bone mineral density with dual energy x-ray absorptiometry, quantitative ultrasound and single energy x-ray absorptiometry.
We conducted this prospective study to establish the correlation between dual energy x-ray absorptiometry (DXA), quantitative ultrasound (QUS) and single energy x-ray absorptiometry (SXA) and to establish the role of QUS and SXA as a screening tool for osteoporosis. ⋯ The correlation between all modalities was significant, but varied from high to low. It was high between lumbar spine and femoral neck, moderate between lumbar spine and forearm and low between lumbar spine and QUS of heel. When we used the same WHO criterion of T-score (more than -2.5 SD below normal), QUS detected significantly less numbers with osteoporosis. We conclude that with the present cut-off of T-score, the QUS may not be used as a screening tool. It may need some modification of T-score. However, we need larger multi-center studies with a larger number of patients for further validation.
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Biography Historical Article
Contributions of Ibn Zuhr (Avenzoar) to the progress of surgery: a study and translations from his book Al-Taisir.
This study of the original Arabic edition of the book Al-Taisir Fil-Mudawat Wal-Tadbeer (Book of Simplification Concerning Therapeutics and Diet) written by the Muslim physician Abu-Marwan Abdel-Malik Ibn Zuhr (Avenzoar, 1093-1162 AD) aimed at evaluating his contributions to the progress of surgery and providing English translations of relevant excerpts. Ibn Zuhr s unique experiment performing a tracheotomy on a goat, proved the safety of this operation in humans and represented a further step in the development of the experimental school started by Al-Razi (Rhazes) of Baghdad in the ninth century who is known to have given monkeys doses of mercury to test it as a drug for human use. Ibn Zuhr also performed post mortems on sheep in the course of his clinical research on treatment of ulcerating diseases of the lungs. ⋯ He also drew the red lines at which a physician should stop, during his general management of a surgical condition; a step forward in the evolution of general surgery as a specialty of its own. He believed in prophylaxis against urinary stone disease and reported the importance of dietary management for that purpose. Furthermore, Ibn Zuhr enriched surgical and medical knowledge by describing many diseases and treatment innovations not ever described before him.
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We compared the postischemic cerebral protective effects of sevoflurane and desflurane in rats with incomplete cerebral ischemia. ⋯ These data indicate that sevoflurane and desflurane have cerebral protective effects when given after ischemia.
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Mobile masses within the left atrial cavity are commonly caused by organized thrombi or left atrial myxoma. The use of transesophageal echocardiography has provided means for differentiation between the 2 conditions. We report a case of a left atrial mass in a female patient who presented with mitral stenosis and atrial fibrillation, and was diagnosed by transthoracic echocardiography (TTE). ⋯ Consequently, the patient was referred for surgical treatment and the mass removed through left atriotomy. Microscopic examination revealed a highly organized thrombus. We conclude that TTE is still a reliable tool in the diagnosis of large mobile atrial thrombi; TEE is needed when differentiation from atrial myxoma is difficult.
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Case Reports
Drotrecogin alfa (activated) treatment in a neonate with sepsis and multi organ failure.
The administration of drotrecogin alfa (activated) improves outcome in adult patients with severe sepsis. Since the published pediatric experience with this drug is limited, the role of drotrecogin alfa (activated) in children, and especially in newborns is not well established. We describe a 3-day-old neonate with septic shock and multiorgan system failure, including circulatory, respiratory, renal failure, and disseminated intravascular coagulation, refractory to intensive fluid resuscitation and inotrope support. ⋯ Aside from transient thrombocytopenia, no significant side effects were observed. A brain MRI performed on day 18 after discontinuation of treatment was normal. The positive hemodynamic effect and outcome of treatment in this patient, indicates that drotrecogin alfa (activated) may play a similar role in the treatment of sepsis in neonates as already established in adults.