Saudi Med J
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Randomized Controlled Trial
Lack of effect of N-acetylcysteine treatment to ameliorate the progression of multiple organ failure.
To investigate whether prolonged infusion of the oxygen free radical scavenger N-acetylcysteine (NAC) that is commenced immediately after admission to intensive care unit (ICU) could ameliorate the development or progression of multiple organ failure (MOF). ⋯ N-acetylcysteine (40 mg/kg/day) that was commenced immediately after admission to ICU did not ameliorate the progression of MOF in this small cohort of patients. We believe routine prophylactic use of low-dose NAC in all critically ill patients does not provide positive protection.
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Randomized Controlled Trial Comparative Study
Comparison between drainage and curettage in the treatment of acute pilonidal abscess.
Simple incision and drainage of a sacrococcygeal pilonidal abscess is associated with more than 40% recurrence. Definitive treatment of the chronic pilonidal sinus is recommended 4-8 weeks after incision and drainage. The present prospective clinical trial study was designed to compare the curettage and drainage of the acute abscess of the pilonidal sinus. Hospital stay, wound healing, and recurrence were noted. ⋯ Unroofing and curettage, which is associated with higher rates of healing and lower rates of recurrence, may be the treatment of choice in the acute pilonidal abscess.
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We report a case of serious nosocomial meningitis due to a multidrug-resistant Acinetobacter baumannii in a 23-year-old woman who had a posterior fossa craniotomy with upper cervical laminectomy for excision of a meningioma at the level of foramen magnum. Post-operatively, she had neck pain with continuous fever and deterioration in the level of consciousness and convulsions. The CSF was turbid and had neutrophil pleocytosis. ⋯ The patient failed high doses of imipenem, ciprofloxacin and systemic colistin but responded well to intraventricular injections of colistin 125,000 units twice daily for 3 weeks. No apparent side effects were noticed. We have reviewed other similar cases reported in the literature.
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A retrospective analysis of acute pain service (APS) was performed to look at the epidural and patient-controlled analgesia (PCA) with respect to their indications, duration and quality of pain control, dosage regimen and common side effects. ⋯ In the past decade, APS has provided a safe and efficient service to over 10 thousand postoperative obstetric and gynecology patients. Epidural analgesia as compared to PCA provided superior analgesia but caused more frequent minor side effects. More resources are required to provide good quality APS to all eligible postoperative patients for the desirable period.