Saudi Med J
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Randomized Controlled Trial Comparative Study
Spinal versus epidural anesthesia for transurethral resection of the prostate.
To compare spinal versus epidural anesthesia for transurethral resection of the prostate. ⋯ Spinal anesthesia proved to be superior to epidural anesthesia by providing lower incidence of patient movement.
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Case Reports
Subcutaneous panniculitic T cell lymphoma mimicking histiocytic cytophagic panniculitis in a child.
Subcutaneous panniculitic T-cell lymphoma is a very rare malignancy in the pediatric age group, its association with hemophagocytic syndrome had been described but the association with the skin lesions mimicking histiocytic cytophagic panniculitis which is characteristic of hemophagocytic syndrome has not, to our knowledge, been described in children. We report a child with panniculitic T-cell lymphoma associated with bone marrow hemophagocytosis and subcutaneous histiocytic infiltration with active phagocytosis simulating histiocytic cytophagic. We stress the importance of searching for T-cell lymphoma in patients with panniculitis and hemophagocytic syndrome.
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To review all cases of cesarean section in the primigravid mother delivered at the Riyadh Armed Forces Hospital between January 1996 and December 1997. To determine its incidence, describe the clinical indications, outcome and highlight areas of improvement in an attempt to reduce the rate of cesarean section. ⋯ The rate of cesarean section in the primiparas was similar to the rate of cesarean section in the obstetric population. The rate of cesarean section in the primiparas breech was slightly higher than cesarean section in the multiparas breech. Fetal distress was the leading indication for cesarean section in twins and those with cephalic presentation. The rate of cesarean section can be safely reduced by reviewing and auditing the primary indication for cesarean section, the Consultants doing frequent rounds on delivery suites and being involved directly in cesarean section decision, careful interpretation of fetal monitoring and allowing more patients with breech presentation to have vaginal delivery under close observation.
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The high clinical and socio-economical impact of cartilage defects and chondral degeneration is well-known. After trauma or without a known etiology, often young patients suffer from pain and a loss of function leading into a decrease of physical activity and, more severe, into long term disability and unemployment. The clinical use of autologous chondrocyte transplantation was introduced in 1994 reporting the data of a pilot study. The objective of this study is to evaluate the efficacy of this method of surgery. ⋯ Autologous chondrocyte transplantation has to be considered a safe and effective method for the treatment of large full thickness cartilage defects. Alternative treatments are symptomatical: drilling, abrasion, lavage, chondroplasty, or osteotomies. The short term results are promising but a lot of patients have to be treated for osteoarthritis as a consequence of failure with total joint arthroplasty. Osteochondral transplantations have the disadvantage of limited harvesting sites and the impairment of the subchondral bone plate.
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Case Reports
Long term intubation and successful weaning in two children with Guillain-Barre syndrome.
No definite criteria exists in Guillian-Barre syndrome in children regarding prolonged ventilation through an endo-tracheal tube without tracheostomy and successful weaning using a T-piece. Here we report two such cases of Guillian-Barre syndrome requiring prolonged intubation for 56 days and ventilation for 30 days and ultimately successfully weaning them using the T-piece. Both the children eventually made a complete recovery, highlighting the point that in children prolonged intubation and ventilation using the portex tube is equally good, if not, better than tracheostomy with its attendant risks.