1.The Rubber Stopper: A Simple and Inexpensive Technique to Prevent Pin Tract Infection following Kirschner Wiring of Supracondylar Fractures of Humerus in Children
Santy JE ; Kamal J ; Abdul-Rashid AH ; Ibrahim S
Malaysian Orthopaedic Journal 2015;9(2):13-16
Percutaneous pinning after closed reduction is commonly
used to treat supracondylar fractures of the humerus in
children. Minor pin tract infections frequently occur. The
aim of this study was to prevent pin tract infections using a
rubber stopper to reduce irritation of the skin against the
Kirschner (K) wire following percutaneous pinning.
Between July 2011 and June 2012, seventeen children with
closed supracondylar fracture of the humerus of Gartland
types 2 and 3 were treated with this technique. All patients
were treated with closed reduction and percutaneous pinning
and followed up prospectively. Only one patient, who was a
hyperactive child, developed pin tract infection due to
softening of the plaster slab. We found using the rubber
stopper to be a simple and inexpensive method to reduce pin
tract infections following percutaneous pinning.
Bone Wires
2.A molecular survey on cystic echinococcosis in Sinnar area, Blue Nile state (Sudan).
Kamal IBRAHIM ; Romig THOMAS ; Kern PETER ; Rihab Ali OMER
Chinese Medical Journal 2011;124(18):2829-2833
BACKGROUNDCystic echinococcosis (CE) is a zoonosis caused by the cestodes of the Echinococcus species. Its life cycle involves dogs and other canids as definitive hosts for the intestinal tapeworm, as well as domestic and wild ungulates as intermediate hosts for the tissue-invading metacestode (larval) stage. The disease has a special impact on disadvantaged pastoralist communities and is listed now among the three top priority neglected tropical disease (NTD). Therefore, CE is a neglected disease even in high endemicity regions. This study aimed at investigation of the prevalence of CE in different animals slaughtered for food consumption in Sinnar area, Blue Nile states in Sudan.
METHODSA survey of CE in livestock was conducted from April 2009 to March 2011 in Sinnar area, Blue Nile state in Sudan. Location, parasitological status and fertility conditions were determined. In addition, 120 hydatid cysts (30 from camels, 62 from cattle and 28 from sheep) were examined by polymerase chain reaction (PCR) and mitochondrial gene sequencing for the genetic allocation of Echinococcus strains or species
RESULTSThe prevalence of CE was 29.7% (30/101) in camels, 2.7% (62/2310) in cattle and 0.6% (26/4378) in sheep. It was shown that infection rates increased with age in camels, cattle and sheep. In camels, 67% (20/30) of the infected animals were aged between 2 - 5 years whereas 58% (36/62) of the infected cattle were > 5 years. In sheep, the prevalence rate was distributed equally between animals ranging 2 - 5 years and > 5 years. Even though multiple cysts were found in some animals, the average number of cysts per animal was close to 1 in all examined species. Lungs were found to be the predilection sites for the parasite in both camels and cattle, while most of the cysts found in sheep were located in the liver. About 63.4% of cysts encountered in camels were considered as large (5 - 7 cm), whereas those in cattle and sheep were medium (2 - 4 cm) and small (< 2 cm) respectively. The highest fertility rate was found in camel cysts with 85.4% (35/41) followed by cattle (50.0%, 32/64) and sheep (39.0%, 11/28). All examined cysts belonged to Echinococcus canadensis G6, which was confirmed to be the overwhelmingly predominant species in that area.
CONCLUSIONThe epidemiological situation in Sinnar area, Blue Nile state is characterized by intense transmission of Echinococcus canadensis G6, thereby closely resembling the situation in most other regions of Sudan.
Animals ; Camelus ; parasitology ; Cattle ; Cattle Diseases ; epidemiology ; Echinococcosis ; epidemiology ; Echinococcus ; genetics ; pathogenicity ; Geography ; Polymerase Chain Reaction ; Sheep ; parasitology ; Sheep Diseases ; epidemiology ; Sudan ; epidemiology
3.Assessment of anterior positioning splint in conjunction with lateral pterygoid BTX injection to treat TMJ disc displacement with reduction — a preliminary report
Maram TAEMA ; Nouran Abdel NABI ; Samira IBRAHIM ; Heba Ahmed KAMAL ; Aala’a EMARA
Maxillofacial Plastic and Reconstructive Surgery 2021;43(1):33-
Objective:
Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases.
Methods:
Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months.
Results:
Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores.
Conclusions
Group I showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.
4.Significance of tumor-associated neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio in non-invasive and invasive bladder urothelial carcinoma
Wael Abdo HASSAN ; Ahmed Kamal ELBANNA ; Noha NOUFAL ; Mohamed EL-ASSMY ; Hany LOTFY ; Rehab Ibrahim ALI
Journal of Pathology and Translational Medicine 2023;57(2):88-94
Background:
Tumor-infiltrating neutrophils and lymphocytes play essential roles in promoting or combating various neoplasms. This study aimed to investigate the association between tumor-infiltrating neutrophils and lymphocytes and the neutrophil-to-lymphocyte ratio in the progression of urothelial carcinoma.
Methods:
A total of 106 patients diagnosed with urothelial carcinoma were was. Pathological examination for tumor grade and stage and for tumor-infiltrating neutrophils, both CD4 and CD8+ T lymphocytes, as well as the neutrophil- to-lymphocyte ratio were evaluated.
Results:
The presence of neutrophils and the neutrophil-to-lymphocyte ratio correlated with high-grade urothelial neoplasms. In both low- and high-grade tumors, the lymphocytes increased during progression from a non-invasive neoplasm to an early-invasive neoplasm. CD8+ T lymphocytes increased in low-grade non–muscle-invasive tumors compared to non-invasive tumors. Additionally, there was a significant decrease in CD8+ T lymphocytes during progression to muscle-invasive tumors.
Conclusions
Our results suggest that tumor-infiltrating neutrophils and CD8+ T lymphocytes have a significant effect on tumor grade and progression.
5.Saudi Experts Consensus on Diagnosis and Management of Pediatric Functional Constipation
Dhafer B. ALSHEHRI ; Haifa Hasan SINDI ; Ibrahim Mohamod ALMUSALAMI ; Ibrahim Hosamuddin ROZI ; Mohamed SHAGRANI ; Naglaa M. KAMAL ; Najat Saeid ALAHMADI ; Samia Saud ALFURAIKH ; Yvan VANDENPLAS
Pediatric Gastroenterology, Hepatology & Nutrition 2022;25(3):163-179
Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.
6.Low Dermatitis Potential of a Powder-Free, “Accelerator-Free” Non Natural Rubber Latex Gloves Using Modified Draize Study
Maryam Sakinah Jeffrey ; Wan Muhamad Aiman Wan Muhamad ; Iman Jeffrey ; Hanisah Jeffrey ; Mardhiah Jeffrey ; Muhammad Syafiq Muhammad Isa ; Said AlGhora ; Emad Ibrahim Husein Shaqoura ; Doaa kamal Ibrahim Shaqoura ; Sharifah Ismail ; Nor Wajihan Muda ; Siti Maryam Abdul Jabar ; Saadiah Sulaiman
Malaysian Journal of Dermatology 2017;38(June):65-71
Introduction:
The escalated demand for protective rubber glove in the healthcare industries has resulted in increased
prevalence of glove related skin problem, irritant and allergic contact dermatitis and latex sensitivity.
The industry has recently introduced a new nitrile glove product using a novel patented non-sulphur
system to effect co-valent bond crosslinking to provide the desired elasticity of the gloves. This glove
also has ionic crosslinking provided by the zinc oxide used in the formulation and the carboxylic
group of the nitrile latex. The main objective of this study is to prove that residual chemical additives
at a level that may induce Type IV allergy in the unsensitized general user population are not present
in this rubber glove and to compare it with a powder free latex examination glove.
Methods:
In collaboration with the Islamic University of Gaza, we conduct modified test on a specially formulated
and powder free, accelerator free LOW DERMA™ enhanced nitrile rubber glove that has physical
properties and barrier integrity similar to that of NRL gloves. This glove does not contain sulphur or
sulphur related compound. Two sets of Powder free, accelerator free LOW DERMA™ Nitrile Patient
Examination Gloves*, white and blue colour were tested using the modified draize-95’ test. Filter
paper soaked in normal saline and powder free latex examination glove were used as control.
Results:
A total of 209 subjects, 149 subjects, Caucasian (71.29%), 30 subjects, Afro Caribbean (14.35%) and
30 subjects, Asiatic (14.35%) were recruited. All 209 subjects had a final patch testing scoring of not
more than 1.5 during both the induction phase and the challenge phase for both types of Powder Free
Nitrile Patient Examination Gloves (white and blue) and to the negative control, normal filter paper
and the powder free NRL control glove. Conclusion:
The skin sensitization test (‘Modified Draize-95’ Test) of Powder Free Nitrile Patient Examination
Gloves (white and blue) and the powder free NRL examination glove were negative. There was no
clinical evidence on the presence of residual chemical additives at the level that may induce Type
IV allergy in unsensitized general user population for both Powder Free Nitrile Patient Examination
Gloves, blue and white colored, non-sterile. Both gloves qualify for “Low dermatitis Claim”.
7.Administration of tranexamic acid for victims of severe trauma within pre-hospital care ambulance services (PHCAS) in Malaysia
Shah Jahan Mohd Yussof ; Shamila Mohamad Ali ; Nurul Azlean Norzan ; Mohd Amin Mohidin ; Anandakumar Krishnan ; Ahmad Ibrahim Kamal Batcha ; Ahmad Tajuddin Mohamad Nor ; Aik Howe Teo ; Mohamed Saed Mian ; Fatahul Laham Mohamed ; Ridzuan Mohd Isa ; Mohd Idzwan Zakaria ; Mohd Khairizam Mohd Yusoff ; Joseph Mathew ; Mark Fitzgerald ; Sabariah Faizah Jamaluddin ; Kiat Kee Gan
The Medical Journal of Malaysia 2019;74(4):300-306
Introduction: Trauma is a Global threat and the 5th highest
cause of all-cause mortality in Malaysia caused
predominantly due to road traffic accidents. Majority of
trauma victims are young adults aged between 21-40 years
old. In Malaysia, 24 out of 100,000 population die annually
due to trauma, rating us amongst the highest in South East
Asia. These alarming figures justify aggressive preventive
and mitigation strategies. The aim of this paper is to
promote the implementation of evidence-based
interventions that will reduce the rate of preventable death
because of trauma. Tranexamic acid is one of the few
interventions in the early management of severe trauma with
level-one evidence. Tranexamic acid has been proven to
reduce all causes of mortality and mortality due to bleeding.
Evidence proves that it is most effective when administered
early, particularly within the 1st hour of trauma. This
proposed guideline is formulated based upon quality
evidence from multicentre studies, clinical practices in other
countries and consideration of the local demographic
factors with the intent of enabling an easy and simple
pathway to administer tranexamic acid early in the care of
the severely injured.
Conclusion: The guideline highlights select pre-hospital
criteria’s and the methods for drug administration. The
authors recognise that some variants may be present
amongst certain institutions necessitating minor
adaptations, nevertheless the core principles of advocating
tranexamic acid early in the course of pre-hospital trauma
should be adhered to.