Australasian Medical Journal
Not a member yet
1482 research outputs found
Sort by
Overview of Human Brucellosis in Aseer Region, Saudi Arabia
No full textBackgroundBrucellosis is a common zoonotic disease of the Middle Eastern countries. Acute cases of brucellosis are often treated as cases of Pyrexia of unknown origin.AimsThe main aim of this study is to compare the epidemiological, clinical and laboratory findings of the 42 culture positive cases of Brucella.Methods Forty two culture positive cases of Brucella were obtained from both in -patients and outpatients with a history of pyrexia over a period of two years (Nov 2014-Nov 2016). The patients' files were examined retrospectively for the history, clinical features, and lab findings.Results The prevalence of brucellosis was calculated to be 11.1 per cent as 42 cases were positive for brucellosis out of 377 of PUO cases Of the 42 cultures positive patients the percentage of males (57.1 per cent) were almost equal to the females(42.8 per cent). The mean±S.D age was 28.5±13.65. 28.5 per cent had a history of livestock associations (Chi-square 3.8889, a p-value of 0.048607) which was statistically significant. 26.2 per cent had a history of raw milk and dairy produce intake (Chi-Square 2.6276, p-value of 0.105023) this was not statistically significant. 9.5 per cent had a family history of brucellosis; this association was not statistically significant as well (chi-square statistic 1.8651, p-value of 0.172034). 61.9 per cent presented as acute cases, 30.9 per cent of sub-acute cases and 7.1 per cent as chronic cases respectively. The pre- dominant clinical symptom was Fever (100 per cent) with the commonest clinical signs being the osteoarticular signs (30.9 per cent). Raised ESR and CRP positives were seen in 34 cases (80.9 per cent) and 23 cases (55 per cent) respectively followed by Anaemia in 22 cases (52.3 per cent). Forty two cases were blood culture positive. All the cases were sensitive to the recommended regimen of Doxycycline and streptomycin.ConclusionBrucellosis is still a major health problem in the Middle Eastern countries especially in the Kingdom of Saudi Arabia. Although latest diagnostic equipment are available lacunae in the skill and knowledge prove to be a disadvantage. This scenario may lead to blind treatment which in turn can lead to the development of antibiotic resistance which is another problem altogether
Differentiation of N-acetyltransferase 2 (NAT2) rapid and intermediate acetylator based on genotype and urinary assay
Get PDFBackgroundDetermination of the acetylator type of NAT2 generally can be predicted based on genotype data from the NAT2 database. However, in some reported studies, it does not show 100 per cent concordance with the phenotype based on urinary assay. The assay generally only differentiates the rapid and slow acetylator but does not consider the intermediate one. AimsWe conducted this study to define the phenotype of NAT2 based on both genotyping and urinary assay and to determine the concordance rate between both methods in rapid and intermediate acetylator groups. Methods NAT2 genotyping was done using the PCR-direct sequencing in a total of 30 healthy subjects. However, for the NAT2 phenotypes we only selected 19 healthy subjects that carry rapid or intermediate acetylator genotype, without involving slow acetylator phenotype. The assay was done by measuring the ratios of urinary caffeine metabolites following controlled diet exposure.Results Both data obtained from genotyping and urinary assay showed 2 samples that belonged to the rapid acetylator and 17 samples that belonged to the intermediate acetylator. The mean metabolic ratio of the rapid acetylator group showed a higher level (0.5) than the intermediate group (0.28). The predicted acetylation status of NAT2 SNPs from genotyping was matched with the phenotype which was determined by urinary analysis.ConclusionOur result showed a 100 per cent concordance of NAT2 phenotype based on the genotyping and urinary assay. Based on this study we suggest that NAT2 phenotype based on genotyping method is simpler and faster, rather than using the urinary assay that is more laborious and costly
Prospective clinical study of prosthetic treatment outcome of implant-retained- removable-partial-denture during 5 year-follow-ups
Get PDFBackgroundIRRPD offers patients the ability to upgrade their treatment planning to implant-supported-overdentures (ISOs) or implant-supported-fixed-prostheses (ISFPs) through insertion of more implants in the future after the loss of the remaining natural teeth.AimsThe purpose of this prospective-clinical-study was to evaluate the success rate and treatment outcome of IRRPD for 15 patients, during at least 5-year-follow-ups after prosthetic rehabilitation with respect to implant mobility, peri-implant-marginal-bone-levels, and prosthetic complications.Methods 15 successive patients were attended the Department of Implantology and Prosthodontics in TUMS, and received Implant-Retained-Removable-Partial-Dentures (IRRPDs). Two standard-size-dental-implants (Implantium/Dentium system, internal hexagon, Seoul, South Korea) were placed in distal-extension-areas for each patient. After the osseointegration period, all patients received IRRPDs using two Ball attachments. All the participated patients were followed-up at least for 5 years, and the survival rate of 30 implants was evaluated. The patients’ satisfaction of function, phonetics, and aesthetics was assessed by means of questionnaire.Results None of the studied patients reported any prosthetic complications during the follow-up-periods such as attachment loosening, metal housing loosening, or denture fracture. No implants failure was recorded, so that the cumulative-implant-survival rate was 100 per cent. The mean marginal-bone-resorption (MBR) around the two implants was 0.9mm with a range of 0.5–1.4mm. Teeth aesthetics was judged as excellent or very good by 86.7 per cent of the patients, while phonetics and mastication were considered excellent or very good by 66.7 per cent and 73.3 per cent of the patients, respectively.Conclusion15 patients received 30 implants for the fabrication of IRRPDs in the posterior-edentulous-sites. The IRRPDs were delivered to the patients by the same practitioner. After 5-year-follow-ups-schedule, this prospective-clinical-study supported the use of IRRPDs in the posterior region when the patients cannot afford more implants insertion for the construction of ISFPs.Within the limitation of this study, the following conclusions can be drawn:1. The survival rate of all 30 implants was 100 per cent.2. No prosthetic complications were occurred during 5-year-follow-ups-period.3. IRRPDs treatment option should be encouraged to be used in the posterior-edentulous-sites as an alternative option to ISFPs.4. IRRPDs can provide appropriate function, phonetics, and aesthetics
Negative attitudes & misinformation to breastfeeding among young generation in a nursing program
Get PDFBackgroundStudents nurses’ negative attitudes, misinformation and lack of support in relation to breastfeeding practice is a major contributing factor to decrease the prevalence and duration of breastfeeding. AimsTo identify breastfeeding attitudes and knowledge among students in a nursing program.Methods A cross-sectional study using validated questionnaire was conducted. The questionnaire includes 8 multiple choice questions on breastfeeding management, 7 questions on attitudes and 13 questions on the knowledge of breastfeeding. Data collection took place in the spring academic term in 2016 at a public university in Saudi Arabia. 250 questionnaires were distributed, of which 234 were completed and returned with a response rate 93.6 per cent. Inclusion criteria included second to fourth year nursing student with the age range from 18–25 years old. Descriptive statistics were used for data analysis and non-parametric statistic (Mann-Whitney Test) was performed to compare the groups.Results The results were explained taking into consideration students nurses with or without children. Mean attitude’s score for participants without children was 157 as compared to 77 for those with children. The results showed similar negative attitude toward breastfeeding among participants, regardless of having children or not (p=0.35). This means that there was no significant difference in attitudes toward breastfeeding among nursing students either they are having children or not. However, having personal experience with breastfeeding did not increase breastfeeding attitudes and knowledge (p=0.35 vs. p=0.93, respectively).ConclusionThe results highlight that female nursing students have negative attitudes, misinformation and lack of knowledge on breastfeeding
Corneal cross-linking in a child with osteogenesis imperfecta syndrome and keratoconus
Get PDFCross-linking (CXL) is a well-established procedure in children with keratoconus (KC), but cases of CXL and osteogenesis imperfecta (OI) have not been published in the literature, despite the association between physiopathology of these diseases. This is the first case, to the best of our knowledge, of a young girl with both OI and KC that underwent a CXL treatment. In this case, CXL was performed at 6-years-old prior to an expected progression, without complications and probably stopped further keratoconus progression
Trichobezoar - A hair-raising surgical emergency
No full textA trichobezoar is a mass of undigested hair in the proximal gastrointestinal tract. It is a rare condition seen in young females with psychiatric disorders of trichotillomania and trichophagia or mental retardation. We present a case of an intellectually impaired 14-year-old girl with a gastric trichobezoar discovered during an emergency laparotomy. We will discuss the limited but salient findings on history and examination. Through a review of the literature, imaging modalities and treatment options for the early versus late stage of trichobezoar presentations will be identified. Through our case, subsequent holistic management will also be highlighted to prevent recurrence
Oral rehabilitation with an implant-supported mesostructure on a microvascularized mandibular graft
No full textDue to the increased survival of the population, treatment of oral cavity tumour patients is increasingly common. In this context, oral rehabilitation construction methods have been developed to contribute to improving the patient's quality of life. Developments in the areas of oral implantology and rehabilitation, along with microvascularized grafts, have increased the possibility of rehabilitating patients undergoing hemimandibulectomy with more effective and lasting treatment. This article aims to demonstrate an aesthetic and functional oral rehabilitation method, both in terms of the oral cavity and the lower face, in a young patient submitted to a left lateral hemimandibulectomy, using a mesostructure fixed onto implants
Management of chylous ascites following hand assisted laparoscopic donor nephrectomy: Case report
Get PDFWe report a case of chylous ascites following a hand assisted laparoscopic donor nephrectomy (HALDN). In this case a 70-year-old male was re-admitted three weeks after undergoing a left HALDN with anorexia and abdominal distension. Abdominal CT confirmed ascites. Paracentesis yielded five litres of chylous fluid. He was treated conservatively with a high protein, low fat diet and made a full recovery. The management of this complication remains controversial with some advocating early surgical intervention and others preferring conservative management techniques. Consideration must be given to early surgical intervention in cases not responding immediately to conservative measures
High dose, fast delivery magnesium sulphate in a 3-year-old acute severe asthmatic
Get PDFAcute severe asthma when respiratory failure is imminent is not addressed in world asthma guidelines. Intravenous magnesium sulphate, salbutamol and aminophylline all have advocates but what order, speed of delivery or dosage is left up to the individual physician treating the patient. A child in respiratory failure was given a large, fast dose of intravenous magnesium sulphate before intravenous salbutamol which relaxed bronchial smooth muscle immediately and tracheal intubation and lung ventilation was avoided. Justification for this treatment is discussed
A new view of genetic mutations
Get PDFI discussed RNA editing mechanisms leading to the diversity of protein; new mechanisms escape from common general knowledge in biology that one gene encoding for one single protein. I also gave two known examples of RNA editing mechanisms that generate a high level of protein diversity: chemosensory proteins (CSPs) and odour binding protein (OBP) families. It is worthy to note that these RNA variants are not disease-causing mutations but rather an evolutionary mechanism in microorganisms and insects. Furthermore, these genetic variants presenting at the RNA level are not lethal and tissue-specific. One example, the sex pheromone (bombykol) gland of the silkworm moth Bombyx mori, is the preferential site of RNA mutations. Moreover, I have perhaps demonstrated that RNA splicing, editing and/or protein recombination are the crucial mechanisms for the totipotent cells to differentiate into a specific cell type in a given tissue. I give a global view of the basic phenomenon of eukaryotic cells and present a new perspective for the treatment of genetic diseases