King Fahd Military Medical Complex

Dhahran, Saudi Arabia

King Fahd Military Medical Complex

Dhahran, Saudi Arabia
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Kavarodi A.M.,King Fahd Military Medical Complex | Thomas M.,Hamad Medical Corporation | Kannampilly J.,Dr. Johnnys Dental Clinic
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: The expatriate population in Qatar largely comprises workers from the Indian subcontinent which has a very high rate of oral malignancy. Social and cultural habits and as well premalignant risk factors in this population remain prevalent even after migration. Materials and Methods: This cross sectional study assessed the prevalence of risk factors and occurrence of oral precancerous lesions in a low income group expatriate community from the Indian subcontinent residing in Qatar. Results: Among the 3,946 participants screened for oral premalignant lesions 24.3% (958) were smokers and 4.3 % (169) were pan chewers while 6.3% (248) were users of both smoked and smokeless forms of tobacco. Significantly higher proportion of industrial laborers (49.9%) followed by drivers (24.1%) were found to be smokers (p=0.001). The prevalence of white lesions was higher in smokers versus non-smokers 3.5% versus 2.3% (p=0.111), however this difference was statistically non-significant. Red and white lesions were highly significant (i.e. 1.2 % and 10.9% respectively) in the subjects with pan chewing and smoking habits (p=0.001). A significant proportion (8.9%) of the subjects with pan chewing habit showed evidence of oral precancerous lesions (p=0.001). Conclusions: Even though smoking and pan chewing were two significant risk factors detected in this population, their prevalence and occurrence of premalignant lesions are low as compared to the studies conducted in their home countries.

Introduction Transversus abdominis plane (TAP) block is used as a part of multimodal analgesia in decreasing pain of lower abdominal wall incision. Local anesthetic instillation of wounds through subcutaneous or subfascial catheters is used to treat postoperative pain in different types of surgery. The aim of this randomized controlled trial was to study the opioid-sparing effect of these two techniques (if any) compared to placebo in women undergoing gynecologic procedures through transverse lower abdominal incisions. Methods Seventy-eight ASA I-III patients planned to undergo gynecologic procedures through a transverse lower abdominal incision were randomly divided into three equal groups: Control (C) group (n = 26), Continuous Wound Infusion (CWI) group (n = 26), and continuous transversus abdominis plane block (TAP) group (n = 26). After standardized general anesthetic and before extubation, the patients were given the allocated treatment. A morphine patient-controlled analgesia (PCA) was started postoperatively alongside with the local anesthetic (or placebo) infusion. Cumulative dose of morphine PCA in the first postoperative 48 h was the primary outcome. Secondary outcomes included visual analog pain score (VAS) at rest and on movement and complications of morphine PCA. Results The cumulative dose of morphine PCA in the first postoperative 48 h was higher in control group than in groups CWI and TAP (P < 0.001). However, no significant difference was found between groups CWI and TAP. No significant differences were found among the three groups regarding VAS during rest but TAP group showed less pain scores than groups C and CWI on movement. The three groups were similar regarding morphine side effects. Conclusion Continuous bilateral TAP block and CWI can decrease PCA morphine consumption in the first postoperative 48 h when compared to placebo in women undergoing gynecologic surgery through transverse lower abdominal incision. Continuous TAB block might give better analgesia with movement than CWI. © 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.

Omar A.M.,King Fahd Military Medical Complex
Egyptian Journal of Anaesthesia | Year: 2012

Introduction: In spite of introduction of intermediate-acting neuromuscular blocking drugs (NMBDs), incidence of postoperative residual muscle weakness is still high. The aim of this trial is to study the effect of systemic lidocaine infusion on intraoperative consumption of rocuronium and TOF ratios at extubation and on arrival to postanesthesia care unit (PACU). Methods: Forty-six ASA I-III patients aged 16-60 yr were randomly allocated into two groups: lidocaine (L) group (n = 23) and control (C) group (n = 23). After induction of standard endotracheal general anesthesia with fentanyl, propofol and rocuronium, patients of group L were given i.v. lidocaine bolus (1.5 mg kg -1) followed by continuous infusion (1.5 mg kg -1 h -1) till time of endotracheal extubation while patients in group C were given equal volumes of normal saline. Rocuronium was titrated based on clinical signs. On conclusion of surgery, neostigmine was given to reverse the effects of rocuronium if TOF count was two or more. Immediately before extubation, TOF ratio was measured and recorded and considered the primary outcome. Results: There were no significant differences between the two study groups regarding intraoperative fentanyl doses or core temperature at the end of surgery. End-tidal sevoflurane concentrations were significantly lower in group L than in group P (P < 0.01). The dose of rocuronium was significantly less in group L than in group C (P = 0.001). Train-of four ratios were significantly higher in group L than in group C either before extubation (P < 0.001) or on arrival to PACU (P = 0.001). Conclusion: The current study shows that intraoperative use of i.v. lidocaine infusion in generally anesthetized patients can result in higher TOF ratios at time of extubation and on arrival to PACU when rocuronium was given based on clinical signs. © 2012 Egyptian Society of Anesthesiologists. Production and hosting by Elsevier B.V. All rights reserved.

Jaber S.,King Fahd Military Medical Complex
Asian journal of endoscopic surgery | Year: 2011

We report a severely infected necrotizing pancreatitis managed with hand-assisted laparoscopic necrosectomy along with a review of the relevant literature. Minimally invasive necrosectomy has been shown to be efficient and advantageous in managing necrotizing pancreatitis. Multiple techniques have been advocated over the last decade. Laparoscopic pancreatic debridement is a feasible option for some patients with necrotizing pancreatitis. We selected hand-assisted laparoscopic pancreatic necrosectomy, which has gained some favor over open necrosectomy because of the morbidity and mortality associated with laparotomy. We report on an Indian male patient who presented with acute abdomen and severe jaundice. A CT scan of the abdomen showed severe necrotizing pancreatitis. After conservative management failed, a hand-assisted laparoscopic pancreatic necrosectomy was performed. The patient recovered and was discharged 4 weeks after surgery. © 2011 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Blackwell Publishing Asia Pty Ltd.

Al-Hassan D.,King Fahd Military Medical Complex | Blanke P.,University Hospital Freiburg | Leipsic J.,University of British Columbia
Minerva Cardioangiologica | Year: 2013

Degenerative calcific aortic stenosis represents the most common valve abnormality with increasing incidence in the elderly. Studies have shown that aortic stenosis is a fatal disease with a high cardiovascular death rate if untreated. However, many patients are encumbered with multiple comorbidities making them high-risk candidates for surgical aortic valve replacement, which is the hitorical treatment of choice. Transcatheter aortic valve implantation (TAVI) has seen rapid advancements over the last number of years with over 50000 TAVI procedures being performed in 40 countries with excellent prognosis proving TAVI to be a feasible alternative therapy to traditional surgical aortic valve replacement to treat high-risk patients. In addition to clinical suitability, imaging plays an essential role for optimal patient selection and to help select the appropriate prosthesis and to help reduce the likelihood of complications and adverse events. Fundamental to the procedure success, is the non-invasive assessment of the aortic annulus, the evaluation of the aortic root and the determination of the access to the aortic annulus. Among different imaging modalities that have been employed, multidetector computed tomography (MDCT) is increasingly used because of its capability of 3-dimentional (3D) determination of the non-circular nature of the aortic annulus as well as the complex aortic root anatomy. Additionally, MDCT provides a deep understanding of the structural integrity of the transcatheter aortic valve and enables the evaluation of the prosthesis location after TAVI and identification of post procedure complications. In this article, we discuss the current role of MDCT in pre-TAVI evaluation but also in the guidance of the procedure and in post-procedure follow-up.

Al-Hassan D.,King Fahd Military Medical Complex | Leipsic J.,University of British Columbia
Future Cardiology | Year: 2013

Coronary computed tomographic angiography (CCTA) provides anatomic detail of lumen stenosis and information on plaque burden, plaque extent and plaque characteristics. CCTA does not, however, provide insight into the hemodynamic significance of a stenosis, which is essential to allow appropriate revascularization decision-making. This could reduce downstream invasive coronary angiography and nonbeneficial coronary revascularization, particularly with intermediate coronary stenosis. Invasive fractional flow reserve (FFR) is the gold standard for the determination of lesion-specific ischemia and the need for revascularization. Advances in computational technology now permit calculation of FFR using resting CCTA image data, without the need for additional radiation or medication. Early data demonstrate improved accuracy and a discriminatory ability of FFR computed tomography to identify ischemia-producing lesions compared with CCTA alone. This new, combined anatomic-functional assessment has the potential to simplify the noninvasive diagnosis of coronary artery disease with a single study to identify patients with ischemia-causing stenosis who may benefit from revascularization. © 2013 Future Medicine Ltd.

Darwish M.A.,University of Dammam | Al Khaldi N.M.,King Fahd Military Medical Complex
Life Science Journal | Year: 2013

Objectives: to assess the Knowledge related to hepatitis B among fourth year medical students, in University of Dammam. Subjects and Methods: This was a cross sectional study conducted in College of Medicine, University of Dammam; Eastern Saudi Arabia. A total of 139 students represented the sample of the study. Data were collected by using structured, self-administered questionnaire which was divided into two parts with a total of thirty four questions. The first part included socio-demographic data and other information as histories of hepatitis B vaccination status, needle stick injury and family history of hepatitis B family. The second part included second part included questions to assess the level student knowledge concerning hepatitis B infection. The data were entered and analysed using Statistical Package for Social Sciences (SPSS) software version 16. Results: The mean age of participating students was 21.2 ± 0.72 years and the female participants constituted 52.5% of the study group. The mean knowledge score of all the students was 17.63 ± 4.8. Almost 50% of the students had good knowledge; 39.6% and 10.1% had average and poor knowledge respectively. The level of knowledge about hepatitis B infection among male and female students was not statistically significantly different. Also this knowledge was not significantly related to either vaccination or screening for hepatitis B or Needle stick exposure. There was a significant relationship between marital status and hepatitis B knowledge (p<0.01) with more knowledge among unmarried students. Level of hepatitis B knowledge was significantly (p<0.05) higher among students with negative family history for HBV infection. Conclusion: This study highlights the satisfactory knowledge of the fourth year medical students but there was a gap which needs to be corrected or modified regarding methods of transmission, prevention and post-exposure management of hepatitis B. Medical students should be well educated about counseling for accidental needle pricks and availability of post-exposure prophylaxis.

Mohamed E.,King Fahd Military Medical Complex | Guella A.,King Fahd Military Medical Complex
Transplantation Proceedings | Year: 2013

Background This survey was conducted to assess the public perception on organ donation and transplantation. Methods A random sample of the population attending the outpatient clinics in Dhahran Military Hospital, Saudi Arabia, from December 1, 2011, to January 31, 2012, answered a questionnaire related to the above aim. Results From 582 subjects who answered the questionnaire, 85 were excluded for incoherent answers. From the remaining 497, 77.7% were males and 22.3% females with the age ranging from 18 to 65 years, and the majority was at a secondary or university level of education. More than 90% were aware organ transplantation and donation. From a religious point of view, 68.6% considered it legal to donate organs versus 26.2%. Those who disagreed with the concept of donation believed that one kidney is not enough to survive (50%), and that the remaining kidney may be affected (25.8%), whereas 15.2% expressed fear of the operation. Kidney transplantation was the preferred treatment for 73.2% of respondents and 12.75% were in favor of dialysis. Regarding financial incentive, 14.5% asked for reward from the government, 3.4% believed that the reward should come from the donor, and the majority (82.1%) stated that organ donation should be for the sake of God. Finally, there was a 61.2% willingness of respondents to donate relatives' organs after brain death. Conclusion The level of awareness about donation and transplantation in our population was found to be satisfactory. Religion was not a bar for organ donation; moreover, financial incentive was not found to be a positive stimulus toward donation because the majority was willing to donate for the sake of God. © 2013 by Elsevier Inc. All rights reserved.

Yasawy M.I.,University of Dammam | Mohammed A.E.,Riyadh Military Hospital | Bassam S.,Riyadh Military Hospital | Karawi M.A.,Riyadh Military Hospital | Shariq S.,King Fahd Military Medical Complex
World Journal of Gastroenterology | Year: 2011

AIM: To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration (PAIR) in the management of hepatic hydatidosis. METHODS: Twenty-six patients with 32 hepatic hydatid cysts had PAIR. Twenty-two patients received at least 2 wk of drug therapy before the procedure was carried out to reduce the risk of recurrence from spillage during the procedure. The procedure was performed under local anesthesia with a 19-gauge 20 cm long needle, the cyst was punctured, cystic content (approximately 30 mL) was aspirated by a 12-14 F pigtail catheter and aspirated fluids were sent for analysis. Once the cyst was almost empty, two-thirds of the net amount of material aspirated was replaced by hypertonic saline and left in the cavity for about 30 min, with the catheter left in place for reaspiration of most of the fluid. When the amount of fluid drained was less than 10 mL per 24 h, the drainage catheter was removed. RESULTS: All 32 cysts showed evidence of immediate collapse after completion of the procedure, and before discharge from hospital, ultrasound examination showed fluid reaccumulation in all cysts. Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts. To confirm the sterility of these cystic cavities, seven cysts were reaspirated on average 3 mo after the procedure. Investigations revealed no viable scolices. CONCLUSION: PAIR using hypertonic saline is very effective and safe with proper precautions. © 2011 Baishideng.

PubMed | King Fahd Military Medical Complex
Type: Journal Article | Journal: Urology annals | Year: 2017

Renal Cyst infections are rare, account for approximately 10% of causes for hospitalization in patients with adult polycystic kidney disease. We reported a rare case of ruptured emphysematous renal cyst with infection extending into the right perinephric space with gas forming organism involving the renal collecting system and the urinary bladder.

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