El Hassan E.,Emergency Residency Program |
Mohamed A.,United Arab Emirates University |
Ibrahim M.,Sheikh Khalifa Medical City |
Margarita M.,Sheikh Khalifa Medical City |
And 2 more authors.
Obesity Surgery | Year: 2013
Background: Leaks occur in 1.4-20 % (Bohdjalian et al., Obes. Surg. 20:535-540, 2010; Nocca et al., Obes Surg. 18:560-565, 2008; Stroh et al., 19:632-640, 2009; Aurora et al., Surg. Endosc. 26:1509-1515, 2012) of patients following laparoscopic sleeve gastrectomy (LSG). Leaks may lead to major morbidity and prolonged hospitalization. Endoscopic stent placement is a potential management strategy that needs expertise and also has recognized complications (stent migration, significant dysphagia, and failure) (Rosenthal et al., Surg. Obes Relat. Dis. 8:8-19, 2012). A standard method of managing leaks following LSG has not been established. This study aims to evaluate the outcomes of consecutive patients with leaks following LSG managed at BMI Abu Dhabi Tertiary Multidisciplinary Bariatric Surgery, Abu Dhabi, UAE. Methods: We examined all patients presenting to BMI Abu Dhabi between February 2010 and May 2012 with leaks following LSG. Data were obtained from the hospital medical record, and IRB approval was obtained. All patients were managed by utilizing a standardized operative management strategy without the use of endoscopic stenting. Results: A total of five patients were referred to us for higher level of care; during the same time period, we performed 71 LSGs without a leak. Patients were optimized and resuscitated adequately before surgery. Intraoperatively, all patients had endoscopy, and a T tube was placed inside the leak if clearly identifiable. Otherwise, the leak site was drained adequately without attempting to place sutures, and a jejunostomy tube was inserted. All leaks healed following an initial period of hospital stay, followed by an outpatient period on jejunostomy tube feeding and nil per os. Conclusion: Single-stage operative management of leaks after LSG utilizing a standardized operative strategy without the use of endoscopic stenting is both safe and effective. © 2013 Springer Science+Business Media New York.
Lee P.,Singapore General Hospital |
Kupeli E.,Mesa Hospital |
Mehta A.C.,Sheikh Khalifa Medical City |
Mehta A.C.,Cleveland Clinic
Clinics in Chest Medicine | Year: 2010
Stents are used for palliation of symptoms of central airway obstruction caused by either malignant or benign conditions. Stents may be applied for maintaining airway patency after dilatation of postinflammatory and infectious strictures, for airway dehiscence after lung transplantation, and for the management of tracheobronchomalacia. Fistulas between trachea or bronchi and the esophagus and dehiscence of pneumonectomy stump can be protected with covered stents. Choice of stent depends on careful patient selection, characteristics of airway stenosis, physician's expertise, and availability of equipment. Placement of tube stents requires rigid bronchoscopy and dilatation of strictures beforehand, whereas metal stents can be applied using a flexible bronchoscope. Advantages and disadvantages of commonly used airway stents are discussed. © 2010 Elsevier Inc. All rights reserved.
Waness A.,Sheikh Khalifa Medical City
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2012
Even though rare, tuberculous peritonitis (TBP) in patients on continuous ambulatory peritoneal dialysis (CAPD) is a perilous condition. Physicians worry about continuing treatment of their patients, whether to continue this modality of dialysis or switch to hemodialysis. A retrospective cohort study of 89 patients undergoing CAPD over a 12-year period was carried out for any episode of peritonitis with the objectives to find out the incidence of TBP in these patients, evaluation of patients' 3-year survival, possibility of retention of Tenckhoff catheter, and modality of dialysis post-infection. One hundred and three episodes of peritonitis occurred in our patients. Most of them were bacterial and occasionally fungal. We identified four cases of TBP, with one patient having concurrent bacterial infection in the peritoneal fluid. The clinical presentation was insidious with cloudy fluid in all cases. The diagnosis was established by the polymerase chain reaction (PCR) technique in one case, by positive peritoneal fluid culture for Mycobacterium tuberculosis in two cases, and clinically in the fourth one that responded well to anti-tuberculous therapy. All four patients survived their mycobacterial infection. Removal of catheter was necessary in all four patients and all were converted to hemodialysis. Three patients remained on hemodialysis thereafter, and one patient had to be re-implanted with a new catheter and was restarted on CAPD. TBP in patients undergoing CAPD in Jeddah remains a real concern, especially with the evidence of high prevalence of tuberculosis and with the emergence of drug-resistant tuberculosis. We recommend early initiation of anti-tuberculous therapy and removal of the Tenckhoff catheter for better survival. Most of these patients probably will require conversion to hemodialysis, but in a selected few CAPD can be restarted.
Albrecht E.,University of Cape Town |
Richards J.C.,Royal Perth Hospital |
Pollock T.,Sheikh Khalifa Medical City |
Myers L.,University of Cape Town
British Journal of Ophthalmology | Year: 2011
Aim: To evaluate the use of intravitreal dexamethasone as adjunctive therapy in the treatment of presumed bacterial endophthalmitis. Design: Prospective, double masked, randomised placebo-controlled clinical trial. Methods: Patients with 'post cataract surgery', 'bleb-related' and 'other' endophthalmitis were grouped and randomised to receive intravitreal ceftazidime (2.225 mg/0.1 ml), vancomycin (1 mg/0.1 ml), and either dexamethasone (0.4 mg/0.1) or placebo. All underwent vitreous and aqueous sampling for microbiological analysis. Injections were repeated after 48 h if necessary. The primary outcome measure was Snellen visual acuity on presentation, within the first 14 days post injection, and at 2-4 months. Results: 62 patients completed the protocol from 2001 to 2005. Thirty patients received intravitreal dexamethasone and 32 received intravitreal placebo. There was no statistically significant difference in the visual outcomes of either group with a mean 2.79 Snellen lines improvement of the intravitreal dexamethasone group versus 1.8 lines in the placebo group. Subgroup analysis suggested a clinical trend to better visual acuity in the post cataract steroid subgroup with mean 4.1 lines improvement versus 2.7 in the placebo group (p=0.33). No adverse events attributable to the dexamethasone were reported. Conclusions: Intravitreal dexamethasone appears safe and may be of benefit in post cataract surgery bacterial endophthalmitis.
Hassan A.,Sheikh Khalifa Medical City |
Whately C.,Sheikh Khalifa Medical City |
Whately C.,Welcare Hospital |
Letts M.,Sheikh Khalifa Medical City
Journal of Bone and Joint Surgery - Series B | Year: 2010
Stüve-Wiedemann syndrome is an autosomal-recessive disorder characterised by bowing of the long bones, progressive scoliosis, episodic hyperthermia and respiratory distress, usually resulting in death in infancy. We reviewed five children with the condition who had been followed since birth and who survived into childhood with a mean age at operation of 7.8 years (5 to 14). There was marked functional impairment with dysplasia of the long bones and scoliosis. Treatment of the triplanar deformities of the femora involved the use of the Ilizarov technique with the Taylor Spatial Frame. Walking was preserved and improved in three children along with considerable enhancement of the appearance. Early insertion of a growing rod to control the progressive juvenile scoliosis was beneficial. The use of the Taylor Spatial Frame is strongly recommended to address the major complex deformities of the lower limbs which are encountered in this condition and to prevent their progression. ©2010 British Editorial Society of Bone and Joint Surgery.
Khalil A.B.,Sheikh Khalifa Medical City
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists | Year: 2010
To describe a case of papillary carcinoma of the thyroid with fibromatosislike stroma, emphasize the need for a diligent search for papillary thyroid cancer in the presence of a fibroproliferative lesion, highlight the peculiar hormonal response of the stromal component, and review the pertinent literature. We present the clinical, laboratory, radiologic, and pathologic findings in a patient with papillary carcinoma of the thyroid with fibromatosislike stroma and review the related published material. A 29-year-old woman presented to our surgical department because of a large mediastinal mass. She underwent surgical removal of the mass by means of a median sternotomy and neck extension. Pathology examination revealed macroscopically tan scarlike tissue, which by histologic study consisted of a dominant fibroproliferative lesion overshadowing a minor component of papillary carcinoma of the thyroid. Further neck exploration with total thyroidectomy revealed multifocal papillary carcinoma of the thyroid. Postoperatively, the patient received radioiodine treatment. A local and aggressive recurrent tumor was observed during a subsequent pregnancy; the lesion was not amenable to complete resection but fascinatingly responded to antiestrogen therapy (orally administered tamoxifen). The presence of a fibroproliferative lesion could be misleading. A diligent search should be made for a papillary thyroid carcinoma component within fibromatosislike stroma. The mode of manifestation of the tumor and its response to hormonal manipulation are distinctive features of this case.
Rajah J.,Sheikh Khalifa Medical City |
Thandrayen K.,University of Witwatersrand |
Pettifor J.M.,University of Witwatersrand
European Journal of Pediatrics | Year: 2011
Abstract Rickets remains a common problem among infants and children in many countries worldwide. Although the classical presentation associated with bone abnormalities is well known, paediatricians need to be aware of atypical presentations, especially in the first 6 months of life. Furthermore, although vitamin D deficiency rickets remains the commonest form of rickets in most countries, health care providers need to be aware of other possible causes and their typical clinical and biochemical presentations. This article discusses these and highlights the characteristic features of various forms of rickets and possible pitfalls clinicians should be aware of when confronted with a patient with suspected rickets. In conclusion, the recent advances made in understanding the underlying pathogeneses of the various forms of rickets has helped to delineate the diagnostic tests that assist in the diagnosis and management of the disease in children. © Springer-Verlag 2011.
News Article | October 28, 2016
· Continued good growth and results despite holiday period · Our client is pleased with of our initial work at Sheikh Khalifa Medical City Ajman (SKMCA) · Our new management team is now in place and leading the development of SKMCA Third quarter 2016 · Sales revenues increased to SEK 189.1 million (160.4) and organic growth amounted to 15 percent (7) · EBITDA amounted to SEK 7.4 million (1.1) · EBITDA margin amounted to 3.9 percent (0.7) · Result after tax (EAT) amounted to SEK
News Article | October 28, 2016
· Fortsatt bra tillväxt och resultat trots semesterperioden · Goda omdömen från vår uppdragsgivare på vårt initiala arbete i Sheikh Khalifa Medical City Ajman (SKMCA) · Vår nya ledningsgrupp är nu på plats och leder utvecklingen i SKMCA Tredje kvartalet 2016 · Försäljningsintäkterna ökade till 189,1 MSEK (160,4) och den organiska tillväxten uppgick till 15 procent (7) · EBITDA uppgick till 7,4 MSEK (1,1) · EBITDA-marginalen uppgick till 3,9 procent (0,7) · Resultat efter skatt (
News Article | October 28, 2016
GÖTEBORG, Sweden--(BUSINESS WIRE)--Regulatory News: GHP Specialty Care AB (STO:GHP) · Continued good growth and results despite holiday period · Our client is pleased with of our initial work at Sheikh Khalifa Medical City Ajman (SKMCA) · Our new management team is now in place and leading the development of SKMCA Third quarter 2016 · Sales revenues increased to SEK 189.1 million (160.4) and organic growth amounted to 15 percent (7) · EBITDA amounted to SEK 7.4 million (1.1) · EBITDA margin amo