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Abdulrahman S Al-Mulhim

Publications and source records attributed to Abdulrahman S Al-Mulhim.

12 recordsLinked to original sources
PubMed2006

Post hemorrhoidectomy pain. A randomized controlled trial.

OBJECTIVE: To compare the effect of metronidazole on post conventional hemorrhoidectomy pain in patients with third and fourth degree hemorrhoids. METHODS: Two hundred consecutive patients admitted in King Fahad Hospital, Hofuf, Saudi Arabia between June 2002 and May 2004 for surgical treatment of 3rd and 4th degree hemorrhoids were randomly assigned into 2 groups. In Group 1 (100 patients) pre and postoperative metronidazole was used and in Group 2 (100 patients) no medications were given. All patients received castor oil from 2 days before surgery and lactulose after surgery for 2 weeks. Patients were discharged home when free of pain. RESULTS: Patients in group 1 had significantly less pain than those in the second group. Hospital stay and time to first bowel motion were not significantly different between both groups and, early and late complications appear similar. Return to normal activity was significantly shorter in the metronidazole group. CONCLUSION: Prophylactic metronidazole in Milligan-Morgan hemorrhoidectomy is associated with less pain and earlier return to normal activity.

Adult↗
PubMed2006

Osteoarthritis of knees and obesity in Eastern Saudi Arabia.

OBJECTIVE: To find out the prevalence and relation between osteoarthritis of knees and obesity in Al-Ahsa region, Kingdom of Saudi Arabia (KSA). METHODS: The study included 243 male and female patients diagnosed with osteoarthritis of knees between June 2001 to March 2003. All patients were recruited from the Physical Therapy Department, King Fahd Hofuf Hospital, Hofuf, KSA. The clinical diagnosis was supported by plain x-rays of knees, and of other joint if needed. The weight and height of all patients were taken using one standard weight and height scale, and body mass index was also calculated and recorded. RESULTS: More than 90.53% of the patients referred with osteoarthritis of the knees were obese or overweight. The mean body weight of all patients was 84.61 kg and the mean height was 1.59 meters. Osteoarthritis of the knees was more common in obese female than male patients with a female to male ratio of 2.37:1. CONCLUSION: Obesity is a disease. The aim of all health professionals and others in the community should be directed to the prevention of this disease and its risk to develop multiple complications.

Adult↗
PubMed2005

Fine-needle aspiration diagnosis of primary cutaneous cryptococcosis in an immunocompetent patient: a case report.

We report a case of a primary cutaneous cryptococcosis (PCC) in immunocompetent man diagnosed by fine-needle aspiration (FNA) and confirmed by special stains and culture study. The patient presented with a 2-wk history of two separate skin nodules over the forehead and the left lumbar region. FNA smears revealed a necrotizing suppurative granulomatous inflammation with numerous yeasts of Cryptococcus surrounded by clear halos, which were present within multinucleated giant cells and in the intercellular spaces. This was confirmed subsequently by special stains and a culture of the aspirated material. This case report reemphasizes the role of FNA as a useful modality in the early diagnosis of cutaneous cryptococcosis, especially in clinically unsuspected cases.

Adult↗
PubMed2005

Contamination of patients' files in intensive care units: an indication of strict handwashing after entering case notes.

BACKGROUND: The extent to which bedside patients' files become contaminated and the range of bacterial flora attributable to contamination in high-risk areas of the hospital are not known with certainty. The aim of the present study was to determine the degree of contamination of the patient's files and also to analyze and compare the spectrum of contaminant bacterial flora between the intensive care unit (ICU) and surgical wards, the 2 most high-risk areas for nosocomial transmission of infection. METHODS: Microbiologic samples were collected from the exposed outer surface of the patients' files kept bedside in the ICU and surgical wards with sterile swabs moistened with sterile normal saline. Swabs were cultured within an hour of collection on blood agar and MacConkey's agar plates, which were incubated at 37 degrees C for 48 hours. Gram-negative bacilli were identified by Gram's stain, catalase, oxidase tests, and API 20E and API 20NE. Staphylococcus species were identified by Gram's stain, catalase test, and tube coagulase test. Antibiotic susceptibility of the isolated bacteria was determined by the disk diffusion technique according to the criteria of National Committee for Clinical Laboratory Standards (NCCLS). RESULTS: In ICU, 85.2% (87/102) and, in surgical wards, 24.7% (22/89) of patient's files were found to be contaminated with pathogenic and potentially pathogenic bacteria (OR, 17.664; 95% CI: 8.050-39.423; P < .0001). Pseudomonas aeruginosa was the most commonly isolated bacteria (32.3%, 33/102) in ICUs, whereas Staphylococcus aureus was the peak contaminant (11.2%, 10/89) of the files in surgical wards. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 6.8% (7/102) of ICU patient's files, whereas only 1.1% (1/89) of patient's files in surgical wards were contaminated with MRSA (OR, 6.484; 95% CI: 3.215-13.463; P < .0001). The multidrug-resistant P aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Serretia marcesens isolated from the patient's files had the same antibiotic resistance pattern as of these bacteria isolated from the patients. CONCLUSION: The majority of the patient's files in ICUs were contaminated often with multidrug-resistant bacteria and even MRSA. Contaminated files could be a source of transmission of infection. To prevent this, handwashing practice should be strictly followed after attending the patient and before entering the case notes in the patient's file. The maintenance of good hand hygiene by the health care workers (HCWs) after handling contaminated files should perhaps be the most prudent approach to prevent patient-patient transmission of infection in high-risk areas including ICU and surgical wards.

Cross Infection↗
PubMed2004

Thyroid low-grade B-cell lymphoma (MALT type) with extreme plasmacytic differentiation: report of a case diagnosed by fine-needle aspiration and flow cytometric study.

We describe a case of thyroid marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with extreme plasmacytic differentiation in an 80-year-old woman who had presented with a rapidly growing thyroid swelling. The diagnosis was initially suspected on fine-needle aspiration (FNA) and subsequently confirmed by flow cytometric analysis of the aspirated material. The smears revealed features of Hashimoto's thyroiditis admixed with large numbers of atypical large plasmacytoid lymphoid cells accompanied by variable numbers of small lymphocytes and mature plasma cells. The differential diagnosis of a predominantly plasmacytic smears on FNA of the thyroid is discussed herein, with emphasis on the role of immunophenotypic studies to exclude or confirm the diagnosis of lymphoma.

Aged↗
PubMed2004

The role of fine needle aspiration cytology and imprint cytology in cervical lymphadenopathy.

OBJECTIVE: To determine the diagnostic accuracy of cervical lymphadenopathy by fine needle aspiration (FNAC) and imprint cytology (IC). METHODS: This study included 94 patients with cervical lymphadenopathy. This study was carried out in the Departments of General Surgery and Pathology, King Fahad Hospital, Hofuf, Kingdom of Saudi Arabia, from June 2001 through to July 2002. They were subjected to clinical examination and FNAC of one of the enlarged lymph nodes. This was followed by IC and histological examination of this lymph node after its excision. RESULTS: Clinical examination was correct in 78% of the cases. The overall accuracy of fine needle aspiration was 93%. It was accurate on all cases of reactive hyperplasia, 93% of tuberculosis lymphadenitis, 90% in Hodgkin's lymphoma, 86% in non-Hodgkin's lymphoma, and 91% of metastasis lymphadenopathy. On the other hand, the overall accuracy of IC was higher than that of fine needle aspiration, being 97%. It diagnosed all cases of reactive hyperplasia and non-Hodgkin's lymphoma, 97% in tuberculosis lymphadenitis, 90% in Hodgkin's lymphoma and 95% in metastasis lymphadenopathy. CONCLUSION: These techniques proved to be reliable, rapid, and inexpensive procedures in diagnosis of lymphadenopathy. They can differentiate well between inflammatory and neoplastic lesions, in cases of lymphoma, cytological diagnosis should be followed by histological diagnosis for accurate classification and grading.

Adult↗
PubMed2002

Laparoscopic versus open appendectomy in females with a clinical diagnosis of appendicitis.

OBJECTIVE: Appendectomy can be performed using either a laparoscopic technique (LT) or an open technique (OT). We compared the following items operative, anesthesia, length of stay, post-operative pain, medicine, wound healing, days to return to normal activity in both groups. METHODS: This study was carried out at King Fahad Hospital, Hofuf, Al-Hassa, Kingdom of Saudi Arabia, from January 1999 to April 2000. We randomly assigned 60 female patients to appendectomy by LT or OT. The 2 groups were compared concerning demographic data. The differences were considered statistically significant at a P value < 0.05. RESULTS: The open group had shorter anesthesia and operative time (68, 50 versus 85, 65 minutes). The laparoscopic group had a significant reduced postoperative narcotic requirement (P<0.05), quicker reintroduction of diet and quicker return to normal activity. CONCLUSION: Laparoscopic appendectomy in female patients with clinical diagnosis of appendicitis is the procedure of choice for the diagnosis and the management of acute appendicitis.

Adolescent↗
PubMedDate not supplied

Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists.

BACKGROUND: Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. METHODS: In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by a pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. RESULTS: Of 692 FNABs, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6 % of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. CONCLUSIONS: The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnostic accuracy of FNAB technique.

Biopsy, Fine-Needle↗