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Biomedical subjects

Ibrahim Al-Habdan

Publications and source records attributed to Ibrahim Al-Habdan.

9 recordsLinked to original sources
PubMed2005

Effect of parity on bone mineral density among postmenopausal Saudi Arabian women.

OBJECTIVE: Osteoporosis and osteopenia among postmenopausal Saudi Arabian women are common to the extent of over 60%. Pregnancy, multiparity and prolonged lactation are suggested as factors modifying negatively in the development of osteoporosis. Earlier reports from the institution indicated a beneficial role of multiparity in postmenopausal osteoporosis (PMO). We conducted this study to measure the effect of parity on bone mineral density (BMD) measurement of lumbar spine and the upper femur. METHODS: We conducted this prospective study at King Fahd Hospital of the University, College of Medicine, King Faisal University, Dammam, Saudi Arabia, between January 2002 and June 2003. This study analyzed 256 patients who attended orthopedic clinics. The data gathered was age, duration of menopause, number of children borne, height and weight for body mass index (BMI) calculation. We excluded women with secondary osteoporosis from the study. We entered the patients orthopedic complaints in the database. We carried out the BMD measurements using Hologic total body DEXA machine. We analyzed the data using SPSS package with significance at p<0.05 and confidence interval of 95%. For final analysis, we took into consideration an average of results of the lumbar spine and hip region. RESULTS: We analyzed the available data of 256 patients. We divided the patients into 2 groups; group A with >6 children and group B with women of <5 children. In group A, there were 116 women and 140 in group B. The mean age of patients in group A was 56.81 (50-65) years SD +/- 5.19 and in group B the mean age was 58.86 years (48-76) SD +/- 7.68. The average BMI in group A was 31.95 kg/m2 and in group B it was 29.14 kg/m2. The BMD of the lumbar spine of group A was 0.850 g/cm2 (SD+/-0.112) compared to group B of 0.699 g/cm2 (SD+/-0.141), p<0.005. The BMD of the hip region of group A was 0.836 g/cm2 and that of group B patients was 0.716g/cm2 (p<0.01). In women with <5 children, 25.5 had normal BMD as compared to 47 in women with >6 children, 25.4% were osteoporotic in group A and in group B 48%. As per the World Health Organization classification 56% in group A had an increased risk of fracture as compared to 77.5% in group B women. CONCLUSION: Our results indicate that women who had borne >6 children were less osteoporotic and of low fracture risk as compared to those women who had <5 children. The BMD of the women with >6 children was statistically higher than their counterparts, and they sustain this after prolonged lactation. We believe that increased parity protects women from osteoporosis and the severity of the disease, and it is our suggestion that women with <5 children and those nulliparous, who are at increased risk of developing osteoporosis should be investigated and treated accordingly.

Absorptiometry, Photon↗
PubMed2003

Birth-related fractures of long bones.

OBJECTIVE: Birth-related fractures of the long bones are not rare. METHODS: This study presents a retrospective analysis of birth-related fractures of long bones seen at the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. RESULTS: There were 21 fractures (clavicle 11, femur 6, humerus 3 and radius 1) during the 10-year period, with an overall incidence of 0.67 per 1000 live births. Neonates with fractures had higher birth-weight (p<0.001) as compared to the control group and other parameters like gestational age and mode of delivery were not significant. CONCLUSION: It is recommended that neonates with fractures must have quicker appointments in the outpatient clinics to prevent deformities and secondly those with fracture clavicles should be thoroughly evaluated to rule out damage to brachial plexas as well.

Birth Injuries↗
PubMed2003

Birth associated trauma.

OBJECTIVE: To assess the incidence of birth-injuries seen at the King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia (KSA). METHODS: A retrospective analysis was carried out in 31,028 consecutive deliveries between January 1986 and December 1996 at the King Fahd Hospital of the University, Al-Khobar, KSA. The study group was compared with a matched control group. RESULTS: There were 203 newborns with 208 injuries with an incidence of 6.70 per 1,000 live births. The majority (55%) of the injuries was sustained during normal vaginal deliveries and the least were during cesarean section (5.2%). The average gestational age was 39 weeks (25-44 weeks) in the study group and in the control group was 38.84 (21-44 weeks). The birth weight in the study group was 3323 gms (780-6190) and the control group was 3015 gms (790-6,015) p<0.01. The Apgar score in the study group was 7 and 9 at one and 5 minutes and in the control group was 8 and 9. There were 104 scalp injuries, 50 nerve injuries, 20 fractures (11 clavicle and 9 long bones) and 21 newborns had intracranial hemorrhage. CONCLUSION: This study demonstrates a variety of birth related trauma at the teaching institution with a lower overall incidence as compared to reports from the literature. The only significant factor was that birth weight was higher in the study group as compared to the control group (p <0.01). It is recommended that every effort be required to further decrease the incidence of birth injuries.

Birth Injuries↗
PubMedDate not supplied

Glove perforation in pediatric orthopedic practice.

A prospective study was conducted to assess the glove perforation rate during 100 consecutive pediatric orthopedic operations. Eight hundred fifty-four gloves were tested for perforations. The overall glove perforation rate was 8.43%. Assistant surgeons had a rate of 45.8%, surgeons 33.4%, and scrub nurses 20.8%. More perforations were noticed on the left glove; the thumb and index finger were the most common sites of perforation. The duration of surgery was significantly related to the perforation rate. Two patients had postoperative wound infections and the gloves of surgeons and assistant surgeons were found to be perforated. Every attempt needs to be made to reduce the risk of glove perforation.

Equipment Failure↗
PubMedDate not supplied

Double or single gloves: which is safer in pediatric orthopedic surgery.

BACKGROUND AND AIM: Surgical gloves should form an efficient barrier between surgeons and patients to prevent cross infection. Single gloves (SGs) have long been reported unsafe, and usage of double gloves (DGs) is still not universal. No study has reported the usage of DGs in pediatric orthopedic operations. The aim of this study was to assess the efficacy of DGs versus SGs in prevention of body fluid contact between patients and surgeons during pediatric orthopedic surgery. METHODOLOGY: After 150 pediatric orthopedic operations, DGs and SGs were collected and tested for perforations. Gloves were tested for size, site, and number of perforations among principal surgeons, assistant surgeons, and scrub nurses. Gloves were not changed during long surgical procedures and were changed only if perforations were identified and recorded. The DGs used were Maxitex Duplex, powder-free indicator gloves and the SGs were of Gammex-Ansell. One hundred unused gloves of each group were tested as controls. Medical records of the patients were reviewed for age, sex, type of operation, duration of operation, and any postoperative wound infection. The data were entered in database and analyzed using SPSS package. The data were compared between double and SGs using t test with a level of statistical significance at P less than 0.05. RESULTS: Five hundred twenty-six DGs and 316 SGs were tested. Forty-three perforations were detected in DGs (8.1%). Outer gloves were breached in 7.8% and inner in 0.3% as compared with SGs in which 28 (8.7%) were perforated. In DGs, 4% had multiple perforations compared with 11.9% in SGs. There was a statistical significance (P<0.001) when the perforations of inner gloves were compared with the SGs. None of the inner perforations were recognized during surgery, but the outer gloves of the DGs were recognized in 71% as compared with 9% in SGs (P<0.001). The majority of perforations were seen in the nondominant hand in surgeons and assistants hands, whereas scrub nurses had 85% of perforations in the dominant hand. The index finger was the site of perforations in DGs (53.4%; SGs, 43%). The inner gloves were breached only when the outer glove was found to be perforated. The duration of surgery had a direct impact on the number of perforations. There were no perforations in DGs in less than 60 minutes as compared with 3 (10.7%) in SGs. Between 60 and 120 minutes, the perforations in the DGs were 11, and in SGs, 21. During the study period, 4 patients had surgical site infection. Three were superficial and one deep-seated infection. In 3 patients with infection, the gloves were found to be perforated, and 1 patient with infection had no perforations in the gloves. CONCLUSION: Our study confirms that DGs are safer than SGs during pediatric orthopedic operations. In the event of nonavailability of DGs, SGs should be changed on an hourly basis during long procedures. Lastly, there exists a relationship between surgical site infection and glove perforations.

Equipment Design↗
PubMedDate not supplied

Assessment of nosocomial urinary tract infections in orthopaedic patients: a prospective and comparative study using two different catheters.

Catheter-related nosocomial urinary tract infection in postoperative orthopedic and trauma patients was studied prospectively using nitrofuroxone-impregnated urinary catheters (study group) and regular silicone-coated Foley catheters. Fifty adults in each group were randomly assigned. In Group A, antibiotic-impregnated catheters were used, and in the other, non-antibiotic-impregnated urinary catheters were used (Group B). The variables studied were age, sex, type of surgery, duration of surgery, number of catheter days, days of intravenous line, and hospital days. In patients, urinary tract infection (UTI) was diagnosed by culture and the organism was isolated. The average age in the study group was 43.90 years (range, 14-95 years) compared with the control group (mean age, 42.22 years; range, 14-102 years). Catheter days in the nitrofuroxone-impregnated catheters was 7.9 days (range, 2-37 days) versus 7.2 days (range, 2-30 days). The intravenous line in the group was 9.16 days (range, 2-35 days) versus 8.8 days (2-22 days). There were six infections (P = 0.028) in the control group compared with the study group. The length of operation was similar in each group. Our study indicates that nitrofuroxone-impregnated catheters have the potential to reduce nosocomial catheter-related UTIs in postoperative orthopedic and trauma patients.

Adolescent↗
PubMedDate not supplied

Diaphyseal femoral fractures in children: should we change the present mode of treatment?

Three hundred thirty-nine diaphyseal fractures of the femur in 327 children were studied retrospectively. There were 196 boys and 131 girls, with a mean age of 5.59 years (range, 1 day-14 years). The majority of the children were < 6 years of age. In 67.8% of the children, the fracture was caused by a road traffic accident. Seventy-seven of the children had associated injuries. The minimum hospital stay was 15 days, and the maximum was 42 days (mean, 32.6 days). The most common site of fracture was at the middle third (N = 206), and 133 were the transverse type. The mode of treatment was balance skin traction in 146, skeletal traction in 72, hip spica in 22, internal fixation in 16, and external fixators in 5. The average follow up was 7.8 years. Complications were few. Our experience indicates that with a conservative mode of treatment, there is no risk of overgrowth, and a rotational malalignment of up to 20 degrees corrects during growth. We believe that diaphyseal fractures of the femur in children can be safely managed nonoperatively and economically, contrary to the present advocacy of operative treatment. The operative mode of treatment should be used in selected cases.

Accidents, Traffic↗
PubMedDate not supplied

Can double gloves improve surgeon-patient barrier efficiency?

The aim of this study was to compare double gloves (DGs) with single gloves (SGs) during orthopedic and trauma surgery in prevention of blood contact between patients and surgeons. DGs and SGs were collected after orthopedic operations, tested for size, site, and number of perforations. Medical records were reviewed for age, sex, type of operation, duration, and postoperative wound infection. Data were compared using t-test with level of statistical significance at P < 0.05. Five hundred seven operations yielded 1204 DGs and 830 pairs SGs. In DGs, perforations were detected in 220 outer glove and 39 inner glove (10.7%). In SGs, 226 perforations were detected (13.3%). The incidence of perforations in inner gloves of the double indicator glove was 1.6% (P < 0.001). During surgery, perforations were recognized in DGs in 67% compared with 12% in SGs (P < 0.005). This study confirms that DGs form an efficient barrier between patients and surgeons.

Equipment Failure↗