Biomedical subjects

Mohammed A Al-Ghazo

Publications and source records attributed to Mohammed A Al-Ghazo.

5 recordsLinked to original sources

PubMed2007

Single breath vital capacity induction of anesthesia with 8% sevoflurane versus intravenous propofol for laryngeal tube insertion in adults.

OBJECTIVE: To compare the conditions for laryngeal tube airway insertion obtained by the inhalation of 8% sevoflurane using a vital capacity breath (VCB) technique with propofol intravenous induction. METHODS: We carried out a prospective, randomized, single blind study at King Abdullah University Hospital, Irbid, Jordan from September 2005 to April 2006. Involved in this study were 80 adult (ASA physical status I and II) patients aged 26-70 years undergoing elective surgery under general anesthesia. The patients were randomized into 2 groups. An independent observer noted the time to loss of consciousness, the presence of adverse events, time to successful laryngeal tube placement and the number of attempts needed until a successful laryngeal tube insertion. RESULTS: With the single VCB method, sevoflurane produced a loss of consciousness faster than propofol did (51.6 +/- 4.4 versus 59.7 +/- 4.9 seconds, p<0.001). The insertion of laryngeal tube was faster in the propofol group (77.2 +/- 20.2 versus 122.2 +/- 33.3 seconds, p<0.001) and required fewer attempts (1.2 +/- 0.4 versus 1.6 +/- 0.7, p<0.02). The overall incidence of complications during the induction of anesthesia as well as during the laryngeal tube insertion, especially apnea (42% versus 0%; p<0.001), was more frequent in the propofol group (82.5% versus 27.5%; p<0.001). CONCLUSION: We conclude that vital capacity breath induction with sevoflurane produces a faster loss of consciousness and fewer side effects than propofol and efficient for laryngeal tube insertion, but takes slightly longer than propofol due to the prolonged jaw tightness.

Adult↗

PubMed2005

A prospective randomized trial comparing transurethral prostatic resection and clean intermittent self-catheterization in men with chronic urinary retention.

OBJECTIVE: To determine whether a preliminary period of clean intermittent self-catheterization (CISC) before transurethral resection of the prostate (TURP) improves bladder contractility and surgical outcome in men with chronic urinary retention (CUR), and whether pressure-flow studies (PFS) before TURP predict the outcome. PATIENTS AND METHODS: The study was a two-centre, pragmatic and randomized trial. Included were 41 men scheduled for TURP with lower urinary tract symptoms (LUTS), an International Prostate Symptom Score (IPSS) of > 7, benign prostatic enlargement and a persistent postvoid residual urine volume (PVR) of > 300 mL. They had conventional PFS using unphysiological filling. The patients then gave consent and were randomized into two treatment groups; the first had TURP after stabilizing renal function by indwelling catheterization if indicated, and the second was taught CISC. Men in both groups were reviewed at 3 and 6 months after surgery or the start of CISC, by the IPSS, urine culture and assay of plasma creatinine, and upper tract imaging and repeat PFS at 6 months. The primary outcome variables were IPSS, maximum urinary flow rate, voiding and end-filling pressures, and mean PVR; secondary variables included treatment failure, complications and other urodynamic measures. RESULTS: Of the 41 patients, 17 (mean age 67 years, range 52-84) were randomized to immediate TURP and 24 (mean age 69 years, range 55-85) to CISC. There was a significant improvement in IPSS and quality of life at 6 months in both groups (P < 0.001). In the CISC group there was a significant improvement in voiding and end-filling pressures, indicating recovery of bladder function (P < 0.001 for each). Of the 41 men, nine (22%) with voiding pressures of < or = 45 cmH2O had no significant improvement in symptoms or urodynamic variables. Detrusor overactivity was found in 17 (41%) patients, of whom six had upper tract dilatation which resolved after treatment. CONCLUSION: The present results emphasize the usefulness of CISC in ensuring the recovery of bladder function in men with CUR. Measuring the voiding pressure before TURP can predict the surgical outcome. Both CISC and immediate TURP are effective for relieving LUTS and result in a better quality of life. A preliminary period of CISC before TURP for men with CUR and low voiding pressure may be valuable. The presence of upper tract dilatation is associated with high end-void and end-fill bladder pressures, and such men have a good outcome from surgery.

Aged↗

PubMed2005

Tuberculous epididymitis and fertility in North Jordan.

OBJECTIVES: To describe the clinical characteristics of tuberculous epididymitis and its effect on male subfertility in a general hospital in the north of Jordan. METHODS: A retrospective case study of the hospital records of patients with genitourinary tuberculosis managed at Princess Basma Teaching Hospital in Irbid, North Jordan during the period of 1994-2001. RESULTS: Of the 16 patients with genitourinary tuberculosis, 9 were found to have tuberculous epididymitis. The mean age was 41.2 years. The main presentation was an insidious onset of painful scrotal swelling, mostly on the left side. Mean duration of symptoms was 10.6 weeks. Most patients had no history of previous tuberculosis and no Mycobacterium Tuberculosis in their urine. Six months of anti-tuberculous chemotherapy was effective, combined with surgery for scrotal abscesses. Although all patients recovered, the results on fertility are considerable. CONCLUSION: Isolated tuberculous epididymitis is the most common form of genitourinary tuberculosis. A 6-month course of anti-tuberculous chemotherapy is effective in combination with surgery for large scrotal abscesses. The fertility outcome is of concern. Sperm retrieval and cryopreservation have to be considered for potential intra-cytoplasmic sperm injection.

Adult↗

PubMedDate not supplied

Circumcision revision in male children.

OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004). Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years). RESULTS: Most of unsatisfactory primary circumcisions (86.7%) were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

Child↗

PubMedDate not supplied

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction.

OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND METHODS: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92) using Dornier lithotriptor S (MedTech Europe GmbH) or URS (n = 120). Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p < 0.0001). In addition, 88% of patients who underwent ESWL versus 20% who underwent URS were discharged home the day of procedure. Minor complications occurred in 3.3% and 8.3% of the ESWL and URS groups, respectively (p = 0.127). No ureteral perforation or stricture occurred in the URS group. Postoperative flank pain and dysuria were more severe in the URS than ESWL group, although the differences were not statistically significant (p = 0.16). Patient satisfaction was high for both groups, including 94% for URS and 80% for ESWL (p = 0.002). CONCLUSIONS: URS is more effective than ESWL for the treatment of distal ureteral calculi. ESWL was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was significantly higher for URS according to the questionnaire used in this study.

Adolescent↗