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Biomedical subjects

O A Hamour

Publications and source records attributed to O A Hamour.

5 recordsLinked to original sources

Non-typhoid Salmonella septicemia and visceral leishmaniasis in a renal transplant patient.

BACKGROUND: We report on a renal transplant patient with recurrent attacks of fever, in which Salmonella septicemia as well as visceral leishmaniasis were diagnosed. PATIENT: The patient was a 62-year-old man with diabetic nephropathy and a living related kidney transplantation. RESULTS: Nearly 2 years after the transplantation, the patient developed recurrent attacks of fever, which were initially diagnosed as non-typhoid salmonellosis and improved after treatment. Three months later, he had relapses of fever. As the patient developed pancytopenia, a bone marrow aspiration was done, showing Leishmania parasites. The patient responded well to treatment with sodium stibogluconate. CONCLUSIONS: A high index of suspicion, together with better diagnostic assays to detect visceral leishmaniasis, is warranted in the diagnostic work-up of any fever of unknown origin in immunocompromised patients, especially in endemic areas.

Bacteremia↗

Laparoscopic colectomy. Where do we stand?

Laparoscopy has changed our approach to surgery, instrumentation and training. The techniques are evolving for a wide range of surgical procedures outside the biliary tree. Currently available data suggests that laparoscopic colectomy can be completed safely in most cases. It is feasible and offers patient-related benefits similar to those described for other laparoscopic procedures. The advisability of performing laparoscopy for cure of colorectal malignancy has been challenged because the recurrence rates and overall cure rates remain unknown. Until prospective randomized trials resolve these issues neoplastic colon laparoscopic surgery must be the prerogative of selected and specialized centers.

Colectomy↗

Minimal invasive surgery: a district hospital experience.

This was a prospective analysis of the first 162 patients who underwent biliary and nonbiliary minimally invasive (video laparoscopic) procedures in the Royal Commission Medical Centre (RCMC) over two periods separated by a one year interval (September 1993-September 1994)-(October 1995-February 1996). One hundred and fifty patients had video laparoscopic cholecystectomy (VLC). Thirty four males and 116 females with a mean age of 39.7 years (range 16-80). Forty two patients (28%) were admitted as emergency (37 acute cholecystitis, 5 acute pancreatitis). The indication for VLC was symptomatic gall stones. The VLC was accomplished successfully in 144 patients (96%). Six patients (2 electives and 4 emergency) required a conversion for various reasons, unfavourable anatomy being the commonest. Ten patients with preoperative evidence of a dilated common bile duct, with or without stones had an ERCP done in another hospital 200 km away. The median operative time was 100 minutes (range 30-270 minutes) There were three major complications (one CBD injury, one bleeding from gall bladder bed and one post operative acute pancreatitis) and 6 minor complications (urethral bleeding, atelectasis post-operative pyrexia, umbilical port cellulitis, prolonged ileus and acute anxiety state). The median hospital stay was 72 hours for successful VLC. Twenty five per cent of the patients did not require any narcotic analgesic. Twelve patients (7.4%) had one or another non-biliary video laparoscopic procedure. Our results suggest that VLC can be offered and performed safely in the majority of patients presenting with acute and/or chronic cholecystitis and that the results we achieved in a district hospital are comparable to other series. We conclude that VLC will continue to be demanded by patients and non-biliary video laparoscopic procedures which were slow to develop in our hospital will continue to need special training, interest and expertise before it can be adopted as a routine.

Adolescent↗

Isolated injury to the pancreas due to blunt abdominal trauma: a case report.

In the present report we are describing a case of acute pancreatitis resulting from blunt abdominal trauma. The case history, clinical and laboratory findings as well as Laparotomy findings indicated that acute pancreatitis in this case was caused by isolated injury to the pancreas sustained in the course of a blunt abdominal trauma. The clinical course of the case is given and the incidence and diagnostic problems are discussed.

Acute Disease↗

Splenic preservation after traumatic rupture. A remote hospital experience.

OBJECTIVE: The aim of this study is to describe the outcome of treatment modalities, the length of hospital stay and blood transfusion requirements of patients with traumatic splenic rupture. It also discusses the pros and cons of each treatment given, to determine its feasibility and pre-requisites in a set-up similar to this one. SET-UP: The Royal Commission Medical Centre is a 340-bed secondary care facility located in Yanbu Industrial City, in the western part of Saudi Arabia. It serves the population of the city (approximately 40,000) plus a catchment area of nearly 300,000. METHODS: A retrospective cross-sectional design was used in this study. The medical records were reviewed to abstract the required data. RESULTS: Twenty-one patients (15 males, 6 females) were included. The age ranged between 4 and 57 years, with a mean of 20.8 years and a SD of 13.3 years. A total of 14 spleens (66.6%) were preserved. Non-operative treatment (active conservative) was given to 12 patients while two spleens were preserved operatively by splenorraphy. Seven (33.3%) had operative treatment in the form of splenectomy. The blood transfusion requirement was significantly less in the non-operative treatment modality (p<0.005). The outcome of treatment was significantly better in the non-operative treatment modality (p<0.005). The length of hospital stay was not statistically significantly different. CONCLUSION: Active-conservative treatment is a viable and safe alternative in stable patients with splenic injury due to blunt trauma when intensive care and monitoring facilities are available and properly utilized.

Adolescent↗