PubMed Health⌕ Search

Biomedical subjects

Y Arabi

Publications and source records attributed to Y Arabi.

35 records · Page 2Linked to original sources
PubMed1979

Influence of neomycin and metronidazole on colonic microflora of volunteers.

The influence on colonic microflora of neomycin and metronidazole alone, or in combination, was studied in volunteers taking a normal diet. Bacterial counts on daily faecal samples revealed that metronidazole had no influence on anaerobic faecal bacteria. Neomycin on the other hand, was effective against sensitive aerobes. However, the combination of neomycin and metronidazole profoundly reduced both aerobic and bacteria. Assay of faecal antibiotic concentrations showed that neomycin achieved high intraluminal levels while metronidazole was undetectable or present at low concentrations.

Bacteroides fragilis↗
PubMed1978

Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea.

The efficacy of vancomycin in pseudomembranous colitis was assessed in a prospective randomised controlled trial. Forty-four patients with postoperative diarrhoea were allocated to five days' treatment with either 125 mg vancomycin six-hourly or a placebo. Sixteen patients had high titres of the neutralised faecal toxin characteristic of pseudomembranous colitis; nine received vancomycin and seven placebo. At the end of treatment faecal toxins were present in one patient given vancomycin compared with five of the controls. Vancomycin caused the disappearance of Clostridum difficile from the stool in all except one patient, whereas toxicogenic strains of Cl difficile persisted in all but one of the controls. Histological evidence of psuedomembranous colitis had disappeared by the end of treatment in six out of seven patients given vancomycin compared with only one out of seven patients given vancomycin compared with only one out of five patients given placebo. In patients with faecal toxins bowel habit had returned to normal in seven of the vancomycin group compared with only one of the controls, but there was no significant difference in clinical response among patients without faecaal toxins. The results suggest that vancomycin eliminates toxin-producing Cl difficile from the colon and is associated with rapid clinical and histological improvement in patients with pseudomembranous colitis.

Bacterial Toxins↗
PubMed1978

Diarrhoea and pseudomembranous colitis after gastrointestinal operations. A prospective study.

241 patients who had gastrointestinal operations were studied prospectively. Postoperative diarrhoea occurred in 58 patients (24%) and was significantly more common after exposure to antibiotics. 9 patients (4%) had high titres of a neutralisable faecal toxin characteristic of pseudomembranous colitis. Toxigenic Clostridium difficile strains were isolated from the stools of all patients with neutralisable faecal toxin. If pseudomembranous colitis is defined as the presence of neutralisable faecal toxin, then the diagnosis is often missed by sigmoidoscopy and rectal biopsy.

Anti-Bacterial Agents↗
PubMed1978

Diagnosis of pseudomembranous colitis.

Twenty-eight patients with histologically proved pseudomembranous colitis have been seen in one hospital since July 1975. All patients with the disease had received antibiotics, six for infections not requiring operations; the other 22 cases all occurred after major surgery. All the patients had diarrhoea; six patients also had fever with clinical signs of sepsis, and three had abdominal pain thought to be due to anastomotic dehiscence after colonic resection. Pseudomembranous colitis was associated with white blood counts over 15 000/mm3 in 17 patients and albumin concentrations of less than 30 g/1 in 18. Pseudomembranous colitis was an incidental finding at necropsy in two of six patients who had not had an operation. Of the 22 patients who had had major surgery, nine died from this complication; in all except two of these cases the diagnosis was made only at necropsy. If pseudomembranous colitis is suspected on clinical grounds or if there is an unexplained complication after colorectal surgery repeat sigmoidoscopy and testing for faecal toxins should be carried out to establish the diagnosis so that prompt supportive treatment can be given.

Adolescent↗
PubMed1978

Influence of bowel preparation and antimicrobials on colonic microflora.

The influence of three types of preoperative mechanical bowel preparation on colonic microflora has been studied in 88 patients undergoing elective bowel resection and compared with 21 controls. Neither conventional bowel preparation (CBP) using oral magnesium sulphate, enemas and rectal washouts nor whole bowel irrigation (WBI) via a nasogastric tube influenced the type or number of organisms in the colon at the time of operation. The administration of an elemental diet (ED) was associated with only a small reduction the numbers of Escherichia coli (P less than 0.02). The addition of oral neomycin and metronidazole for 48 h before operation to all three methods of bowel preparation was associated with a highly significant reduction in the counts per ml of E. coli (P less than 0.001) and Bacteroides fragilis (P less than 0.001) in the colon. There was no correlation between the diameter of the lesion being resected with the numbers of bacteria in the colon even when oral neomycin and metronidazole were added to the bowel preparation.

Adult↗
PubMed1978

Randomized multicentre trial of oral bowel preparation and antimicrobials for elective colorectal operations.

A study of 120 patients undergoing elective colorectal operations has investigated the effect of adding oral neomycin and metronidazole to bowel preparation in a double-blind randomized controlled trial. Comparisons have also been made between a standard mechanical preparation and the use of an elemental diet. The addition of neomycin and metronidazole to bowel preparation significantly reduced the rate of wound sepsis (P less than 0.01), septicaemia (P less than 0.02) and anastomotic dehiscence (P less than 0.02); anaerobic infections were abolished and there was a significant reduction in the incidence of aerobic Gram-negative infections. Elemental diets were shown to have no advantage over mechanical preparation.

Administration, Oral↗
PubMed1978

Influence of inflammatory bowel disease on intestinal microflora.

The microflora of the jejunum, ileum, and colon has been studied from operative samples in Crohn's disease (n = 30), ulcerative colitis (n = 15), and controls (n = 40). There was no significant difference in the flora of patients with ulcerative colitis compared with controls. In Crohn's disease there was a significant increase in E. coli (P less than 0.001) and B. fragilis (P less than 0.001) in the ileum and of E. coli (P less than 0.001) and lactobacilli (P less than 0.01) in the colon. The abnormal ileal flora in Crohn's disease was unrelated to serological evidence of disease activity (indices: ESR, serum albumin, serum seromucoids), diameter of the ileum, or excision of the ileocaecal valve. The abnormal colonic flora in Crohn's disease was not related to presence of macroscopic colitis.

Bacteroides fragilis↗
PubMed1977

Anal pressures in hemorrhoids and anal fissure.

Maximal anal pressures have been measured after proctoscopy in 145 patients with hemorrhoids, 48 patients with anal fissure, and 78 asymptomatic control subjects. Anal pressures in patients with hemorrhoids (106 +/- 40 cm H2O) and anal fissure (130 +/- 43 cm H2O) were very significantly higher than those of controls (88 +/- 34 cm H2O) (P less than 0.001). Because patients with anal fissure have high anal pressures, these patients should benefit from manual dilatation of the anus or lateral subcutaneous sphincterotomy; however, only young male patients with hemorrhoids have anal pressures that are significantly higher than age- and sex-matched controls. Digital assessment and the two finger test are unreliable indicators of high anal pressure. These results indicate that measurement of anal pressure is useful in assessing the suitability of manual dilatation or sphincterotomy in the treatment of hemorrhoids.

Adolescent↗
PubMedDate not supplied

A randomized controlled trial to compare anal dilatation with lateral subcutaneous sphincterotomy for anal fissure.

A prospective randomized trial has compared manual dilatation of the anus (MDA)during general anesthesia with lateral subcutaneous spincterotomy (LSS) during local anesthesia for the management of anal fissure in 156 patients. The two groups were similar with respect to age, sex and symptoms. There was no difference in the duration of time off work or early complications of treatment but, four months after operation, 93 per cent claimed to have been improved by MDA compared with 78 per cent after LSS (P less than 0.05). Recurrent fissure was recorded in 13 patients after LSS (29 per cent) compared with four (10 per cent) after MDA (P less than 0.02). There was a significant reduction in anal pressure at four months (P less than 0.02) after MDA, (123 +/- 31 to 97 +/-33) and LSS (127 +/- 36 to 104 +/- 32), but the anal pressure remained unchanged by operation in all patients where pressures were measured with recurrent fissure. These data indicate that MDA gives better results than LSS for treatment of anal fissure and that successful treatment is associated with a reduction in anal pressure.

Adult↗
PubMedDate not supplied

Critical care medicine in Saudi Arabia.

Critical care medicine remains underdeveloped in many parts of the world. In Saudi Arabia, there have been major developments in the past 2-3 decades. The purpose of this review is to give an account of the current status of critical care practice (including services provided during the haj season) and training in Saudi Arabia using examples of primary, secondary and tertiary care hospitals. The future needs of the profession are also addressed.

Certification↗