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Z Memish

Publications and source records attributed to Z Memish.

25 records · Page 2Linked to original sources
PubMed2000

Clinical aspects of miliary tuberculosis in Saudi adults.

OBJECTIVE: To review all cases of miliary tuberculosis (MT) over a period of 7 years in a Saudi Arabian population, to determine the clinical and laboratory characteristics and diagnostic methods, and to compare our data with others reported in the literature. DESIGN: A retrospective case review. RESULTS: Of 780 cases of active tuberculosis seen over period of 7 years, 47 (6%) had MT. The majority of the patients were aged over 60 years (68%). The most common symptoms were fever and weight loss. Risk factors were present in 70% of cases, mainly diabetes mellitus, history of prior tuberculosis, chronic liver and renal disease, immunosuppressive drug therapy and malignancy. Miliary pattern on chest radiography was seen in 89%. The most common laboratory abnormalities were anemia (66%), lymphopenia (89%), low albumin (87%), and high alkaline phosphatase (80%). Fiberoptic bronchoscopy was diagnostic in 7/10 (70%), bone marrow examination in 8/11 (73%), and liver biopsy in 14/16 (88%). High alkaline phosphatase and lymphopenia were associated with high yield of liver biopsies and bone marrow examination: 13/14 (93%) and 7/8 (88%), respectively. Death occurred in 10/47 (21%); all of these had radiological evidence of miliary pattern, and 80% had comorbid conditions. CONCLUSION: These data confirm and extend the results of other studies and suggest that MT is a disease of the elderly and immunocompromised, and is associated with high mortality. A high index of suspicion is required for diagnosis.

Adolescent↗
PubMed1998

Evolution of brain tuberculomas under standard antituberculous treatment.

The treatment of brain tuberculomas is primarily medical. Surgery, excision or biopsy, is generally performed when the diagnosis is in doubt or there is no response to medical therapy. The aim of this study was to determine the radiological evolution of intracranial tuberculomas under standard anti-tuberculous drug therapy and to establish guidelines for better management of these patients. Eighteen patients were studied retrospectively. None of them had surgical intervention and all were treated by standard antituberculous drugs and had serial computed tomography (CT) scans until disappearance or stabilization of brain lesions. The regression of lesions' size and number was slow in the first month (mean -7.3%) then became rapid after this (-15% to -20% per month). A paradoxical increase in size was noted in three patients in the first month. All three had associated meningitis. All tuberculomas disappeared on CT scan after 12 months of therapy. Most of the edema images disappeared by 6 months. This study would suggest that a long treatment regimen of 15-18 months may not be necessary in most intracranial tuberculomas occurring in non-immunocompromised patients. It also demonstrates that medical trial in well tolerated suspected cases should last for at least 2 months before considering other etiologies or surgical exploration.

Adolescent↗
PubMed1998

Childhood bacterial meningitis in Saudi Arabia.

This study analysed the bacterial aetiology and outcome of childhood meningitis observed over an 11-year period. Charts of 70 children with this diagnosis were reviewed. Three children were under 1 month of age, five were between 1 and 3 months and 60 were between 3 months and 5 years. The remaining two were over 5 years. There were 36 females and 34 males. The presenting symptoms in decreasing order of frequency were fever 86%, vomiting 29%, poor feeding 19%, seizure 14% and lethargy 14%. Aetiological organisms were as follows: Haemophilus influenzae 66%, Streptococcus pneumoniae 24%, Neisseria meningitidis 4%, Group B Streptococci 4%, and Staphylococcus aureus 2%. All H. influenzae isolates except one were sensitive to ampicillin. None of the S. pneumoniae isolates were resistant to penicillin. Complications occurred in 26% of the patients and included subdural effusion 23%, hearing loss 14%, seizure disorder 10%, developmental delay 9%, hydrocephalus 6% and motor deficit 30%. One patient died. Among H. influenzae cases, one of the 15 patients treated with steroids developed hearing loss. In contrast, four out of 31 who did not receive steroid therapy suffered from hearing loss. Haemophilus influenzae type b is the predominant cause of childhood bacterial meningitis in Saudi Arabia. Universal H. influenzae type b vaccination for children is highly recommended.

Child↗
PubMed1995

Underestimation of surgical site infection rates in obstetrics and gynecology.

BACKGROUND: With the increasing volume of same-day operations and shortened hospital stays, it becomes more likely that a significant percentage of surgical site infections will occur after these patients' discharges. METHODS: To document the true incidence of postdischarge surgical site infection, surveillance was undertaken in a group of obstetric and gynecologic patients. The study consisted of two parts. (1) A questionnaire was mailed to each surgeon, inquiring about clinical evidence of infection. The infection control service continued to do surveillance of wound infection in the usual manner, and the results of the two methods were compared. (2) A questionnaire was provided to patients undergoing operation, inquiring about signs and symptoms of wound infection. RESULTS: A total of 469 surgical procedures were included, with a total of 24 infections detected (5.2%). Of these, 14 infections (58.3%) were detected by the usual surveillance method. An additional 10 infections (41.7%) were detected after patient discharge by the physician questionnaire. Only two of the 24 infections were detected by the patient questionnaire. CONCLUSIONS: Failure to include postdischarge surgical site surveillance results in a substantial underestimation of the true surgical site infection rate. Physician input and strong support have prompted a regular biannual postdischarge surgical site surveillance program in this patient population.

Female↗