In the last two decades there have been dramatic changes in the epidemiology of Clostridium diffi... more In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency
International Journal of Surgery and Medicine, 2017
Background. Early laparoscopic cholecystectomy for acute cholecystitis is technically demanding p... more Background. Early laparoscopic cholecystectomy for acute cholecystitis is technically demanding procedure associated with more rate of conversion to open cholecystectomy and more complications. Recently some studies demonstrate the feasibility of laparoscopic cholecystectomy for acute cholecystitis. However, many surgeons still prefer delayed laparoscopic cholecystectomy for acute cholecystitis. Our aim of this prospective randomized study was to compare the operative time, conversion rate, hospital stay, outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis Patients and Methods. Between January 2010and January 2015, 62patients with a diagnosis of acute cholecystitis underwent early laparoscopic cholecystectomy within 72 h of admission (group I). This study group was compared with a control group of 114patients of acute cholecystitis, who underwent delayed laparoscopic cholecystectomy after an initial period of conservative treatment (group II). Results. There was no significant difference in the conversion rates (3 in group I versus 2 in group II), duration of postoperative stay (2days in group I versus 3.5 days in group II) postoperative analgesia requirements and postoperative pain scores. However, duration of surgery was significantly more in group I (110 minutes versus 85 minutes in group II).No mortality was seen in either group. Total costs were higher (6450 ± 875.4 versus 8570 ± 775 Saudi Ryal; P = 0.0001) in group II patients. Conclusions. Early laparoscopic cholecystectomy for acute cholecystitis is safe, feasible, with shorter hospital stay and cost effective management of acute cholecystitis cases.
Background: Increased body mass index (BMI) increase the incidence of seroma formation and wound ... more Background: Increased body mass index (BMI) increase the incidence of seroma formation and wound infection rates and subsequently increases wound dehiscence and ugly scar formation following abdomenoplasty and body contour surgery and also many other aesthetic and plastic surgery. The aim of this study was to determine the effect of BMI on the outcome of abdominoplasty operation. Methods: We carried out a prospective study of all patients who underwent abdominoplasty at our institution. Patient were divided into two groups. Group I were subjects with body mass index <30 kg/m2 while group II were patients with body mass index >30 kg/m2. Demographics and complications (minor and major) were recorded. Results: Sixty seven patients were enrolled. Group I were 32 patients with a mean age of 35.71 and group II 35 patients with mean age of 36.26 years. Seroma formation, wound complications, prolonged hospital stay and complications were significantly more in group II. Conclusion: We found that increased BMI significantly increased operative time, hospital stay, drainage duration and drainage amount. Our findings showed that obesity alone could increase the incidence of complications and poor outcome of abdominoplasty.
International journal of critical illness and injury science, 2013
To evaluate our experience with non-operative management of blunt liver trauma at a level II trau... more To evaluate our experience with non-operative management of blunt liver trauma at a level II trauma hospital in the Kingdom of Saudi Arabia. We prospectively evaluated 56 patients treated for blunt liver trauma at our hospital over a 4-year period (April 2008 to April 2012). Patients who were hemodynamically stable [non-operative group I (NOP)] were treated conservatively in the intensive or intermediate care unit (ICU or IMCU). Patients who were hemodynamically unstable or needed laparotomy for other injuries were treated by urgent laparotomy [operative group II (OP)]. All NOP group patients had computed tomography (CT) of the abdomen with oral and intravenous contrast. Injuries grades were classified according to the American Association for the Surgery of Trauma (AAST). Follow-up CT of the abdomen was performed after 2 weeks in some cases. A total of 56 patients were treated over a 4-year period. Twenty patients (35.7%) were treated by immediate surgery. NOP group of 36 patients (64.3%) were managed in the ICU by close monitoring. Surgically treated group had more patients with complex liver injury (90% versus 58.3%), required more units of blood (6.05 versus 1.5), but had a longer hospital stay (16.6 days versus 15.1 days). None of the patients from the non-operated group developed complications nor did they need operation. The only mortality (in two patients) was in the operated group. The NOP treatment is a safe and effective method in the management of hemodynamically stable patients with blunt liver trauma. The NOP treatment should be the treatment of choice in such patients whenever CT and ICU facilities are available.
In the last two decades there have been dramatic changes in the epidemiology of Clostridium diffi... more In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency
International Journal of Surgery and Medicine, 2017
Background. Early laparoscopic cholecystectomy for acute cholecystitis is technically demanding p... more Background. Early laparoscopic cholecystectomy for acute cholecystitis is technically demanding procedure associated with more rate of conversion to open cholecystectomy and more complications. Recently some studies demonstrate the feasibility of laparoscopic cholecystectomy for acute cholecystitis. However, many surgeons still prefer delayed laparoscopic cholecystectomy for acute cholecystitis. Our aim of this prospective randomized study was to compare the operative time, conversion rate, hospital stay, outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis Patients and Methods. Between January 2010and January 2015, 62patients with a diagnosis of acute cholecystitis underwent early laparoscopic cholecystectomy within 72 h of admission (group I). This study group was compared with a control group of 114patients of acute cholecystitis, who underwent delayed laparoscopic cholecystectomy after an initial period of conservative treatment (group II). Results. There was no significant difference in the conversion rates (3 in group I versus 2 in group II), duration of postoperative stay (2days in group I versus 3.5 days in group II) postoperative analgesia requirements and postoperative pain scores. However, duration of surgery was significantly more in group I (110 minutes versus 85 minutes in group II).No mortality was seen in either group. Total costs were higher (6450 ± 875.4 versus 8570 ± 775 Saudi Ryal; P = 0.0001) in group II patients. Conclusions. Early laparoscopic cholecystectomy for acute cholecystitis is safe, feasible, with shorter hospital stay and cost effective management of acute cholecystitis cases.
Background: Increased body mass index (BMI) increase the incidence of seroma formation and wound ... more Background: Increased body mass index (BMI) increase the incidence of seroma formation and wound infection rates and subsequently increases wound dehiscence and ugly scar formation following abdomenoplasty and body contour surgery and also many other aesthetic and plastic surgery. The aim of this study was to determine the effect of BMI on the outcome of abdominoplasty operation. Methods: We carried out a prospective study of all patients who underwent abdominoplasty at our institution. Patient were divided into two groups. Group I were subjects with body mass index <30 kg/m2 while group II were patients with body mass index >30 kg/m2. Demographics and complications (minor and major) were recorded. Results: Sixty seven patients were enrolled. Group I were 32 patients with a mean age of 35.71 and group II 35 patients with mean age of 36.26 years. Seroma formation, wound complications, prolonged hospital stay and complications were significantly more in group II. Conclusion: We found that increased BMI significantly increased operative time, hospital stay, drainage duration and drainage amount. Our findings showed that obesity alone could increase the incidence of complications and poor outcome of abdominoplasty.
International journal of critical illness and injury science, 2013
To evaluate our experience with non-operative management of blunt liver trauma at a level II trau... more To evaluate our experience with non-operative management of blunt liver trauma at a level II trauma hospital in the Kingdom of Saudi Arabia. We prospectively evaluated 56 patients treated for blunt liver trauma at our hospital over a 4-year period (April 2008 to April 2012). Patients who were hemodynamically stable [non-operative group I (NOP)] were treated conservatively in the intensive or intermediate care unit (ICU or IMCU). Patients who were hemodynamically unstable or needed laparotomy for other injuries were treated by urgent laparotomy [operative group II (OP)]. All NOP group patients had computed tomography (CT) of the abdomen with oral and intravenous contrast. Injuries grades were classified according to the American Association for the Surgery of Trauma (AAST). Follow-up CT of the abdomen was performed after 2 weeks in some cases. A total of 56 patients were treated over a 4-year period. Twenty patients (35.7%) were treated by immediate surgery. NOP group of 36 patients (64.3%) were managed in the ICU by close monitoring. Surgically treated group had more patients with complex liver injury (90% versus 58.3%), required more units of blood (6.05 versus 1.5), but had a longer hospital stay (16.6 days versus 15.1 days). None of the patients from the non-operated group developed complications nor did they need operation. The only mortality (in two patients) was in the operated group. The NOP treatment is a safe and effective method in the management of hemodynamically stable patients with blunt liver trauma. The NOP treatment should be the treatment of choice in such patients whenever CT and ICU facilities are available.
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