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  Citation statistics : Table of Contents
   2012| April-June  | Volume 2 | Issue 2  
    Online since July 28, 2012

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Evaluation report of health care services at the Syrian refugee camps in Turkey
Zaher Sahlool, Abdul Ghani Sankri-Tarbichi, Mazen Kherallah
April-June 2012, 2(2):25-28
DOI:10.4103/2231-0770.99148  PMID:23210017
  8 7,115 1,181
Characteristics and outcome of critically ill patients with 2009 H1N1 influenza infection in Syria
Reem Alsadat, Abdulrahman Dakak, Mouna Mazlooms, Ghasan Ghadhban, Shadi Fattoom, Ibrahim Betelmal, Nabil Abouchala, Mazen Kherallah
April-June 2012, 2(2):34-37
DOI:10.4103/2231-0770.99156  PMID:23210019
Objectives: To describe the epidemiologic characteristics, clinical features, and outcome of severe cases of 2009 H1N1 influenza A infections who were admitted to the intensive care units (ICUs) in Damascus, Syria. Materials and Methods: Retrospectively, we collected clinical data on all patients who were admitted to the ICU with confirmed or suspected diagnosis of severe 2009 H1N1 influenza A with respiratory failure at 4 major tertiary care hospitals in Damascus, Syria. Acute Physiology and Chronic Health Evaluation (APACHE) II system was used to assess the severity of illness within the first 24 h after admission. The outcome was overall hospital mortality. Results: Eighty patients were admitted to the ICU with severe 2009 H1N1 infection. The mean age was 40.7 years; 69.8% of patients had ≥1 of the risk factors: asthmatics 20%, obesity 23.8%, and pregnancy 5%; and 72.5% had acute lung injury or adult respiratory distress syndrome, 12.5% had viral pneumonia, 42.5% had secondary bacterial pneumonia, and 15% had exacerbation of airflow disease. Mechanical ventilation was required in 73.7% of cases. The mean hospital length of stay was 11.7 days (median 8 days, range 0-77 days, IQR: 5-14 days). The overall mortality rate was 51% for a mean APACHE II score of 15.2 with a predicted mortality of 21% (standardized mortality ratio of 2.4, 95% confidence interval: 1.7-3.2, P value < 0.001). Conclusion: Critically ill patients with severe 2009 H1N1 infection in this limited resource country had a much higher mortality rate than the predicted APACHE II mortality rate or when compared with the reported mortality rates for severe cases in other countries during 2009 H1N1 pandemic.
  7 3,654 486
Hypoglycemia due to an adult-onset nesidioblastosis, a diagnostic and management dilemma
Mohammed Qintar, Firas Sibai, Mohammad Taha
April-June 2012, 2(2):45-47
DOI:10.4103/2231-0770.99164  PMID:23210022
We describe a case of a 40 year old patient with recurrent severe fasting and postprandial symptomatic hypoglycemia that occurred 6 years after gastric bypass surgery. The hypoglycemia was associated with increased insulin and C peptide but all diagnostic modalities for localizing an insulinoma were negative. Medical management failed to control symptoms and the patient underwent subtotal pancreatectomy. Surgical tissue examination confirmed the diagnosis of noninsulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) or nesidioblastosis. Initially after surgery the patient had full remission but after 6 months hypoglycemia recurred. However, this time it was well-controlled with octreotide treatment.
  5 6,086 764
Bleeding Meckel's diverticulum diagnosed and treated by double-balloon enteroscopy
Snorri Olafsson, Julie T Yang, Christian S Jackson, Mohamad Barakat, Simon Lo
April-June 2012, 2(2):48-50
DOI:10.4103/2231-0770.99166  PMID:23210023
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract. The diagnosis of symptomatic MD has been cumbersome. Several case reports been published regarding direct visualization of MD with double balloon enteroscopy (DBE); diagnosing a bleeding MD leading to surgical resection. We report the use of DBE for the treatment of a bleeding MD.
  2 3,513 361
Lessons learned from the 2009-2010 H1N1 pandemic
Naem Shahrour
April-June 2012, 2(2):38-39
  - 2,352 341
Hemodialysis in an underserved area (Hama, Syria): A base for a situation analysis project
Ziad Arabi
April-June 2012, 2(2):29-33
DOI:10.4103/2231-0770.99150  PMID:23210018
  - 2,808 392
Mobile anesthesia: Ready, set, pack, and go
Issam Khayata, Jesse Bourque
April-June 2012, 2(2):40-44
DOI:10.4103/2231-0770.99163  PMID:23210021
Introduction: Although we get into the habit of thinking that anesthesia cannot be safely delivered without the availability of all equipments available in a state of the art Operating room, we find ourselves faced with situations where the availability and mobility of all this equipment is limited ; this results in the impetus to start a thought process of how we can perform mobile anesthesia with less technology. Disaster situations, such as earthquakes, floods, or armed conflicts, might happen in areas where access of a regular operating room might be hours away or not available at all. Golden Hour: Delivering mobile Anesthesia during the golden hour can be a totally different experience from customary anesthesia practices in a regular operating room.It requires setting up a field/forward surgical teams with its organization and structure. Total Intravenous anesthesia gained popularity in crisis and combat situations and has been documented as a safe method in crisis situations.Anesthesia configured medic bag: Is a modified medic bag that can be utilized to contain the most commonly used Anesthesia supply material in a portable way. Conclusion: In reviewing the knowledge of how to provide anesthesia in crisis and disaster situations we conclude that there is evidence that anesthesia can be safely and efficiently delivered in a remote areas with limited tools and technology.
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