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   2014| July-September  | Volume 4 | Issue 3  
    Online since May 28, 2014

 
 
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EDITORIALS
Syrians' alternative to a health care system: "field hospitals"
Fares Alahdab, Mustafa Haj Omar, Saeed Alsakka, Ahmad Al-Moujahed, Bassel Atassi
July-September 2014, 4(3):51-52
DOI:10.4103/2231-0770.133329  PMID:24982824
  7 3,207 419
The syrian national kidney foundation: Response for the need of kidney patients during the crisis
Akram Al-Makki, A Oussama Rifai, Lina Murad, Abdul R Zanabli, Anas Kayal, Khaldoun Soudan, Mazen Kherallah, Fahd Alsaghir, Mohamed Sekkarie
July-September 2014, 4(3):54-57
DOI:10.4103/2231-0770.133331  PMID:24982825
  3 3,500 399
ORIGINAL ARTICLES
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial
Manal Bawazeer, Majed Aljeraisy, Esam Albanyan, Alanazi Abdullah, Wesam Al Thaqafi, Jaber Alenazi, Zaam Al otaibi, Mohammed Al Ghaihab
July-September 2014, 4(3):58-65
DOI:10.4103/2231-0770.133333  PMID:24982826
Background: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on infants (1 to 12 months) who were diagnosed in the emergency department with moderate-to-severe bronchiolitis. The primary outcome was the rate of hospital admission within 7 days of the first dose of treatment, and the secondary outcomes were changes in respiratory distress assessment instrument score, heart rate, respiratory rate, and oxygen saturation (O 2 Sat) over a 4-hour observation period. Infants (n = 162) were randomly assigned to four groups: A (dexamethasone + racemic epinephrine) = 45, B (placebo and racemic epinephrine) =39, C (dexamethasone and salbutamol) = 40, or D (placebo and salbutamol) = 38. Results: Patients who had received dexamethasone + epinephrine exhibited similar admission rates compared to placebo + epinephrine or salbutamol (P = 0.64). Similarly, no statistically significant difference was observed in the rate of hospitalization for patients who received dexamethasone + salbutamol compared to those who received placebo + epinephrine or salbutamol (P = 0.51). Clinical parameters were improved at the end of the 4-hour observation period for all treatment groups. Treatment with dexamethasone + epinephrine resulted in a statistically significant change in HR over time (P < 0.005) compared to the other groups. Conclusions: This study adds to a body of evidence suggesting that corticosteroids have no role in the management of bronchiolitis for young infants who are first time wheezers with no risk of atopy.
  3 4,115 651
An assessment of diabetes care in Palestinian refugee camps in Syria
Samer Alabed, Aisha Guul, Claire Crighton, Fares Alahdab, Munes Fares, Mohammad Morad, Mohamad B Sonbol, Mohammed E Madmani, Anas Sasa, Nigel Unwin
July-September 2014, 4(3):66-70
DOI:10.4103/2231-0770.133337  PMID:24982827
Background: Palestinian refugees have been a displaced group of people since 1948, many of whom are living in refugee camps in the Middle East. They are entitled to free health care from the United Nations Relief and Work Agency (UNRWA). They show a higher prevalence of diabetes than the population in their host countries in the Middle East. This study examined the realities of care for diabetic patients in UNRWA health clinics in Damascus, Syria. The aim was three‑fold: To investigate the level of diabetes care, to probe patients' level of general understanding of their disease and its management, and to search for areas of potential improvement. Methods: Data on patient education and care was gathered over a 1 month period from August 4, 2008 to September 4, 2008 using questionnaires and direct observation of the workflow at the clinics. Clinic‑led care was observed by the study team using checklists during patient visits. All of the clinic staff and sampled patients were interviewed. The main areas of care assessed were: Patient follow‑up; examination of eyes and feet; availability of medications; and patient education. A total of 154 people with diabetes were sampled from three refugee camps situated around Damascus. Results: A total of 154 patients, three doctors and seven nurses composed the sample of the study. Foot examinations were almost always neglected by health staff and eye examinations were not offered by the UNRWA clinics. Interviews with patients showed that: 67% (95% confidence intervals [CI]: 0.59‑0.70) had to buy their medication at their own expense at least once due to medication shortage in the UNRWA clinics, 48% (95% CI: 0.40‑0.55) displayed poor knowledge regarding the cause and exacerbating factors of diabetes, 65% (95% CI: 0.56‑0.72) had not heard of insulin, and 43% (95% CI: 0.35‑0.51) did not know for how long they needed to take their medications.
  1 6,458 469
CASE REPORTS
A case of septicemia due to Chyresobacterium indologenes producing bla NDM-1
Atul Khajuria, Ashok Kumar Praharaj, Mahadevan Kumar, Naveen Grover
July-September 2014, 4(3):71-73
DOI:10.4103/2231-0770.133338  PMID:24982828
A multidrug resistant Chyresobacterium indologenes was isolated from blood in a case of septicemia. The organism was resistant to carbapenems and was positive for bla NDM-1 ; transferable through plasmid.
  - 2,591 312
Kenny-Caffey syndrome type 1
Tony El Jabbour, Tarek Aboursheid, Mohammad Baraa Keifo,  Ismael Maksoud, Diana Alasmar
July-September 2014, 4(3):74-76
DOI:10.4103/2231-0770.133340  PMID:24982829
Kenny-Caffey syndrome type 1 is a rare hereditary skeletal disorder. We present here a documented case of a 7-month-old girl with the characteristic symptoms of growth retardation, dysmorphic features, and hypoparathyroidism.
  - 2,480 291
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