Biomedical subjects

T M Al-Jaberi

Publications and source records attributed to T M Al-Jaberi.

4 recordsLinked to original sources

PubMed2001

Excision and simple primary closure of chronic pilonidal sinus.

OBJECTIVE: To evaluate the outcome of asymmetrical complete excision of pilonidal sinus with simple primary closure without using drains or tension sutures. DESIGN: Prospective study. SETTING: Teaching hospital, Jordan. SUBJECTS: 46 patients with chronic pilonidal sinus treated between November 1994 and October 1998 by excision of the sinus down to the sacrococcygeal fascia and simple primary closure of the wound without tension sutures or drains. RESULTS: Patients stayed in hospital for 48 hours and postoperative pain was minimal. Complete healing was achieved in 41 patients (89%) after a mean follow up period of 36 months (range 12-60). Two patients (4%) developed recurrent sinuses and in three (7%) the wound broke down. All the patients who healed completely were back to work within three weeks of the operation. CONCLUSION: Excision and simple primary closure is a cost-effective way of treating chronic pilonidal sinus.

Adolescent↗

PubMed2000

Fournier's gangrene: changing face of the disease.

PURPOSE: Our experience with ten cases of Fournier's gangrene prompted us to review the related literature to highlight the current status of the disease. METHODS: Data from ten patients with the diagnosis of Fournier's gangrene treated at our center from January 1997 until December 1998 were analyzed. These patients were treated by aggressive resuscitation, triple antibiotics, and urgent surgery. The English-language medical literature for the past 30 years was reviewed. RESULTS: The epidemiologic features of our patients were similar to those reported in other recent studies. Mortality rate was 20 percent. Currently, the disease affects both genders and a wide range of ages, has a more insidious onset than in the past, and is not idiopathic. Associated systemic disorders (diabetes, alcoholism, and immunosuppression) are common. Perianal infection is the commonest cause and is associated with more moribund features. CONCLUSION: The epidemiology of Fournier's gangrene is changing from its original description. Population aging worldwide--as a result of improving health care--and therefore the increasing prevalence of associated medical disorders may explain these changes. These factors may also explain the consistently high mortality rate during more recent years, masking any survival benefits from improved medical care. Better understanding of the pathophysiology has reduced the ratio of idiopathic cases to a minimum.

Fournier Gangrene↗

PubMed2000

Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain?

BACKGROUND: Shoulder pain is common after laparoscopic cholecystectomy (60.5%) and can delay return to normal activities. The cause is unclear but may involve referral of pain from the traumatized area. PATIENTS AND METHODS: A total of 75 patients with chronic cholecystitis who underwent laparoscopic cholecystectomy were randomized into two groups. Group I (37 patients) had 10 mL of 0.25 % bupivacaine instilled into the gallbladder bed and Calot's triangle area at the end of cholecystectomy. Group II (38 patients) served as controls and had no bupivacaine instillation. Postoperative shoulder pain was evaluated. RESULTS: Six patients in Group I developed shoulder pain (16%) compared with 23 patients in Group II (60.5%). The difference was statistically significant (P = 0.0002). CONCLUSION: The raw area of the removed organ is at least partially responsible for shoulder pain after laparoscopic cholecystectomy. Local bupivacaine is effective in reducing such pain.

Adult↗

PubMed1997

Colorectal adenocarcinoma in a defined Jordanian population from 1990 to 1995.

PURPOSE: This study aims to evaluate cancer of the large bowel as it occurred in a defined Jordanian population, with special reference to its epidemiologic aspects. Second, this study was undertaken to compare these results with those of other countries and those previously reported from Jordan. METHODS: Records of patients diagnosed as having colorectal adenocarcinoma during a six-year period in Irbid province, Jordan, were reviewed. The material was analyzed retrospectively with respect to various epidemiologic features, and the results were compared with those of other countries and those previously published about the Jordanian population. RESULTS: Between January 1990 and December 1995, 109 new patients with colorectal adenocarcinoma were managed, an incidence of 3.8/100,000/year. Male to female ratio was 1:1.05 for colonic cancer and 1.36:1 for rectal cancer. The maximum incidence was seen in the sixth and seventh decades. A total of 12.8 percent of the patients were younger than 40 years of age. The rectum was the most common site involved in 30.3 percent of the patients, followed by the sigmoid, right colon, and the rest of the colon. When compared with previous Jordanian figures, a shift toward the western figures was noted. The delay in diagnosis was noted from the 8.2 months of delay before diagnosis and the advanced stage of the disease at the time of diagnosis. A total of 49.5 percent of the cases were in Dukes B stage, 30.3 percent in Dukes C, and 19.3 percent in Dukes D. Only one patient was in Dukes A stage. A total of 13.8 percent of the cases were mucinous adenocarcinoma. A total of 26.5 percent of the patients presented with complications. CONCLUSIONS: As for colorectal adenocarcinoma, we still share the epidemiologic characteristics of developing countries, but there is a shift toward those of western communities. Flexible sigmoidoscopy is encouraged for evaluation of lower gastrointestinal symptoms, and education of the public and medical staff about colorectal diseases is needed to improve the outcome.

Adenocarcinoma↗