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   Table of Contents - Current issue
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May-August 2019
Volume 2 | Issue 2
Page Nos. -

Online since Saturday, February 13, 2021

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REVIEW ARTICLE  

Snakebite in Saudi Arabia: A public health risk needs to be re-visited p. 21
Ahmed Salah Eldin Gouda, Bandar Saeed Al Balwi, Fadi Ibrahim Alanazi, Sulaiman Timah Alanazi, Khalaf Alwan Al-Enezi
DOI:10.4103/sjfms.sjfms_5_20  
Snakebite envenoming is a neglected tropical disease causing a global public health risk. The real magnitude of this risk in Saudi Arabia could not be fully identified, together with the reported prevalence of highly venomous snakes. This study reviews the reported prevalence, clinical manifestations, and treatment plans of local snakebite victims from the published data on the main electronic databases in the last 20 years. The search resulted in a total of nine studies. All the included published studies collected their data within the time frame from 1983 to 2010, and located in only four governments of Saudi Arabia. The most common snakes identified were Cerastes cerastes and Echis coloratus, and most of the included cases showed coagulopathy. Different types of antivenom were used in the included studies with no stated treatment protocol. Our study concluded that there is a necessity for approaching a nation-wide survey study on the prevalence of snakebite injury with generalization of an evidence-based treatment protocol for management of snakebite victims.
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ORIGINAL ARTICLES Top

Assessment of blood pregabalin stability at different postmortem durations p. 28
Rawan A Almowalad, Hanan Emara, Hatem Ahmed, Samah F Ibrahim
DOI:10.4103/sjfms.sjfms_3_20  
Background: Pregabalin (PRG) has been abused due to its availability and its cheap price. This study is aimed to test the postmortem stability of PRG in blood specimens. Materials and Methods: Ninety-six male rats were divided into four groups, which were given oral doses of PRG: 4 g and 2.5 g/kg for 1 day; 50 mg and 20 mg/kg/day for 21 consecutive days. Antemortem PRG stability was assessed at 4 and 6 h after the last ingested dose, while postmortem stability was assessed at 24 and 48 h after death using gas chromatographymass spectrometry. Results: Our study could detect that -80°C was a storage temperature that could reserve PRG stability in antemortem and postmortem blood samples. The increase in oral PRG dosage was accompanied with a significant increase in blood PRG concentration. Postmortem PRG blood concentrations were decreased in comparison to antemortem concentrations. However, this decrease did not highlight a statistically significant difference in PRG stability (P < 0.05) at the tested storage condition. Conclusion: PRG analysis could be performed in a peripheral blood specimen within 2 days of sampling.
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Estimation of age from medial clavicle radiological ossification staging in a regional population of Eastern India p. 32
Soumeek Chowdhuri, Arindam Ghosh, Saikat Das, Ritwik Ghosh, Tapas Kumar Bose
DOI:10.4103/sjfms.sjfms_7_19  
Background: Previous studies on medial clavicular epiphysis for age estimation using X ray have shown different results among the Spanish population, German population, and others. Studies with adequate sample size, involving the East Indian (Bengali) population, has not been found, based on which our objective of performing this study was decided. Subject and Method: Our study conducted among patients who were brought for examination of the chest due to various medical reasons, 200 cases were selected randomly after considering the inclusion and exclusion criteria from age 10 to 26 years, and clavicular ossification stage was determined by three observers by studying X ray images. Results: it is seen that the mean age for achieving Stage 3 in males is 17.50 years and females is 16.73 years. This can be significant from the point of view of declaring a person juvenile as per the various laws applicable. Conclusion: These results from our study signify that from the forensic point of view, the epiphyseal cartilage of the medial end of the clavicle can be of corroborative significance in assessment of age in doubtful cases of crime accused and in cases of immigration.
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Imaging evaluation of head injuries in children resulting from negligence p. 36
Ali Al Orf, Khawaja Bilal Waheed, Ahmad Mohammad Oqailan, Farrukh Zulfiqar, Mahdi Taha Nassar, Faisal Mohammad Alzahrani, Nawaf Nasser Aljubair, Zechariah Jebakumar Arulanantham
DOI:10.4103/sjfms.sjfms_4_20  
Context: Child abuse comprises physical, sexual, and psychological abuse. Many children evaluated for child abuse have noninflicted injuries due to supervisory neglect. Aims: The aim of this study is to evaluate the imaging findings in children with isolated head injuries due to neglect and to highlight the vulnerable age group. Settings and Design: A retrospective case-based study in Radiology department at King Fahad Military Medical Complex (KFMMC) in the eastern region of Saudi Arabia from January 2017 to 2020. Subjects and Methods: We retrospectively reviewed imaging findings of children (under 18 years) with head injuries related to negligence who were notified under Domestic Violence and Neglect Protection Prevention Program by the Medical Services Department at our KFMMC Hospital in Dhahran. Unconfirmed cases and those who lost follow-up were excluded. Skull radiographs and computed tomography of the brains were evaluated, and findings were labeled as “E” (extracranial, subgaleal hematoma, and scalp injury), “C” (cranial; fracture, and its location), and “I” (intracranial, extradural and subdural hematoma, brain contusion, etc.,). Imaging findings were documented in children aged under 5 years and between 5 and 18 years. Statistical Analysis Used: The Chi-square test was used to determine the association. P < 0.05 was considered statistically significant. Results: Out of total 583 cases of notified child abuse cases, “neglect” accounted for 14.5% (n = 85) of cases, with a mean age of 33 months. Among 85 children with isolated head injuries, abnormal imaging findings were seen in more than half of children (n = 47, 55.2%). Children under 5 years were mostly affected with fractures (C) seen as common findings (n = 34, 72.3%), whereas 19 (40.4%) had intracranial (I) abnormalities (P = 0.89). Conclusions: Head injuries resulting from negligence occur mostly in children under 5 years. Fractures account for more than two-thirds of injuries in children with abnormal imaging findings.
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