The rapid emergence and recovery from sevoflurane anesthesia is associated with a high incidence of emergence agitation in children, ranging up to 80% (Yan-lin and Hong-bo, 2010). Both ketofol and dexmedetomidine have been shown to successfully reduce the incidence and severity of EA, if administered at the end of sevoflurane anesthesia. However, it was not determined which agent has better efficacy. The purpose of this study was to compare the effectiveness of ketofol and dexmedetomidine, given 10 min before the end of surgery, in preventing EA. Patients and methods: Ninety pediatric patients, aged 3-6 years old, American Society of Anesthesiologists I or II, and undergoing orthopedic surgeries under sevoflurane-based anesthesia were recruited into the study. They were randomly assigned to one of three equal groups: Group K, received ketofol (ketamine 0.25 mg/kg and propofol 1 mg/kg); Group D, received dexmedetomidine 0.3 lg/kg and Group C, received 0.9% normal saline. The study drugs were given 10 min before the end of surgery. In postanesthesia care unit, incidence of EA was evaluated with Aono's four point scale and the severity of EA was assessed using Paediatric Anesthesia Emergence Delirium scale upon awakening (T0), after 10 min (T10), 20 min (T20), and 30 min (T30). Extubation time, emergence time and time of first analgesic requirement were also recorded. Results: There were no significant differences in demographic data, duration of surgery or sevoflurane exposure among the three groups. The incidence of EA in group K and group D was similar and significantly lower than that in group C at T0, T10, and T20. The incidence of EA decreased significantly over time in all groups. The severity of EA was significantly lower in groups K and D than in group C at T0, T10 and T20. Time to extubation and to get modified Aldrete score P9 was significantly longer in group D than that in group K. In comparison to control group, group K had longer extubation time and time to get modified Aldrete score P9. The time of first analgesic requirement was significantly longer in group K than that of group D. Both groups K and D provided better analgesic effect in early postoperative period when compared to control group.

No abstract

There is a little information about dementia in Saudis. This is a retrospective chart review study from1995-2010. to describe the demographic characteristics and the risk factors of dementia, the prevalence of different types of dementia, and the current clinical practice of dementia in Saudi tertiary care hospital. A total of 418 demented patients (236 males, 182 females) their mean age was 78.8. Prevalence of diabetes 32%, hypertension 71.53%, dyslipidemia 30.05% and depression 24.41%. Clinically 64.37% of patients had memory impairment, 54.25% had confusion and 34.63% had personality changing. The commonest type of dementia was mixed dementia 18.37% followed by Alzheimer disease15.87%. 16.10% of patients had received cholinesterase inhibitor and 9.78% had received memantine. Infection was the commonest cause of frequent admission (40%) Mortality rate was 77.99%. The commonest cause of death was infection (38.34%) followed by cardiovascular causes like stroke (23.34%) and cardiac diseases (17.48%). Conclusion: (1) Mixed dementia is the commonest type of dementia in Saudis due to high prevalence of cardiovascular diseases risk factors. (2) High prevalence of depression among demented Saudi patients. It requires early recognition and treatment. (3) Demented patients have frequent admissions and long stay in hospital which makes the economic cost is very high. (4) Mortality rate among demented patients is high and the outcome of dementia is expected to be poor. The underlying message of this study is to increase awareness of the public and health system about the impact of dementia in Saudis and the need for prevention strategies, trained physicians and more research.

No abstract

No abstract