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Search Results: 1 - 10 of 223 matches for " Rifat Latifi "
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Critique of: Blunt splenic trauma: Splenectomy increases early infectious complications: A prospective multicenter study
Ammar Almadani,Husham Abdul Rahman,Mazin A. Tuma,Rifat Latifi
Journal of Emergency Medicine, Trauma and Acute Care , 2012, DOI: 10.5339/jemtac.2012.17
Abstract: Critique of: Demetriades D, Thomas S, Elias D, et al. Blunt splenic trauma: Splenectomy increases early infectious complications: A prospective multicenter study. J Trauma; 2012, Volume 72, Number 1, 229-234.
Critique of ‘Management of post-traumatic retained hemothorax: A prospective, observational, multicenter AAST study’
Rahma Salim,Mazin A. Tuma,Rifat Latifi,Hassan Al Thani
Journal of Emergency Medicine, Trauma and Acute Care , 2012, DOI: 10.5339/jemtac.2012.11
Abstract: Background:The natural history and optimal management of retained hemothorax (RH) after chest tube placement is unknown. The intent of our study was to determine practice patterns used and identify independent predictors of the need for thoracotomy. Methods: An American Association for the Surgery of Trauma multicenter prospective observational trial was conducted, enrolling patients with placement of chest tube within 24 h of trauma admission and RH on subsequent computed tomography of the chest. Demographics, interventions, and outcomes were analyzed. Logistic regression analysis was used to identify the independent predictors of successful intervention for each of the management choices chosen and complications. Conclusion:RH in trauma is associated with high rates of empyema and pneumonia. VATS can be performed with high success rates, although optimal timing is unknown. Approximately, 25% of patients require at least two procedures to effectively clear RH or subsequent pleural space infections and 20.4% require thoracotomy.
Multiple Organ Dysfunction Syndrome (MODS): Is It Preventable or Inevitable?  [PDF]
Ayman El-Menyar, Hassan Al Thani, El Rasheid Zakaria, Ahmad Zarour, Mazin Tuma, Husham AbdulRahman, Ashok Parchani, Ruben Peralta, Rifat Latifi
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.37A127
Abstract:

Multiple organ dysfunction syndrome (MODS) is a systemic, dysfunctional inflammatory response that requires long intensive care unit (ICU) stay. It is characterized with high mortality rate depending on the number of organs involved. It has been recognized that organ failure does not occur as an all-or-none rule, but rather a range of organ dysfunction exists resulting in clinical organ failure. In the absence of a gold standard scoring or tool for early diagnosis or prediction of MODS, a novel bio-clinical scoring is mandatory. Moreover, understanding the pathophysiology of MODS in medical, surgical and trauma, ICUs should take a priority to achieve a favorable outcome. Herein we reviewed the literatures published in English language through the research engines (MEDLINE, Scopus, and EBASE) from 1982 to 2011 using key words: “multiorgan dysfunction”, “organ failure”, “intensive care units” to highlight the definition, mechanism, diagnosis and prediction of MODS particularly at its earliest stages. Bring up new bio-clinical scoring to a stage where it is ready for field trials will pave the way for implementing new risk-stratification strategy in the intensive care to reduce the morbidity and mortality and save resources. Prospective studies are needed to answer our question and to shift MODS from an inevitable to a preventable disorder.

Delayed Presentation of Intussusception with Perforation after Splenectomy in Patient with Blunt Abdominal Trauma
Ibrahim Afifi,Hassan Al-Thani,Sajid Attique,Sherwan Khoschnau,Ayman El-Menyar,Rifat Latifi
Case Reports in Surgery , 2013, DOI: 10.1155/2013/510701
Abstract: Adult intussusception (AI) following blunt abdominal trauma (BAT) is a rare surgical condition. We present a case of delayed diagnosis of ileocecal junction intussusception with a perforation of small bowel in a 34-year-old male with a history of fall from height. Initial exploratory laparotomy revealed shattered spleen requiring splenectomy. Initial abdominal computerized tomography scanning (CT) scan showed dilated small bowel with no organic obstruction. Patient started to improve with partial distention and was shifted to rehabilitation unit. On the next day, he experienced severe abdominal distention and vomiting. Abdominal CT showed characteristic intussusception at the distal ileum. Secondary exploratory laparotomy revealed severe adhesions of stomach and small bowel to the anterior abdominal wall with dilated small bowel loops and intussusception near the ileocecal junction with perforation of small bowel. The affected area was resected and side-to-side stapled anastomosis was performed. Though small bowel intussusception is a rare event, BAT patients with delayed symptoms of bowel obstruction should be carefully evaluated for missed intussusception. 1. Introduction Intussusception is the telescoping of one segment of the gastrointestinal tract into an adjacent one and usually occurs in children [1]. John Hunter was the first to describe the clinical and pathological characteristics of intussusceptions. Sir Fredrick Treves proposed the first management plan for intussusception which is being practiced to date [2]. Unlike children in whom most cases are idiopathic, the majority (80%) of adult intussusception (AI) cases have an underlying cause which could be due to development of tumors, fibrosis after surgery, and Meckel’s diverticula. Cases following blunt abdominal trauma are rare [3]. AI is relatively uncommon with different clinical presentation, diagnosis, and management compared to childhood intussusception [4]. AI is often diagnosed late during emergency laparotomy and the delayed diagnosis may be attributed to nonspecific presentation such as chronic colicky pain and intermittent partial intestinal obstruction associated with nausea and vomiting [5]. AI mainly needs surgical treatment which includes bowel resection with prior reduction of intussusception [4]. The increased utility of computerized tomography scanning (CT) helps in early evaluation of patients with abdominal pain and confirms the diagnosis for the possible AI without subsequent delay [1]. Definitive diagnosis of intussusception is possible due to its marked diagnostic
Left Internal Mammary Artery Injury Requiring Resuscitative Thoracotomy: A Case Presentation and Review of the Literature
Ammar Al Hassani,Yassir Abdul Rahman,Ahad Kanbar,Ayman El-Menyar,Abubaker Al-Aieb,Mohammad Asim,Rifat Latifi
Case Reports in Surgery , 2012, DOI: 10.1155/2012/459841
Abstract: Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA). Method. A case presentation treated at the Level I trauma center at Hamad General Hospital, in Doha, Qatar and review of the literature on LIMA injuries reported cases. Results. LIMA injury as a cause of hemothorax is not uncommon, but to our knowledge our case is the first massive tension hemothorax with witnessed cardiac arrest reported in the literature requiring emergency thoracotomy, performed in trauma room, with full recovery. Conclusion. Injury to the LIMA with massive tension hemothorax requires immediate resuscitative thoracotomy.
Left Internal Mammary Artery Injury Requiring Resuscitative Thoracotomy: A Case Presentation and Review of the Literature
Ammar Al Hassani,Yassir Abdul Rahman,Ahad Kanbar,Ayman El-Menyar,Abubaker Al-Aieb,Mohammad Asim,Rifat Latifi
Case Reports in Surgery , 2012, DOI: 10.1155/2012/459841
Abstract: Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA). Method. A case presentation treated at the Level I trauma center at Hamad General Hospital, in Doha, Qatar and review of the literature on LIMA injuries reported cases. Results. LIMA injury as a cause of hemothorax is not uncommon, but to our knowledge our case is the first massive tension hemothorax with witnessed cardiac arrest reported in the literature requiring emergency thoracotomy, performed in trauma room, with full recovery. Conclusion. Injury to the LIMA with massive tension hemothorax requires immediate resuscitative thoracotomy. 1. Background The concept of a thoracotomy as a resuscitative measure began with Schiff’s promulgation of open cardiac massage in 1874 [1]. The value of resuscitative thoracotomy (RT) in resuscitation of the patient with penetrating injuries to the heart with witnessed loss of vital signs has been demonstrated [2]. Overall analysis of the available literature indicates that the success of RT approximates 35% in penetrating cardiac wound, patient arriving in shock, and 15% for all penetrating wounds. Conversely, patient outcome is relatively poor when RT is done for blunt trauma, 2% survival in patients in shock and less than 1% survival with no vital signs [3]. Current indications for RT are penetrating injury to the chest and “cardiac box” with witnessed loss of vital signs and persistent, severe hemorrhagic shock that precludes transport to the OR. Direct injury to the heart resulting in pericardial tamponade and cardiac arrest are most common. To our knowledge, this is the second case of left internal mammary artery (LIMA) injury causing massive tension hemothorax, not relieved by a chest tube, reported in the literature. 2. Case Presentation A 32-year-old male sustained multiple stab wounds to the left chest, approximately 45 minutes before he was brought to the trauma room. Less than five minutes after arriving to the trauma resuscitation room (TRU) the patient had no detectable pulse and blood pressure. A left chest thoracotomy tube was inserted and approximately 1800?mL of blood was immediately evacuated, but the patient’s vital signs were not detectable. Left resuscitative thoracotomy was done and large
Delayed Presentation of Traumatic Intraperitoneal Rupture of Urinary Bladder
Hazim H. Alhamzawi,Husham M. Abdelrahman,Khalid M. Abdelrahman,Ayman El-Menyar,Hassan Al-Thani,Rifat Latifi
Case Reports in Urology , 2012, DOI: 10.1155/2012/430746
Abstract: Blunt injury of the urinary bladder is well known and usually associates pelvic fractures. Isolated bladder injury is a rare condition and on the other hand, delayed bladder perforation is an extremely rare entity. Herein, we described an unusual case of isolated delayed intraperitoneal bladder rupture that occurred on the third post injury day in a young male in the absence of free intraperitoneal fluid and pelvic fracture. The diagnostic workup, course and the need for surgical repair of the injury is presented. 1. Introduction Around 60% to 85% of all bladder injuries result from blunt abdominal trauma (BAT) but the incidence of intraperitoneal urinary bladder (UB) rupture is relatively uncommon from blunt injuries [1]. Isolated UB rupture following blunt trauma has an insidious presentation, and often results in delayed diagnosis and management [2–8]. The mechanism of injury include sudden compression of the full bladder, shear forces, or a pelvic fracture [2, 3, 9]. Rupture of bladder may be presented with lower abdominal pain, inability to void, and perineal ecchymoses [3]. The cardinal sign of injury to the bladder is gross hematuria [6], which is present in more than 95% of cases, while only about 5% of the patients have microscopic hematuria alone [6, 7]. Over 80% of the patients with UB rupture had an associated pelvic fracture in centers with high percentage of blunt trauma. On the other hand around 6% of patients with pelvic fracture sustain a bladder injury [3, 6]. Diagnosis of bladder injury, several days after admission, could be either a missed diagnosis or a truly delayed rupture. Delayed diagnosis of bladder rupture may be associated with laboratory abnormalities such as metabolic derangements, and leukocytosis. Delay in the presentation and treatment may substantially increases mortality [7–10]. Therefore, early and accurate diagnosis with imaging techniques is imperative. Computed tomographic cystography (CTC) and/or retrograde cystography (RGC) are the standard imaging tools for the diagnosis of bladder injury [4–10]. We present a case of delayed rupture of UB due to blunt trauma without associated injuries. 2. Case Report A twenty three-year old male patient sustained BAT due to fall from a 3-meter height. Initial vital signs were: blood pressure136/80?mmHg, heart rate 64?BPM, respiratory rate 20 per minute, oxygen saturation of 100% on room air, and temperature of 36.9°C. Patient was fully conscious with neither external bleeding nor neurological deficits. Abdominal examination showed mild generalized tenderness and voluntary
Cognitive Congestion Control for Data Portals with Variable Link Capacity  [PDF]
Ershad Sharifahmadian, Shahram Latifi
Int'l J. of Communications, Network and System Sciences (IJCNS) , 2012, DOI: 10.4236/ijcns.2012.58058
Abstract: Network congestion, one of the challenging tasks in communication networks, leads to queuing delays, packet loss, or the blocking of new connections. In this study, a data portal is considered as an application-based network, and a cognitive method is proposed to deal with congestion in this kind of network. Unlike previous methods for congestion control, the proposed method is an effective approach for congestion control when the link capacity and information inquiries are unknown or variable. Using sufficient training samples and the current value of the network parameters, available bandwidth is adjusted to distribute the bandwidth among the active flows. The proposed cognitive method was tested under such situations as unexpected variations in link capacity and oscillatory behavior of the bandwidth. Based on simulation results, the proposed method is capable of adjusting the available bandwidth by tuning the queue length, and provides a stable queue in the network.
Decentralization of a Multi Data Source Distributed Processing System Using a Distributed Hash Table  [PDF]
Grzegorz Chmaj, Shahram Latifi
Int'l J. of Communications, Network and System Sciences (IJCNS) , 2013, DOI: 10.4236/ijcns.2013.610047
Abstract: A distributed processing system (DPS) contains many autonomous nodes, which contribute their own computing power. DPS is considered a unified logical structure, operating in a distributed manner; the processing tasks are divided into fragments and assigned to various nodes for processing. That type of operation requires and involves a great deal of communication. We propose to use the decentralized approach, based on a distributed hash table, to reduce the communication overhead and remove the server unit, thus avoiding having a single point of failure in the system. This paper proposes a mathematical model and algorithms that are implemented in a dedicated experimental system. Using the decentralized approach, this study demonstrates the efficient operation of a decentralized system which results in a reduced energy emission.
Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country
Ahmed Abdel-Aziz,Ayman El-Menyar,Hassan Al-Thani,Ahmad Zarour,Ashok Parchani,Mohammad Asim,Rasha El-Enany,Haleema Al-Tamimi,Rifat Latifi
Advances in Pharmacological Sciences , 2013, DOI: 10.1155/2013/842593
Abstract: Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3%) was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5%) and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group ( ). Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines. 1. Introduction Surgical antimicrobial prophylaxis (SAP) is an initial administration of short course of an antimicrobial agent prior to surgery in order to prevent surgical site infections [1]. SAP is critical in preventing infections that may lead to sepsis, organ failure, and death during hospital stay. Despite huge advances in antiseptic measures, antibiotics, and preoperative precautions, surgical site infection (SSIs) still accounted for high morbidity and mortality [2]. SSI is the second most common type of health care-associated infection after urinary tract infections [3]. Also, SSI was reported to represent 14–16% of the estimated two-million nosocomial infections affecting hospitalized patients in the United State [4]. It has been reported that at least 5% of patients undergoing a surgical procedure developed SSI [5]. Kirkland et al. [6] showed that patients who developed SSI have 60% more chances of prolonged intensive care unit stay, five fold increased risk of readmission to the hospital and two-times higher rate of mortality compared to patients who had no SSI. One of the most common microorganisms that are involved in SSI is Staphylococcus aureus, which is reportedly
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