Management of ureteropelvic junction obstruction associated with congenital upper urinary tract anomalies in children: Single-center experience

Purpose We report our experience in the management of ureteropelvic junction  obstruction in children with congenital upper urinary tract anomalies.Materials and methods A retrospective review was performed for all children with primary ureteropelvic junction obstruction associated with upper urinary tract anomalies between 1999 and 2011 at our hospital. Medical records were reviewed for patient age, sex, type of urinary tract anomalies, affected side, indication of surgery, and operative details. Clinical and radiological outcomes were assessed. Success was defined as both symptomatic relief and radiographic resolution of obstruction at final follow-up.Results There were 12 children (10 boys and two girls) with mean age of 5.3 years (range 1–13 years). Anomalies included ectopic pelvic kidney in six patients,  crossed fused ectopia in two, a horseshoe kidney in two, and duplex renal units in two. The left kidney was affected in seven and the right kidney in five children. All patients were managed by open dismembered pyeloplasty. No significant perioperative complications were encountered in the study group. The mean follow-up was 30 months (range 15–45 months). Overall success rate was 84%. Relief of obstruction was evident in 10 patients as documented by intravenous urography or diuretic renography. Secondary nephrectomy was necessitated in two patients; one had severely impaired ipsilateral renal function and the other had recurrent pyelonephritis without radiological improvement.Conclusion Despite the anomalous renal anatomy and the challenging surgical  exposure, dismembered pyeloplasty in children with upper urinary tract anomalies has a high success rate with excellent functional results.Keywords: crossed ectopic, horseshoe kidney, obstruction, pyeloplasty, urete

Decision support systems classification in industry

This research has presented a discussion of related literature on decision support systems (DSS) and its role in production systems. The first part of the research presents DSS and how this has evolved until 2010. The next part of the research provides a discussion of the decision making process and the data mining phases as these relate to DSS. The last part of the research presents further discussion of DSS and various perspectives on the criteria that could be used for DSS. The criteria in the classification of DSS includes the following: user relationship; orientation; scope of use; type and frequency of decision making; mode of assistance; focus area; objective; capacity; degree of guidance; and, degree of non-procedurality. The research also included a discussion of industry 4.0, which is known as the fourth revolution in the industry

The Utilization of Educational Media in Health Institutes in the Kingdom of Saudi Arabia

The aim of this research paper is to evaluate the utilization of educational media in the Secon. dary Health Institutes of the Ministry of Health in the Kingdom of Saudi Arabia. A questionnaire was specifically designed by the researcher to evaluate media utilization by male and female teachers in the Secondary Health Institutes. Teachers included in the research sample , N = 185, were asked to indicate their opinions on a 5-dimensional scale , strongly agree - absolutely disagree, . The results obtained from the study showed that most teachers did not have unfavourable responses usually held against the use of educational media and a majority of them produced some educational media. Moreover, respondents overwhelmingly expressed their need to be educated and trained in the utilization of educational media

Determining symptoms for chest radiographs in patients with swine flu (H1N1)

Background: The question arises about the chest X-ray findings and clinical symptoms in swine flu and about the most important clinical finding when correlated with the chest radiograph. Should physicians order a chest X-ray in each patient suspected of having swine flu? Material/Methods: There were 179 patients with a high suspicion of swine flu. All 179 patients had an initial chest radiograph. As many as 65 males (representing 56% of the projected study population) had a normal chest radiograph, while 35 males (representing 55.6% of the study population) had an abnormal chest X-ray. As many as 51 females (representing 44% of the population) had a normal chest X-ray, while 20 females (representing 44% of the study population) had abnormal chest X-rays. Results: Polymerase chain reaction (PCR) was not a determining factor for normal vs. abnormal chest X-ray (CXR). Rapid antigen test was not a determining factor for normal vs. abnormal CXR. Fever was not a determining factor for normal vs. abnormal CXR. Cough appears to be a determining factor for normal vs. abnormal CXR. Sore throat appears to be a determining factor for normal vs. abnormal CXR. Chest pain was not a determining factor for normal vs. abnormal CXR. Presence of cough with PCR was statistically significant. Conclusions: In my opinion, chest radiographs in patients with suspected H1N1 should only be obtained if there is a cough or sore throat. Other symptoms associated with H1N1 do not warrant a chest radiograph unless absolutely necessary