Qatar Medical Journal - Volume 2000, Issue 2

Difficult intubation has an incidence of 1.5-8.5%. Failed intubation occurs in 0.13-0.3% of general anaesthetics and it has been found that 30% of the mortality attributed to anaesthesia is related to difficulties in the management of the airway(1). Many techniques and instruments have been advocated in the management of difficult airways; one of these being the Bullard laryngoscope (BL). We report the management of two cases of difficult airway due to limited mouth opening using the Bullard laryngoscope.

A 15-year-old girl sustained a jelly fish sting to her left hand and subsequently developed acute vascular insuffi-ciency of the left index and middle fingers with a threat of distal gangrene.

Jelly fish venoms are complex mixtures of polypeptides and enzymes pathogenic to man by means of their anti-genic properties. Fatal reactions can be caused by hy-persensitivity of the toxins on the heart, respiratory center or kidneys. Local or generalized skin eruption, exagger-ated local oedema, local fat atrophy and pigmentary changes are also features of the jelly fish sting. A direct neurotoxic effect of the jelly fish venom on big nerves as radial, median and ulnar nerve palsies has been reported by Peel.

A Qatari boy presented at birth with muscular weakness and was diagnosed as a case of Walker Warburg syndrome (WWS) on the basis of muscular dystrophy, eye abnormalities and brain anomalies. This is believed to be the first case of WWS reported from the Arab countries. Other similar muscular dystrophies associated with brain anomalies are described and discussed.

Report of a rare occurrence of koro-like symptoms as a part of transient post-ictal schizophrenia-like psychosis in a Jordanian patient The etiology is reviewed in relation to the literature.

Hypolalemic periodic paralysis is an uncommon complication of thyrotoxicosis. It usually affects men of Oriental origin and presents with acute and profound muscle weakness especially of the lower extremities. We report a 46 year old man from Kuwait with sudden paralysis of both legs. Physical examination showed signs of thyrotoxicosis and laboratory tests revealed severe hypokalemia, very low serum thyroid-stimulating hormone and very high free thyroxin. The motor deficit regressed within 8 hours of 80 mmol ofKCI infusion. Awareness of such a problem is essential to avoid life threatening cardiac arrhythmia. Once recognized the treatment is simple and the prognosis is excellent.