Etiologies and management of postural tachycardia syndrome in children

Postural tachycardia syndrome [POTS] is a chronic condition with frequent symptoms of orthostatic intolerance or with sympathetic activation and excessive tachycardia while standing, without significant hypotension. The aim of this review was to discuss the pathogenesis and to outline the diagnosis and treatment guidelines. We conducted a literature review of articles published up to 2017, in following databases; PubMed, and Embase investigating postural tachycardia syndrome in children. We restricted our search to only English published articles with human subjects concerning children under 16 years. POTS is a disorder of the autonomic nervous system that could create considerable disability amongst previously healthy people. Patients with POTS show a HR rise of 30 bpm within 10 min of standing [or greater in kids], are typically hyperadrenergic, and tend to have a reduced blood volume. The pathophysiology of POTS is complex and the result of a variety of separate systems producing a common pattern of signs. The specific pathogenesis of POTS has yet not been completely clear. A variety of uncommon factors might be involved in the pathogenesis. Selecting the correct therapy according to the detailed pathogenesis could absolutely enhance the efficiency of medicine. Treatments targeting the hypovolemia and the excess sympathetic nervous system activation may assist eliminate symptoms

Risk factors of stroke among young adults in KSA

Background: Current literature suggests that hospitalization rates kept increasing with time because stroke risk factors such as high blood pressure, diabetes and obesity have been increasing in the general population. Moreover, stroke is particularly devastating among young people because of its disabling effects, which can last a lifetime. Stroke in young adults is often missed by less experienced clinicians due to its unexpectedness, leading to lost opportunities for intervention

Aim of the study: was to assess the awareness of young adults in KSA of the risk factors, signs and symptoms of stroke

Methods: The present cross-sectional study enrolled 150 Saudi males and females who were randomly selected during the period from October2017 to December 2017. A self-report questionnaire was used to evaluate STROKE awareness among participants while Statistical Package for Social Sciences [SPSS] method was used for data analysis

Results: Our study revealed that the majority of participants were able to relate stroke to the correct underlying risk factors particularly obesity and smoking which score 85.3% and 84.0% respectively. Likewise, 75% agreed that fatty food is a contributing risk factor for stroke while only 61% thought that diabetic patients are at a higher chance for developing stroke. As for the signs of cerebral stroke, the majority of participants had basic knowledge on the signs and symptoms of stroke such as hypertension [83%], face drop, difficulty speech and arm Weakness[76%]. In the meantime, Overall, an average of 13% of participants declared no knowledge across all questions

Conclusions: Our study revealed improved yet still insufficient knowledge of brain stroke among the study group of young Saudi females and males adults regardless to the age group since the majority of participants were able to correlate stroke with the key predisposing risk factors as well as the signs of stroke. This indicates that proper intervention was in place to spread the awareness of this crucial medical emergency. However, this effort needs to continue to further improve knowledge about stroke, risk reduction, and appropriate stroke response and prevention. Nevertheless, further studies should be conducted on a larger scale to make a definite conclusion on the regression of stroke awareness in young adults population in Saudi Arabia

Evaluation of Anterior Cruciate Ligament partial tear injury management

Background: Cruciate ligament is divided into two ligaments [Anterior Cruciate Ligament and Posterior Cruciate Ligament] and is attached to the femur and tibia. The rate Anterior Cruciate Ligament partial tear is high among athletes and it is relatively high in comparison to other knee injuries. Anterior Cruciate Ligament partial tear commonly associated with hem-arthrosis of the knee and can evolve into complete tear. Various approaches have been suggested to treat Anterior Cruciate Ligament partial tear. However, deciding which approach to follow is still controversial

Objective: In this study we aimed at reviewing the current available literatures reporting on the management of partial tears of the ACL

Methods: PubMed database was used for articles selection, and the following keys used in the mesh ["Anterior Cruciate Ligament /partial tear"[Mesh] OR "Anterior Cruciate Ligament /management"[Mesh] OR "Anterior Cruciate Ligament /outcomes"[Mesh]]. 10 studies were enrolled according to our inclusion and exclusion criteria

Conclusion: The initial treatment after an ACL injury is rest, ice and usually crutches. Immobilization is important while the patient remains symptomatic. A course of conservative treatment by physiotherapy can be successful in patients not participating in strenuous physical activity. In patients with a high functional demand, even after a conservative program, surgical treatment is often required. Keeping ACL remnants when reconstructing the ACL is recommended. It might be beneficial on knee function because it preserves numerous mechanoreceptors that favor knee proprioception. In prepubescent children with several years of growth ahead, physical-sparing technique like Micheli technique is recommended. Less invasive techniques such as Thermal modification of knee's connective tissues can be suggested in order to reduce the dilemma and difficulty of the operation for the surgeon

Awareness, frequency and prevalence of DKA with D.M. type 1 children in Al-Jouf region

Background: Diabetes Mellitus [DM] is a developing worldwide wellbeing concern. In 2000, diabetes affected an expected 171 million individual's world-wide; moreover, by 2011 this had expanded to more than 366 million and numbers are relied upon to surpass 552 million by 2030. Objective: The present study aimed at increasing the awareness and prevents the complications of diabetes mellites type 1 in children

Methodology: The current study was a cross-sectional community-based study of a qualitative and quantitative approach. Our study enrolled 80 candidates, from both gender. Participants were subjected to controlled self-administered close-ended study questionnaire all through the period between July to August 2018; and one month for data analysis. Our current data were taken from Al-jouf population in Saudi Arabia

Results: [58; 72.5%] of the participants were having children with diabetes; where only 22; [27%] of them were not having children with diabetes. Moreover, 60; 75% were answered that they have only one child with diabetes, while [14; 17.5%] answered that they have two children and the lowest rate was for the third group who answered that they have more than three children [6; 7.5%]. Furthermore, the age ranges of the diabetic children were [1-5 years old] with proportions of [14; 17.5%], [6-10 years old] with [28; 35%], and the highest range was [11+ years old] with [38; 47.5%]

Conclusion and Recommendation: the current study sheds light on a global and nationwide health problem that affects children in the first stage of life which is diabetes type1. It has a high rate in urban communities. The findings of the present study highlighted the need of raising and improving the awareness through educational programs about management of self-care to prevent and/or reduce the increasing numbers of children patients with DM1

Awareness of risk factors of DKA among diabetic adults in KSA

Background: Diabetic ketoacidosis [DKA] is a complication of Diabetes mellitus [DM] that lingers to have high rates of morbidity and mortality regardless of advances in the management of DM. DKA mainly results from insulin deficiency from new-onset diabetes, insulin noncompliance and increased insulin need because of infection. Most persons with DKA have type 1 diabetes however, a subgroup of type 2 diabetes patients might as well have ketosis-prone diabetes

Aim of the work: To assess the level of awareness of the risk factors of DKA as well as the adherence of DM patients with drugs

Methods: This is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected diabetic Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences [SPSS] 23. Awareness levels for DKA were calculated as absolute frequencies and were reported as overall percentages

Results: A total of 100 randomly selected diabetic Saudi adults [81 females and 19 males], 56% were diagnosed with DM-1 while 44% had DM-2 and only 11% were active sport practitioners. Moreover, only 62% reported a robust adherence to DM medications. The majority of the respondent scored low knowledge on DKA [54%]. Regarding awareness of predisposing risk factors: 9% and 29% of the participants have related DKA to infection and febrile illness respectively. While, 50% of them suggested that there was an association between physical stress and DKA

Conclusion: Our results revealed a compelling need to bridge the disparity in awareness of DKA among Saudi adults with both types. The current knowledge gap doesn't only incur a significant cost burden on the patients and their sponsors because of the high cost treatment and rehabilitation but also and more severely the complications that can be life-threatening if not spotted and treated quickly

Prevalence of hypothyroidism and its associated risk factors in Arar City, Saudi Arabia

Background: Hypothyroidism is a common endocrine disorder worldwide. The prevalence of hypothyroidism depends on many factors, such as age, sex and geographical factors

Objective: This study is carried out to assess the prevalence of hypothyroidism and the related etiology and risks in the general population of Arar city, northern border of Saudi Arabia

Methods: A cross-sectional study was conducted in Arar, Northern Saudi Arabia. A multistage stratified random sampling technique was used. A pre-designed online questionnaire was distributed among the targeted population and filled by participants after a brief introduction or explanation of the idea of the research to the public. Sampled participants filled out the self-reported predesigned questionnaire to collect socioeconomic and thyroid diseases related data

Results: In our study, the prevalence of hypothyroidism was 25.5% [116/454], females are more affected than males, as 57.7% of the cases were female, most of them [80%] aged 21-60 years old and 40% of the cases has a family history of the disease. 64.7% of the cases were on medical treatment but only 16% of them responded. While surgical treatment were found in only 8% of the cases

Conclusion: Hypothyroidism is prevalent in Arar, Northern Saudi Arabia, females were more affected than males. Knowledge of factors influencing thyroid dysfunction help the public to guard against these prevalent diseases. More studies should be carried out in Arar city to stress on the individual thyroid disorder. The studies should be community based with clinical and laboratory diagnosis of cases

Awareness of risk factors of hernia among adults in Riyadh, KSA

Background: Abdominal wall hernias are a very common surgical condition affecting all ages and both genders. The main predisposing factors of hernias include pregnancy, weight lifting, constipation, weight gain as well as some chronic diseases such as Asthma Diabetes Mellitus

Aim of the study: was to assess the awareness of the risk factors of abdominal hernias among adults of both genders and different BMI ranges in Riyadh population [Saudi Arabia]

Methods: This is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected high-risk to development Hernia Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences [SPSS] 23. Awareness levels for Hernia were calculated as absolute frequencies and were reported as overall percentages

Results: overall results showed that only 48% of the respondents could relate hernia to the key underlying risk factors while 22% denied the correlation and 30% claimed no knowledge on the risk factors and the association with hernia development. However, majority of participants [87%] suggested a correlation between hernia and heavy lifting. Moreover, more than half of the study group [65% and 62%] related pregnancy and surgery as a contributing factor for hernia. While a lack of awareness was obvious on other risk factors such as smoking, chronic, constipation prostate enlargement, asthma and DM with a knowledge score of 37%, 36%, 32%, 32% and 29% respectively

Conclusion: Our study revealed lack of public knowledge on the predisposing factors for hernia among the study group of young Saudi female and male adults regardless to the age and BMI range. Despite the fact that 87% related hernia to heavy lifting, less than 65% of participants could correlate hernia to pregnancy and surgery while not more than 36% could correlate hernia with other key predisposing risk factors such as smoking, enlarged prostate, asthma, DM and chronic constipation. This indicates that proper intervention is needed to broadly raise the awareness of hernia risk factors among Saudi adults. This can be achieved by mass media awareness campaigns such as TV and radio health education programs as well as campaign at schools, universities and health centers

Prevalence and risk factors for gallstones among population in Riyadh city, KSA 2017

Background: the most common risk factors for gallstones formations are old age, female gender, obesity and diabetes mellitus. However, information about the prevalence and significant risk factors in Kingdom of Saudi Arabia [KSA] are limited

Objectives: evaluating the prevalence and risk factors of gallstone disease among Saudi population in Riyadh, Kingdom of Saudi Arabia [KSA]

Methods: a cross sectional study that included 500 subjects adult Saudi population who were randomly chosen from February -June 2017. The volunteers were subjected to clinical evaluation, laboratory investigations and ultrasound examination

Results: the overall prevalence of gallstone disease was 8.6%. The older age, female gender, physical activities and obesity are key factors in the gallstones progression. Also, diabetes, liver enzymes and the lipid profile were modifiable risk factors for gallstones

Conclusion: the risk factors for gallstones formation are old age, female gender; physical activities and obesity were key factors in the gallstones progression