Neglected bilateral posterior shoulder fracture dislocation in an uncontrolled seizure patient

Posterior dislocation of the shoulder is a rare injury that occurs secondary to trauma and seizures. Diagnosis is often missed and treatment is challenging. Neglected posterior dislocation is associated with Hill-Sachs lesion which leads to locking of dislocation. Correct diagnosis is achieved by history taking, a physical examination and appropriate imaging. In neglected shoulder dislocation with uncontrolled seizure and humeral head defects of up to 45% the McLaughlin procedure shows excellent results at follow-up

Cellular and molecular responses of Saudi chronic myeloid leukaemia patients to imatinib (sti-571): ten year experience

The cyto-genetic hallmark of chronic myeloid leukaemia [CML], the Philadelphia chromosome [Ph], is the first consistent chromosomal abnormality that has been associated to a certain cancer type. In CML, Philadelphia chromosome is present leading to resistance to cell death and rapid proliferation. The aim of this study is to evaluate the different responses, toxicity and survival of Saudi CML patients to imatinib mesylate. All newly diagnosed CML patients who were treated with imatinib were included in this study. We investigated haematological, and molecular and cytogenetic responses by CBC, FISH and RT-PCR respectively. Cell proliferation and apoptosis were assayed using AUC and TUNEL respectively. Of the 12 cases, 9 [75%] were males and 3 [25%] were female. Four [33%] of the cases were diagnosed incidentally and 8 cases [67%] presented mainly with fatigue [75%], fever [58%], and splenomegaly [83%]. Signs of bleeding and rashes were rare at presentation. The majority of patients had low risk [8, 67%], and 33% had intermediate risk; but none of them had high risk CML. At the last follow up, 11 [92%] were in remissions. One patient [8%] was in remission after 3 years, 4 [33%] were in remission after 6 years, one was in remission after 7 years and 5 [42%] were in remission after 10 years. Only one patient had incomplete major molecular response [MMR] to imatinib after 12 years. The majority of the patients [10, 83%] were in MMR after 6 years and 42% of them were in MMR after 10 years of therapy. Adverse effects of imatinib were not reported by the patients. Imatinib treatment resulted in the reduction of proliferation and induction of apoptosis of CML CFU-GM cells. Imatinib mesylate is capable of treating Philadelphia chromosome-positive CP-CML without any adverse effects.

Puberty development among children and adolescents with chronic disease in Saudi Arabia

Increasing numbers of children with chronic health conditions are now surviving into adolescence and adulthood because of advancing health care. These chronic health conditions are generally known to impact a child's growth and development, including pubertal development. In Saudi Arabia, chronic diseases are prevalent, yet no reports of pubertal onset and its relation to chronic illness are available. The aim of this study was to explore pubertal development among Saudi children and adolescents with a chronic illness. Cross-sectional study conducted at schools in Riyadh, Saudi Arabia in 2006. Those students whose parents reported that their son/daughter had a chronic illness and/or was taking a long-term medication underwent a physical examination to determine sexual maturity rating and growth parameters. Of 1371 students who participated in the study, 155 [11.3%] had a chronic illness. Of those, 79 [51%] were male, and the mean SD age of all the students was 11.4 [2.4] years. Ninety [58%] students were taking medication for their health condition. Bronchial asthma was reported to be the most common chronic condition [n=66; 42.6%], followed by blood disorders [n=41; 26.5%]. Fifty-three [34%] students were overweight or obese. For male gonadal [G] development, the mean age of boys with G stage 2 was 11.7 years; stage 3: 13.5 years; stage 4: 14.1 years; and stage 5: 14.6 years. For female breast [B] development, the mean age of girls with B stage 2 was 10.7 years; stage 3: 11.3 years; stage 4: 12.4 years; and stage 5: 14.1 years. The pubic hair development for both boys and girls was similar to the corresponding gonadal or breast development, respectively. The age of onset of pubertal development for both boys and girls with a chronic illness are within normal limits. The high prevalence of overweight and obesity may contribute to this phenomenon, yet further studies should consider the effects of disease severity and chronicity and medication use as possible confounders