Prevention of rheumatic heart disease in Saudi Arabia: fact or fiction?

Thirty-four children, 6-14 years of age, with recurrent acute rheumatic fever or already established rheumatic heart disease were studied to highlight the reasons and consequences of rheumatic fever recurrences. The majority of cases belonged to low and middle-class large families with ready access to medical care. Although 62% of the patients had a history of pharyngitis prior to the onset of rheumatic fever and the majority of them sought medical attention, they received inadequate treatment. All patients developed rheumatic recurrences because they were not on prophylaxis at all or they took their medications irregularly. The main reasons for non-compliance were lack of proper counselling, child's resentment of injections, or inaccessibility to penicillin injections. Cardiac involvement was detected in 32 patients of whom 56% had isolated mitral regurgitation, 6% had isolated aortic regurgitation, 34% had multivalvular regurgitation, 3% had mitral regurgitation and stenosis, and 28% had congestive heart failure. Current strategies for primary and secondary prevention must be intensified if rheumatic fever and rheumatic heart disease are to become diseases of the past

Necrotizing enterocolitis in Riyadh

All proven cases of necrotizing enterocolitis [NEC] diagnosed in the neonatal intensive care unit [NICU] at King Khalid University Hospital, Riyadh between July 1983 and August 1988 were reviewed. There were 20 cases diagnosed to have NEC. During the study period, there were 1635 admissions to the NICU giving an incidence of NEC of 1.2% of all NICU admissions. Mean birthweight of cases was 1653g [range: 840-3140 g], mean gestational age was 31.6 weeks [range: 26-40 weeks] and the mean age at diagnosis was 8.5 days [range: 1-37 days]. The main predisposing factors were prematurity [80%]; sepsis [75%] and hyperosmolar milk formula feeding [40%]. The common Presenting features were abdominal distension [80%], increasing gastric residue [70%] and blood in the stools [25%]. Surgery was required in 40% of cases