Human brucellosis in Northern Saudi Arabia

Analysis of the clinical features, laboratory findings, treatment given and complications seen in brucellosis patients at the Northern Area Armed Forces Hospital, Hafr Al-Batin, Kingdom of Saudi Arabia. We retrieved and reviewed the record charts of all patients from January 1995 to December 2001 with a clinical diagnosis of brucellosis whose brucella agglutination titre was 1:160 or greater from the Medical Records Department of Northern Area Armed Forces Hospital, Hafr Al-Batin. We extracted from the files the information on age, gender, occupation, history of raw milk or milk products ingestion, presenting symptoms and physical signs. We also noted the results of routine laboratory tests, treatment given, outcome of treatment and complications. One hundred and fifty-nine patients [males 101, females 58 with a ratio of 1.7:1] had a diagnostic label of brucellosis and a brucella titre of >/-1:160. Thirty-three [20.8%] were /-60 years. Fever [>/-=37.7oC] featured in 126 [79.2%] patients; joint pain in 112 [70.4%]; while 77 [48.4%] had bone pain. We recorded the abdominal pain in 18 patients [11.3%] vomiting in 9 [5.7%] and anorexia in 6 [3.8%]; splenomegaly in 6 [3.8]%, hepatomegaly and lymphadenopathy in 2 [1.3%] patients. Brucella tube agglutination titres ranged from 1:160 to 1:5120. Thirty-eight [35.8%] patients had anemia [Hb <12 gms/dl]; 12 patients [9.8%] had lymphocytosis [lymphocyte count >1 k/L]. Ten patients [6.2%] had bacteremia. We used Rifampicin and doxycycline in 87 cases [54.7%], doxycycline and streptomycin in 33 [20.8%], and rifampicin and streptomycin in 20 [12.6%] for 6 weeks or longer [we used combinations including septrin in the remaining patients]. We recorded relapse in 18 patients [11.3%]. Pneumonia, epididymo-orchitis in 2 cases [1.3%] each, abortion, threatened abortion in one case each, complicated the disease in these patients. Brucellosis is endemic in Northern Saudi Arabia as in other parts of the Kingdom. The clinical and laboratory features and response to therapy are also similar

Prevalence of antibodies to Hepatitis C virus in hemodialysis patients in Riyadh

Prevalence of antibodies to hepatitis C virus [anti-HCV] was determined in 190 adults [mean age 40.4 years; range 15 to 75] with end-stage renal disease [ESRD] who are on regular hemodialysis in the Nephrology Unit, Riyadh Central Hospital. The overall prevalence rate was 53.7% [48.7% and 61.0% in Saudi's and expatriates, respectively]. These figures are considerably higher than the figures of 34.8% reported from hemodialysis units in Riyadh, 20% in Spain, 5.5% in Germany, and 1% in the United Kingdom. The possible reasons for the high prevalence of this marker of HCV in our hemodialysis unit are considered and suggestions made for its control

Upper gastrointestinal bleeding among Saudis: etiology and prevalence - the Riyadh Central Hospital experience

Fiberoptic esophagogastroduodenoscopic examination of 747 Saudi patients who presented with acute upper gastrointestinal [UGI] bleeding between January 1984G to December 1986G showed that ruptured esophageal varices, erosive gastritis, duodenitis and peptic ulcer disease were the most common findings. There were 515 males and 232 females [M:F2.2:1]. Multiple lesions were detected in 83% of patients, emphasizing the need to anticipate more than one lesion at endoscopy in a patient with UGI bleeding. Sixty-seven patients [8.9%] gave a history of drug ingestion prior to the episode of bleeding; gastric and duodenal erosions were the most common lesions in these patients. No source of bleeding was apparent in 26 [3.5%] patients at the time of endoscopy. Endoscopy rather than barium studies has become established as the standard investigation in our patients with upper gastrointestinal bleeding

Prevalence of antibodies to hepatitis C virus in Saudi and expatriate women in Riyadh, Saudi Arabia

Six of 511 [1.17%] parturient Saudi females were positive for antibodies to hepatitis C virus [HCV], while one of 171 [0.58%] expatriate female nurses tested positive for the antibody. The prevalence of 1.17% in Saudis compares with 1.2% among pregnant women in Spain, while none of the 40 pregnant women screened in England tested positive for anti-HCV. Antibodies to hepatitis B core antigen in the same sample from Saudi women were positive in 24.6%. Judging by the low prevalence of its antibody, HCV is not as highly endemic as hepatitis B virus [HBV] in this population

Prevalence of antibodies to hepatitis C virus in Saudi patients with chronic liver disease

The prevalence of antibodies to hepatitis C virus [anti-HCV] has been measured in 113 Saudi patients with chronic liver diseases. Twenty-five percent of 20 patients with hepatocellular carcinoma [HCC] were positive for anti-HCV and 29.7% of 38 patients with cirrhosis and 27.3% of 33 patients with liver fibrosis, respectively, also tested positive. The positivity rate for a miscellany of liver diseases [22] was 13.6%. The differences between these prevalence rates were not statistically significant. By comparison, 45% of HCC tested positive for hepatitis B surface antigen [HB[s]Ag] while 52.7% of cirrhosis cases were positive. These rates were statistically significant when compared with HB[s] Ag positivity rates of 9.1% and 18.2% in the liver fibrosis and miscellaneous groups. The role of hepatitis C virus [HCV] may be secondary or additive in the causation of chronic liver disease and hepatocellular carcinoma in this environment in which hepatitis B virus [HBV] is highly endemic