Pulmonary hypertension in Saudi Arabia: a single center experience

Several international studies have described the epidemiology of pulmonary hypertension [PH]. However, information about the incidence and prevalence of PH in Saudi Arabia is unknown. To report cases of PH and compare the demographic and clinical characteristics of PH due to various causes in a Saudi population. Newly diagnosed cases of PH [defined as mean pulmonary artery pressure > 25 mmHg at right heart cauterization [RHC]] were prospectively collected at a single tertiary care hospital from January 2009 and June 2012. Detailed demographic and clinical data were collected at the time of diagnosis, along with hemodynamic parameters. Of the total 264 patients who underwent RHC, 112 were identified as having PH. The mean age at diagnosis was 55.8 +/- 15.8 years, and there was a female preponderance of 72.3%. About 88 [78.6%] of the PH patients were native Saudis and 24 [21.4%] had other origins. Twelve PH patients [10.7%] were classified in group 1 [pulmonary arterial hypertension], 7 [6.2%] in group 2 [PH due to left heart disease], 73 [65.2%] in group 3 [PH due to lung disease], 4 [3.6%] in group 4 [chronic thromboembolic PH], and 16 [14.3%] in group 5 [PH due to multifactorial mechanisms]. PH associated with diastolic dysfunction was noted in 28.6% of group 2 patients, 31.5% of group 3 patients, and 25% of group 5 patients. These results offer the first report of incident cases of PH across five groups in Saudi Arabia

Zoonotic brucellosis: an underestimated or misdiagnosed disease in Egypt

Over six months, 329 suggestive consecutive brucellosis human cases were diagnosed in attending the out-patients clinics of Al Azhar and Ain Shams Universities Hospitals and Giza Governorate Farmers. They were 100 females and 229 males with ages ranged between 15-65 years old. A total of 213 [64.75%] were working in dairy farm and/or consumed raw milk, 16 [14.85%] used home slaughtering of sheep, and 100 [30.4%] were working in Giza Government slaughter-house. Clinically and by ELISA-IgM 259 out of 329 the subjects were proven brucellosis patients [77.8%]. Besides, other patients had toxoplasmosis, or Schistosomiasis mansoni or fascioliasis. Double infection was encountered with toxoplasmosis and either schistosomiasis or fascioliasis. The causes of endemic liver parasitosis that may give false-clinical diagnosis were excluded. Signs and symptoms of brucellosis patients were fever [91.5%], chills [84.1%], Myalgia [69.5%], headache [58.2%], fatigue [77.2%], anorexia [54.1%], tachycardia [38.6%], hepato-and/or splenomegaly [46.2%], lymphadenopaqthy [19.6%] lower back abdominal pain [8.8%] and/or constitutive symptoms [13.1%]

Electropherotypes and Subgroups of Group A Rotaviruses Circulating among Diarrhoeic Children in Kano; Nigeria

Background: It is estimated that about 600?000 children die annually as a result of severe dehydrating diarrhea caused by rotaviruses. The virus is a double stranded RNA (dsRNA) virus with 11 segments. Group A rotaviruses show a characteristic 4-2-3-2 pattern following electrophoresis. The VP6 subgroups; I and II exist. This work was carried out to study the prevalence of rotavirus infection among children 0-5 years with diarrhea in Kano; and to determine the circulating subgroups and electropherotypes and of the rotavirus isolates. Methods: Two hundred and eighteen stool specimens from children 0-60 months (198 diarrheic and 20 non-diarrheic) were collected from different hospitals and health care centers in Kano and subjected to group A rotavirus enzyme linked immunosorbent assay (ELISA) to determine presence of group A rotavirus; subgroup ELISA to determine the VP6 subgroups and polyacrylamide gel electrophoresis (PAGE) to determine the electropherotypes present. Results: The long electropherotypes (47.05) of four variations dominated over the short electropherotype (17.64). About 11.76of the isolates were of mixed infection. Dominance of subgroup II (45) over subgroup I (25); and the presence of both subgroups I and II (10) and neither subgroup I nor II (15) was observed in this study. Conclusion: Information on the genomic diversity of the RNA electropherotypes in this region; Kano; is reported in this study

Rotavirus infection in four states in north-western Nigeria

Background: Rotaviruses are associated with 611;000 deaths worldwide and with 33;000 deaths in Nigeria in children 5 years of age annually. However; limited data exit on rotavirus (RV) infection in North-western Nigeria. This study surveyed RV infection in four states in Northwestern Nigeria. Methods: During July 2002 to July 2004; 1063 (869 diarrhoeic and 194 control) stool samples were collected from children 0.05). The highest RV burden was detected in children aged below six months. The infection occurred throughout the study period. The most common clinical features associated with RV were fever (71);vomiting (64.1) and a combination of fever and vomiting (48.2). Vomiting was strongly associated with RV (p 0.01). There was a statistically significant association between food type and rotavirus infection (p 0.05); with the highest prevalence occurring amongst children exclusively breast-fed. The majority of the RV positive samples revealed long electropherotypes and VP6 subgroup I + II specificity. Conclusion: Rotavirus was shown to be an important cause of diarrhoea in children 0-5 years of age in Northwestern Nigeria. An effective vaccine would therefore need to be administered at birth for children in the study area since there is no effective way to completely eliminate rotavirus infection other than vaccination. There is also a need for additional studies in Nigeria to provide data required to hasten vaccine introduction

Transvaginal ultrasound is a valuable investigation in female stress incontinence

Objectives: To evaluate the role of transvaginal ultrasound (TVUS) in studying the anatomical bases of genuine stress urinary incontinence (SUI) and understanding the causes of success and failure of operations aiming at the treatment of incontinence. Patients and Methods: This study included 15 continent females (Group I, healthy control) and 46 patients complaining of SUI (Group II). All cases were subjected to full history, physical examination, urodynamic evaluation and TVUS examination. In 42 patients of Group II, TVUS was repeated one year after treatment of incontinence, while four patients were lost to follow-up. In 36 of these 42 cases (85.7%), treatment was successful (Group IIIa), while treatment had failed and SUI had persisted or recurred within one year in six cases (Group IIIb, 14.3%). We used TVUS to measure the bladder-symphysis distance (BS), the rotational angle(RA), the bladder neck motility (BNM) and the vertical bladder neck descent. Results: While the mean BS was insignificantly shorter in Group II compared to Group I (2.24 ± 0.7cm versus 2.4 ± 0.5 cm, p = 0.08), the mean RA, BNM and vertical bladder neck descent were significantly larter in Group II (115 ± 17o 29 ± 16o 1.4 ± 0.4 cm for Group II versus 94 ± 15o 20 ± 5o 0.34 ± 0.4 cm for Group I). The comparison between Groups I and II showed that the TVUS-measured parameters correlated well with the clinical condition. A comparison between Group IIIa (BS = 2.2 ± 1 cm, RA = 100 ± 19o BNM = 22 ± 4o and vertical bladder neck descent = 0.38 ± 0.5 cm) and Group IIIb (BS = 2.2 ± 0.5 cm, RA = 117 ± 16o, BNM = 30 ± 9o and vertical bladder neck descent = 1.4 ± 0.3 cm) showed that the TVUS-measured parameters correlated well with the surgical outcome. Conclusions: TVUS is a valuable tool for the diagnosis and postoperative evaluation of SUI and may help in understanding the causes of success and failure of surgical treatment of SUI