Favorable impact of Nigella sativa seeds on lipid profile in type 2 diabetic patients

The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus [DM] has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa [NS] seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients. A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered orally in a dose of 1, 2, and 3 g/day for 12 weeks. All patients were subjected to measurement of total cholesterol [TC], triglycerides [TG], low-CJ density lipoprotein cholesterol [LDL-c], and high-density lipoprotein cholesterol [HDL-c] before treatment and 4, 8, and 12 weeks thereafter. Patients receiving 1 g/day NS seeds for 12 weeks [group 1] showed I nonsignificant changes in all the parameters except for a significant increase in HDL-c after 4 weeks of treatment. However, patients ingested 2 g/day NS displayed a significant decline in TC, TG, and LDL-c, and CD a significant elevation in HDL-c/LDL-c, compared with their baseline data and to group 1 patients. Increasing

Modified Alvarado score for acute appendicitis in overweight patients

To find out the efficacy of Modified Alvarado [MA] scoring system in diagnosis of acute appendicitis in the overweight patients. All the patients with suspected acute appendicitis admitted in the surgical department at King Fahad Hospital, Hofuf, Al-Hassa, during the period from September 2004 to December 2006 were included in the study. Patients with score of 7 or more of modified Alvarado score were included, patients with score of 6 or less were excluded. All patients underwent diagnostic laparoscopy, and the diagnosis was confirmed by histopathological examination. There was total of 228 patients. Twenty -four percent were overweight and 12% patients were obese. Sixty percent of the patients had confirmed diagnosis of acute appendicitis. Modified Alvarado scoring system is an easy method for diagnosis for acute appendicitis. It can be used as complementary aid for supporting the diagnosis of acute appendicitis in overweight and obese patients

Morbidity patterns among King Faisal University Students, Al Hassa, Kingdom of Saudi Arabia

To explore the prevalent morbidity problems among students at King Faisal University. To identify the nature of referred cases and assess the efficiency of the referral system. This was a retrospective, records-based descriptive study, involving the examination of the health records of students at King Faisal University, who attended the Medical Center for Primary Health Care services in a five-year period. A pre-tested compilation sheet was used for data collection. Out of 2472 consultations, about 58% of the diagnosed morbidity conditions were of infectious nature, mostly affecting the respiratory [62%], dental [14%], gastrointestinal [7%], and skin infections [5%], with more prevalence among males. The non-infectious morbidity conditions were recorded more among females and included muscle and joints problems [16%], allergic conditions [15%], gastrointestinal [8%], and trauma [5%]. Some of the encountered morbidity demonstrated seasonal variation. Case referrals were about 6%, more in the non-infectious conditions, with a deficient feedback system. Quality improvement of the medical records and the establishment of a proper referral system are necessary. Health education on preventable morbid conditions should be organized and implemented

Frequency of methylenetetrahydrofolate reductase C677T polymorphism in patients with cardiovascular disease in Eastern Saudi Arabia

Homozygosity for the C677T mutation in the gene of the thermolabile enzyme 5, 10 methylenetetrahydrofolate reductase [MTHFR] associates with reduced enzyme activity, leading to mild hyperhomocysteinemia. We now know that an elevated level of homocysteine is an important risk factor for cardiovascular disease [CVD]. The objective of this study was to determine the prevalence of the C677T mutation in Saudi patients diagnosed with CVD. Over a period of 2 years [2003-2004] in a case control study, we determined the prevalence of the C677T mutation in 83 CVD patients and in 40 age and gender-matched controls in the Eastern Province of Saudi Arabia. We determined the MTHFR genotype by restriction fragment length polymorphism and allele specific hybridization procedures. The CVD group showed over representation of the C677T allele frequencies [20.5%] compared with unaffected controls [15%] [p=0.3]. Furthermore, the genotypic data indicated that the prevalence of homozygosity for the C677T mutation was dramatically higher in the CVD patients [10.8%] when compared with normal [0%] [p=0.058]. These results suggest that the MTHFR C677T variant mildly influences CVD. However, we require further investigation in large independent samples

Electives during medical internship

The purpose of the study was to find out the reasons for selecting elective rotations during a rotating medical internship. One hundred and seventy-eight medical interns in the College of Medicine, King Faisal University, Dammam, Kingdom of Saudi Arabia during the period March 2001 to August 2002 completed a questionnaire for their selection reasons with responses on a scale of 1-5. The study comprised 60% males and 98.3% Saudis. The most frequently chosen electives are dermatology 28.1%, radiology 20.8%, anesthesia 9.6% and otorhinolaryngology [ear, nose and throat [ENT]] 9%. Significantly, more males [89.2%] chose radiology rotation and more females [75%] chose ENT rotation. The leading reasons to choose an elective rotation are: 1. to gain broad medical training and education, 2. to assist in choice of future specialty, and 3. being relevant to future specialty. The mean score for ENT and dermatology is higher than radiology and anesthesia for the response "to participate in medical practice in different institute", while dermatology is higher than anesthesia for the response "to help getting acceptance for job in the same institute", and radiology is higher than ENT and anesthesia for the response "it has infrequent or no night duties". The reasons chosen reflect the educational value of the electives and their important role in choosing future career. Dermatology and radiology rotations are most popular electives, with additional though different reasons

Electrophysiological findings in newly diagnosed non-insulin-dependent diabetics: a prospective study

This study reports the electrophysiological findings in patients with newly diagnosed non-insulin-dependent diabetes mellitus [NIDDM] studied in the Neurodiagnostic Laboratory of the King Fahd Hospital of the University [KFHU], Al-Khobar, Saudi Arabia. Twenty-nine patients [22 males, 7 females, mean ages 47 and 37 years, respectively] were studied within four weeks of establishing the diagnosis. They were all given nerve conduction studies by the same examiner. Comparison was made with data from a group of 64 normal control subjects. In the study patients, the mean distal sensory peak latency in milliseconds [ms] +/- standard deviation [SD] was 3.5 +/- 0.41 ms in 35 median nerves, 3.2 +/- 0.72 ms in 35 ulnar nerves, 1.9 +/- 0.34 ms in 23 superficial radial nerves and 3.5 +/- 0.61 in 36 sural nerves. The mean distal motor latency +/- SD was 4.6 +/- 0.95 ms in 39 median nerves, 3.5 +/- 0.58 ms in 38 ulnar nerves, 4.8 +/- 1.02 ms in 44 tibial nerves and 6.0 +/- 1.08 ms in 36 peroneal nerves. The electromyogram examination was performed on 24 patients and showed evidence of denervation and/or chronic reinnervation in seven [29%]. The frequency of abnormalities in the studied peripheral nerves was 60% for median, 63% ulnar, 33% peroneal, 16% tibial and 8% sural

Idiopathic hyperprolactinaemia: aclimical study of 140 patients

Report the findings and experience in the management of 140 patient with idiopathic hyperprolactinaemia treated at the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, and the effect of the treatment with bromocriptine on the restoration of normal menstrual pattern and fertility. Method: The study was conducted over a period of five years in 140 patients with idiopathic hyperprolactinaemia who were investigated and treated at the Endocrinological, Infertility and Gynaecological Clinics at the King Fahd Hospital of the University, Al-Khobar between January 1988 and December 1992. The initial serum prolactin levels ranged from 28.5 to 224 ng/ml, with a mean of 62 ng/ml. Among the 140 patients with idiopathic hyperprolactinaemia, 102 patients were complaining of infertility. All the patients in the study were treated with bromocriptine to normalise serum prolactin or to achieve pregnancy. Result: Out of the 102 infertile patients, 82 [80.3%] achieved pregnancy with bromocriptine therapy alone, and the remaining 20 patients received additional treatment with clomiphene and Human Chorionic Gonadotrophine for induction of ovulation. A total of 88 [86.2%] patients achieved pregnancy, 76 had full term pregnancy and 12 ended with abortion. There was no significant difference in the pregnancy rate, between the patients with initial low serum prolactin levels and those with high levels. Similarly, the presence of galactorrhea did not influence the pregnancy rate. No lethal congenital foetal abnormalities were observed in the patients. Bromocriptine therapy in the treatment of hyperprolactinaemia is safe and effective resulting in high pregnancy rate and resumption of normal menstrual pattern

Diagnostic and therapeutic valve of ERCP and prediction of outcome: a retrospective analysis

The objective is to analyze the experience of using diagnostic and therapeutic ERCP and to attempt identifying the independent factors that predict positive and useful procedures. The medical records of 198 patients seen during the period 1991-1993 were retrospectively reviewed. There were 102 males and 96 females with a mean age of 45.2 SD + 16.7 year. The main indications for performing the procedure were jaundice, abdominal pain, nausea and/or fever. Laboratory tests showed elevated direct bilirubin in 50% of patients, deranged liver enzymes in 43%, and ESR was raised in 51% and fever was documented in 52% of patients. The cannulation of both ducts was successful in 93% of all procedures. The commonest finding was gallbladder and common bile duct stones [CBD]. In 54 patients out of 64 with CBD stones, stones were removed endoscopically. Stepwise regressive analyzis has identified age above 40 years, presence of jaundice [total bilirubin > 2.5 mg/ml] and raised ESR [> 25 mm in the 1st hour] as significant factors that independently predict a positive ERCP that revealed findings previously unknown [useful procedure]. Diagnostic and therapeutic ERCP is an integral part in management of biliary and pancreatic ducts disorders. The validity of clinical prediction role should be tested prospectively

Clinical presentation of spontaneous primary hypothyroidism in adults

In a retrospective study of 309 cases of hypothyroidism seen at King Fahd Hospital of the University [KFHU], Al-Khobar, 124 [90 Saudis and 34 non-Saudis] adult patients with spontaneous primary hypothyroidism satisfied the inclusion criteria for detailed analysis. Their male: female ratios for Saudis and non-Saudis were 1:4.6 and 1:3.9 respectively. The majority were diagnosed in their third and fourth decades. The prevalence of previously undiagnosed spontaneous and biochemically overt primary hypothyroidism in Saudis was 5.2/1000 females and 0.94/1000 males. FT[4]I was normal in 43 [35%] and low in 81 [65%]. FT[4]l correlated with cold intolerance, constipation, dry skin, hoarseness, delayed reflex relaxation, and coarse and cold skin. In rank order, presenting symptoms in those with low FT[4]l were tiredness [56%], cold intolerance [38%], constipation, weight gain, menstrual disturbance - especially amenorrhea - [36% each], dry skin [35%], hoarseness [31%]; signs were coarse skin [53%], delayed reflex relaxation [32%], cold skin and goiter [24% each]. The above clinical findings may help physicians in the early detection of primary hypothyroidism. Population-based studies are necessary to provide more data on this disease in this country

Severe diabetic ketoacidosis treated with tris hydroxymethyl aminomethane

We present a case of severe diabetic ketoacidosis complicated by pancreatitis, which developed insulin resistance, persistant acidosis and hypernatremia, and was successfully treated with Tris Hydroxymethyl Aminomethane

Factors influencing medical students career preferences

We studied 100 medical students who completed the final certifying exam, to determine their choice of future specialties and the factors which influenced their choice. We used a questionnaire derived from the Graduation Questionnaire by the Association of American Medical Colleges. Sixty one% and 31% chose medical and surgical specialties respectively. Eight% chose supportive services. The leading factors considered in students' choice of medical specialty were "challenging diagnostic problems", "excellent courses or clerkship" and "Intellectual content of specialty". While those for surgical specialties were "possess necessary skills/talent", "type of patients encountered"," lack of overcrowding in the field" and "excellent courses or clerkships". Majority, 87% made their choice of specialty during their clinical clerkships. There were similarities to students in developed countries in attitudes which identify with the vocational aspects of future career probably due to similarity of medical curriculum and setup. Male students' avoidance of obstetric and gynaecology and the potential role of economic factor are examples of cultural and social influence on career preference