Prevalence of iodine deficiency disorders among school children in Saudi Arabia: results of a national iodine nutrition study

This study aimed at establishing updated data on iodine nutrition among schoolchildren in Saudi Arabia. A cross-sectional cluster survey among schoolchildren aged 8-10 years was conducted during February-April 2012. Children were clinically examined for goitre, urine and household salt samples were collected to estimate urinary iodine concenteration [UIC] and iodine content in salt. The overall goitre prevalence at the national level among 4 016 children was 4.2%. The prevalence was < 5% in all regions of the country except southern region with a prevalence of 12.7%. The median UIC of 2224 samples was 133 microg/L, with 74.3% of the surveyed children with UIC>/=100 microg/L. Analysis of salt samples [n = 4242] revealed that 69.8% of households were consuming adequately iodized salt. The findings suggest iodine sufficiency at the national level, however southern region still has a goitre prevalence of mild degree severity and the proportion of households consuming adequately iodized salt is still below recommendations

An Improved PCR-RFLP Assay for Detection and Genotyping of Asymptomatic Giardia lamblia Infection in a Resource-Poor Setting

Laboratory workers, in resource-poor countries, still consider PCR detection of Giardia lamblia more costly and more time-consuming than the classical parasitological techniques. Based on 2 published primers, an in-house one-round touchdown PCR-RFLP assay was developed. The assay was validated with an internal amplification control included in reactions. Performance of the assay was assessed with DNA samples of various purities, 91 control fecal samples with various parasite load, and 472 samples of unknown results. Two cysts per reaction were enough for PCR detection by the assay with exhibited specificity (Sp) and sensitivity (Se) of 100% and 93%, respectively. Taking a published small subunit rRNA reference PCR test results (6%; 29/472) as a nominated gold standard, G. lamblia was identified in 5.9% (28/472), 5.2%, (25/472), and 3.6% (17/472) by PCR assay, RIDA® Quick Giardia antigen detection test (R-Biopharm, Darmstadt, Germany), and iodine-stained smear microscopy, respectively. The percent agreements (kappa values) of 99.7% (0.745), 98.9% (0.900), and 97.7% (0.981) were exhibited between the assay results and that of the reference PCR, immunoassay, and microscopy, respectively. Restriction digestion of the 28 Giardia-positive samples revealed genotype A pattern in 12 and genotype B profile in 16 samples. The PCR assay with the described format and exhibited performance has a great potential to be adopted in basic clinical laboratories as a detection tool for G. lamblia especially in asymptomatic infections. This potential is increased more in particular situations where identification of the parasite genotype represents a major requirement as in epidemiological studies and infection outbreaks.

Chemotherapy-induced febrile neutropenia in patients with breast cancer. A multivariate risk assessment model for first cycle chemotherapy

To identify factors that increase the risk of developing febrile neutropenia [FN] during the first cycle of chemotherapy in breast cancer patients. In this retrospective study, we reviewed the records of 211 patients with confirmed breast cancer treated with chemotherapy at the Princess Norah Oncology Center, King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia between January 2010 and May 2012. Statistical analysis was conducted using descriptive analysis, univariate, and multivariate logistic regressions. A multivariate regression of FN occurrence in the first cycle was developed. The median age of patients was 48 years. Febrile neutropenia was documented in 43 [20.3%] of 211 patients. Twenty-one [49%] of the 43 patients had FN during the first cycle of chemotherapy. A multivariate logistic regression revealed that age [odds ratio [OR] 1.059, 95% confidence interval [CI]: 1.007-1.114], non-anthracycline and/or taxane-based chemotherapy regimens [OR of 39.488; 95% CI: 4.995-312.187], and neo-adjuvant chemotherapy [OR of 8.282; 95% CI: 1.667-41.152] were the most important independent risk factors of FN. Identifying risk factors of FN may help to target high-risk patients with granulocyte colony-stimulating factor prophylaxis and reduce FN incidences, with subsequent morbidities and mortalities

Incidence and potential risk factors of post-tonsillectomy hemorrhage

To evaluate the incidence of postoperative tonsillectomy hemorrhage [PTH] and to identify the possible risk factors associated with its occurrence. A Retrospective Study. Two private hospitals: Mahayel Hospital and Saudi German Hospital. Four hundred seventy-seven patients had tonsillectomy or adenotonsillectomy from January 2008 to December 2013. All PTH incidents were identified. A data collection sheet was constructed by the author, which included patient's age, sex, and day of postoperative bleeding evaluation. Result: Two hundred eighty-eight [60.4%] were children and 189 [39.6%] were adults. Two hundred forty-two [50.7%] were males. The indication for tonsillectomy in 394 [82.6%] was recurrent tonsillitis and in 83 [17.4%] was obstructive sleep apnea. Twenty-nine [6.1%] patients had PTH, 8 [27.6%] had primary PTH and 21 [72.4%] had secondary. The incidence of PTH was significantly higher among adult patients than children [9%, 4.2%, respectively, p=0.031] and among patients with recurrent tonsillitis than those with obstructive sleep apnea [7.1%, 1.2%, respectively, p=0.041]. There were no statistically significant differences in timing of PTH [primary or secondary] according to patients' characteristics. The incidence of PTH in our study is not high. Risk factors include older age and preoperative recurrent tonsillitis. PTH occurs mainly 24 hours postoperatively. Awareness of these risk factors should help improve patient care and outcomes

Effectiveness of grommet insertion in resistant otitis media with effusion

To determine the effectiveness of myringotomy and grommet insertion [MGI] in patients with otitis media and effusion [OME], who failed medical treatment. Mahayel Private Hospital, Aseer Region, Saudi Arabia. Retrospective study. Records of eighty-six children [50 boys and 36 girls], aged 1-12 years, who had MGI for chronic OME between January 2005 and December 2010 were reviewed. Patients' data included: presenting complaints, indications for MGI, ear examination, hearing threshold and tympanometry. The age ranged from 1 to 12 years, 62 [72.1%] were less than 6 years old. Hearing and academic performance improved after grommet insertion. The study revealed that OME occurred mostly in preschool age. Hearing loss was noticed in 64 [74.4%], impaired social interaction in 37 [43%], difficulty in learning in 15 [17.4%] and delayed speech in 11 [12.8%]. The leading presenting complaint is hearing loss. MGI is indicated if medical treatment failed. Hearing threshold improves significantly postoperatively

Prophylactic antibiotics in patients with chronic suppurative otitis media undergoing tympanoplasty: a comparative study of augmentin versus amoxicillin

To compare the usefulness of prophylactic augmentin compared with amoxicillin in patients undergoing tympanoplasty. This study was conducted in 3 hospitals namely Aseer Central Hospital, Saudi German Hospital and Al-Namas Hospital in Aseer Region. This study included 32 CSOM patients without any complications. They were randomized into 2 groups, Group A [n=16], who received intravenous 1.2 mg augmentin after the induction of the anesthesia followed by 7 days oral augmentin in a doses of Ig Bid or Group B [n=16] who received amoxicillin 500 mg thrice a day for one week. The clinical success was significantly higher among patients who received augmentin [Group A] compared with those who received amoxicillin [Group B] in preventing the postoperative infection [p=0.033]. Among patients in Group A, 15 cases [93.7%] had successful take of graft compared with 10 cases [62.5%] in group B. The use of prophylactic augmentin antibiotic is more effective in preventing early post-tympanoplasty infection compared with amoxicillin

Knowledge and concern about avian influenza among secondary school students in Taif, Saudi Arabia

This study identified knowledge and concerns about avian influenza among secondary school students in Taif, Saudi Arabia. A stratified random sample of 514 students from 6 secondary schools was given a self-administered multiple-choice questionnaire. Knowledge scores were significantly related to socioeconomic indicators. Approximately 70% of the participants reported that media [TV and/or radio] was the source of their information. Overall, 65.4% of the participants said they expected there to be cases of avian influenza in Saudi Arabia this year. Females were more concerned than males [70.9% versus 58.9%]. Effective school health education programmes should be implemented in order to prepare the community to deal with this important threat