Role of diffusion-weighted MRI in neuro-behcet disease

We report the findings on serial diffusion-weighted MRI in a 29-year-old male with neuro-Beh‡et's disease. Initial T2-weighted and fluid-attenuated inversion recovery images showed a hyperintense lesion in the brain stem. The lesion showed slight hyperintensity on diffusion-weighted images with no evidence of diffusion restriction on apparent diffusion coefficient maps. A follow up study after 7 months showed complete resolution of the brain stem lesion. Our findings indicate that diffusion-weighted imaging is a useful tool to differentiate acute exacerbation of neuro-Behcet's disease from acute infarction, and therefore it helps in selecting the appropriate therapy

Characteristics of immunization providers in Riyadh and their self-perception of competency

To study the demographic characteristics of immunization providers in Riyadh City and their self-perception of competency. A cross-sectional study was conducted among immunization providers in Riyadh City from August 2003 to March 2004. This study covered 71 institutions: [25 primary health care centers, 30 private clinics and dispensaries, 8 government hospitals and 8 private hospitals]. Immunization providers were selected by stratified random process. One hundred and one physicians participated in the study and the data were obtained by self-administered questionnaires, tabulated and analyzed using appropriate statistics. The participating physicians were mostly pediatricians [50.5%] and general practitioners [38.6%]. About 47% of them had had no training in immunization during the preceding 10 years. Self-evaluation revealed that 30.7% of them ranked themselves as excellent, 67.3% as average and 2.0% as poor immunization providers. Self-confidence was associated with specialty, qualification, place of work, years of experience and training on immunization [p<0.05]. Most of participating doctors [83.7%] used books as their references. The doctors were least confident in vaccinating pregnant and lactating women and the vaccination of travelers to endemic areas. To improve immunization services, doctors should be trained before being involved in this practice. There should be frequent distribution of national and international protocols with the auditing of the practice to improve and sustain a highly effective service