Seroprevalence of human cytomegalovirus antibodies among children with type I diabetes mellitus in the Aseer Region, Southwest KSA

Objectives: this study is aimed at determining the seroprevalence and possible infectivity factors of human cytomegalovirus [HCMV] in children affected by type 1 diabetes mellitus [T1DM] in the Aseer Region of KSA

Methods: a total of 205 children diagnosed with T1 DM who routinely attended the Diabetic Centre [DC] of Aseer Central Hospital [ACH] in Abha KSA were randomly selected. Another control group of 51 nondiabetic children were also selected. Sera of both groups were tested for HCMV-specific IgG and IgM using an indirect enzyme linked immune-sorbent assay [ELISA]

Results: the recorded HCMV-IgG seroprevalence rates were found to be higher in both groups of children than the IgM responses, which were consistently low. There were no obvious differences between the two groups in terms of HCMV responses. No significant variations were observed between girls and boys in terms of the seroprevalence rates. The highest positive IgG prevalence rates to HCMV were observed among 11- to 15-year-old children, and the least positive rates were noted in children younger than 5 years of age. Children from Abha city and its vicinity showed relatively higher HCMVspecific IgG and IgM responses rates than children from other localities

Conclusions: despite the presence of high HCMV-IgG response rates among the studied group of children, this study could not identify the associated clinical manifestations. There is no correlation between T1 DM and virus infectivity, as this research could not find differences in serological responses to the virus between the diabetic and non-diabetic children

Bowel function and its associated variables in Saudi adults a population based study

To study bowel patterns [function/habits] and its associated variables in an adult Saudi population. In a cross sectional study, a 21-item questionnaire on bowel function [habits and frequency] was distributed to 10,000 high school students from all 5 regions of Riyadh City, Saudi Arabia, between February and April 2011. The randomly selected students, and 2 of their household or family members completed the questionnaire. Socio-demographic characteristics, eating habits, chronic diseases, and medications used were studied. Sixty-one percent [N=4918] were above the age of 16 years, of which 51.5% were males, and 88.1% were Saudis. It was observed that 18.1% of respondents perceived their bowel movements as being irregular and abnormal. There was no association between gender and abnormal/irregular bowel movement [OR: 0.89; p=0.13]. Individuals over 60 years suffered from bowel pattern abnormalities [OR=1.8; p=0.01]. Educational status [secondary], occupation [teacher and unemployed], diet habits, and chronic diseases of study subjects were also statistically significantly associated with their bowel movements. Respondents consuming more vegetables, fruits, meats, dairy products, and rice had significantly more normal bowel movements. Females tended to defecate less frequently as compared with males [p<0.0001]. Approximately 40% of both genders have bowel movements at least once a day. Our results may serve as a baseline for appropriate intervention strategies, and also for future studies to substantiate, negate, or add more observations/conclusions.

Thrombosis of the internal jugular vein resulting from migration of a sharp esophageal foreign body

Internal jugular vein [IJV] thrombosis is a rare, but potentially fatal condition. A 59-year-old female patient was referred to our hospital 3 weeks after ingesting a foreign body [FB]. Twice endoscopic examinations at the referring hospital were negative. On arrival at our hospital, she was in pain, and the left side of her neck was swollen. A CT of the neck revealed the presence of a slender pointed radio-opaque FB in the left IJV together with a large thrombus containing a small central abscess. Surgical removal of the FB was performed together with ligation of the left IJV. The postoperative recovery was uneventful. Medical centers without proper diagnostic facilities should transfer such cases to better-equipped centers

Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation [AF] in a tertiary hospital in Riyadh, Saudi Arabia. We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Documented acute and chronic AF was present in 157 [21.8%] and 563 [78.1%] patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems [chest infection, bronchial asthma, and pulmonary embolism] were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus [DM] in 68.8%, hypertension [HTN] in 59.3%, chronic lung diseases [bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease] in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease [IHD] in 23.1%. In 9 [1.3%] patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF [P<0.01]. Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

reliability of an Arabic translation of the chronic obstructive pulmonary disease assessment test

To produce a conceptually equivalent Arabic version of the Chronic Obstructive Pulmonary Disease [COPD] Assessment Test [CAT], and to assess its reliability. A prospective observational study was carried out from June 2010 to September 2010 at King Abdulaziz Medical City and King Khalid University Hospital, Riyadh, Saudi Arabia. We conducted this study in 2 phases. Phase 1: the translation of the CAT from English to Arabic, through forward and backward translation, as well as pilot testing. Phase 2: assessment of the test-retest reliability of the CAT for 45 patients with COPD who received optimal care by their pulmonologist. This study was conducted on 45 participants. The CAT mean total [ +/- SD] score at the test session was 10.7 +/- 5.8, and 9.2 +/- 4.5 at the re-test session. The interclass correlation of the total score was 0.9 [p=0.000076]. The strongest correlation was for the item of confidence in leaving home with a value of 0.92 [p=0.000082], whereas the weakest was for the item related to sleep with a value of 0.53 [p=0.007]. The Arabic version of the CAT was found to be easy to administer, reliable, and had a strong interclass correlation reflecting stability over time and across the items

Quasispecies of genotype 4 of hepatitis C virus genomes in Saudi patients managed with interferon alfa and ribavirin therapy

Many patients with hepatitis C virus [HCV] infection do not respond to antiviral treatment, possibly due to viral quasispecies. We aimed to investigate whether the quasispeices population could be used as a predictor of response to therapy in our patients. The quasispecies of HCV genotype 4 [HCV-4] were studied in 25 naive Saudi patients at zero, three, and six months following interferon alfa and ribavirin combination therapy. Hypervariable region 1 within the E2/NS1 gene of the virus was analyzed by the single-strand conformation polymorphism [SSCP] technique after amplification. Pretreatment DNA bands by SSCP [2-7 bands] were detected in all patients. In those who achieved a complete virological response within six months [viral load <0.2 Meq/mL; n=7], bands ranged from 2-6 [mean = 3.71 +/- 1.25]. In six of these seven patients, the number of SSCP bands remained either the same or decreased sequentially. In those patients who did not respond [viral load >0.2 Meq/mL; n=18], the bands also ranged from 2-7; mean 3.77 +/- 1.73. In six of these non-responding patients, the SSCP bands remained the same or decreased sequentially. There was no significant difference between pretreatment quasispecies composition and response [P=.53]. Two of the four patients with pretreatment high viral load and the same or decreased composition of quasispecies bands responded to the therapy. Quasispecies in our studied patients cannot be used to predict responsiveness to treatment, but may offer an explanation for failure of most HCV-4 patients to respond to interferon alfa and ribavirin therapy

Isoenzyme electrophetic characterization of leishmania major, the causative agent of zoonotic cutaneous leishmaniasis in north and west Saudi Arabia

Several expeditions were carried out to four localities [Al-Madinah Almonawarah, Tabouk region, Al-Jouf and Northern Frontiers regions] in Northern and Western Saudi Arabia for sampling zoonotic cutaneous leishmaniasis [ZCL] cases from patients and rodents. Biopsy samples were collected from 51 patients complaining of skin lesions, most of which [40 or 78.4%] proved to be ZCL. Amastigotes were detected in 33 patients [64.7%], but only 30 [58.9%] gave successful growth of promastigotes in the culture media. The positive cases were Saudis 14 [35%] and non-Saudis 26 [65%].Five species of rodents were caught, Meriories libycus, Psammomys obesus, Rattus rattus, Jaculus jaculus and Hystrix indica. The first species was the most dominant [90%] in which Leishmania parasites were detected. The Leishmania isolates from man and rodents were identified by isoenzyme electrophoresis and proved to be Zymodeme LON-4

Allergic reaction to bismuth-lodoform-paraffin paste [BIPP] following ear surgery

Bismuth lodoform Paraffin Paste [BIPP] impregnated ribbon gauze is one of the most commonly used packs after external and middle ear surgery. Allergic reaction to BIPP is rare. We report two cases of hypersensitive BIPP reaction following tympanoplasty surgery. To our knowledge no such cases have been reported previously in Qatar. We reviewed the literature and discuss the management and its prevention

Rhinosporidiosis in Qatar: a case report and literature review

Rhinosporidiosis is a chronic granulomatous inflammatory disease characterised by polypoid lesions of the mucus membranes. The disease is endemic in India but very rare in the Middle East. We report the clinical presentation, management, and histopathology of the first case of rhinosporidiosis in Qatar and review the literature

Prevalence of metabolic syndrome in Saudi adult soldiers

To estimate the prevalence of metabolic syndrome in Saudi male soldiers aged 20 years and above using the criteria of the National Cholesterol Education Program Adult Treatment Panel III [NCEP-ATP III]. We performed a cross-sectional survey involving a group of 2250 Saudi male soldiers aged 20-60 years residing in a military city in Northern Saudi Arabia in 2004. Participants were recruited from a primary care setting. Anthropometric data together with a brief medical history were obtained from the subjects at initial contact. Laboratory investigations were performed on the following day after fasting for 12 hours. Data on all variables required to define the metabolic syndrome according to NCEP ATP III criteria were available only for 1079 subjects who attended the laboratory for investigations [response rate: 47.9%]. Data obtained from these subjects were analyzed excluding the non-respondents from the study sample. The age-adjusted prevalence of metabolic syndrome was found to be 20.8%. Abdominal obesity was the most common component in the study population [33.1%] closely followed by raised serum triglycerides [32.2%] and elevated systolic blood pressure [29.5%]. Over two-thirds of the subjects [71%] exhibited at least one criterion for metabolic syndrome. Prevalence of individual factors and mean values of the components of the syndrome showed a steady increase with increase in age and body fat. The estimated prevalence conforms to the rates found in other studies performed in the Middle East and elsewhere. High rates of this syndrome predict an increased burden of cardiovascular disease and diabetes among Saudis over the next few years and call for effective healthcare planning to contain this epidemic

Frequency of visits for health care by low-birth-weight and preterm Saudi infants in the first year of life

A retrospective hospital-based cross-sectional survey in a Saudi Arabian hospital compared the frequency of visits to hospital of low-birth-weight and normal-birth-weight infants and of preterm and full-term infants during the first year of life. A multivariate analysis of the visits for health care with birth weight, term, Apgar score, mode of delivery and sex was made for 1892 infants. The number of visits for health care was significantly higher for low-birth-weight and preterm infants. While the mode of delivery had no effect on the frequency of visits, male sex and poor Apgar score 5 minutes after birth were associated with greater frequency of visits to specialty clinics and higher rates of hospitalization

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

Utilization of diagnostic services in the primary care

To analyze the pattern of utilization of diagnostic tests by the Primary Care Services of the National Guard Housing Complex at Riyadh, Kingdom of Saudi Arabia and to correlate this pattern with other variables [age, gender, problem or diagnosis]. This is a retrospective cross-sectional medical record of the use of laboratory and x-ray facilities in the primary care setting using International Classification of Primary Care [ICPC-2] for encoding of data. The study was carried out at King Fahad National Guard Hospital covering a period of one year from January 1998 to December 1998. Two hundred and forty-five diagnostic tests were ordered at 2290 patient visits. At least one test was requested for 6.5% encounters. Ten tests were ordered per hundred encounters. The total problems managed were 2592 and at least one test was ordered for 6% of problems managed. Sixty-five% of the tests were ordered for females while 35% of the tests were ordered for males. Age-wise, the maximum number of tests was requested for children aged <3 years. Compared to different international figures a lower rate of diagnostic testing has been found and the majority of tests were requested for children. Females rate was significantly higher compared to males