Awareness of cardiovascular disease in eastern Saudi Arabia

To estimate the awareness of cardiovascular disease [CVD] and their determinants in a screening campaign in the eastern province of Saudi Arabia. All national residents in the eastern province of Saudi Arabia aged 30 years and above, were invited to participate in a screening campaign for the early detection of diabetes and hypertension at more than 300 examination posts throughout the eastern province. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart attack, angina, arterial disease, stroke, and transient ischemic attack. Weight, height, blood pressure, and glucose concentration were measured. Out of 197,681 participants, 5372 [2.7%] were aware of a history of a CVD. The prevalence correlated well with age. It was higher in women, widows, and subjects with lower level of education. More than 75% of affected subjects had two or more risk factors. A substantial proportion of those with a history of CVD had multiple risk factors, necessitating an effective, focused policy for the prevention and treatment. Increased effort is required to promote an awareness of cardiac disease and also probably target primary care providers involved in the screening process

Hypertension in the eastern province of Saudi Arabia: results of a screening campaign

To estimate the prevalence of hypertension through a screening campaign in the Eastern Province of Saudi Arabia, and examine its association with lifestyle factors. In 2004, all Saudi residents in the Eastern Province, aged 30 years and above were invited to participate in a screening campaign for the early detection of diabetes and hypertension. Blood pressure was recorded by trained nurses using a mercury sphygmomanometer, based on the recommendations of [JNC- VII]. A positive screening test for hypertension was defined as systolic and/or diastolic blood pressure of >/= 140 and 90 mm Hg, respectively. Subjects who had positive screening tests were asked to come on the following day for a confirmation of the reading. Hypertension was considered if there was a persistent reading of systolic and/or diastolic blood pressure of >/= 140 and 90 mmHg after confirmation, or when there was history of a previous diagnosis. 21% of the sample was positive from previous history or screening. After confirmation, the prevalence of hypertension dropped to 15.6%, pre-hypertension was 3.7%, whereas the prevalence of undiagnosed hypertension was 2.8%. The prevalence rose with age. It was higher in women than in men of all age groups and in all sectors of the eastern province, although the mean systolic and diastolic BP was higher in men than women. It was higher with lower education, in widows and divorcees than others [P<0.0001]. The yield of the screening for abnormal blood pressure was high. Systematic follow-up of subjects with abnormal screening results is vital

Arthroscopic removal of the impinging acromio-clavicular joint spur

29 patients with impingement syndrome of the shoulder were studied between January 2005 and February 2006. Main cause of impingement of the supraspinatus tendon was undersurface spurs of the acromioclavicular joint, as demonstrated on X-rays and essentially coronal cuts of MRI. Arthroscopic subacromial decompression together with shaving of the undersurface acromioclavicular joint spurs was performed for all patients. Results were evaluated according to UCLA rating score at an average of 15 months, which, was raised at an average of 50 points. We conclude that pre-operative evaluation of exact cause of impingement syndrome is essential as well as removal of offending cause at arthroscopy

Tibio-femoral attachment site combinations as a determinant for Acl graft impingement

The purpose of this study was to assess graft impingement both qualitatively and quantitatively, with different tibio-femoral combinations. Three tibial [T1-T3] and three femoral [F1-F3] attachment sites resulting in nine different tibio-femoral combinations were studied on 8 fresh frozen cadaveric knees. Bungee cords coated with barium paste were used to simulate the grafts used clinically. Lateral knee radiographs in full extension were done for the cord with each combination. Radiographic impingement was graded according to the following classification: Type [I] no contact with roof. Type [II] contact with roof but no deformation of the cord. Type [III] contact with roof with deformation of the cord. Superlow Fuji films inserted in the femoral notch lying between the roof and the cord with the knee positioned in full extension were used to quantitatively assess graft impingement for each combination. Anterior tibial cord placement consistently led to graft impingement with cord deformation type III radio-graphic classification. Tibial tunnels central in the ACL stump [T2] demonstrated 3 knees classified as type II and 5 as type I. Posterior tibial tunnels [T3] were consistently classified as type I with no contact with the roof. In conclusion, tibial tunnels central in the ACL stump and 7mm anterior to the PCL were non-impinging radiographically, with insignificant contact pressure developing between the roof and graft. It was also apparent that graft impingement was mainly dependent on the tibial rather than the femoral attachment site or combination of both

Overweight and obesity in the eastern province of Saudi Arabia

To describe anthropometric characteristics of participants and the influence of sociodemographic and cardiovascular risk factors involved in the prevalence of obesity in the eastern province of Saudi Arabia. In the year 2004, all Saudi residents in the Eastern province aged 30 years and above, were invited to participate in a community screening campaign for early detection of diabetes and hypertension. Demographic data, medical history, life habits, weight, height, blood pressure, and glucose concentration were recorded using a structured questionnaire. Obesity and overweight were defined by body mass index [BMI] >/= 30 kg/m2 and 25-29.9 kg/m2, respectively. Logistic regression was used to predict the association of the significant factors with the prevalence of obesity. Out of 195,874 participants, the overall prevalence of obesity was 43.8%, while 35.1% were overweight. The prevalence of underweight was 1.3%. The peak prevalence of obesity was observed in the age group 50-59 years. Obesity was higher among women than men, higher in housewives, and among the less educated than others [p<0.0001]. Linear regression analysis showed a strong proportional association of BMI with diabetes, hypertension, triglycerides and cholesterol, and an inverse proportional association with physical activity and smoking. Obesity and overweight constitute an important health problem affecting a high proportion of Saudi population. Addressing associated factors, and enhancing public health education is an important aim to focus on for weight control

community based screening campaign for the detection of diabetes mellitus and hypertension in the eastern province, Saudi Arabia: methods and participation rates

To describe a community-based diabetes and hypertension screening campaign, the percentage of screened positive individuals, identified the participation rate, and the factors affecting the participation. Campaign design and methods: A community-based screening campaign whose main objective was the screening for diabetes and hypertension was conducted in the Eastern Province of Saudi Arabia for three and half months in the year 2004. A structured questionnaire was used. Diabetes mellitus was diagnosed on the basis of repeated detection of a fasting blood sugar equal to or more than 126 mg/dl, and hypertension when the blood pressure was 140/90 mm Hg or more. Of the 650, 000 target population 214, 381 [33%] participated, and 197, 681 questionnaire were completed of the number of individuals screened, 31, 711 [16%] were positive for abnormal blood pressure and /or glucose, and needed confirmation of their results. Only 17296 [54, 5%] of them were referred to health facilities for confirmation of results Conclusion; Community screening campaigns for diabetes mellitus and hypertension is extremely efficient in identifying undiagnosed diabetic and hypertensive individuals. The most successful strategy for the screening and confirmation of results was through PHCCs, especially in the rural areas, where there was good organization and strict adherence to guidelines on methodology

Circulating soluble Fas and Fas antigen tissue expression in human bladder cancer

This study was performed to determine the role of sFas and Fas expression in human bladder cancer. The percussion of schistosomiasis association and correlations between various parameters and tumor progression were evaluated as well. Fifty patients [24 with chronic cystitis and 26 with bladder cancer [20 with transitional cell carcinoma and 6 with squamous cell carcinoma]] were included in this study and fifteen individuals served as normal controls. SFas level in sera was estimated using enzyme linked immunosorbent assay. Fas expression in bladder tissue was immunohistochemically determined. SFas level and% of Fas expression in chronic cystitis and bladder cancer patients were significantly higher than normal controls. Moreover, a significant increase in sFas level and% of Fas expression was detected in chronic cystitis associated with schistosomiasis compared to chronic nonspecific cystitis. SFas level was significantly increased with tumor progression in the invasive group compared to the noninvasive group; whereas,% of Fas expression was comparable in both groups. Moreover, the number of Fas positive cases was significantly high in invasive than noninvasive

molluscicidal efficacy of three products against Biomphalaria alexandrina and Lymnaea natalensis

The toxicity of three local formulated products [Sol EC [mineral oil], Sisi-6 [surfactant] and castor bean oil EC [plant oil]] was tested against Biomphalaria alexandrina and Lymnaea natalensis in two water sources. The results indicated that in dechlorinated water after 24-hour exposure, castor bean oil was the most toxic product against the snails, followed by Sisi-6 and Sol [EC] with LC90 of 250 ppm and 8 ppm against B. alexandrina and L. natalensis, respectively. When Nile water was used after 6-hour exposure, a high concentration of castor bean oil [4 LC90] did not cause 100% mortality of the snails; it was achieved by 2 LC90 of Sisi-6 with Nile water. On the other hand, castor bean oil was more fatal to eggs of the snails [LC90 = 660 ppm] than the other two products. In general, L. natalensis was more susceptible to the experimental products than B. alexandrina

subserosal extramural tunnel for uretral implantation in the Ileal-W bladder: an ideal antireflux Technique for dilated ureters

Anti reflux in ileal pouches could be a real challenge when the ureters are considerably dilated. We adopted in this work the technique of subserosal extra lumenal tunnel 1st presented by Abol-Enein and Ghoneim, which we applied with some modifications to suit the dilated ureters, both in augmentation ileo cystoplasty and after radical cystectomy. The technique was applied in 19 patients in two groups. Group I was 11 patients for bladder substitution after radical cystectomy and group II was 8 patients for augmentation after supra trigonal cystectomy for neurogenic or contracted bladder. Patients were followed for 6 to 36 months by routine lab, ultrasound, intravenous pyelography [renogram for some] ascending and voiding pouchography and urodynamics. In the 38 renal units done by the technique, all with considerably dilated ureters, non was refluxing throughout the follow up period. 2 units in one patient were obstructed and managed primarily endoscopicaly, but later, one ureter needed open surgical correction. We found this technique ideal for dilated ureters even in the Bilharzial thick walled, with no incidence of reflux and assuming the original anatomical appearance of the uretrovesical junction with easy endoscopical manipulation if needed

Skin and subcutaneous tissue underneath flaps for treatment of lymphedema of the lower limbs: Modified technique

In the present study skin and subcutaneous tissue excision underneath flaps was done for the management of 20 cases with moderate and severe lymphoedema of the lower limbs. The follow-up period ranged between 6 months and 3 years. The inclusion of the deep fascia in the base of the flaps [at least 4 cm], enabled to maintain viability of the flaps at the ankle region. Also, the downward pull of the skin and fascia flaps allowed for more excision of skin and subcutaneous tissue at the ankle region. Thirteen patients had good results, five patients had satisfactory results and one case showed no improvement. Major flap necrosis occurred only in one case. The results point out that this approach provides reasonable surgical compromise, reliable improvement and minimal unfavorable post-operative complications compared to the results of previous reports