Maternal knowledge and use of folic acid among Saudi females

To explore and find out the level of awareness regarding folic acid's [FAs] importance, current use, and timing of administration among pregnant Saudi females. This is a cross-sectional study conducted randomly among women aged 18-45 years old, attending the Antenatal and Gynecology Clinics at the Maternity and Children's Hospital, Al-Qassim, Kingdom of Saudi Arabia from January to November 2012. A total of 1250 subjects were approached, and 1000 women expressed their verbal consent to participate. The questionnaire consisted of 17 items, and results were analyzed using univariate and multivariate analysis. A total of 88.4% of women were aware of FA. However, only 4.4% of them took FA before pregnancy. Compared to highly educated women [20.4%], only 5% of illiterate women use FA during the first trimester of their pregnancy. Univariate and multivariate analysis showed that educational level had a significant association with FA awareness and use [p=0.001; odds ratio: 0.000; 95% confidence interval: 1.001 to 1.080]. Most women recall hearing of FA from their doctors. Only 48 women reported a history of a previous child with congenital anomalies, and 4 of them [8.3%] of them used FA before pregnancy. We found that only 4.4% of the studied women use FA in their preconceptional period. The higher the educational level, the more the knowledge, and frequent use of FA. Poor level of awareness among lower educated woman requires medical authorities to broadcast the importance of FA, and there may be a need to fortify food with FA

Amplatzer septal occluder and atrioventricular block: a case report and literature review

Transcatheter closure of secondum atrial septal defect [ASD] is an alternative option to open heart surgery with good short and long-term outcomes. For this purpose, the Amplatzer septal occluder [ASO] device is widely used. Arrhythmias are known complications of ASD device closure including atrial ectopy and heart block. We report a seven-year-old female patient who developed second degree atrioventricular block [AVB] within few hours after ASD device closure using ASO device. At the seventh post-procedure day; while under close observation; patient regained sinus rhythm which was maintained thereafter. A 3-day course of prednisolone was given

Transcatheter closure of patent ductus arteriosus in infantile form of scimitar syndrome with a type II amplatzer ductal occluder

We report a unique case of infantile form of Scimitar syndrome with a patent ductus arteriosus and pulmonary hypertension. The PDA was closed percutaneously using the new Amplatzer Ductal Occluder device type II

Outcome of Norwood and Damus-Kaye-Stansel procedures for univentricular congenital heart anomalies

To review the experience with Norwood and Damus-Kaye-Stansel [DKS] staged repair in the management of hypoplastic left heart syndrome [HLHS], or functional single ventricle [FSV] with systemic outflow tract obstruction [SOTO]. A retrospective study was conducted from a single center from January 2001 to September 2007 at the Cardiac Sciences Department, King Abdulaziz Cardiac Center, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. The cardiac departmental database was reviewed, together with the echocardiographic findings. Demographic data representing age and weight at operation, gender, cardiac anatomy, non-cardiac abnormalities, and operative details were collected. Twenty-eight patients with a diagnosis of HLHS were included in the study. The mean +/- SD for weight was 3.4 +/- 0.85kg and 32 +/- 37 days for age. All infants at our institution who underwent a Norwood or DKS surgery for HLHS, or other forms of FSV with SOTO were included. All included patients underwent first stage palliation consisting of either a classical Norwood procedure in 6/23 [21%] patients, or a modified Norwood with right ventricle to pulmonary artery [RV-PA] conduit in 22/28 [79%] patients. After first stage palliation, 23 patients [82%] survived, and all but one underwent second stage palliation with bidirectional cavopulmonary anastomosis [BCPA]. The survival rate after second stage repair was 91%. Subsequently, 4 patients completed a third stage Fontan with 100% survival. All deceased patients had HLHS. The Norwood procedure is applied to a heterogeneous group of patients with variable outcomes in certain subgroups. Patients with HLHS palliated with the Norwood procedure are at a greater risk for morbidity and mortality compared to those with other forms of FSV with SOTO