Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia

The aim of this study was to assess the prevalence of neuropathic pain among patients suffering from chronic low back pain using the Leeds assessment of neuropathic symptoms and signs [LANSS] pain scale. This was a pilot study collected from 10 centers in the Middle East Region, with each center enrolling 10 patients between November 2004 and January 2004. In total, 100 patients with chronic low back pain were included in the study. The LANSS clinical assessment score was used to assess the presence of neuropathic pain. Patients with score >/= 12 were considered to have neuropathic pain, while patients with score a less than 12 were considered as having nociceptive pain. We found that 41% of the chronic low back pain patients had neuropathic pain and 59% had nociceptive pain. The ability to identify neuropathic pain mechanisms should lead to individualized treatment resulting in improved pain control in this group of patients with chronic low back pain

Insulin oedema in children: a report of two cases and review of literature

Two diabetic children developed generalized oedema and hepatomegaly soon after treating their ketoacidosis and improving their blood glucose levels. The diagnosis of insulin oedema was based on the exclusion of other major causes of oedema, its temporal relationship to improved diabetes control and its transient and relatively benign nature. Various pathophysiological mechanisms including the sodium and water retention properties of insulin are reviewed. Insulin oedema is usually self-limiting, though a short course of diuretics could be used in severe cases

clinical presentation of childhood diabetes mellitus in Riyadh, Saudi Arabia

Over a 2-year period, 428 diabetic patients were admitted to King Khalid University Hospital, Riyadh, Saudi Arabia. Of these, 106 [24.8%] had Type I [insulin-dependent] diabetes mellitus. Of the total diabetic admissions 29 [6.8%] were children under 12 years. Diabetic children formed 0.6% of the total paediatric admissions. Analysis of 60 diabetic children below 12 years of age registered in the paediatric diabetic clinic over a 4-year period, showed that males were more frequent than females. Ten patients had an onset in the second year of life. The family history was positive in 34 [56.7%] cases, and 11% of the familial cases were in first degree relatives. The parental consanguinity rate was 20%. One child each presented with brucellosis, typhoid fever and infective hepatitis at the onset. There was a tendency to misdiagnose children presenting under 1 year as gastroenteritis or pneumonia. Two children presenting with gross hepatomegaly created diagnostic problems. Almost 93% of patients presented within 1 month of the onset of symptoms and 28% in less than 1 week. At the onset, 33 [55%] of the patients had ketoacidosis, four of whom were comatose. Only eight [32%] of 25 children seen at onset went into remission. Type I [insulin-dependent] diabetes mellitus, is we believe more common than has been reported previously from Saudi Arabia. More studies are needed to confirm this impression

Outpatient management of childhood diabetes: experience of a pediatric diabetes clinic at King Khalid University Hospital, Riyadh

This article described the first 4 years' experience of a clinica for children with diabetes which was established in 1983 and was run by a team. Sixty children below 12 years of age were registered during this period, 34 boys and 26 girls. All the patients and their parents were given an educational program at first contact and thereafter, an even the illiterate parents were trained early. Variations in the availability of insulin's and/or insulin syringes created confusion among parents. Dietary misconceptions were common, and dietary instructions were more difficult to impose than elsewhere; as a result, almost 31.1% of children were on a free diet. Almost 94% of patients were trained on home blood glucose monitoring. Out of 45 patients analyzed, 26 [61.9%] were doing it regularly and 12 [28.6%] irregularly; four [9.5%]had stopped is completely. In none of the patients was urine testing [stopped completely. The mean glycoasted hemoglobin in the patients was 11.5%. Parnets' training and a phone call system helped prevent hospitalization of children. On the basis of this experience, a series of recommendations have been formulated to assist children and their parents in the management of childhood diabetes