Assessment of quality of life among head-and-neck cancer patients

Objectives: To assess QOL of different head and neck cancer patients. Materials and Methods: A cross sectional study of 35 subjects with HNC was selected based on the type of cancer. After a background study, 35 subjects were chosen classifying on the type of cancer and were assessed using an interview schedule. Results: Physical as well as emotional score was poor among the group (312.5 and 349.5). The results had a high degree of variation. Conclusion: QOL among HNC patients were concluded to be poor

Acute back pain: a survey of primary health care physicians' awareness and knowledge of "red flag" signs

Background: the failure to detect "red flag" signs in patients presenting with acute low back pain can adversely affect the outcome of management. This can seriously affect the quality of life and productivity of the patient

Objective: the present questionnaire-based study was performed to assess the knowledge and awareness of red flag signs among primary health care physicians managing patients with acute back pain in Riyadh, Saudi Arabia

Materials and Methods: the study sample size was comprised of 80 subjects. The level of knowledge was assessed by means of a new structured self-administered questionnaire. The design of this questionnaire was based on the Agency for Health Care Research and Policy [AHCRP] guidelines for detection of red flag signs. Physicians were asked about red flag signs that indicate the presence of tumor, infection, spinal fracture, or cauda equina syndrome

Results: sixty-eight [85% of total] physicians were aware of red flag signs. Of the 68 physicians who were aware of the red flag signs, 58 [72%] were aware of neurological deficit, 36 [45% of total] were aware of extremes of age [<10 years and >50 years], and 33 [41% of total] were aware of and routinely inquired about the history of spinal trauma, whereas only 24 [30% of total] were aware of and inquired about constitutional symptoms in their patients with acute back pain

Conclusion: although low back pain is extremely common, knowledge and awareness of red flag signs of primary health care physicians managing patients with acute back pain in Riyadh appear to be inadequate. This indicates a lack of adherence to the international guidelines. Specific educational programs should target these deficiencies and increase awareness

Identification of possible glyoxalase II inhibitors as anticancer agents by a customized 3D structure-based pharmacophore model

The glyoxalase system [which consists of glyoxalase-I and glyoxalase-II] is a ubiquitous metabolic pathway involvedin cellular detoxification of the cytotoxic 2-oxoaldehydes. Tumour cells have high metabolic activity which results inincreased cellular levels of such toxic metabolites. Therefore, tumour cells respond to this increase by increasing theactivity of the detoxifying glyoxalase system which makes it a viable target for the development of anticancer drugs.This work represents the first study that aims to find none-glutathione-based inhibitors of the glyoxalase-II enzyme aspotential anticancer drugs based on computer aided drug design. In this study, a customized 3D structure-basedpharmacophore model was generated which is a hybrid of three complementary 3D pharmacophores. Since glyoxalase-II is a binuclear zinc metalloenzyme, a customized Zn-binding pharmacophoric feature was added to the generatedpharmacophore to aid the search for selective glyoxalase-II inhibitors through virtual screening of small-moleculesdatabases. Retrieved hits were extensively filtered then docked into the binding site of the enzyme. In order tomaximize the chances of finding potential inhibitors of glyoxalase-II, docked hits were rescored using different scoringfunctions and consensually scored. Ten of the top ranked hits were selected as potential glyoxalase-II inhibitors

Normal knee angles in the adult Saudi population

To study knee angles in the adult Saudi population and compare their values to the published data from other populations. Antero-posterior bilateral radiographs of 333 normal knees of 120 males and 213 females, with age range of 18-65 years, were studied retrospectively at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from January 2009 to December 2009. Tibiofemoral [TFA], lateral distal femoral [LDFA], and lateral proximal tibial [LPTA] angles were measured and the mean of each angle was calculated. The relationship between each angle and age, gender, and side of the body was tested, and compared with the international figures. The mean for TFA in Saudis was 174.41 degrees, LDFA was 90.07 degrees and LPTA was 89.42 degrees. All angles were not significantly related to gender. Significant relations existed between TFA and side of the body, and between LDFA and age. Variations in means and ranges of knee angles between the Saudi and other populations were determined. A significant difference existed between means of TFA, LDFA, and LPTA of Saudis and those of Caucasians, between mean of TFA of Saudis and that of Chinese, and between mean of LPTA of Saudi males and that of Chinese males. The means of TFA of selected age groups in Saudis differed significantly when compared to those in the corresponding age groups in Japanese and Australian Caucasians. Knee angles are like many other skeletal angles that may have ethnic variation between different populations. The study reinforces the need for reference values of knee angles in a given population

Transient osteoporosis of the hip/bone marrow edema syndrome with soft tissue involvement: a case report

Transient osteoporosis of the hip [TOH] is a rare condition mainly affecting pregnant women in their third trimester and middle aged men. We report a case of TOH/Bone marrow edema syndrome in pregnancy with involvement of the surrounding soft tissues on magnetic resonance image, which has not been previously reported. The presence of such edema in the soft tissues may help to differentiate this condition from early avascular necrosis of the hip, and may also provide an insight into the pathogenesis of the condition. The reported patient was treated conservatively and fully recovered

Percutaneous vertebroplasty complications

Percutaneous vertebroplasty, among various other options, has become a mainstay in the management of osteoporotic and malignant vertebral fractures. The purpose of this article is to describe complications arising from the procedure, which can be classified as mild, which may include a temporary increase in pain and transient hypotension; moderate, including infection and extravasation of cement into the foraminal, epidural or dural space; and severe such as cement leakage in the paravertebral veins, leading to pulmonary embolism, cardiac perforation, cerebral embolism or even death. Vertebroplasty is not a procedure without complications. The article defines them and describes methods to minimize them

Penile necrosis due to calciphylaxis in a patient of end stage renal disease

A case of a 72-year-old diabetic, hypertensive male with end stage renal disease as a result of the underlying condition of calciphylaxis, presenting with gangrene of the glans penis is reported. In calciphylaxis, calcification of small and medium-sized arteries occurs, which may result in ischemia and gangrene. A computed tomography scan of the lower abdomen, pelvis, and the upper thigh was performed, which showed diffuse and extensive calcification of the walls of the small and medium-sized arteries, with almost complete obliteration of the lumen of the small arteries. A 3-dimensional reconstruction of the penis using volume rendering technique, demonstrated the ulceration of the glans penis in an exquisite manner. The appearance is so peculiar that no histological confirmation is needed. A review of relevant literature related to the etiopathogenesis, radiological findings, treatment, and prognosis is also discussed

Usefulness of procalcitonin and some inflammatory parameters in septic patients

To evaluate the efficacy of procalcitonin [PCT] to identify critically ill patients with sepsis in comparison with leukocyte count, body temperature, C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], and interleukin-6 [IL-6]. We performed our prospective observational study in 75 patients admitted with acute systemic inflammatory response and suspected infection. The final diagnosis was systemic inflammatory response syndrome [SIRS] in 38 patients, sepsis in 22, severe sepsis in 10, and suspected viral sepsis in 5. Blood samples were taken on the first day of hospitalization in Al Mwasaa Hospital, Damascus, Syrian Arab Republic, from July 2006 to January 2007. We estimated the relevance of the different parameters by using the t-test, Pearson's correlation coefficient, and area under the receiver operating characteristic curves. Mean PCT concentrations on admission were 0.37 ng/ml for SIRS [n=38], 3.31 ng/ml for sepsis [n=22], 40.2 ng/ml for severe sepsis [n=10], and significant differences existed in plasma PCT levels among the 3 groups. The PCT was the only distinguisher between sepsis and non-infectious SIRS, whereas it exhibited the best discriminative power between sepsis and severe sepsis with an area under the curve [AUC] of 0.966 followed by IL-6 with an AUG of 0.836. The PCT also do not correlate with any of the studied parameters within the SIRS group and the sepsis group. Assessing PCT levels is a more reliable way to indicate sepsis in newly admitted patients with systemic inflammations compared with conventional inflammatory parameters and IL-6

Susceptibility to and severity of tuberculosis is genetically controlled by human leukocyte antigens

To assess the role of HLA polymorphism in the susceptibility to tuberculosis in Syria. We used the polymerase chain reaction with sequence specific primer method to study the DRB1* locus in 147 Syrian patients with positive sputum smear or sputum culture for Mycobacterium tuberculosis strains, and 209 Syrian healthy matching individuals with negative tuberculin skin test. Patients were randomly recruited from the Damascus Health Center of Tuberculosis and Pulmonary Diseases during 2005-2007. The study was carried out at the Laboratory for Research and Genetic Consultations, in the Faculty of Medicine of Damascus University, Damascus, Syria. A significant decrease of the DRB1*11 allele was observed in patients compared to controls [34.7% in patients versus 51% in control, odds ratio [OR]=0.51, p=0.003, corrected p=0.04], whereas the DRB1*04 allele was increased in patients [38.8% in patients versus 26.4% in controls, OR=1.77, p=0.01, corrected p>0.05]. This increase became significant when individuals with the DRB1*11 allele were removed from both patients and controls [33% in DRB1*11 negative patients versus 17% in DRB1*11 negative controls, OR=2.5, p=0.003, corrected p=0.03]. In addition, pulmonary cavitation was significantly increased in the DRB1*04 positive patients compared to patients without the DRB1*04 allele [33% in DRB1*04 positive patients versus 16% in DRB1*04 negative patients, OR=2.7, p=0.04]. The DRB1*04 allele is associated with susceptibility to pulmonary tuberculosis, whereas DRB1*11 is associated with protection from pulmonary tuberculosis in the Syrian population. In addition, cavity formation in patients with pulmonary tuberculosis seems to be favored by presence of the DRB1*04 allele

Magnetic resonance imaging evaluation of temporomandibular joint derangement in symptomatic and asymptomatic patients

To highlight the importance of MRI in evaluation of the tempromandibular joint [TMJ]. The MRI examination was performed at King Khalid University Hospital, Riyadh, Saudi Arabia with the approval from the local ethics committee, on 34 patients [68 joints] between January 2006 and November 2007, in which 10 were considered asymptomatic subjects [control]. The remaining had symptoms and signs of TMJ pain or dysfunction, including limitation of movement and clicking. All our subjects were examined in both closed and open mouth position. Images were obtained by 1.5-T MRI system, in oblique sagittal plane utilizing 3 pulse sequences including T1 and T2 spin-echo, and spoiled gradient recall sequences. The evaluation of the meniscal disc configuration and position was carried out by 2 radiologists. Sixteen out of 20 joints of asymptomatic subjects were normal. In the other 2 asymptomatic subjects, the MRI showed anterior disc displacement with reduction in 3 joints, and degenerative changes in 2 joints. Out of the 48 symptomatic joints, 26 [45%] joints were considered normal, while the other 22 joints showed anterior dislocation without reduction. Degenerative joint disease was also seen in 18 joints. The MRI with the use of surface coils markedly improves the delineation of internal derangement of the TMJ, therefore, it enhanced the capability of detecting certain abnormalities, which proved to have a statistical significance in symptomatic patients

Bilateral chronic quadriceps tendon tear secondary to repeated seizures

Chronic bilateral quadriceps tendon tear is an uncommon clinical entity when it is associated and caused by epilepsy resulting in repeated falls. We describe here a young male who presented with the inability to walk and a long history of seizures. The clinical exam, with plain radiographs and magnetic resonance imaging allowed accurate diagnosis as well as proper management

Bohlerls and Gissane's angles of the Calcaneus in the Saudi population

The purpose of this study is to measure Bohler s angle [BA] and Gissane s angle [GA] in the Saudi population and compare their values to the published data. Lateral plain radiographs of 229 normal feet and ankles of 158 females and 71 males, with age range of 15-72 years, were studied retrospectively at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between 2002 and 2003. Bohler's angle and GA were measured and the mean and standard deviation of each angle were calculated. The relationship between each angle and age, gender, and side of body was tested, and compared to international figures. The mean BA in the Saudi population was 31.21 degree with a range of 16-47 degree. The mean GA was 116.16 degree with a range of 96-152 degrees. Bohler's angle and GA are not significantly related to age, gender, or side of body. Moreover, the range of both angles was wider than that reported in the literature. The study shows the difference between the Saudi and various other populations in regard to BA and GA, and reinforces the need to establish the normal ranges of BA and GA in a given population