Severe tracheomalacia secondary to double aortic arch. Any role in posterior aortopexy? A case report

Tracheomalacia is the abnormal collapse of the tracheal lumen and is common after cardiac compression. In the severe types, tracheomalacia can lead to significant morbidity, especially if encountered in a critical area, such as the distal part of the trachea, immediately above the tracheal bifurcation. We report a case that did not improve after cardiac surgery with persistent airway narrowing of more than 90%, requiring ventilatory support for a year. The case was difficult to manage, but the patient eventually showed a significant improvement after a posterior aortopexy that helped a lot in weaning him off the ventilator with a residual persistent audible wheeze and recurrent chest exacerbation. The diagnostic and therapeutic options for the case will be discussed

Pulmonary alveolar microlithiasis in Saudi child: a case report

Background: Pulmonary alveolar microlithiasis [PAM] is a rare but not uncommon disease; it showed worldwide distribution either familial or sporadic, the most reported cases in Europe, especially in Turkey. The presence of round shaped little bodies containing concentric calcareous lamellas in pulmonary alveolus is the hallmark of the disease. With this study, we report a case of PAM in Arabic descent, a Saudi child, who represented the most characteristics of the disease in dissociation between definite radiological pattern of the lungs and relatively poor clinical symptoms

Case Presentation: A-9-year-old Arabic female, presented with occasional nonproductive cough for one year, the patient suspected milliary TB and received antituberculous therapy

Examination: Revealed well pleasant child with finger clubbing and clear chest. The patient followed for two years, with marginal deterioration in her general condition

Conclusion: Here, we reported a sporadic case of PAM in Saudi child that presented with nonspecific clinical picture, which resulted in misdiagnosis and consequently improper management. The case proves the slowly progression of the disease

Overview of allopurinol decisions in primary care: a narrative review

Background: Allopurinol is a type of drug called a xanthine oxidase inhibitor. It functions by lowering the production of uric acid in the body. It can be found in the kind of an oral tablet. Generalist physicians, specifically general internists and primary care physicians, are usually the first to see individuals with gout and for that reason play an essential role in the diagnosis and management of these patients. Gout is mostly managed in primary care and lasting treatment aims to reduce serum uric acid degrees with using allopurinol. Urate lowering therapy is indicated in patients who have had an acute gout attack and whose uric acid level remains high, increasing the risk of a subsequent attack. The effect of allopurinol on uric acid level is dose dependent and variable

Aim of the Study: In the present review, we aimed at discussing the indications of Allopurinol in primary care along with its benefits and side effects which should be considered by patients and physicians before prescribing it

Methods: Narrative review was conducted using electronic database such as; PubMed/Medline, Embase, Google scholar, for relevant articles related to our concerned topic which is about the usage of allopurinol in primary care and methods that family doctors use to make a decision about the usage, published up to 2018

Conclusion: The benefit-risk balance of allopurinol should be carefully assessed with respect to the patients' condition and medical profile before prescription in the PCU