Benign acute childhood myositis in the eastern region of Kingdom of Saudi Arabia; a 5-year experience

To assess the epidemiological, clinical and laboratory characteristics, and outcomes of BACM in children diagnosed at a teaching hospital in the eastern province of the KSA. A retrospective study of 28 patients admitted to the hospital with the diagnosis of BACM was carried out at King Fahd Hospital of the University, AlKhobar, Kingdom of Saudi Arabia [KSA], from January 2008 to December 2012. Demographics, clinical characteristics, laboratory findings and patients' responses were analyzed. Thirty episodes were reported over 5 years with incidence of 3.17 per 100,000. The male to female ratio was 6:1. The mean age was 6 years. A seasonal peak during the winter months was observed. The major symptoms were fever, inability to walk in all the patients [100%] and symptoms of upper respiratory tract infections found in 70%. Major clinical findings were the normal deep tendon reflex and calf muscle tenderness in 76.6% and 100% respectively. The prominent laboratory findings were the high creatine phosphokinase [CPK] and leukopenia in 100% and 60%, respectively. Our findings showed that the clinical and epidemiological features associated with BACM, in the KSA, have the similar pattern of other studies from different regions in the world. A nationwide survey, however, is necessary to investigate the overall incidence, risk factors and the outcome of BACM in the KSA

Clinical description of human bocavirus viremia in children with LRTI, Eastern Province, Saudi Arabia

Human bocavirus [HBoV] is a major etiology of lower respiratory tract infection [LRTI] in young children. We tested 149 patients admitted to King Fahd Hospital of the University with diagnosis of LRTI. Viremia caused by the different studied viruses was detected in 31.5% of the total cases by Real-time Polymerase chain reaction. We report five patients who were positive for HBoV in serum samples. Clinical presentation ranged from mild to severe disease as one of them required admission to intensive care unit. Wheezing was a striking feature in most of our patients, but fever was not a consistent finding

Knowledge about bronchial asthma management in primary health care physicians in Al-Khobar city, Saudi Arabia

The prevalence of bronchial asthma [BA] is increasing in the Kingdom of Saudi Arabia. Primary health care [PHC] centers follow the national protocol, which is based on the severity of the disease for the management of asthma. The Saudi initiative for asthma [SINA] management adopted from the global initiative for asthma guidelines, which was recommended by several recent studies, is based on the control level of asthma. To assess the knowledge of PHC physicians and family medicine [FM] residents in Al-Khobar, about the management of BA. A cross-sectional study was conducted in all PHC centers and the university FM clinic in Al-Khobar. All PHC physicians and 3[rd] and 4[th] year FM residents were included in the study. A self-administered questionnaire developed according to SINA guidelines was used to assess theoretical knowledge of BA, and a predesigned checklist was used to assess the different inhaler techniques. Scoring was established and collected data were analyzed. Only 8% of the sample had good theoretical knowledge of BA; 41% had poor knowledge. The knowledge of the residents was better than that of the PHC physicians. The mean knowledge score was significantly better among those using guidelines compared to the rest. About 23% had good knowledge of inhaler techniques. Knowledge of PHC physicians and FM residents about dry powder inhalers was deficient, and PHC physicians had little knowledge of metered dose inhalers with spacers. The knowledge of physicians about the management of BA was deficient. The national guidelines based on the level of control for asthma management should be updated and physicians given periodic training

continuous glucose monitoring system [CGMS] in patients with beta-thalassemia major

Background: Blood transfusion-dependent beta Thalassemia Major [BTM] patients are at risk of hemosiderosis. Hemosiderosis of pancreas results in impaired glucose homeostasis tolerance and diabetes mellitus [DM]. Since glycosylated hemoglobin has limited role in patients with hemoglobinopathies, this study was conducted as a first attempt worldwide to understand glucose homeostasis and evaluate efficacy of Continuous Glucose Monitoring [CGM] system as a diagnostic tool of abnormal glucose homeostasis in these patients

Materials and Methods: A case series study of six non-diabetic, transfusion-dependent beta-thalassemia patients aged 9-13-year-old. Clinical and laboratory data were collected on admission for their monthly transfusion. Patients were connected to CGM systems for one day

Findings: Using CGM and based on American Diabetes Association guidelines, three patients were found to have abnormal glucose levels of diabetic range. The other three showed impaired glucose tolerance. Among all patients, glycosylated hemoglobin [HbA1C] readings have an inverse relationship to CGM and calibration readings

Conclusion: CGM could be a promising tool for evaluating BTM patients. Larger studies are recommended

Pediatric pulmonary services in Saudi Arabia

The purpose of this study was to assess the available pediatric pulmonary services, in terms of workforce, resources, and distribution across Saudi Arabia. This would help in proper utilization of resources and direct future planning. A cross-sectional survey among pediatric pulmonologists registered in the Saudi Thoracic Society. Among 43 practicing pediatric pulmonologist in Saudi Arabia, 29 have responded to the survey [response rate of 67.4%]. The majority of practicing pediatric pulmonologists were young graduates with less than 5 years' experience [44.8%] and were North American training programs graduates [69%]. The majority of the respondents [51%] were located in Riyadh, 27% in Jeddah, 14% in the Eastern region and 3% in Madinah and Al-Majma'a. Most of the respondents had access to basic diagnostic tools required in the subspecialty, a majority of them [85%] lack dedicated pediatric pulmonary function laboratories. Nearly, 80% of the hospitals performed less than 50 flexible bronchoscopies/year. Pediatric pulmonology is a growing subspecialty in Saudi Arabia with well-trained and experienced physicians. Our study represents an overview of the available pediatric pulmonology services in Saudi Arabia, which would help in future planning and better utilization of the available resources

Bronchial atresia in a neonate with congenital cytomegalovirus infection

Bronchial atresia [BA] is characterized by a mucus-filled bronchocele in a blind-ending segmental or lobar bronchus with hyperinflation of the obstructed segment of the lung. We describe a neonate who presented on his 9th day of life with respiratory distress. Chest computed tomography showed a soft tissue density involving the right middle lobe [RML]. RML lobectomy confirmed the diagnosis of BA. Cytomegalovirus was detected by polymerase chain reaction in blood, urine, and tracheal aspirates which may provide further insight into the pathogenesis of BA