Biliary vs non-biliary acute pancreatitis: diagnostic prediction and course in Saudi Arabian patients

In a retrospective analysis, all consecutive cases of acute pancreatitis [AP] in Saudi patients admitted to the University Hospitals in Riyadh over the 5-year period 1984-1988 were analysed. There was a total of 59 admissions in 50 patients [31 females and 19 males]. In 74% gallstone was the associated pathology, with females forming 78.4%. The admission plasma concentrations of amylase, glutamic oxaloacetic transaminase [GOT], total bilirubin and alkaline phosphatase were significantly higher in cases of biliary AP compared with non-biliary attacks [p<0.001]. At 48 h, there was a significant drop in the values of amylase [p< 0.001], GOT [p< 0.001], bilirubin [p< 0.01] and alkaline phosphatase [p<0.02] in the biliary pancreatitis group. The clinical course in terms of severity, complications and mortality was, however, not different in the two groups. It is suggested that biochemical parameters should be utilized together with ultrasonography in the early diagnosis and identification of severe cases of gallstone AP so that a more effective mode of therapy such as endoscopic cholangiopancreatography and endoscopic sphincterotomy could be instituted

Acute pancreatitis: experience in a University Hospital in Riyadh, Saudi Arabia

In a retrospectively study, all cases of patients with acute pancreatitis admitted consecutively to the University Hospital in Riyadh over five-year period 1984-1988 were analyzed. There were a total of 104 attacks in 91 patients. Mean patient age was 42.4 years and the female to male ratio was 1.5:1. In 67%, gallstones were the associated cause; idiopathic acute pancreatitis was diagnosed in only 11.5%. Among the 50% [55%] Saudi nationals, two thirds were females and 76% had biliary pancreatitis. Using modified Glasgow severity prediction criteria. 21% of the attacks were designated as "severe disease". Mortality in this series was 3.3%; all deaths occurred in the "severe disease' group and all had nonbiliary acute pancreatitis. Pseudocysts developed in six patients, including a pancreatic abscess in one. This study shows that acute pancreatitis is not a common medical emergency in Saudi Arabia and is predominantly biliary-associated, especially affecting females. This disease seems to follow a more benign course and has lower morbidity than that described from the West

Guar gum in non-insulin dependent diabetes mellitus: a double-blind crossover, placebo-controlled trial in Saudi Arabian patients

We conducted a double-blind crossover, placebo-controlled trial to evaluate the effects guar gum, as a food additive, on gylcemic control, plasma lipid concentration, and body weight in 39 Saudi patients with non-insulin-dependent diabetes mellitus. All subjects were overweight and their diabetes was uncontrolled on diet and maximum doses of oral hypoglycemic agents. Mean fasting plasma glucose [FPG] and glycosylated hemoglobin [H[b]A1] concentrations after treatment with guar were significantly lower than those seen with placebo [FPG: 11.0 +/- 0.042 versus 12.70 +/- 0.53 mmol/L; p< 0.01; H[b]A1: 11.00 +/- 0.35% versus 11.90 +/- 0.30%, P< 0.05]. The postprandial plasma glucose level was also significantly lower when guar was added to an identical test meal than observed with placebo [P< 0.02]. The total plasma cholesterol level decreased from 2.76 +/- 0.21 mmol/L prior to treatment to 5.00 +/- 0.16 mmol/L [P< 0.01] at the end of treatment. There was no significant change in body weight during either phase of the study. Guar treatment was associated with a higher rate of side-effects in our study than have been previously reported, but this rate declined with time and the drug was well tolerated. We found guar to be a safe, useful, and effective adjunct in the management of patients with non-insulin-dependent diabetes mellitus that is uncontrolled with conventional therapy