High volume retrograde portography for better discrimination of the portal vein during TIPS procedure.

Background: Imaging of the portal vein prior to puncture for TIPS is essential. Purpose: With this study, we examined a modified retrograde portography with regard to the reliable representation of the portal vein. Material and Methods: Prospective evaluation of 65 TIPS interventions with regard to the delimitation of the portal vein and the exact parameters of retrograde portography such as catheter diameter and contrast medium volume per injection. Results: Retrograde portographies with a large-lumen catheter (10 F) and a large contrast medium volume (40 mL) were performed in 35/63 patients with significantly better delineation of the portal vein than when using 5 F catheters with 10 mL contrast medium. Conclusion: The so-called high volume retrograde portography leads to better delimitation of the portal vein during TIPS application.

Level of health awareness of Saudi patients on renal replacement therapy.

OBJECTIVE: To assess health awareness in patients on renal replacement therapy (RRT) in Saudi Arabia. METHODS: This is a cross-sectional survey using a 22-item questionnaire in 143 randomly selected adult RRT patients [40 on hemodialysis (HD), 61 on peritoneal dialysis (PD) and 42 with renal transplant (TX)]. The study was carried out at King Abdul-Aziz Medical City, Riyadh in April 2006. The questionnaire was designed to evaluate patients' knowledge in 5 areas: 1. causes of renal failure, 2. biology of the kidneys, 3. symptoms of kidney disease, 4. therapeutic options available, 5. national kidney patients support facilities. The association between the level of awareness (the percentage of correct answers) to different demographic factors was assessed. RESULTS: Three fifths of the patients had less than secondary education. The average mark for correct responses of all patients was 45.9% with a highest (58%) for the category on biology of the kidney and lowest (36.8%) for national kidney patients support facilities. The PD group had the highest score (54.4%) followed by HD (44.3%) and finally TX (35.1%). CONCLUSION: The level of our patients; health awareness is lower than satisfactory. Level of education seems to be a contributory factor.

Socio-demographic study of major depression in Qatar.

OBJECTIVE: To evaluate the socio-demographic characteristics of major depressive disorders in the State of Qatar, which has a high percentage of expatriates. METHODS: Out of 7460 outpatient psychiatric clinic attendees at Hamad Medical Corporation, Doha, Qatar, between November 1993 through December 1998, 2483 patients met the diagnosis of depressive disorder. Prospectively, we interviewed 1114 patients who met the diagnosis of Depressive Episode and Recurrent Depressive Disorder according to International Classification of Disease-10 (major depressive disorder according to Diagnostic and Statistical Manual-IV). The data was coded and analyzed by using Statistical Package for Social Sciences under windows. RESULTS: Thirty-three point three percent of the patients met the diagnosis of depressive disorder and those with major depressive disorder were 14.9% of the total. Of those with major depressive disorder approximately 2/3rd had a single depressive episode and one 3rd had recurrent attacks. Major depressive disorder is significantly equal in both sexes, married patients of both sexes have a significantly higher rate than others. There is a remarkable consistent rise in the frequency of recurrent depression, compared with significant decline in frequency of single depression with age. Major depressive disorder is significantly more among the unemployed. Among the employed, skilled workers have significantly higher rate of major depressive disorder than non-skilled and professionals. CONCLUSION: In nonhomogeneous societies such as Qatar and the Arabian Gulf in general, where men outnumber women, the distribution of major depressive disorder among outpatients is inconsistent with other studies. Age, sex and occupation are the important risk factors for major depressive disorder. Marriage has no protective effect in major depressive disorder.