Coronavirus Disease in Children: A Single-Center Study from Western Saudi Arabia.

INTRODUCTION: Local data in Saudi Arabia regarding pediatric SARS-CoV-2 infection is limited. This study is aimed at adding insight regarding the effect of the novel coronavirus on pediatric patients by studying the presentation, laboratory parameters, and disposition of SARS-CoV-2-infected pediatric patients in one center in Jeddah, Saudi Arabia. Methodology. A retrospective study was conducted at the International Medical Center (IMC) in Jeddah, Saudi Arabia, to assess features of pediatric patients admitted with COVID-19 from April 2020 to September 2020. RESULTS: A total of 43 patients were found to meet the study inclusion criteria. The most common presenting symptom was fever (53.5%) in study participants followed by complaints of cough, runny nose, and shortness of breath (37.2%). Lymphocytopenia was evident among 60% of those studied. Elevated C-Reactive Protein was remarkable in 24.9%. More than half of those (53.5%) studied required only supportive treatment. CONCLUSION: COVID-19 disease for the most part is mild in children with a varying clinical picture and nonspecific laboratory parameters. Further, large-scale national-based studies are needed to help in the early identification of pediatric cases at risk of complication due to COVID-19 infection hence providing proper and timely management, identifying population-specific disease pattern and perhaps targeted immunization.

Awareness regarding childhood asthma in Saudi Arabia.

OBJECTIVE: Assessing the knowledge and awareness of the Saudi society about bronchial asthma in children. METHODS: Structured questionnaires were randomly distributed to 1039 Saudi Arabians in May 2014 at Jeddah, Riyadh, and Dammam. RESULTS: The awareness of bronchial asthma questions showed that 67% of total sample thought that it could be a fatal disease, and only 13.2% thought that there is a difference between bronchial asthma and chest allergies in children. 86.1% thought that the symptoms of bronchial asthma include dyspnea and nocturnal cough, and 45.7% thought that fever, a runny nose and throat inflammation are not symptoms. 60.2% thought that infectious respiratory diseases may increase bronchial asthma progression. In addition, 40% thought that the use of antibiotics doesn't help in diminishing bronchial asthma complications, and some thought that the patient can stop medication after an acute asthma attack. 34.1% thought that inhaled medication for asthma doesn't cause addiction. Very highly significant results are shown between bronchial asthma knowledge and age, the level of education, marital status, and if the individual knows a person who suffers from bronchial asthma (P < 0.001). There are positive correlations between bronchial asthma knowledge and age, marital status, and level of education (r = 0.152, 0.150, 0.197), respectively. CONCLUSION: The study demonstrated that bronchial asthma knowledge in the Saudi Arabian population is insufficient, and efforts should be carried out to spread bronchial asthma management.

Pediatric pulmonary services in Saudi Arabia.

OBJECTIVE: 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. METHODS: A cross-sectional survey among pediatric pulmonologists registered in the Saudi Thoracic Society. RESULTS: 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. CONCLUSION: 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.

Vaccination with heat-shocked mononuclear cells as a strategy for treating neurodegenerative disorders driven by microglial inflammation.

Naturally occurring T regulatory cells targeting epitopes derived from various heat shock proteins escape thymic negative selection and can be activated by vaccination with heat shock proteins; hence, vaccination with such proteins has exerted favorable effects on rodent models of autoimmune disorders. A more elegant way to achieve such vaccination, first evaluated clinically by Al-Harbi in the early 1990s, is to subject mononuclear cells to survivable heat shock ex vivo, incubate them at physiological temperature for a further 24-48 h, and then inject them subcutaneously; anecdotally, beneficial effects were observed with this strategy in a wide range of autoimmune and inflammatory conditions. There is growing evidence that M1-activated microglia play a primary or secondary role in the pathogenesis of numerous neurodegenerative diseases, as well as in major depression. T regulatory cells, by polarizing microglial toward a reparative M2 phenotype, have the potential to aid control of such disorders. It would be appropriate to test the heat-shocked mononuclear cell vaccination strategy in animal models of neurodegeneration and major depression, and to evaluate this approach clinically if such studies yield encouraging results.

Congenital vitamin D deficiency: a rare etiology of an acute life threatening event in early infancy.

Infants born to mothers with deficiency of vitamin D and/or calcium due to cultural modifications in their diets, life style and clothing habits, are at risk of developing early and fatal sequelae of hypocalcemic vitamin D deficiency. We present a 44-day-old infant with hypocalcemia secondary to congenital vitamin D deficiency, who presented as a recurrent Acute Life Threatening Event (ALTE) resulting in an unexpectedly prolonged intensive care course. This report suggests that evaluation of vitamin D status should be included as part of the workup of ALTE and we describe evidence-based preventive measures for both mothers and infants who are at risk for vitamin D deficiency.

Intensive behavioral therapy for primary enuresis.

OBJECTIVE: To assess the effect of intensive behavioral therapy on Saudi children with primary enuresis. METHODS: Twenty-six children, aged 6-14-years, presented with complains of bed wetting during a 12-months period from January 2001 through to January 2002, ArAr Central Hospital, Kingdom of Saudi Arabia were studied in an interventional, non-randomized trial without control. After complete verbal autopsy, physical examination and laboratory investigation, they were offered intensive behavioral therapy. They were evaluated for response, regularity, esteem and recurrence of enuresis. RESULTS: Mean age of the study group was 9.6-years (SD = +/- 2.6) and boys were affected almost twice of girls (P<0.05). Family history, social history and school performance did not show any significant (P>0.05) association with enuresis. Sixty point five percent were regular and out of those 27.9% never missed any visits. 91.7% were completely dry out of regular patients. There was 75% success rate in those, who visited 4-8 times while 25% in those, who visited 1-3 times. Ninety-six percent of the parents and 80.7% of the children were fully satisfied with this therapy. Socio-economic status seems to play a significant (P<0.05) role in regularity of follow up and response to behavioral therapy. CONCLUSION: This result shows an excellent response to intensive behavioral therapy in primary enuresis if the follow up is regular.