Tetany in a Young Female Not Resulting From Hypocalcemia.

Here, we report on a case of a 24-year-old female who is previously medically healthy. She was admitted with a case of gastroenteritis. During her hospitalization, we noticed that the patient's wrists and metacarpophalangeal (MCP) joints were flexed, with her bilateral proximal (PIP) and distal (DIP) interphalangeal joints extended. Furthermore, she exhibited positive Chvostek and Trousseau signs. Her clinical features were consistent with acute tetany; however, she was demonstrating normal levels of calcium. Other laboratory results were positive for severe metabolic alkalosis and hypophosphatemia. Her signs and symptoms resolved completely after one dose of intravenous calcium gluconate. This case is notable because tetany alongside normocalcemia is a rare condition. Therefore, the immediate management of such cases is crucial.

Depression Screening for the Geriatric Population Visiting Primary Healthcare Centers in the Eastern Region of Saudi Arabia.

Background Depression is considered one of the most common psychiatric disorders that affects more than 260 million people in all age groups worldwide. Yet, among the geriatric population, in which it can show nonspecific symptoms, depression can be easily underdiagnosed. The objectives of this study are to assess the prevalence of depression among the geriatric population in primary healthcare centers and to estimate the effects of different sociodemographic and medical factors. Methodology A total of 408 patients aged 60 years or older were approached in the primary healthcare centers of the eastern region of Saudi Arabia. Using the Patient Health Questionnaire-9, patients were either interviewed or filled the questionnaire by themselves. Questions about sociodemographic data and medical and medication histories were included in the questionnaire. Results Of the 408 participants, 173 (42.4%) reported depressive symptoms; 115 (28.2%) of the participants had mild depression, 50 (12.3%) had moderate depression, and 8 (2%) reported moderately severe depression. Correlates of depression included elderly patients aged 75 years or more, of whom 78.9% showed depression compared to 39.3% of those who were 60-65 years old (P = 0.001). Furthermore, the female elderly showed higher rates of depression compared to males (52.8% vs. 35.7%; P = 0.001). A reported 81.1% of the elderly were diagnosed with chronic diseases; approximately half of them were depressed, while only 32.9% of the elderly free of diseases were depressed (P = 0.001). Conclusions The prevalence of depression is high among the elderly in the eastern province of Saudi Arabia, especially in those who complain of chronic diseases, older patients, and females. Screening for depression must be employed early to manage depressive symptoms and prevent further complications.

Novel Behavior of the 2019 Novel Coronavirus With Invasion of the Cardiac Conduction System in the Young.

We report the case of a 35-year-old man (an oil engineer) referred as a coronavirus disease-2019 (COVID-19) case with heart block and a four-day history of headache and fever. The patient was hemodynamically stable with normal respiratory effort and oxygen saturation. Three consecutive COVID-19 tests were positive since admission. Comprehensive clinical assessment investigations were performed. Apart from mild acute phase reactants elevation, all results were within reference limits. He had no leukocytosis and normal cardiac enzymes, chest x-ray findings, echocardiography findings, and healthy coronary arteries. The patient had a fever and electrocardiographic evidence of sinus node dysfunction associated with Mobitz type 2 atrioventricular block that progressed to complete heart block. This was a unique presentation of COVID-19 in a young, otherwise healthy man with the sole manifestation confined to the cardiac conduction system and the absence of respiratory involvement, hypoxemia, and acidosis.

Biventricular Outflow Obstruction Associated With Atrioventricular Septal Defects and Patent Ductus Arteriosus: An Extremely Rare Combination.

We present an extremely rare combination of biventricular outflow obstruction associated with atrioventricular septal defects and patent ductus arteriosus (PDA). Almost all the other published cases, including ours, were associated with other congenital cardiac lesions other than biventricular outflow obstruction. Most cases ended with poor outcomes. Our patient was a 55-day-old term female infant. She was managed by successful aortic balloon valvuloplasty with successful early outcome.