ABSTRACT
Tuberculous otitis media is an uncommon cause of chronic suppurative infection affecting the middle ear and mastoid. Unfortunately, the signs and symptoms of tuberculous otitis media are very similar to those of non-tuberculous otitis media, which can make early diagnosis challenging. It is crucial to diagnose and treat the condition early to prevent damage to the ear and potential complications involving the central nervous system. We present a case of a 13-year-old Saudi girl who presented with a two-week history of headaches associated with photophobia. She had been complaining of ophthalmalgia, otalgia, and decreased hearing for one year. Physical examination revealed bilateral optic disc swelling with grade 3-4 papilledema, middle ear effusion, and bilateral hearing loss. CT scan showed sinusitis with right otomastoiditis and right petro-mastoiditis. MRI with magnetic resonance venography (MRV) revealed cerebral venous thrombosis. Tuberculosis screening by polymerase chain reaction (PCR) of a sputum sample and right ear effusion sample taken by tympanocentesis was done and it came back positive three weeks later. She was started on anti-tuberculous treatment, with clinical improvement observed over six months. Multiple factors contributing to the delay in diagnosis possibly included the lack of awareness about this ailment among doctors, leading to a low suspicion rate, variable clinical presentation, and diagnostic pitfalls.
ABSTRACT
Background Epilepsy is a prevalent pediatric neurological disorder, with widespread implications globally. Parents' knowledge and attitudes toward their epileptic children play a pivotal role in the well-being and management of the condition. Despite its prevalence in Saudi Arabia, awareness and perceptions vary across communities. Objective This study aimed to assess parents' knowledge, awareness, and attitudes toward children with epilepsy in the Al Baha region of Saudi Arabia. Methods A descriptive, cross-sectional study was conducted in the Al Baha region from November 2022 to January 2023. An anonymous, self-administered questionnaire was distributed among 390 parents, targeting those aged 18-60 years. Results While the majority recognized that epilepsy is not contagious, misconceptions persisted. Nearly 67.7% of families lacked clarity on the causes of epilepsy. Most believed in the potential curability of epilepsy, favoring medication as the primary treatment. A significant association was identified between having an epileptic child and knowledge of seizure-first aid. The majority held an optimistic view regarding the academic and extracurricular achievements of epileptic children. Conclusion The study highlights a mix of informed and misinformed beliefs among parents in the Al Baha region. While many perspectives were encouraging, certain misconceptions underlined the need for continued awareness campaigns and educational initiatives. Addressing these gaps is essential for providing comprehensive care and inclusion of children with epilepsy in the community.
ABSTRACT
Background and Purpose: To determine the common precipitating factors for breakthrough seizures in children with epilepsy. Methods: This retrospective study reviewed the charts of children with epilepsy who were followed up in the pediatric neurology clinic of King Fahad Hospital in Al-Baha region, Saudi Arabia, between January 2015 and August 2022. Children between 1 to 14 years of age who had epilepsy, as per the International League Against Epilepsy definition and received anti-seizure medication with a seizure-free period of at least 2 months before breakthrough seizure episode, were included in the study. Results: Of the 108 children included in the study, the mean age was 6.8±1.6 years, and among them (55.5%) were male. Most parents (69.5%) were unaware of the triggering factors of seizure. The majority of patients (88%) reported at least one precipitating factor for breakthrough seizures and the most common one was systemic infection associated with fever (52.8%), and then non-compliance to medications in (34.3%) of the patients. In terms of the electroencephalogram, around 84 patients (77.8%) had abnormal electroencephalogram. Finally, monotherapy was maintained in 63.9% of patients. Conclusions: We conclude that the most common trigger for breakthrough seizure is a systemic infection associated with fever and non-compliance to anti-seizure medications. Increasing the level of awareness by different methods may help limit or even prevent seizures from occurring. Randomized controlled trials could shed light on the adjustment of anti-seizure medications temporarily by increasing the dosage or giving extra doses during the infection to avoid breakthrough seizures.
ABSTRACT
BACKGROUND: The medical workforce plays a pivotal role in advancing human health, particularly within the healthcare system of Saudi Arabia. While government-employed healthcare providers form the central structure of the system and offer free healthcare services, the private healthcare sector is also witnessing significant growth. In parallel, the field of child neurology has experienced notable transformations in recent years, with continued expansion. This expansion brings forth a range of challenges for both current and future pediatric neurologists, necessitating careful consideration and proactive measures to address them. AIM OF THE STUDY: To investigate and analyze the current characteristics of the workforce, with a specific focus on their employment status and related data. METHODS: This is a cross-sectional analysis, using a survey to assess the distribution of pediatric neurologists in Saudi Arabia (SA). The final analytical sample included 82 subjects, working in 13 regions in SA. A descriptive analysis was used to address the study question. RESULTS: The survey received responses from a total of 82 pediatric neurologists in Saudi Arabia (response rate 55%), with 38 (46%) being men and 44 (54%) being women. The mean age was 33 ± 1.225 years. The majority of participants practiced in major cities such as Riyadh and Jeddah. Nearly 50% of pediatric neurologists experienced some form of delay in obtaining their first job, ranging from 1 to 36 months. CONCLUSION: The landscape of the pediatric neurology workforce is currently witnessing noteworthy demographic shifts. With the majority of practitioners concentrated in major cities, there is an ongoing demand for qualified professionals in peripheral areas. This study describes the real-life challenges faced by pediatric neurologists, particularly the delay in securing employment after graduation, and underscores the critical importance of addressing these persistent issues along the journey of pediatric neurology.
ABSTRACT
PURPOSE: Depression is one of the most common psychological disorders. The nutritional etiology of the depression proposes that vitamin D may play a significant role in the pathogenesis of depression. Further, vitamin D deficiency has been found to aggravate depression in animals. Therefore, vitamin D treatment might be a potential therapeutic aid in depression management. This study aimed to explore the antidepressant effects of vitamin D in a Bacillus Calmette-Guerin (BCG)-induced depression model. METHODS: Thirty-six mice were randomly assigned to short-term and long-term experimental groups. In each group, mice were randomly subcategorized into three subgroups: 1. control (received vehicle), 2. BCG (received BCG [107 CFU/mouse]), and 3. BCG + vitamin D (received vitamin D [60.000 IU/kg] before BCG [107 CFU/mouse] inoculation). After completion of the two experimental periods (3 days for the short-term group and 2 weeks for the long-term group), the mice underwent three behavioral tests: locomotor activity, the forced swimming test (FST), and the tail suspension test (TST). RESULTS: Locomotor activity did not significantly differ among the subgroups in either the long-term or short-term groups. In the short-term group, the total immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. However, in the TST, no significant difference was found between the vitamin D-treated group and the BCG group. In the long-term group, the immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. Similarly, the total immobility time on the TST was also significantly lower in the vitamin D-treated mice than in the BCG-treated mice. CONCLUSION: Vitamin D is useful in the management of depressive behavior. The potential role of vitamin D in the etiology of depression should be investigated in future work.
