Case report: Restrictive cardiomyopathy presenting with complete thromboembolism occlusion of the terminal part of the abdominal aorta in a preadolescent Saudi girl.

Restrictive cardiomyopathy (RCM) is a rare disease in children, accounting for <5% of all pediatric cardiomyopathies. It may be idiopathic or may be a secondary to a systemic disease. The disease is characterized by normal systolic function with impaired ventricular filling caused by stiff ventricular walls. Children with RCM often present with symptoms of exercise intolerance, shortness of breath, weakness, and chest discomfort. Thromboembolism events are an unusual presentation of RCM. We are reporting a preadolescent female from the eastern province of Saudi Arabia who presented with sudden right lower limb swelling, paresthesia, and pain caused by a complete occlusion of the terminal part of the abdominal aorta and both common iliac arteries. Echocardiography revealed dilated atria, normal ventricle dimensions and two floating thrombi in the left atrium. The patient was successfully managed with an anticoagulant, surgical thrombectomy and cardiac transplantation.

Awareness, Perceptions, and Desirability of Epidural Analgesia Among Pregnant Women in King Fahad University Hospital, Al Khobar.

BACKGROUND: Childbirth is a normal life event that is considered to have the most severe pain faced by women in their lifetime. However, this pain can be managed in many ways such as using epidural analgesia (EDA).  Objective: This study focuses on assessing the awareness, perceptions, and desirability of EDA among pregnant women at King Fahad University Hospital (KFUH), Al Khobar. METHODS: A cross-sectional study was conducted at KFUH in Al Khobar, Eastern Province of Saudi Arabia. The study took place from November to December 2020 by using a pre-designed questionnaire developed by the researchers based on a thorough literature review of prior studies. A total of 209 pregnant females participated in the study. The study included all pregnant women attending antenatal clinics and the emergency room at KFUH and we excluded postpartum women from the study. RESULTS: A total of 209 pregnant women participated in this two-month study and completed the questionnaire. The majority of women were between the age of 30-35 years old (33%), while a few (16%) were less than 24 years. The patient's perception was found to be significantly influenced by age and household income. On the other hand, awareness of EDA complications and desirability was seen to be associated with income. CONCLUSION: Study results demonstrate that the majority of pregnant women were aware, as well as had a positive perception and desirability toward using EDA for labor pain. On the other hand, pregnant women who had a lack of awareness and perception toward EDA may suffer more from labor pain, which will negatively affect their birth experience and may make it less enjoyable. Therefore, education about different types of analgesia, especially EDA, should be included in an antenatal care program.