Gastroparesis: an under-recognised manifestation of systemic amyloidosis.

Gastrointestinal (GI) amyloidosis can be acquired or genetic and is commonly caused by chronic inflammatory illnesses (AA amyloidosis), haematological malignancies (AL amyloidosis) and end-stage renal disease (beta-2 microglobulin amyloidosis). The accumulation of these aberrant proteins disrupts the structures and functions of many organs; the least common of which is the GI tract. GI presentations depend on the type, location and amount of amyloid deposition. Symptoms can range from nausea and vomiting to fatal GI bleeds. Pathological examination of the involved tissue with characteristic green birefringence under polarised light is used to confirm the diagnosis. Patients should be considered for further evaluation to rule out additional organ involvement, notably cardiac and renal. We present a patient with amyloidosis-induced gastroparesis, an under-recognised presentation of systemic amyloidosis in the gastroenterology system.

Association between prehypertension and psychological distress among adults in Saudi Arabia: A population-based survey.

BACKGROUND: Prehypertension is a precursor to hypertension status. Psychological distress has been identified earlier among hypertensives; however, there is little evidence for the presumptive relationship between prehypertension and psychological distress. OBJECTIVE: The study aimed to assess the psychological wellbeing of the Al-Kharj, Saudi Arabia population, using the General Health Questionnaire (GHQ-12) and correlating it with prehypertensive patients in the same population. METHODS: A cross-sectional analysis of the population of Al-Kharj, Saudi Arabia, was carried out between January and June of 2016. With an 85 percent response rate, a total of 1016 participants participated in the study. A multiple linear regression analysis was performed to assess the relationship between prehypertension and psychological distress. RESULTS: The findings of the adjusted analysis demonstrated that, on average prehypertensive patients were more distressed psychologically than non-hypertensive patients (unstandardized Beta regression coefficient = 3.600; P-value 0.025). Similarly, on average women were found to be more psychologically distressed than men (unstandardized Beta = 1.511, P-value 0.002). Civil workers and unemployed individuals were more psychologically distressed than employed individuals (unstandardized Beta = 1.326, P-value 0.041) while adjusting for the sociodemographic and other variables such as BMI, diabetes status, cholesterol, and smoking status. CONCLUSION: The current study shows that as compared to normotensive patients, self-rated mental wellbeing and psychological wellbeing are all considerably poorer among prehypertensive patients. To prevent individuals from having negative psychological outcomes and their long-term complications, the Government of Saudi Arabia needs to concentrate on prehypertensive, female, and unemployed individuals. Well-designed longitudinal studies, primarily in Saudi Arabia, are needed in the future to research the cause and impact of poor mental health and prehypertension.

Prevalence, incidence, and risk factors of epilepsy in arab countries: A systematic review.

OBJECTIVE: To describe the prevalence, incidence, and risk factors of epilepsy in Arab countries. METHODS: In this systematic review, electronic databases including PubMed, ProQuest Public Health and Cochrane Library were searched to identify relevant English articles published until April 2020. The search was conducted to cover all 22 Arab countries. Studies were eligible for inclusion if they assessed any of these epidemiological parameters of epilepsy: prevalence, incidence, and/or risk factors and focused on at least one of the Arab countries. The quality of the studies was evaluated using standardized quality assessment tools. RESULTS: Twenty-nine articles met the inclusion criteria. Out of the 22 Arab countries, only 11 were found to have published studies reporting on the epidemiology of epilepsy. The median lifetime prevalence of epilepsy in Arab countries was found to be 6.9 per 1000. The median incidence is 89.5 per 100000. The most frequently identified risk factors were parental consanguinity, family history of epilepsy, and a history of perinatal infections/insults. CONCLUSION: The prevalence and incidence of epilepsy varies in Arab countries. The most frequently reported risk factor is parental consanguinity. The lack of epidemiological studies on epilepsy in half of the Arab countries calls for more studies on this aspect to identify the burden and risk factors of epilepsy in this region.

Validation of the Arabic version of the Perinatal Anxiety Screening Scale (PASS) among antenatal and postnatal women.

BACKGROUND: Anxiety among women in the perinatal period is common. Assessing the severity of perinatal anxiety will help monitor the progress of the patient through the stages of anxiety and facilitated the treatment. This study assesses the validity and reliability of the "Perinatal Anxiety Screening Scale" (PASS) in the Arabic language. METHODS: The PASS was translated into Arabic. Two hundred seventeen women in the antenatal and postnatal phase participated (92 antenatal and 125 postnatal) answered to PASS, GHQ12, EPDS-10, and DASS-21. Content validity, factor analysis, internal consistency, and test retest reliability were assessed. RESULTS: Content Validity Index (CVI) and Content Validity Ratio (CVR) were .88 and 0.79; respectively. The scale loaded on four components: acute anxiety, social anxiety, and dissociation; specific fears and trauma; general anxiety and adjustment; and perfectionism and control. Cronbach's Alpha value for the scale was 0.78 and test retest correlation coefficient was 0.94. PASS significantly correlated with EPDS-10 (rho=0.46), GHQ-12(rho=0.58), the three components of DASS-21 (0.47, 0.50, and 0.43; respectively), and experiencing adverse life events. CONCLUSION: The Arabic translated version of the PASS showed reasonably adequate validity and reliability and can be used to screen for anxiety disorder among women in the perinatal phase.