The role of biochemical testing in cystic fibrosis.

INTRODUCTION: Cystic fibrosis (CF) is a life-limiting autosomal recessive disorder as a result of CF transmembrane conductance regulator gene mutation. It has a wide range of disease severity in patients with the same genotype. CASE REPORT: A 5-year-old Malay boy with a history of recurrent pneumonia, presented with productive cough, fever and worsening tachypnoea. Physical examination revealed coarse crepitations, reduced breath sounds and clubbing. Biochemical investigations showed that he had respiratory type 2 failure as a result of bronchiectasis. Sweat conductivity done twice was raised supporting a diagnosis of CF. Other investigations such as bronchoscopy to look for congenital anomaly of the lung, infectious disease screening and tuberculosis, fungal and viral culture and sensitivity were negative. Further cascade screening revealed high sweat conductivity results in his siblings. DISCUSSION: Although CF prevalence is low in Malaysia, it is nevertheless an important diagnosis to be recognised as it is associated with increased morbidity.

Hysteria: A clinical and sociodemographic profile of 40 patients admitted to a Teaching Hospital, 1985-1995.

This is a retrospective clinical study of 40 inpatients diagnosed as suffering from hysteria, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R), admitted to King Khalid University Hospital at Riyadh over a period of 10 years (1985-95). The female:male ratio was 3:1, 80% were less than 30 years of age and 60% were single. Hysterical conversion was the most common type (95%), whereas hysterical dissociation was rare (2.5%). A stressful situation preceded the onset of symptoms in 62.5% of the cases. Twenty-five percent of the patients were clinically depressed. The typical histrionic personality was rare.

The use of sedative-hypnotic drugs in a university hospital in Saudi Arabia.

Sedative-hypnotic drugs (SHD) involve mainly benzodiazepines and barbiturates. For nonhospitalized patients, they are mostly prescribed by general practitioners to patients who are physically ill. In hospitals, most of the patients receiving these drugs are psychiatric patients. This study aims at describing patterns of prescribing these drugs in Saudi Arabia that may be different from that in other countries due to greater legal restriction on psychotropic medications in general. It is a retrospective analysis of charts of the first 100 patients admitted to King Khalid University Hospital (KKUH) from 1 January 1989 to the medical, surgical, psychiatric, and obstetric and gynecology wards. The results are compared to a methodologically similar study from Canada. Generally, SHDs were more frequently prescribed in Canada than in Saudi Arabia. Most of the SHDs were prescribed in the surgical ward and most of the indications in both studies were medical. These and other findings are discussed in the context of cultural aspects in Saudi Arabia.

Obsessive compulsive disorder.

Clinical features of obsessive compulsive disorder (OCD) were found to be similar in various cultures. However, there was no report about phenomenology of this disorder from Moslem or Arab cultures. This study is a review of 45 cases who presented as a psychiatric clinic at a general university hospital in Saudi Arabia. The findings were found to be similar to those reported in Western studies with regard to age of onset, level of functioning, type of onset, course, and co-morbidity. Religious obsessions and compulsions were found to be the most common clinical features. Findings are explained in cultural terms.

The seasonality of mania: Preliminary findings.

The relationship between climatic variables and monthly manic admissions to a teaching hospital in Riyadh, Saudi Arabia was examined over a six-year period. The results indicate a weak but significant correlation between monthly admission rates of mania and day length, humidity, air pressure, and temperature. The correlation did not seem, however, to be strong enough to indicate a seasonal trend. Also, current month climatic variablesare better correlated than previous months. The prevalence of sunshine throughout the year may explain the low correlation with mania admissions unlike reports from other countries.