Knowledge, Attitude, and Perception of Oral Health Among Parents of Children at Risk of Infective Endocarditis: A Cross-Sectional Study.

BACKGROUND: Infective endocarditis (IE) is a serious complication primarily affecting patients with cardiac conditions. It is widely recognized that oral microorganisms contribute to the development of IE. OBJECTIVES: The objective is to assess the knowledge, attitudes, and perception of parents of children at risk of IE by studying the preventive measures employed by them. MATERIALS AND METHODS:  A self-constructed questionnaire composed of 14 questions was distributed among parents of children aged 0-12 years with known cardiac diseases. The parents/caregivers who were attending the pediatric outpatient clinics at King Fahad Medical City (KFMC) were selected randomly. Results: A total of 112 parents responded to this questionnaire. Almost 50% of the participants in this study reported that their children do not brush their teeth regularly, with only 12.5% of them brushing twice a day. Regarding the role of parents in supervising oral hygiene, 62.5% of them stated that they only provide advice but do not watch their child brush their teeth, and only 9.8% of parents are actively involved in advising and watching their children brush their teeth. In this study, 95.5% of parents agreed that maintaining good dental health was crucial for overall body health, and 58% of the participants showed interest in receiving more education about oral health and its impact on overall well-being. To assess the statistical significance, a nonparametric Pearson's chi-square test for fitness was employed. A p-value of ≤ 0.05 was used to report the statistical significance of the results. Conclusion: While the parents demonstrated adequate knowledge of oral health, their attitudes toward it were lacking. So, both parents and children require a modification in their attitudes toward dental care and oral health.

Cardiac Tamponade-Associated Dense Deposit Disease: A Case Report and Review of the Literature.

Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. It can be associated with various cardiac and non-cardiac disorders. Dense deposit disease (DDD) is a rare kidney disease caused by uncontrolled activation of the alternative complement pathway. We are reporting a seven-year-old male child who was diagnosed to have DDD approved by renal biopsy and presented with shortness of breath, cough, and fever. Chest X-ray displayed cardiomegaly. Thereafter, echocardiography showed massive pericardial effusion and left ventricle compression with a risk for cardiac tamponade. He subsequently underwent pericardiocentesis with the removal of 450 ml of pericardial fluid. The patient's edema was not correlated with the described amount of drained pericardial fluid. To the best of our knowledge, this is the first reported case of significant pericardial effusion carrying the risk of cardiac tamponade associated with DDD. With this report, we would like to highlight the importance of cardiac assessment in patients with DDD, in particular those with nephrotic range proteinuria who present with cardiac symptoms and cardiomegaly.

Isolated Right Superior Vena Cava Drained to Left Atrium in a Child with Waardenburg Syndrome and Neurofibromatosis Type I.

Isolated right superior vena cava (SVC) draining to the left atrium (RSVC-LA) is an extremely rare cyanotic congenital heart disease (CHD). Such lesion is easily missed with improper scanning or inattentive interpretation of echocardiography. This can result in potential systemic severe complications. We report a child with RSVC-LA who has two significant non-cardiac co-morbidities, including Waardenburg syndrome and n neurofibromatosis type I (NF1). This patient was referred to cardiology assessment due to unexplained low saturation and was diagnosed as RSVC-LA; however, fortunately not yet showing complications of systemic thromboembolic phenomenon (STEP).

Pediatric Cardiologist's View on Centralization of Pediatric Cardiology Services: A Questionnaire Survey.

The population of the Kingdom of Saudi Arabia (KSA) exceeding 35 million people and in the presence of a non-structured increase in the number of pediatric cardiac centers, we expect to face some concerns like dilution of the service where the volume will be less than the acceptable standards, the increase in mortality and morbidity, and failure to obtain personalized medicine at a reasonable cost. Therefore, we built up this survey questionnaire about those concerns and collected the opinion of expert medical staff in Saudi Arabia who are working in the field of pediatric cardiology. Seventy percent of the responders vs. 25% recommend the centralization of the PCS as the solution for the above concerns, and 94% recommend sticking to the globally accepted criteria when issuing the license of the centers providing PCS including the volume of patients in each center, and minimum multidisciplinary facilities in terms of resources, services, and personnel.

Giant right coronary artery aneurysm secondary to Kawasaki disease in an infant.

Kawasaki disease (KD) is a potentially decapacitating multisystemic vasculitis with unknown etiology that acquired worldwide attention due to associated coronary aneurysms leading to life-threatening complications in very young babies including thrombosis, ischemia, and rupture. High levels of suspicion for early diagnosis and prompt treatment are crucial in preventing serious complications. We report here one of the patients who developed a giant coronary aneurysm but fortunately not a life-threatening complication after 5 years of follow-up. We conclude that later intravenous immunoglobulins (IVIG) treatment could be an important factor-among others-that precipitate into such complications.