Knowledge and Attitudes of Doctors Toward People Living With HIV/AIDS in Saudi Arabia.

OBJECTIVES: Reports showed that Saudi Arabia has low prevalence of HIV/AIDS despite increasing influx of foreign nationals from countries with high risk of HIV. Knowledge and stigmatizing attitudes of health care workers contribute to difficulties of people living with HIV/AIDS (PLWHA) accessing prevention, care, and treatment services. Nothing is known about stigma and discrimination about PLWHA in Saudi Arabia. DESIGN: We assessed knowledge of Saudi Arabian doctors about HIV and their attitudes toward PLWHA using a cross-sectional study design. METHOD: In this study, 1483 doctors completed a self-administered questionnaire. RESULT: Knowledge scores and stigma index were computed from responses to relevant statements in the questionnaire. Stigmatizing attitudes of contact, reproductive rights, blaming, and judgmental were identified. HIV knowledge was a significant predictor of high stigma. Doctors' year of medical practice, status/specialty, and location of practice in Saudi Arabia were major predictors of HIV knowledge. CONCLUSIONS: Evidence of poor knowledge of HIV suggests the need for further training of health workers on HIV transmission mode.

Mortality among tuberculosis patients in Saudi Arabia (2001-2010).

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) still contributes to deaths in Saudi Arabia, among both Saudis and non-Saudis. Exploring the trend of deaths caused by TB and determinants associated with high fatality rate among TB patients is considered as a part of monitoring and evaluation of the performance of National Tuberculosis Control Program to help planners improve policies and procedures used to achieve the targets of TB control. DESIGN AND SETTINGS: The current study is a retrospective one, which used the official notifications of NTP in Saudi Arabia over a period of 10 years (2001-2010). METHODS: A 10-year retrospective study included all TB cases registered in Saudi Arabia with known outcome of survival or death while under anti-TB therapy covering the period January 1, 2001, to December 31, 2010. RESULTS: Mortality among TB patients show a declining trend among Saudis starting from the year 2003 (7.2%6.1%) and a stagnant trend among non-Saudis. Saudi nationality was associated with higher fatality rate compared to non-Saudis (6.4% and 5.4%, respectively). Mortality was positively correlated with advancing age, male sex among Saudis (7.3% compared to 5.3% among females), and female sex among non-Saudis (6% compared to 5% among males), prior history of anti-TB therapy, smear positivity, and human immunodeficiency virus (HIV) seropositivity. CONCLUSIONS: We recommend WHO to modify the definition of death among TB patients. We recommend NTP in Saudi Arabia to adopt and implement International Classification of Diseases (ICD10) for TB patients' registration, improve health care services provided for elderly, monitor and strengthen NTP performance to decrease defaulter and early detect and treat patients, initiate a collaborative TB/HIV activities, and screen all suspected TB patients for HIV. In addition to these, more extended research has to be initiated concerning delayed diagnosis and comorbidities with TB.

Axillary lipoblastoma--tumor recurrence in the right atrium.

This case report describes, for the first time, vascular invasion and recurrence of a lipoblastoma 6 months after the macroscopically complete excision of the initial cervico-axillary tumour. The importance of cytogenetics in the diagnosis of lipoblastoma is emphasized, as is the need to be wary of the diagnosis of lipoma in infancy.

Renal histopathology in fatal cases of diarrhoea-associated haemolytic uraemic syndrome. British Association for Paediatric Nephrology.

Autopsy material was examined from British children dying early in the course of haemolytic uraemic syndrome (HUS). These presented after 1983, the period in which verocytotoxin-producing Escherichia coli (VTEC) infection was confirmed as the leading cause of diarrhoea-associated (D+HUS) in the United Kingdom. Of 18 cases referred for this study, 3 were found on review to have no history of a diarrhoeal prodrome (D-HUS). In the D+ patients, the median duration from onset of diarrhoea to death was 8 days (range 4-42 days). VTEC infection was confirmed in 6 cases. All had neutrophilia at presentation (median 21, range 15-49.8 x 10(9)/l). The 15 cases had uniform pathological features, consisting of glomerular thromboses and congested rather than ischaemic glomeruli. Arteriolar thromboses were common at the hilum of glomeruli and were sometimes also seen proximally, including in interlobular arteries. There were cortical infarcts in 5 cases with extensive thrombosis. Cases were demonstrated to have significantly greater numbers of neutrophils expressed per 100 glomeruli than controls, when counted using immunohistological stains to neutrophil elastase and CD15. This study showed uniformity of the renal changes in D+HUS and gave further evidence of the importance of neutrophils in the pathogenesis of the disease.