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Publisher: Medknow Publishers   (Total: 355 journals)

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Showing 1 - 200 of 355 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access   (Followers: 1)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 7)
African J. of Medical and Health Sciences     Open Access  
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.269, h-index: 10)
African J. of Trauma     Open Access  
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access  
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 7)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 12, SJR: 0.408, h-index: 15)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.308, h-index: 14)
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 5, SJR: 0.441, h-index: 10)
Annals of Saudi Medicine     Open Access   (SJR: 0.24, h-index: 29)
Annals of Thoracic Medicine     Open Access   (Followers: 4, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15, SJR: 0.148, h-index: 5)
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Intl. Surgery     Open Access   (Followers: 9)
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Archives of Pharmacy Practice     Open Access   (Followers: 4)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 3)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.879, h-index: 49)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 1, SJR: 0.362, h-index: 10)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access   (Followers: 1)
Bulletin of Faculty of Physical Therapy     Open Access  
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access  
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 11, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access  
CytoJ.     Open Access   (Followers: 2, SJR: 0.339, h-index: 19)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.131, h-index: 4)
Dental Research J.     Open Access   (Followers: 9)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 4, SJR: 0.205, h-index: 22)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1)
Egyptian J. of Dermatology and Venerology     Open Access  
Egyptian J. of Haematology     Open Access  
Egyptian J. of Internal Medicine     Open Access  
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.121, h-index: 3)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access  
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access  
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.473, h-index: 8)
Environmental Disease     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.496, h-index: 11)
European J. of General Dentistry     Open Access   (Followers: 1)
European J. of Prosthodontics     Open Access   (Followers: 2)
European J. of Psychology and Educational Studies     Open Access   (Followers: 6)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 4, SJR: 1.227, h-index: 12)
Global J. of Transfusion Medicine     Open Access  
Heart India     Open Access  
Heart Views     Open Access  
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 2)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (SJR: 0.318, h-index: 26)
Indian J. of Cerebral Palsy     Open Access  
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 1, SJR: 0.307, h-index: 16)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.243, h-index: 24)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.448, h-index: 16)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 2, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access  
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 1)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.292, h-index: 9)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.53, h-index: 34)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.716, h-index: 60)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.207, h-index: 31)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 1, SJR: 0.233, h-index: 12)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.213, h-index: 5)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 4, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.536, h-index: 34)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 9, SJR: 0.393, h-index: 15)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.218, h-index: 5)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 1)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.35, h-index: 12)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 1, SJR: 0.285, h-index: 22)
Indian J. of Pharmacology     Open Access   (SJR: 0.347, h-index: 44)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.303, h-index: 13)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.496, h-index: 15)
Indian J. of Psychological Medicine     Open Access   (Followers: 1, SJR: 0.344, h-index: 9)
Indian J. of Public Health     Open Access   (Followers: 1, SJR: 0.444, h-index: 17)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4, SJR: 0.253, h-index: 14)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.169, h-index: 7)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.313, h-index: 9)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.366, h-index: 16)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Critical Illness and Injury Science     Open Access  
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 2)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 4, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 1)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 2)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 7)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.239, h-index: 4)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.523, h-index: 15)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 6, SJR: 0.611, h-index: 9)
Intl. J. of Trichology     Open Access   (SJR: 0.37, h-index: 10)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 2)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 4, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access  
J. of Association of Chest Physicians     Open Access   (Followers: 2)
J. of Basic and Clinical Reproductive Sciences     Open Access   (Followers: 1)
J. of Cancer Research and Therapeutics     Open Access   (Followers: 4, SJR: 0.359, h-index: 21)
J. of Carcinogenesis     Open Access   (Followers: 1, SJR: 1.152, h-index: 26)
J. of Cardiothoracic Trauma     Open Access  
J. of Cardiovascular Disease Research     Open Access   (Followers: 3, SJR: 0.351, h-index: 13)
J. of Cardiovascular Echography     Open Access   (SJR: 0.134, h-index: 2)
J. of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 2)
J. of Clinical and Preventive Cardiology     Open Access  
J. of Clinical Imaging Science     Open Access   (Followers: 1, SJR: 0.277, h-index: 8)
J. of Clinical Neonatology     Open Access   (Followers: 1)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 1)
J. of Clinical Sciences     Open Access  
J. of Conservative Dentistry     Open Access   (Followers: 4, SJR: 0.532, h-index: 10)
J. of Craniovertebral Junction and Spine     Open Access   (Followers: 4, SJR: 0.199, h-index: 9)
J. of Current Medical Research and Practice     Open Access  
J. of Current Research in Scientific Medicine     Open Access  
J. of Cutaneous and Aesthetic Surgery     Open Access   (Followers: 1)
J. of Cytology     Open Access   (Followers: 1, SJR: 0.274, h-index: 9)
J. of Dental and Allied Sciences     Open Access   (Followers: 1)
J. of Dental Implants     Open Access   (Followers: 7)
J. of Dental Lasers     Open Access   (Followers: 2)
J. of Dental Research and Review     Open Access   (Followers: 1)
J. of Digestive Endoscopy     Open Access   (Followers: 3)
J. of Dr. NTR University of Health Sciences     Open Access  
J. of Earth, Environment and Health Sciences     Open Access   (Followers: 1)
J. of Education and Ethics in Dentistry     Open Access   (Followers: 5)
J. of Education and Health Promotion     Open Access   (Followers: 5)
J. of Emergencies, Trauma and Shock     Open Access   (Followers: 7, SJR: 0.353, h-index: 14)
J. of Engineering and Technology     Open Access   (Followers: 6)
J. of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
J. of Family and Community Medicine     Open Access  
J. of Family Medicine and Primary Care     Open Access   (Followers: 8)

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Journal Cover Annals of Saudi Medicine
  [SJR: 0.24]   [H-I: 29]   [0 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0256-4947 - ISSN (Online) 0975-4466
   Published by Medknow Publishers Homepage  [355 journals]
  • Synergistic effect of energy drinks and overweight/obesity on cardiac
           autonomic testing using the Valsalva maneuver in university students

    • Abstract: BACKGROUND: Obesity and caffeine consumption may lead to autonomic disturbances that can result in a wide range of cardiovascular disorders.
      OBJECTIVES: To determine autonomic disturbances produced by the synergistic effects of overweight or obesity (OW/OB) and energy drinks.
      DESIGN: Cross-sectional, analytical. 
      SETTING: Physiology department at a university in Saudi Arabia.
      SUBJECTS AND METHODS: University students, 18-22 years of age, of normal weight (NW) and OW/OB were recruited by convenience sampling. Autonomic testing by the Valsalva ratio (VR) along with systolic and diastolic blood pressure, pulse pressure, and mean arterial blood pressure were measured at baseline (0 minute) and 60 minutes after energy drink consumption. 
      MAIN OUTCOME MEASURE(S): Autonomic disturbance, hemodynamic changes.
      RESULTS: In 50 (27 males and 23 females) subjects, 21 NW and 29 OW/OB, a significant decrease in VR was observed in OW/OB subjects and in NW and OW/OB females at 60 minutes after energy drink consumption. Values of systolic and diastolic blood pressure, pulse pressure and mean arterial blood pressure were also significantly higher in OW/OB and in females as compared to NW and males. BMI was negatively correlated with VR and diastolic blood pressure at 60 minutes.
      CONCLUSION: Obesity and energy drinks alter autonomic functions. In some individuals, OW/OB may augment these effects.
      LIMITATIONS: Due to time and resource restraints, only the acute effects of energy drinks were examined.
       
      PubDate: Thu, 01 Jun 2017 14:03:00 +000
       
  • The relationship between thyroid antibody titer and levothyroxine dose in
           patients with overt primary hypothyroidism

    • Abstract: BACKGROUND: Both excess and insufficient thyroid hormone replacement may produce adverse effects in various target tissues; therefore, understanding factors that affect achievement of target TSH levels is crucial. 
      OBJECTIVE: Investigate the relationship between antibody titers and levothyroxine dose.
      DESIGN: Retrospective, review of data in medical records.
      SETTING: Thyroid center of Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.
      PATIENTS AND METHODS: The study population consisted of patients that had been diagnosed as having overt primary hypothyroidism and were taking levothyroxine for at least one year. The serum TSH level for an euthyroid state was between 0.5-4 mIU/L. The levels of anti-thyroid peroxidase (TPOAb) considered positive for antibodies were <5.6 IU/mL and for anti-thyroglobulin (TgAb) autoantibodies <4.10 IU/ mL.
      MAIN OUTCOME MEASURE: Daily levothyroxine doses of antibody-positive and negative patients and association of daily drug requirement with antibody titers.
      RESULTS: The study population consisted of the 303 patients (273 females and 30 males with the mean [SD] age of 46.6 [13.2] years). In the antibody-positive group (n=210) average daily levothyroxine dose was statistically significantly higher than in the antibody-negative group (n=93) (mean of 78.8 [36.7] vs 64.2 [27.1] mg/day, P=.001, respectively). There was a low but statistically significant positive relationship between the TPOAb (r=0.217, P<.01) and TgAb levels (r=0.158, P<.05) and levothyroxine doses in the antibody-positive group.
      CONCLUSION: Antibody titers are positively associated with larger levothyroxine (LT-4) replacement dosing in patients with autoimmune thyroiditis.
      LIMITATION: Unknown antibody titers before starting levothyroxine use. 
      PubDate: Thu, 01 Jun 2017 13:58:00 +000
       
  • Is survival after radical cystectomy for bladder cancer in Saudi patients
           different from that of Western patients?

    • Abstract: BACKGROUND: Although radical cystectomy (RC) is considered the gold standard treatment of muscle invasive bladder cancer, nearly half of patients develop metastases and ultimately die within 2 years. 
      OBJECTIVE: To assess survival, evaluate different prognostic factors that may affect disease-free survival (DFS) in Saudi patients after RC for carcinoma of the bladder and to compare our results with those of Western countries. 
      DESIGN: Retrospective chart review. 
      SETTING: A tertiary care center in Saudi Arabia. 
      PATIENTS AND METHODS: We collected data on patients who underwent RC for bladder cancer in the period between 1979 and 2014. Demographic, clinical and pathological variables and the application of perioperative chemotherapy were reviewed. Univariate and multivariate analyses were done with DFS as the end point.
      MAIN OUTCOME MEASURE: Disease-specific survival.
      RESULTS: On 328 patients for whom data was available, the median follow up was 23 months (range, 2 month-28 years) and median age was 58 years (range, 21-90). Of these patients, 268 were males (81.7%), 235 (71.7%) had urothelial carcinoma (UC), 79 (24.1%) had squamous cell carcinoma (SCC), and 208 (63.4%) had pathological tumor stage 3 or more. The 5-year overall survival (OS) and DFS were 52% and 48%, respectively. There was no statistically significant difference in DFS of patients with UC and pure SCC. On univariate analysis, lymph node status and pathological tumor stage were significant predictors of DFS. Both variables sustained statistical significance in a multivariate analysis. 
      CONCLUSION: Survival following RC is almost the same as others. Moreover, pathological tumor stage and lymph node metastasis were the only independent predictors for survival following RC. Future cooperative prospective studies are required to gain data on our region. 
      LIMITATIONS: Relatively small sample size and retrospective. 
      PubDate: Thu, 01 Jun 2017 13:51:00 +000
       
  • Incidence and outcome of acute kidney injury by the pRIFLE criteria for
           children receiving extracorporeal membrane oxygenation after heart surgery
           

    • Abstract: BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity.
      OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. 
      DESIGN: Retrospective, medical records review.
      SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh.
      PATIENTS AND METHODS: We reviewed the records of all pediatric patients that underwent cardiac surgery and required ECMO postoperatively between 1 January 2011 and 1 January 2016. AKI was classified according to the pRIFLE criteria 48 hours after ECMO initiation. Demographics and concomitant therapies for all patients were collected. 
      MAIN OUTCOME MEASURE(S): Outcome was assessed by recovery from AKI at time of discharge, ICU stay and mortality.
      RESULTS: Fifty-nine patients needed ECMO after cardiac surgery during the study period. Their mean (SD) age and weight was 11.0 (16.5) month and 5.5 (3.6) kg, respectively. All patients had a central venoarterial ECMO inserted. Fifty-three patients (90%) developed AKI after ECMO initiation. The majority of patients (57%) were categorized as pRIFLE-Failure, having a higher mortality rate (28/34 patients, 82%) in comparison to the pRIFLE-Injury and pRIFLE-Risk groups. Twenty-nine patients (49%) required either peritoneal dialysis (PD), or renal replacement therapy (RRT) or both. For AKI vs non-AKI patients, there was a statistically significant difference between mean (SD) ECMO duration (9.0 [8.00] vs 6.0 [2.0] days; P=.02) and ICU stay (37.0 [41.0] vs 21.0 [5.0] days; P=.03), respectively. The overall mortality rate was 58%, with a significant difference (P=.03) between AKI and non-AKI groups. All the patients who survived had normal creatinine clearance at hospital discharge.
      CONCLUSION: There is a high incidence of AKI in pediatric patients requiring ECMO after cardiac surgery, and it is associated with higher mortality, increased ECMO duration, and increased ventilator days. 
      LIMITATIONS: Single-center retrospective analysis and the small sample size limited the precision of our estimates in sub-populations. 
      PubDate: Thu, 01 Jun 2017 13:39:00 +000
       
  • Common nasal deformities among rhinoplasty patients in a university
           hospital in Saudi Arabia

    • Abstract: BACKGROUND: Rhinoplasty has become one of the most common aesthetic procedures in the world. Few studies from the Middle East have described rhinoplasty patients in the region. 
      OBJECTIVE: To investigate common nasal deformities in individuals seeking rhinoplasty at a single institution in Saudi Arabia.
      DESIGN: Retrospective study and chart review.
      SETTING: King Abdulaziz University Hospital, Riyadh, Saudi Arabia. 
      PATIENTS AND METHODS: All patients seeking primary rhinoplasty who were 15 years of age and older were included. The types of external nasal deformities were compared by gender and age groups.
      MAIN OUTCOME MEASURE: Types of external nasal deformities.
      RESULTS: Of the 248 patients investigated, 113 were male and 135 female. The most common external nasal deformity was a broad dorsum (n=163; 65.7%), followed by a bulbous columella (n=154; 62.1%), and deviation (n=150; 60.5%). Upward columella was most common in older patients, and deviation decreased with age. 
      CONCLUSION: The most common deformity among the study population of Saudis was a wide nasal dorsum, bulbous nasal tip and deviated nose. Studying nasal deformity in some ethnic groups has an influence in selecting and practicing specific rhinoplasty approaches.
      LIMITATIONS: Study conducted in one hospital and may not be generalizable.
       
      PubDate: Thu, 01 Jun 2017 13:32:00 +000
       
  • Cutaneous T-cell lymphoma in Saudi Arabia: retrospective single-center
           review

    • Abstract: BACKGROUND: Cutaneous T-cell lymphoma (CTCL) is an uncommon disease with various clinical presentations. The hypopigmented type is more common in individuals with a dark skin complexion. Moreover, childhood CTCL is more common in Mediterranean populations in comparison to the West. 
      OBJECTIVE: To describe CTCL in the Saudi population. 
      DESIGN: A retrospective collection of data on all cases of CTCL from 2010-2016.
      SETTING: Dermatology clinic at a tertiary center in Riyadh, Saudi Arabia.
      PATIENTS AND METHODS: We collected data on all cases of CTCL diagnosed clinically and confirmed pathologically.
      MAIN OUTCOME MEASURE(S): The number of cases of CTCL, gender, age at diagnosis and clinical subtypes. RESULTS: The most common presentation among 125 patients was the classic type (patches and plaques) followed by the hypopigmented and poikilodermatous variants. Males were 58% of the population (n=72). The median age at diagnosis was 41 years and the range was 5 to 86 years. Thirteen percent were younger than 20 years of age. 
      CONCLUSION: Hypopigmented and poikilodermatous types of CTCL are more common in our population than in the West. 
      LIMITATION: Retrospective, single-center data may not be generalizable since difficult cases are more likely to be referred to a tertiary center. 
      PubDate: Thu, 01 Jun 2017 13:27:00 +000
       
  • Current umbilical cord clamping practices and attitudes of obstetricians
           and midwives toward delayed cord clamping in Saudi Arabia

    • Abstract: BACKGROUND: In Saudi Arabia, as in many countries, there is usually no clear definition of the timing of umbilical cord clamping (UCC) in the policies and procedures used by hospitals. The World Health Organization (WHO) recommends delayed cord clamping (DCC) (>1 minute after birth) as it can significantly improve hemodynamics and long-term neurodevelopment. OBJECTIVE: To investigate current practices of healthcare professionals on the timing of UCC in Saudi Arabia. DESIGN: Cross-sectional survey. SETTING: Five tertiary hospitals in Riyadh, Saudi Arabia, during May to October 2016. SUBJECTS AND METHODS: Obstetricians and midwives completed a widely-used questionnaire on UCC practices. MAIN OUTCOME MEASURE(S): Current UCC practices and attitudes of obstetricians and midwives toward DCC. RESULTS: Eighty-two obstetricians and 75 midwives completed the questionnaire for a response rate of 80%. The majority of respondents were aged 30 years or older (81%) and 84% were females. Most respondents were non-Saudi (66%) and had an educational level of bachelor’s degree or higher (72%). Only 42% of respondents reported the existence of UCC guidelines in their practice; 38% reported the existence of a set time for UCC when the neonate was term and healthy, and only 32% had a set time for UCC in preterm neonates. While lower levels of agreement were reported among obstetricians and midwives on the benefits of DCC for babies requiring positive pressure ventilation, the majority of respondents (69-71%) thought that DCC was generally good for both term and preterm babies and that its benefits extend beyond the neonatal period.  CONCLUSIONS: While the majority of obstetricians and midwives that participated in this study had a positive perception toward DCC, this did not translate to their daily practice as most of these professionals reported a lack of existing UCC guidelines in their institutions. Further studies are warranted to confirm these findings.  LIMITATIONS: Participant selection by convenience sampling.  
      PubDate: Thu, 01 Jun 2017 13:17:00 +000
       
  • Student perception of the educational environment in regular and bridging
           nursing programs in Saudi Arabia using the Dundee Ready Educational
           Environment Measure

    • Abstract: BACKGROUND: Taibah University offers regular nursing (RNP) and nursing bridging (NBP) bachelor programs. We evaluated student perception of the learning environment as one means of quality assurance.  OBJECTIVES: To assess nursing student perception of their educational environment, to compare the perceptions of regular and bridging students, and to compare the perceptions of students in the old and new curricula.  DESIGN: Cross-sectional survey.  SETTING: College of Nursing at Taibah University, Madinah, Saudi Arabia.  PATIENTS AND METHODS: The Dundee Ready Educational Environment Measure (DREEM) instrument was distributed to over 714 nursing students to assess perception of the educational environment. Independent samples t test and Pearson’s chi square were used to compare the programs and curricula.  MAIN OUTCOME MEASURE: The DREEM inventory score.  RESULTS: Of 714 students, 271 (38%) were RNP students and 443 (62%) were NBP students. The mean (standard deviation) DREEM score was 111 (25). No significant differences were observed between the programs except for the domain “academic self-perceptions” being higher in RNP students (P<.001). Higher mean DREEM scores were observed among students studying the new curriculum in the RNP (P<.001) and NBP (P>.05).  CONCLUSION: Nursing students generally perceived their learning environment as more positive than negative. Regular students were more positive than bridging students. Students who experienced the new curriculum were more positive towards learning.  LIMITATIONS: The cross-sectional design and unequal gender and study level distributions may limit generalizability of the results. Longitudinal, large-scale studies with more even distributions of participant characteristics are needed.  
      PubDate: Thu, 01 Jun 2017 13:09:00 +000
       
  • Etiology of optic atrophy: a prospective observational study from Saudi
           Arabia

    • Abstract: BACKGROUND: Optic atrophy (OA) represents permanent retinal ganglion cell loss warranting study to establish etiology. 
      OBJECTIVES: To describe neurogenic causes of OA.
      DESIGN: Prospective, observational.
      SETTING: Tertiary care center, Riyadh, Saudi Arabia. 
      PATIENTS AND METHODS: We included consecutive patients of all ages with OA caused by lesions affecting the visual pathways who were referred over a 9-month period (November 2013 to July 2014). Diagnosis was based on visual acuity, ophthalmoscopic features and ancillary tests. Patient demographics, results of a clinical examination, test data and etiology were recorded. For each cause of OA, both gender and age group were analyzed as potential risk factors using simple univariate logistic regression. OA associated with glaucoma and retinal diseases was excluded. 
      MAIN OUTCOME MEASURE: Description of causes of OA. 
      RESULTS: Two hundred and four patients and 353 eyes met inclusion criteria. The median age was 27 years (range 3 months-77 years; interquartile range, 27 years) among 111(54.4%) females and 93(45.6%) males, with no statistically significant difference in age of presentation between the genders. The majority of lesions were bilateral (n=151, 74%). Tumors were the most common cause, accounting for 127 (62.2%) cases. These occurred mostly in adults (72.4%) compared to the pediatric group (OR=3.3, 95% CI: 1.79-6.03; P<.001). Hereditary neoplasia (OR=5.55; 95% CI: 1.67-18.42; P=.005) and metabolic diseases (OR=17.57; 95% CI: 2.15-143.62; P=.007) were more common causes in the pediatric group. There were no significant associations between gender or visual acuity and etiology of OA. In developed nations, OA is frequently the result of ischemia and neuritis. We found many other causes, especially orbital and intracranial tumors. 
      CONCLUSIONS: The frequency of tumors as the cause of OA may represent a higher incidence of aggressive tumors coupled with poor recognition/acknowledgement of symptoms and limited access, resulting in late presentations.
      LIMITATIONS: These findings may reflect bias from selective referrals to a tertiary center and may not represent all of Saudi Arabia. 
       
      PubDate: Thu, 01 Jun 2017 13:01:00 +000
       
  • Xeroderma pigmentosum at a tertiary care center in Saudi Arabia

    • Abstract: BACKGROUND: Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder caused by defective DNA repair that results in extreme sensitivity to ultraviolet (UV) rays. Depending on the type of XP, the disease may affect the skin, eyes and nervous system.
      OBJECTIVES: Describe the dermatologic manifestations in patients suffering from XP.
      DESIGN: Retrospective, descriptive review of medical records.
      SETTING: Dermatology clinic at tertiary care center in Riyadh.
      PATIENTS AND METHODS: This study included Saudi patients with clinically confirmed XP. 
      MAIN OUTCOME MEASURE(S): Demographic and clinical data including pathology and associated conditions and outcomes.
      RESULTS: Of 21 patients with XP, the most common manifestation was lentigines, affecting 18 patients (86%). The most common skin cancer was basal cell carcinoma followed by squamous cell carcinoma (SCC) affecting 15 (71.4%) and 9 (42.8%), respectively. Other skin findings included neurofibroma, trichilemmoma and seborrheic keratosis. Ocular involvement included photophobia, which was the most common finding followed by dryness and ocular malignancies. Two patients showed neurological involvement, which correlated with the type of mutation. 
      CONCLUSION: Considering that XP is a rare genetic disease, this description of our patient population will aid in early recognition and diagnosis.
      LIMITATIONS: Retrospective and small number of patients. Genetic analyses were done for only 5 of the 21 patients. 
       
      PubDate: Thu, 01 Jun 2017 12:52:00 +000
       
  • Self-inflicted eye injury

    • Abstract: Individuals with a factitious ocular disorder feign or exaggerate having an eye injury or intentionally produce an eye injury so as to assume the role of a sick person. We report two cases of self-inflicted ocular injury using needle-like foreign bodies and razor that represent possible diagnoses of Munchausen syndrome. Both patients presented with different clinical pictures that misguided the clinical diagnosis and delayed proper management. Although self-inflicted ocular injuries are rare, ophthalmologists should be aware of the possibility of their existence, particularly when caring for patients with psychiatric conditions.

      SIMILAR CASES PUBLISHED: 13 
       
      PubDate: Thu, 01 Jun 2017 12:47:00 +000
       
  • Soft tissue calcium deposits

    • PubDate: Thu, 01 Jun 2017 12:43:00 +000
       
  • Filariasis: A Report of Three Cases

    • Abstract:  To the Editor: We read with interest the above study by Abdul Haleem.1 The author mentioned that three cases were reported during a period of
      PubDate: Sat, 27 May 2017 03:20:00 +000
       
  • Errata

    • Abstract: Vol 27;1 (January/February 2007): on page 37, Figure 2 was labeled as an MRI scan. it should have been labeled as a CT scan of
      PubDate: Wed, 24 May 2017 06:42:00 +000
       
  • Erratum

    • Abstract: Volume 28;5 (September-October 2008):334-340.Comparison of the 2005 growth charts for Saudi children and adoles­cents to the 2000 CDC growth chartsOn page 339, the following acknowledgement
      PubDate: Wed, 24 May 2017 04:43:00 +000
       
  • Answer to What's Your Diagnosis'

    • Abstract:  Radiographic Findings: The TI sagittal images of the cervical spine (Figure 1) show markedly enhanced lobulated masses within the spinal canal, extending from the level
      PubDate: Mon, 22 May 2017 06:24:00 +000
       
  • Answer to What's Your Diagnosis'

    • Abstract:  Radiographic Findings: The TI sagittal images of the cervical spine (Figure 1) show markedly enhanced lobulated masses within the spinal canal, extending from the level
      PubDate: Mon, 22 May 2017 06:24:00 +000
       
  • National Cancer Control Programmes, Policies and Managerial Guidelines

    • Abstract: This publication is a comprehensive, well-written, easily understood chronology of how to initiate and operate a national cancer program. It covers the spectrum of cancer
      PubDate: Thu, 18 May 2017 16:29:00 +000
       
  • Living with Haemophilia

    • Abstract: Living with Haemophilia is a complete guide to hemophilia, which is written for affected families, medical and paramedical staff, and teachers. It is presented in
      PubDate: Thu, 18 May 2017 16:22:00 +000
       
  • Vascular Pathology

    • Abstract: This book is the first English-language textbook solely devoted to the pathology of vascular disease. It addresses a varied readership: pathologists, vascular physicians and surgeons,
      PubDate: Thu, 18 May 2017 16:10:00 +000
       
  • Recurrent Hydrops Fetalis Due to Kell Alloimmunization

    • Abstract:  We report a case of recurrent hydrops fetalis caused by Kell allo-immunization. The peculiar features of hemolytic disease of the newborn (HDN) due to anti-Kell
      PubDate: Thu, 18 May 2017 07:41:00 +000
       
  • Avian Influenza

    • Abstract:  20 October 2005, WHO Regional Office for the Eastern Mediterranean — The current avian influenza outbreaks are caused by a highly pathogenic influenza virus that
      PubDate: Thu, 18 May 2017 07:38:00 +000
       
  • Bilateral Sensorineural Hearing Loss in Children in the Gizan Area

    • Abstract: This study is a preliminary estimate of bilateral sensorineural hearing loss in Saudi children in the Gizan region. From 1986 to 1990, a total of 185 children with significant bilateral sensorineural deafness were seen. Probable contributory factors are outlined and implications for future management discussed. It is hoped that this paper will convey an increased awareness of this problem.
      PubDate: Thu, 18 May 2017 07:32:00 +000
       
  • Hemostatic Variables in Arab Diabetics

    • Abstract: Blood coagulation studies showed that patients with non-insulin-dependent diabetes mellitus (NIDDM) had significantly higher fibrinogen, FVIII:C, ristocetin co-factor, FV, FIX, lower ATIII, and PCV than those with insulin-dependent diabetes mellitus (IDDM). Diabetics with IDDM had a significantly higher ATIII, ristocetin co-factor, lower plasminogen and alpha-2-antiplasmin, and more enhanced platelet aggregation responses to ristocetin than age-matched controls. Patients with NIDDM as compared with controls, exhibited higher levels of fibrinogen, ristocetin co-factor, FVIII:C, FIX, and platelet count, but lower plasminogen, alpha-2-antiplasmin and PCV, reduced platelet aggregability to collagen, ADP, and ristocetin. Diabetics with retinopathy and nephropathy had still higher levels of fibrinogen, FVIII:C, ATIII and ristocetin co-factor than those without complications. These results are in accord with many similar studies in Caucasians. It is concluded that the pattern of the changes in hemostatic variables noted in Saudi diabetics do not confirm the existence of racial and/or geographical variations in the hemostatic changes associated with diabetes mellitus.
      PubDate: Thu, 18 May 2017 07:31:00 +000
       
  • Diagnosis: Pulmonary arteriovenous malformation (PAVM)

    • PubDate: Thu, 18 May 2017 07:25:00 +000
       
  • Diagnosis: Benign Bowel Distribution of Lanthanum Carbonate

    • Abstract: Hyperphosphatemia in uremic patients is as-sociated with metastatic calcification such as tumoral calcinosis and vascular calcification, and an increased cardiovascular mortality and morbidity.1 To avoid
      PubDate: Wed, 17 May 2017 14:53:00 +000
       
  • A 33-year-old male with a chest lesion on a routine chest radiograph

    • Abstract:  A 33-year-old Bahraini male presented at the health centre for a chest radiograph as part as a part of a routine medical check up for
      PubDate: Wed, 17 May 2017 14:32:00 +000
       
  • Respiratory arrest after low-dose fentanyl

    • Abstract: INTRODUCTIONAppropriate treatment of pain and anxiety is a major part of the routine practice of emergency medicine. This paper reports the first case of severe
      PubDate: Wed, 17 May 2017 13:26:00 +000
       
  • Abdominal aneurysms in Behçet’s Disease

    • Abstract: INTRODUCTIONBehçet’s Disease (BD) is an uncommon systemic disorder affecting the skin, mucous membranes, eye, joints, central nervous system and the blood vessels.  We report two
      PubDate: Wed, 17 May 2017 13:06:00 +000
       
  • Diffuse panbronchiolotos, a potentially misdiagnosed sinopulmonary
           syndrome

    • Abstract: INTRODUCTION Diffuse panbronchiolitis (DPB), a rare sinopulmonary syndrome characterized by chronic inflammation of respiratory bronchioles of unknown etiology, is an important cause of progressive obstructive lung
      PubDate: Wed, 17 May 2017 12:40:00 +000
       
  • Two unusual hematologic presentations of tuberculosis

    • Abstract: INTRODUCTION Tuberculosis (TB), a common health problem in developing countries, is a specific multi-systemic infection that can lead protean manifestations in any organ system. Anemia and
      PubDate: Wed, 17 May 2017 07:08:00 +000
       
  • Management of blunt hepatic and splenic trauma in children

    • Abstract:  
      PubDate: Tue, 16 May 2017 13:56:00 +000
       
  • Serum prolactin and migraine

    • Abstract: INTRODUCTIONProlactin is a polypeptide, consisting of 198 amino acids, secreted from the anterior pituitary gland. Prolactin secretion is influenced by physiologic factors (sleep, pregnancy, stress,
      PubDate: Tue, 16 May 2017 12:51:00 +000
       
  • Transcranial Doppler ultrasound assessment of intracranial hemodynamics in
           patients with type 2 diabetes mellitus

    • Abstract:
      BACKGROUND: Diabetics have a 3-fold risk for cardiovascular diseases compared to non-diabetics. This study was designed to evaluate cerebral hemodynamic changes related to type 2 diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD). TCD is a highly sensitive and specific method of quick bedside assessment of cerebrovascular circulation hemodynamics. PATIENTS AND METHODS: In a prospective study, we compared a group of 100 patients with the diagnosis of type 2 diabetes mellitus (aged 48 to 67 years) and an age- and sex-matched control group of 100 healthy subjects without diabetes mellitus. We measured flow velocities (Vm) and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA). RESULTS: The rate of TCD abnormalities was statistically significantly higher in diabetic patients than in healthy control subjects (55% vs. 11%, P<0.05). The PI was significantly higher in diabetic patients than in healthy controls (P<0.001). Atherosclerotic changes were found in 34.0% and 71.4% of patients suffering from diabetes for <5 and ≥5 years, respectively. CONCLUSION: This study suggests that TCD is a useful marker for the detection of diabetic cerebrovascular changes. The duration and type of diabetes were found to have an impact on the development of pathologic cerebrovascular changes.  
      PubDate: Tue, 16 May 2017 12:08:00 +000
       
  • Acute effects of lobectomy on right ventricular ejection fraction and
           mixed venous oxygen saturation

    • Abstract:
      BACKGROUND: Traditional methods of assessing the operative risk for lung resection provide only a modest ability to predict postoperative morbidity and mortality. The aim of this study was to evaluate the effect of lobectomy on pulmonary hemodynamic and gas exchange variables using the RV thermodilution ejection fraction/oximetric catheter.
      METHODS: We evaluated the acute postoperative effects of lung resection on hemodynamic and gas exchange parameters in 30 patients. Anesthesia was induced with thiopentone sodium and maintained with midazolam, fentanyl and pipecuronium. Intubation was performed with a double-lumen, left-sided endobronchial tube for one lung ventilation. The hemodynamic and gas exchange parameters were recorded before and after induction of anesthesia, and two hours after lung resection. These parameters were also recorded after the classification of the patients according to the underlying lung pathology.
      RESULTS: Lobectomy was associated with significant hemodynamic changes and good maintenance of gas exchange variables. SVI, LVSWI and RVEF were significantly decreased in the early postoperative period after lung resection. MPAP, COP, CI, SVRI, PVRI, RVSWI, and RVEDVI showed no significant changes during the perioperative period. SVO2 showed a significant increase after lung resection when compared with preinduction values, while VO2 significantly decreased. SaO2 , a-A PO2 , QS-QT , DO2 , and O2ER showed no significant changes during the perioperative period.
      CONCLUSIONS: We conclude that in the acute post-resection period (up to 2 hours postoperatively) there is right and left ventricular dysfunction with good maintenance of gas exchange.
       
      PubDate: Tue, 16 May 2017 11:30:00 +000
       
  • Diagnosis: Brugada Syndrome

    • Abstract: Ann Saudi Med 2007; 27(3): 223-224
      PubDate: Tue, 16 May 2017 08:22:00 +000
       
  • "Anatomy Charts" from the collection of Dr. Sami Ibrahim Haddad

    • Abstract: This is the fourth chart (the organs) of the set of four "Anatomy Charts” found in a 264-folio illustrated medical manuscript [N° "500-510/... Ah/1110/n14” in
      PubDate: Mon, 15 May 2017 06:07:00 +000
       
  • Errata

    • Abstract: Volume 24;3 (May-June 2004)On page 193, the following name and address of the author should have appeared with the article "Congenital duodenal diaphragm in eight
      PubDate: Sat, 13 May 2017 22:22:00 +000
       
  • Subdural Hematoma Following Obstetric Analgesia, Causal or
           Coincidence'

    • Abstract: To the Editor: Epidural analgesia is an effective technique to relieve pain during labor.1 Intracranial subdural hematoma (ISH) can present as a rare neurological complication
      PubDate: Sat, 13 May 2017 22:13:00 +000
       
  • Erratum

    • Abstract: Volume 24;4 (July/August 2004)On page 247, the following tables should have appeared as follows:Table 4. Summary of effects of pharmacological agents on bone mineral density
      PubDate: Sat, 13 May 2017 17:17:00 +000
       
  • Erratum

    • Abstract: Volume 24;4 (July/August 2004)On page 306, the following name and address of the author should have appeared with the article "Thoracic ectopia cordis (naked heart)":Dr.
      PubDate: Sat, 13 May 2017 17:04:00 +000
       
  • Erratum

    • Abstract: Volume 23;6 (November/December)On page 419, the degrees for two authors following the letter, A Survey Assessing Patient Satisfaction at Public and Private Healthcare Facilities in
      PubDate: Sat, 13 May 2017 16:48:00 +000
       
  • Glycemic Control and Treatment Satisfaction in Saudi Diabetic Children on
           Insulin Pump Therapy

    • Abstract: To the Editor: Since the introduction of continuous subcutaneous insulin infusion (CSII) in the late 1970s, it has become apparent that the use of insulin
      PubDate: Sat, 13 May 2017 14:49:00 +000
       
  • Syndrome of Acanthosis Nigricans, Insulin Resistance and Acromegaloid
           Features: New Concepts from Old Ideas

    • Abstract:  
      PubDate: Sat, 13 May 2017 10:28:00 +000
       
  • Insulinoma in Iran: a 20-year review

    • Abstract:
      BACKGROUND: The time between onset of symptoms of insulinoma to diagnosis ranges from 10 days to more than 20 years. To help physicians make an earlier diagnosis, we defined the clinical, imaging and paraclinical characteristics of insulinoma in cases from seven referral hospitals in Iran over two decades. 
      METHODS: The medical records of 68 cases with biochemical or histological evidences of insulinoma were reviewed. 
      RESULTS: More males were affected (53%). The mean age at diagnosis was 39±15.3 years. The mean duration of symptoms was 39.9±59.3 months. Eighty-four percent of patients had been initially misdiagnosed as cereberovascular accident (CVA), epilepsy, conversion disorder, and others. Neuroadrenergic symptoms were observed in 89.6% and neuroglycopenic symptoms in 97% of patients. Mean diameter of tumours was 2.9 cm (range, 1cm to to 8.5 cm). Of 52 pathologically confirmed cases of insulinoma, 43 tumours (87.8%) were single and 49 (94.2%) were benign. Fifty-five patients had undergone surgery, with a successful outcome in 44 (80%).
      CONCLUSION: The high incidence of neuroglycopenic symptoms suggest the clinical impression of insulinoma when patients present with a suggestive clinical symdrome. The clinical impression is essential to decrease the frequent delay in the diagnosis of insulinoma. 
       
      PubDate: Thu, 11 May 2017 12:44:00 +000
       
  • Acetylator phenotype in Iraqi patients with allergic contact dermititis

    • Abstract:
      BACKGROUND: Few studies have been done on acetylator status in ACD. This study determined acetylator status in Iraqi patients with allergic contact dermatitis (ACD) in comparison to a matched control group. METHODS: The study included 35 ACD patients and 67 healthy volunteers. The ACD patients were diagnosed clinically and the diagnosis was confirmed by patch test. A detailed history was taken from the patients. After an overnight fast, each control subject and each patient received a single oral dose of 100 mg of dapsone. A blood sample was collected after 3 hours and plasma was separated for determination of dapsone and monoacetyldapsone by HPLC. RESULTS: Twenty-six of the 35 ACD patients returned for follow up. The frequency of slow acetylators in healthy individuals was 71.6%, while the frequency of rapid acetylators was 28.4%. The frequency of slow acetylators in ACD patients was 60% while the frequency of rapid acetylators was 40%. There was no association between the acetylator status, personal history of allergy, patch-test positivity or sites of dermatitis in ACD patients. CONCLUSION: A rapid acetylator status might predispose to ACD, but does not seem to influence other features of the disease.  
      PubDate: Thu, 20 Apr 2017 13:32:00 +000
       
  • Predictive value of thyroid hormones on the first day in adult respiratory
           distress syndrome patients admitted to ICU: comparison with SOFA and
           APACHE II scores

    • Abstract:
      BACKGROUND: Thyroid hormone dysfunction could affect outcome and increase mortality in critical illness. Thereforem in a prospectivr, observational study we analyzed and compared the prognostic accuracy of free tri-iodothyronine (fT3), free throxine (fT4), thyroid-stimulating hormone (TSH), along with the APACHE II and SOFA scoring systems in predicting intensive care unit (ICU) mortality in critically ill patients. 
      PATIENTS AND METHODS: Physiology scores were calculated fir the first 24 hours after ICU admission in 206 patients with acute respiratory distress syndrome. APACHE II and SOFA scores were employed to determine the initial severity of illness. Thyroid hormones were measured within the first 24 hours. logistic regression models were created for APACHE II scores, SOFA scores, and thyroid hormone levels. The models predicted high-and low-risk subgroups. Models that showed a good fit were stratified by Kaplan-Meier survival curves. 
      RESULTS: There were 98 (4736%) survivors and 108 (52.4%) non-survivors. The survivors had a lower APACHE II score (11.50 vs 15.82, P<0.0005), a lower SOFA score (6.06 vs. 9.42, P<0.0005), a yoinger age (57 vs 70 years, P=0.008), a shorter ICU stay (13 vs 16 days, P=0.012), and a higher fT3 level (2.18 vs 1.72 pg/mL, P=0.002) than non-survivors. ICU survival was most closely predicted by a model that included age and fT3 and a model that included APACHE II and APACHE II*sex.
      CONCLUSION: In critically ill patients, serum fT3 concentrations makedly decreased after ICU admission among non-survivors. According to our findings, fT3 levels might have additive discriminatory power to age. SOFA na APACHE II scores in predicting short-term mortality in ARDS patients admitted to ICU. 
       
      PubDate: Thu, 23 Feb 2017 09:48:00 +000
       
  • The pattern of dysphagia in children

    • Abstract:  BACKGROUND: Difficulty in swallowing is not uncommon among children and yet little information is available in the literature. We report our experience on the pattern of this condition. 
      METHODS: We extracted data from the medical records of 42 children wirh dysphagia on age at presentation, nationality, gender, and final diagnosis. 
      RESULTS: Form 1993 to 2002, 96% of 42 children presenting with dysphagia were Saudi nationals, ranging in age from 3 months to 18 years, with a male to female ration of 1:0.6. An etiologic diagnosis wasfound in 30 children (72%). Esophagitis, esophageal strictures and motility disorders were the most common causes of dysphagia, occuring in 16 (38%), 7 (17%), and 4 (10%) children, respectively. Two children had esophageal webs and one had an esophageal ring. Age-related analysis indicated that most of the cases of esophagitis (11/16, 69%) and strictures (5/7, 71%) occured in young children whereas most nondemonstrable causes occured in older children (9/12, 75%).
      CONCLUSION: This report documents a pattern of dysphagia in Saudi Arab children that is similar to descriptions from other countries. 
       
      PubDate: Wed, 22 Feb 2017 12:53:00 +000
       
  • Incidence of musculoskeletal pain in adult Kuwaitis using the validated
           Arabic version of the WHO-ILAR COPCIRD Core Questionnaire

    • Abstract:  BACKGROUND: The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We estimated the incidence of musculoskeletal pain in the first community-based COPCORD study in Kuwait.
      SUBJECTS AND METHODS: The validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire was used in a survey of 2500 randomly selected Kuwaiti households to assess the frequency of musculoskeletal pain, disability, and health-seeking behavior in adult Kuwaitis. Those subjects reporting no musculoskeletal pain were identified and followed-up for a period of one year by contacting them every 2 weeks. Once a respondent reported pain, an appointment to report to hospital was offered and the subject was examined by a rheumatologist using the American College of Rheumatology (ACR) criteria. 
      RESULTS: Of 5159 adults who were non-complainers in an earlier prevalence phase of the study, 3341 responded to phone calls (response rate of 65%). The incidence of musculoskeletal pain was 6.6% (95%CI, 3.4%-9.7%). Age- and sex-adjusted incidence rates were 7.2% (95%CI, 3.4%-10.5%) for females and 6.1% (95%CI, 3.1%-9.2%) for males. The incidence rate increased with increasing age, body mass index, and with being married. The common sites of pain were knee, low back and shoulder. 
      CONCLUSION: The incidence of musculoskeletal pain among Kuwaiti adults is reported for the first time. Further studies adopting the same instrument in other communities are warranted to compare with our findings.
       
      PubDate: Wed, 22 Feb 2017 08:32:00 +000
       
  • Update in Hypertension: The Seventh Joint National Committee Report and
           Beyond

    • Abstract: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation on the Treatment of High Blood Pressure (JNC-VII) had new key messages that need to be highlighted for practicing physicians. More than two years has elapsed since its punlication and several important trials and meta-analyses were published during this period. Most of these publications supported and reinforced the JNC-VII recommendations, but others did not fully agree. Thus, some questions have arisen that need to be addressed in future research. This review will discuss what is new in JNC-VII and post-JNC-VII evidence that supports or disputes the recommendations. In addition, the results of other significant trials will be addressed. Finally, we outline the clinical "bottom line" and emphasize the practical application of this evidence. 
       
      PubDate: Tue, 21 Feb 2017 09:35:00 +000
       
 
 
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