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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: 6)
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
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   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 8)
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: 14, 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: 7, 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: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 6)
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: 2, 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  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 1)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 12, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access   (Followers: 1)
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: 5, 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   (Followers: 1)
Egyptian J. of Haematology     Open Access  
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
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   (Followers: 2)
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   (Followers: 2)
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: 8)
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   (Followers: 1)
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 8, 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   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, 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: 3, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 2)
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: 2, 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: 5, 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: 2)
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   (Followers: 1)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
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: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
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: 7, 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: 3)
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   (Followers: 1)
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: 2)
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: 9, 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   (Followers: 2)
J. of Family Medicine and Primary Care     Open Access   (Followers: 11)

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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]
  • Re: Epidermoid Cyst of the Cecum in an Elderly Man

    • Abstract: To the Editor: Let me offer an addendum to the article entitled "Epidermoid cyst of the cecum in an elderly man" by Ali Uzunlar and Yasar
      PubDate: Thu, 16 Nov 2017 14:12:00 +000
       
  • Re: The Adult Hip Joint in Saudi Arabia

    • Abstract: To the Editor: The hip joint presents some of the most fascinating problems in the field of orthopedic surgery. Injuries and diseases of the adult hip
      PubDate: Thu, 16 Nov 2017 13:48:00 +000
       
  • A 19-Year-Old Male with Cough and Right Lower Lobe Opacity

    • Abstract: A 19-year-old male was referred for investigation of left lower lobe opacity. He was well until two months prior to his presentation when he developed
      PubDate: Thu, 16 Nov 2017 12:55:00 +000
       
  • Primary Sjögren's Syndrome Presenting as Hypokalemic Paralysis

    • Abstract: Sjögren's syndrome (SS) is a chronic inflammatory disorder that usually presents with drymouth (xerostomia) and dry eyes (xerophtalmia orkeratoconjuctivitissicca) and is frequently associatedwith arthralgia or
      PubDate: Thu, 16 Nov 2017 12:49:00 +000
       
  • Pachygyria in a Neonate with Trisomy 21

    • Abstract: Pachygyria is a neuronal migration disorder characterized by reduced and broad cerebral gyri.1The regions of the brain with pachygyria have an abnormally thick cortex that
      PubDate: Thu, 16 Nov 2017 12:14:00 +000
       
  • Live Ascaris Lumbricoides in the Peritoneal Cavity

    • Abstract: Infestation with Ascarislumbricoides is a worldwidephenomenon with up to a quarter of the worldpopulation, mostly in the third-world countries, infected.1,2 A. lumbricoides resides mostly in the middlethird of the jejunum,
      PubDate: Thu, 16 Nov 2017 11:50:00 +000
       
  • Revision Hip Arthroplasty in Sickle Cell Disease

    • Abstract: Sickle cell disease (SCD) is a hemoglobinopathycausing osteonecrosis and collapse of the femoral head that results in secondary osteoarthritis.1 Osteonecrosis is noted in 20% to 50%
      PubDate: Thu, 16 Nov 2017 11:44:00 +000
       
  • Reply to Alavian and Tabatabaei: Serum Viral Markers in Iranian Patients
           with Congenital Bleeding Disorder

    • Abstract: To the Editor: I appreciate the comments of Drs. Alavian and Tabatabaei on our article in the November-December 2008 issue of the Annals.1 The HCV
      PubDate: Thu, 16 Nov 2017 11:06:00 +000
       
  • Filariasis of the Breast, Diagnosed by Fine Needle Aspiration Cytology

    • Abstract: To the Editor: Bancrofitian filariasis has a worldwide distribution, with disease prevalence in Africa, Asia including China, India and Southeast Asia, the Caribbean islands, Central
      PubDate: Thu, 16 Nov 2017 10:47:00 +000
       
  • Is CCR5-Δ32 Mutation Associated with Diabetic Nephropathy in Type 2
           Diabetes'

    • Abstract: To the Editor: Immunological factors like the chemokine-receptor axis recently were proved to have crucial roles in diabetes and its complications.1CCR5 is a G-protein CC
      PubDate: Thu, 16 Nov 2017 10:44:00 +000
       
  • Profile of Major Congenital Anomalies in the Dhahira Region, Oman

    • Abstract: About 2 to 3% of births are associated withmajor congenital anomalies diagnosed at orsoon after birth. Congenital malformations accounted for an estimated 495 000 deaths
      PubDate: Thu, 16 Nov 2017 10:43:00 +000
       
  • Priapism as the First Manifestation of Chronic Myeloid Leukemia

    • Abstract:  To The Editor: A previously healthy 33-year-old Moroccan man was referred to the local hospital for persistent painful erection of the penis that had lasted
      PubDate: Thu, 16 Nov 2017 10:42:00 +000
       
  • Which One is the Urinary Bladder'

    • Abstract: Ann Saudi Med 2009; 29(5): 410-411
      PubDate: Thu, 16 Nov 2017 10:39:00 +000
       
  • Primary Mediastinal Hydatid Disease Leading to Popliteal Artery Hydatid
           Cyst Embolization

    • Abstract: Hydatid disease is a zoonosis caused by Echinococcus granulosus. Infected dogs release eggs through their feces and the eggs infect humans through food and water. The most common locations of hydatid cysts are the liver and lungs, but primary mediastinal involvement, though rare, can be encountered. We report on a 16-year-old female with a primary mediastinal hydatid cyst leading to popliteal arterial embolization. The mediastinal lesion was treated with partial pericystectomy with removal of the germinal membrane and prophylactic albendazole. In endemic areas, it is important to consider hydatid cysts in the differential diagnosis of an acute arterial occlusion. Ann Saudi Med 2009; 29(5): 407-409
      PubDate: Thu, 16 Nov 2017 10:36:00 +000
       
  • Ileosigmoid Knot: A Case Report and Literature Review of 280 Cases

    • Abstract: Ileosigmoid knotting, also known as compound volvulus or double volvulus, is a rare cause of intestinal obstruction. In this condition the ileum wraps around the base of the sigmoid colon and forms a knot. Ileosigmoid knotting is an unusual entity in the West, but is comparatively common in certain African, Asian and Middle Eastern nations. The condition is serious, generally progressing rapidly to gangrene. Awareness of the condition is essential for prompt diagnosis and optimal management. This report describes a case in a 60-year-old male and describes the management of this rare condition. An additional 280 recent cases in the English literature are reviewed as to etiopathogenesis, presentation, diagnostic modalities, surgical interventions and outcome. Ann Saudi Med 2009;29(5): 402-406
      PubDate: Thu, 16 Nov 2017 10:30:00 +000
       
  • Strongyloides Stercoralis Hyperinfection After Corticosteroid Therapy: A
           Report of Two Cases

    • Abstract: Two cases of Strongyloides stercoralis hyperinfection are described. Both patients were expatriates from the Indian subcontinent, and reported the use of corticosteroids. The first patient presented with severe pulmonary disease that necessitated respiratory support, followed by acute abdomen and intestinal obstruction and he succumbed to these diseases. The second patient also presented with acute pulmonary disease, which responded to antihelmintic treatment and supportive care; however, he died later due to his primary disease. The clinical features of S stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and to start appropriate therapy. Because of the seriousness of the disease and the associated high mortality we suggest screening for 5 stercoralis in patients from endemic areas who will be taking immunosuppressive therapy. Ann Saudi Med 2009; 29(5): 397-401
      PubDate: Thu, 16 Nov 2017 10:23:00 +000
       
  • Causes of Admission to Intensive Care Units in the Hajj Period of the
           Islamic Year 1424 (2004)

    • Abstract: BACKGROUND: Approximately 2 to 3 million pilgrims perform Hajj every year. We describe the pattern of diseases, complications, and outcome of pilgrims who required admission to intensive care units (ICUs) during the Hajj period of the Islamic year 1424 (2004).METHODS: This was a cross-sectional study of all patients admitted to 104 ICU beds in four hospitals in Mena and three hospitals in Arafat during the Hajj.RESULTS: Of 140 patients admitted to ICUs, 75 (54%) patients were older than 60 years. The risk of complications and death increased with age, with the highest risk noticed among pilgrims older than 80 years. Ninety- four (67.6%) patients were men. Eighty-nine (63.6%) patients were admitted with cardiovascular diseases and 37 (26.4%) patients with infections. Myocardial infarction (25%) and pneumonia (22%) were the most common admitting diagnoses. Trauma accounted for only 6.4% (9 patients) of admissions. Sixty-three (45.0%) patients recovered and were discharged or transferred to hospital wards in stable condition, 40 (28.6%) were transferred to tertiary care centers for specialized services, 21 (15.0%) were transferred to tertiary care centers after closure of the temporary hospitals in Mena and Arafat, 15 (10.7%) patients died, and one (0.7%) patient was discharged against medical advice.CONCLUSION: This study revealed information on the pattern of diseases and the most common causes of admission of pilgrims to ICUs and the required medical services during Hajj. It is hoped that this information will be of help to health care planners and officials to provide optimal and cost effective health care services to pilgrims in Hajj. 
      PubDate: Thu, 16 Nov 2017 09:14:00 +000
       
  • An Unusual Cause of Gastric Outlet Obstruction: A Pancreaticoduodenal
           Artery Aneurysm

    • Abstract: We present a rare case of gastric outlet obstruction due to compression of the duodenum by a pancreaticoduodenal artery (PDA) aneurysm 2.5 cm in diameter, in a 43-year-old man from Saudi Arabia who presented with persistent vomiting and epigastric pain. The initial investigations and blood works were negative, and esophagogastroduodenoscopy (EGD) was unremarkable. A CT abdomen demonstrated a mass around the duodenum and dilatation of the stomach, and CT angiography showed the PDA aneurysm. The patient was stabilized and then referred to a tertiary center for embolization. Our case demonstrates a diagnostic challenge that physicians may encounter in patients who present with vomiting and epigastric pain. Ann Saudi Med 2009; 29(5): 393-396
      PubDate: Thu, 16 Nov 2017 09:08:00 +000
       
  • Surgical Resident Satisfaction with the Current Surgical Training Program
           in the Riyadh Area

    • Abstract: BACKGROUND: The satisfaction of surgical residents with their training programs plays an important role in dictating its output. This survey was conducted to explore the satisfaction of surgical residents with their training programs in the Riyadh area. METHODS: A survey questionnaire was distributed in four major hospitals to explore the view of surgical residents regarding their training programs. Frequency tables were generated for each question in the survey. RESULTS: About 78 survey forms were distributed and 52 were retrieved (67%). About 45% of residents had a comprehensive orientation on admission to the program, but only 20% felt it was helpful. Only 40% of residents felt that their trainers were committed to training and that the consultants who were trained abroad were more committed than those trained locally (62% vs 36%, P=.01). Only 15% felt the residents themselves had enough bedside teaching or operative experience. Seventy-eight percent of the residents felt that current training does not meet their expectations. However, 85% felt that training abroad was better than local training, and 60% felt it should be mandatory. While 90% felt that training programs should be unified nationally and controlled by one organization, only 6% felt that the current governing body was capable of monitoring the training. Moreover, only 28% felt that current reviews of programs by the governing body are effective. CONCLUSIONS: These results show that surgical residents are generally dissatisfied with current training programs. The study suggests that there are significant weaknesses in the current programs and the governing body may be ineffective in monitoring the programs. We feel that a national review of surgical training programs is warranted in view of these results. Ann Saudi Med 2009; 29(5): 388-392
      PubDate: Thu, 16 Nov 2017 08:57:00 +000
       
  • Hepaticocholecystoduodenostomy Compared with Roux-en-y
           Choledochojejunostomy for Decompression of the Biliary Tract

    • Abstract: BACKGROUND AND OBJECTIVES: The nature of palliative decompressive surgery for unresectableperiampullary tumor is usually determined by the experience of the surgeon. We compared hepaticocholecystoduodenostomy (HCD), a new palliative decompressive anastomotic technique, to Roux-en-y choledochojejunostomy (CDJ) in this prospective, randomized study. PATIENTS AND METHODS: Twenty patients who were to undergo surgery for palliative bypass were randomized into two groups: group I was subjected to HCD (10 patients) and group II to CDJ (10 patients). Pre- and postoperative liver function tests, operative time, operative blood loss, onset of postoperative enteral feeding, length of hospital stay and survival rates were compared in the two groups. RESULTS: Effective surgical decompression was observed clinically as well as on analysis of pre- and postoperative liver function tests in both the groups. The results were statistically significant in favor of patients in group I when compared to those of group II with respect to operative time 84.7 (10.3) min vs 133.6 (8.9) min; P=<.0001 ), operative blood loss 137.8 (37.2) mL vs 201.6 (23.4) mL; P=.001), postoperative enteral feeding 3.3 (0.5) days vs 5.0 (0.7) days; P=<.0001) and length of hospital stay 7.5 (0.7) days vs 9.7 (1.2) days ; P=<.0001). During follow-up, recurrent jaundice was observed in one patient in group I and two patients in group II, while duodenal obstruction developed in one patient in the group I series. Gastrointestinal hemorrhage occurred in one patient belonging to group II. The difference in mean survival time was not statistically significant. CONCLUSION: Based on this small series, HCD seems to be a better palliative surgical procedure than the routinely performed CDJ. Ann Saudi Med 2009; 29(5): 383-387
      PubDate: Thu, 16 Nov 2017 08:33:00 +000
       
  • Vitamin D Levels in Healthy Men in Eastern Saudi Arabia

    • Abstract: BACKGROUND: Studies in 1980s and 1990s indicated that vitamin D levels in the ethnic Saudi Arabian population were low but no studies since that time have evaluated vitamin D levels among healthy young or middle-aged Saudi men. Thus, we assessed the serum level of 25-hydroxyvitamin D (25OHD) among healthy Saudi Arabian men living in the Eastern Province. SUBJECTS AND METHODS: One hundred males aged 25-35 years (the age range of peak bone mass) and 100 males aged 50 years or older were randomly selected and evaluated clinically, including measurement of serum calcium, parathyroid hormone (PTH) and serum 25OHD levels. Vitamin D deficiency was defined as a serum level of 25OHD of ≤20 ng/mL and insufficiency as a serum level between >20 ng/mL and <30 ng/mL and normal ≥30 ng/mL. RESULTS: The mean (SD) age of subjects in the younger age group was 28.2 (4.5) years. Twenty-eight (28%) had low25OHD levels; 10 (10%) subjects were vitamin D deficient with a mean level of 16.6 (3.4) ng/mL and 18 (18%) were vitamin D insufficient with a mean level of 25.4 (2.7) ng/mL. In the older age group, the mean age was 59.4 (15.6) years and 37 (37%) had low 25OHD; 12 (12%) subjects were deficient with a mean 25OHD level of 16.7 (3.4) ng/mL and 25 (25%) were insufficient with a mean 25OHD level of 25.3 (3.3) ng/mL. CONCLUSIONS: The prevalence of vitamin D deficiency among healthy Saudi men is between 28% to 37%. Vitamin D deficiency among young and middle age Saudi Arabian males could lead to serious health consequences if the issue is not urgently addressed. Ann Saudi Med 2009; 29(5): 378-382
      PubDate: Thu, 16 Nov 2017 08:23:00 +000
       
  • Management of Ascites Due to Gastrointestinal Malignancy

    • Abstract: Ascites is the pathological accumulation of fluid within the abdominal cavity. The most common cancers associated with ascites are adenocarcinomas of the ovary, breast, colon, stomach and pancreas. Symptoms include abdominal distension, nausea, vomiting, early satiety, dyspnea, lower extremity edema, weight gain and reduced mobility. There are many potential causes of ascites in cancer patients, including peritoneal carcinomatosis, malignant obstruction of draining lymphatics, portal vein thrombosis, elevated portal venous pressure from cirrhosis, congestive heart failure, constrictive pericarditis, nephrotic syndrome and peritoneal infections. Depending on the clinical presentation and expected survival, a diagnostic evaluation is usually indicated as it will impact both prognosis and the treatment approach. Key tests include serum albumin and protein and a simultaneous diagnostic paracentesis, checking ascitic fluid, WBCs, albumin, protein and cytology. Median survival after diagnosis of malignant ascites is in the range of 1 to 4 months; survival is apt to be longer for ovarian and breast cancers if systemic anti-cancer treatments are available. Ann Saudi Med 2009; 29(5): 369-377
      PubDate: Thu, 16 Nov 2017 07:51:00 +000
       
  • Prevalence of Oral Lesions Among Saudi Dental Patients

    • Abstract: BACKGROUND AND OBJECTIVES: Few studies have been conducted in the Saudi population on oral mucosal lesions. The purpose of this study was to evaluate the type and extent of oral lesions in a study among dental patients at a college of dentistry in Saudi Arabia. PATIENTS AND METHODS: Over a 3-year period, 2552 dental outpatients were interviewed and investigated clinically for the presence of oral mucosal conditions. A thorough oral clinical examination was performed, including a radiographic examination. The diagnosis was confirmed histopathologically when necessary. RESULTS: Of 383 (15.0%) patients found to have oral mucosal lesions, females constituted 57.7% (n=221) and males 42.3% (n=162). The age range of the patients was between 15 to 73 years with a mean age of 38.2 years. The most commonly affected age group was 31 to 40 years, which comprised 21.4% (n=82) of all affected individuals. The least affected age group were individuals older than 61 years. The most common lesion was Fordyce granules (3.8%; n=98), followed by leukoedema (3.4%; n=86) and traumatic lesions (ulcer, erosion) in 1.9% (n=48). Tongue abnormalities were present in 4.0% (n=101 ) of all oral conditions observed, ranging from 1.4% (n=36) for fissured tongue to 0.1% (n=2) for bifid tongue. Other findings detected were torousplatinus (1.3%; n=34), mandibular tori (0.1%; n=2) aphthous ulcer (0.4%; n=10), herpes simplex (0.3%; n=7), frictional hyperkeratosis (0.9%; n=23), melanosis (0.6%; n=14), lichen planus (0.3%; n=9) and nicotinic stomatitis (0.5%; n=13). CONCLUSION: The findings of this study provide information on the types and prevalence of oral lesions among Saudi dental patients. This provides baseline data for future studies about the prevalence of oral lesions in the general population. Ann Saudi Med 2009; 29(5): 365-368
      PubDate: Thu, 16 Nov 2017 07:34:00 +000
       
  • Pediatric Retinal Detachment in the Eastern Province of Saudi Arabia:
           Experience of a Tertiary Care Hospital

    • Abstract: BACKGROUND AND OBJECTIVES: Because no previous studies have addressed the issue, we describe clinical characteristics and surgical outcome of patients with rhegmatogenous retinal detachment (RRD) in a pediatric population of the Eastern province of Saudi Arabia. PATIENTS AND METHODS: We conducted a retrospective review of all consecutive cases of pediatric RRD (0-18 years) patients presenting at Dhahran Eye Specialist Hospital, a tertiary care hospital, in the Eastern Province of Saudi Arabia over a period of 3 years. RESULTS: Twenty patients were included in the study, accounting for 9.4% of all retinal detachment surgery cases performed over a period of 3 years (January 2006 to December 2008). The median age was 11.0 years, (range, birth to 18 years). Trauma, (45%) myopia/vitreoretinal degeneration (10%) and prior ocular surgery (25%) were significant risk factors for RRD. Proliferative vitreoretinopathy (PVR) more than grade C was present in 14/20 (70%) of cases. Most patients (15/20, 75%) were treated with pars plana vitrectomy and placement of an encircling buckle, while silicone oil or gas was used as tamponade in 13/20 (65%) patients. Surgery was successful in 17/20 (85%) cases in achieving retinal re-attachment. Visual acuity improved significantly following surgery (Mean preop 2.146 LogMAR, Mean postop 1.497 LogMAR) (P=.014). Longer duration of RRD (P=.007) and macular involvement (P=.05) were associated with worse anatomical outcomes following surgery. CONCLUSION: Pediatric RRD in the Eastern province is often associated with predisposing pathology. Surgery is successful in achieving anatomical reattachment of the retina in a majority of cases with improvement of visual acuity. Ann Saudi Med 2009; 29(5): 361-364
      PubDate: Thu, 16 Nov 2017 06:44:00 +000
       
  • The Prevalence of Metabolic Syndrome and Cardiovascular Risk Factors in a
           Group of Obese Saudi Children and Adolescents: A Hospital-Based Study

    • Abstract: BACKGROUND AND OBJECTIVES: We assessed the distribution of risk factors associated with the metabolic syndrome in a group of obese Saudi children and adolescents. No previous studies had addressed this issue in the Saudi pediatric population. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of patients evaluated for obesity between 2004 and 2008 and collected data on age, weight, height, body mass index (BMI), BP, fasting lipid profile, fasting glucose, insulin concentrations, and insulin resistance based on the homeostasis assessment model-insulin resistance (HOMA-IR) score. Obesity was defined as a BMI above the 95th percentile for age and gender and metabolic syndrome was diagnosed according to standard criteria. RESULTS: We studied 57 obese Saudi children and adolescents with a mean (standard deviation) age of 9.8 (3.5) years. Mean weight and body mass index (BMI) were 63.7 (28.3) kg and 31.6 (8.0) kg/m2, respectively. Systolic BP was elevated in 24 (42%) of the 57 subjects. Of the 39 children who had a lipid profile in their records, 10 had hypertriglyceridemia, 8 had hypercholesterolemia, 6 had elevated LDL cholesterol levels, and 6 had low HDL cholesterol levels. Impaired fasting glucose was found in 10 of 38 patients in which it was measured, and 9 of 25 patients had fasting hyperinsulinemia. Eleven of 37 patients (29.7%) met the diagnosis of the metabolic syndrome. Diastolic BP correlated positively with BMI (r=0.440, P=.001), and HDL cholesterol correlated negatively with weight and BMI (r=-0.487, P=.002 and r=-0.317, P=.05). HOMA-IR correlated positively with BMI and triglyceride levels and negatively with HDL cholesterol levels. CONCLUSIONS: Obese Saudi children and adolescents have multiple risk factors associated with metabolic syndrome. Ann Saudi Med 2009; 29(5): 357-360
      PubDate: Thu, 16 Nov 2017 05:46:00 +000
       
  • Regional Variations in the Growth of Saudi Children and Adolescents

    • Abstract: BACKGROUND AND OBJECTIVES: No previous study has provided a detailed description of regional variations of growth within the various regions of Saudi Arabia. Thus, we sought to demonstrate differences in growth of children and adolescents in different regions. SUBJECTS AND METHODS: The 2005 Saudi reference was based on a cross-sectional representative sample of the Saudi population of healthy children and adolescents from birth to 18 years of age. Body measurements of the length, stature, weight, head circumference and calculation of the BMI were performed according to standard recommendations. Percentile construction and smoothing were performed using the LMS (lambda, mu and sigma) methodology, followed by transformation of all individual measurements into standard deviation scores. Factors such as weight for age, height for age, weight for height, and head circumference for children from birth to 3 years, stature for age, head circumference and body mass index for children between 2-18 years of age were assessed. Subsequently, variations in growth between the three main regions in the north, southwest, and center of Saudi Arabia were calculated, with the Bonferroni: method used to assess the significance of differences between regions. RESULTS: There were significant differences in growth between regions that varied according to age, gender, growth parameter and region. The highest variation was found between children and adolescents of the southwestern region and those of the other two regions The regression lines for all growth parameters in children <3 years of age were significantly different from one region to another reaching - 0.65 standard deviation scores for the southwestern regions (P=.001). However, the difference between the northern and central regions were not significant for the head circumference and for weight for length. For older children and adolescents a significant difference was found in all parameters except between the northern and central regions in BMI in girls and head circumference in boys. Finally, the difference in head circumference of girls between southwestern and northern regions was not significant. Such variation affected all growth parameters for both boys and girls. CONCLUSION: Regional variations in growth need to be taken into consideration when assessing the growth of Saudi children and adolescents. Ann Saudi Med 2009; 29(5): 348-356
      PubDate: Thu, 16 Nov 2017 04:21:00 +000
       
  • Body Mass Index in Saudi Arabian Children and Adolescents: A National
           Reference and Comparison with International Standards

    • Abstract: BACKGROUND AND OBJECTIVES: Because there are no reference standards for body mass index (BMI) in Saudi children, we established BMI reference percentiles for normal Saudi Arabian children and adolescents and compared them with international standards. SUBJECTS AND METHODS: Data from a stratified multistage probability sample were collected from the 13 health regions in Saudi Arabia, as part of a nationwide health profile survey of Saudi Arabian children and adolescents conducted to establish normal physical growth references. Selected households were visited by a trained team. Weight and length/height were measured and recorded following the WHO recommended procedures using the same equipment, which were subjected to both calibration and intra/interobserver variations. RESULTS: Survey of 11 874 eligible households yielded 35 275 full-term and healthy children and adolescents who were subjected to anthropometric measurements. Four BMI curves were produced, from birth to 36 months and 2 to 19 years for girls and boys. The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th percentiles were produced and compared with the WHO and CDC BMI charts. In the higher percentiles, the Saudi children differed from Western counterparts, indicating that Saudi children have equal or higher BMIs. CONCLUSION: The BMI curves reflect statistically representative BMI values for Saudi Arabian children and adolescents. Ann Saudi Med 2009; 29(5): 342-347
      PubDate: Thu, 16 Nov 2017 04:07:00 +000
       
  • The Need for Hospital-Based Neonatal Palliative Care Programs in Saudi
           Arabia

    • Abstract: The terms palliative care, supportive care, and comfort care are used to describe individualized care that can provide a dying person the best quality of life until the end. The term "end-of-life care" is also used in a general sense to refer to all aspects of care of a patient with a potentially fatal condition. While the concept of palliative care is not new, it has only recently been applied to the neonatal population. To the best of our knowledge, none of the neonatal intensive care units (NICUs) in Saudi Arabia have adopted a neonatal program for palliative care. We believe the main reason is lack of knowledge of such programs and the fear of being accused of being heartless and cruel by providing comfort care for dying babies. Comfort care begins with the diagnosis of a life-threatening/terminal condition, and continues throughout the course of illness regardless of the outcome. In this perspective, our aim is to introduce these programs for caregivers in the NICUs in Saudi Arabia. For this purpose, we have reviewed the current recommendations in establishing neonatal palliative care programs and discussed some of the social and religious aspects pertaining to this issue. Ann Saudi Med 2009; 29(5): 337-341
      PubDate: Thu, 16 Nov 2017 03:58:00 +000
       
  • Comparison of Six-Minute Walking Tests Conducted With and Without
           Supplemental Oxygen in Patients with Chronic Obstructive Pulmonary Disease
           and Exercise-Induced Oxygen Desaturation

    • Abstract: BACKGROUND: There are contradictory reports in the literature on the effects of supplemental oxygen administered before or after exercise tests. In light of this, we compared the results of 6-minute walking tests performed in room-air conditions (A6MWT) and with supplemental oxygen (06MWT) in patients with chronic obstructive pulmonary disease (COPD) and exercise-induced oxygen desaturation. PATIENTS AND METHODS: Thirty-one patients with COPD were included in the study. The A6MWT and 06MWT were performed in randomized order on each patient. During the tests, severity of dyspnea and tiring of the leg were evaluated by the Modified Borg Scale. Heart rate and pulsed oxygen saturation and blood pressure were measured by pulse oximeter. RESULTS: Walking distance was longer with the 06MWT than with the A6MWT (P=0.001). The 06MWT resulted in a smaller increase in dyspnea, leg fatigue, and heart rate and a smaller drop in pulsed saturation than the A6MWT (P<0.05). The walking distance with the 06MWT correlated with respiratory function and hemodynamic parameters (P<0.05).CONCLUSION: The 06MWT, which produced less hemodynamic stress and was safer than the A6MWT, might provide more accurate information on exercise limitation for patients with COPD. These results suggest that the 06MWT can be used as a standard walking exercise test for patients with COPD and exercise-induced oxygen desaturation.

      PubDate: Wed, 15 Nov 2017 14:58:00 +000
       
  • Rapid Detection of Clarithromycin-Resistant Helicobacter Pylori in
           Patients with Dyspepsia by Fluorescent in Situ Hybridization (FISH)
           Compared with the E-Test

    • Abstract: BACKGROUND: Clarithromycin is the antibiotic of choice for treatment of H. pylori-related dyspepsia, but unfortunately, resistance to clarithromycin is not rare. Detection of resistant strains takes 2 to 4 days by conventional methods. In this report, we applied the FISH technique for rapid detection of H. pylori in biopsies of dyspeptic patients.METHODS: Gastric biopsies from 50 patients suffering from dyspepsia were tested in this study. Part of each biopsy specimen was cultured and the remainder was fixed in liquid nitrogen. After mounting of frozen sections on microscopic slides, they were hybridized with oligonucleotide probes for detection of clarithromycin-resistant H. pylori. The slides were visualized under a fluorescent microscope. Susceptibility of cultured strains of H. pylori to clarithromycin was also determined by the E-test and the results were compared.RESULTS: Twenty-five of 50 biopsy specimens examined by FISH were positive for H. pylori. FISH showed that 17 strains (68%) were susceptible to clarithromycin and 6 strains (24%) were resistant. Bacteria isolated following culture of 2 biopsy specimens had a mixture of both clarithromycin-susceptible and resistant strains (8%). There was no discrepancy between the E-test and FISH technique for detection of resistant strains of H. pylori.CONCLUSION: FISH is a rapid technique for detection of H. pylori in clinical samples. Moreover, strains susceptible to clarithromycin can be detected quickly. Therefore, this method is suitable for determination of susceptibility of H. pylori to clarithromycin, especially when a quick decision is necessary for treating dyspeptic patients. 
      PubDate: Wed, 15 Nov 2017 14:47:00 +000
       
  • Congenital Pouch Colon Syndrome: A Report of 17 Cases

    • Abstract: BACKGROUND: Congenital pouch syndrome (CPC) is a rare condition seen in association with anorectal malformation that occurs almost exclusively in northern India. We reviewed cases seen in our institution to study aspects of clinical presentation, diagnosis, embryogenesis and management and raise awareness of this relatively infrequent entity.PATIENTS AND METHODS: From March 2002 to September 2004, 17 neonates/infants (11 males and 6 females) treated for CPC associated with anorectal malformations included 13 with type IV and 4 with type I CPC. Diagnosis was made by a single large air-fluid level on the infantogram occupying more than 50% of the entire abdominal dimension.RESULTS: In all patients, the pouch had fistulous communication with the genitourinary system, and there were other associated anomalies as well. Of 13 patients with pouch colon type IV, 11 neonates underwent laparotomy, ligation of the fistula, excision of the colonic pouch and end colostomy as a stage 1 procedure. Subsequently, these patients underwent definitive surgery, i.e. abdominoperineal posterior sagittal anorectoplasty (AP-PSARP), with or without covering colostomy. Two of 4 patients with type I CPC underwent laparotomy, ligation of the fistula and colorrhaphy as a first-stage operation before AP-PSARP. In our series, 4 patients were diagnosed intraoperatively and were treated in accordance with their operative findings. Post-operatively, there were no major complications except wound infection in some patients. There was one death that was not related to surgery.CONCLUSION: There are variants of the anomaly, but the possibility of CPC needs to be kept in mind as a possible association with anorectal malformations.
      PubDate: Wed, 15 Nov 2017 13:55:00 +000
       
  • Relative Contribution of Digital Rectal Examination and Transrectal
           Ultrasonography in Interpreting Serum Prostate-Specific Antigen Values for
           Screening Prostate Cancer in Arab Men

    • Abstract: BACKGROUND: This study was conducted to determine the utility of digital rectal examination (DRE), transrectal ultrasonography (TRUS) and serum prostate-specific antigen (PSA) in the diagnosis of prostate cancer in men in Arabia, an are of the world with a relatively low incidence of this disease.PATIENTS AND METHODS: 329 patients suspected of having prostate cancer on account of raised serum PSA level (> 4 ng/ml), DRE or TRUS findings, underwent TRUS-guided prostate biopsy. Raised PSA individually as well as combined, or a lesion suspicious of carcinoma on DRE or TRUS was recorded as PSA (+), DRE (+) or TRUS (+), respectively. The contribution of DRE, TRUS and serum PSA to the diagnosis of prostate cancer was analysed.RESULTS: Of the 329 patients who had prostate biopsies 109 cases (33.1%) had PCa. Of these 109 patients 56 (51%) had DRE (+), 77 (42%) had TRUS (+) and 49 ( 66%) had both DRE (+) and TRUS (+). Statistical analysis revealed that DRE (+) tripled the probability for cancer. PSA over a range of 10-50 ng/mL demonstrated an increasing cancer probability ranging from 2 to 3 fold. TRUS (+) was only significantly associated with cancer risk if PSA was elevated. The presence of all three factors increased the cancer probability by 6 to 7 fold.CONCLUSION: TRUS findings are dependent on PSA for interpretation while DRE (+) with elevated PSA makes PCa more likely. 
      PubDate: Wed, 15 Nov 2017 13:38:00 +000
       
  • Gigantic Cerebral Hydatid Cysts in Childhood

    • Abstract: Echinococcosis is a parasitic disease caused by infestation of various body tissues by the encysted larvae of Echinococcosis granulosa, the tape-worm. The definitive host for
      PubDate: Tue, 14 Nov 2017 09:47:00 +000
       
  • Diagnosis: Calcific Myonecrosis of the Calf

    • Abstract: Ann Saudi Med 2007;27(1):55-59
      PubDate: Tue, 14 Nov 2017 09:42:00 +000
       
  • Erratum

    • Abstract: Volume 26;6 (November/December 2006) - On page 493, the title of the article should have read as follows: Hematological parameters in sickle cell anemia patients
      PubDate: Tue, 14 Nov 2017 09:40:00 +000
       
  • Jabir Ibn Hayyan

    • Abstract:  Abu Musa Jabir Ibn Hayyan Al-Azdi, sometimes called al-Harrani and al-Sufi, is considered the father of Arab chemistry and one of the founders of modem
      PubDate: Tue, 14 Nov 2017 09:16:00 +000
       
  • A Case of Urinary Bladder Benign Polyp Treated Successfully by Resection
           in a Child

    • Abstract:  To the Editor: We report a case of a 3-year old boy that presented with recurrent urine retention secondary to a bladder polyp. Acute urine
      PubDate: Tue, 14 Nov 2017 09:13:00 +000
       
  • The Role of Endoscopy in Childhood Chronic Abdominal Pain

    • Abstract:  To the Editor: Chronic abdominal pain (CAP) is a common complaint of children presenting to pediatricians and gastroenterologists. It is believed to account for 2%
      PubDate: Tue, 14 Nov 2017 09:07:00 +000
       
  • A Previously Healthy 77-Year-Old Man with a Painful Mass in the Calf for
           Two Months

    • Abstract: Ann Saudi Med 2007;27(1):49-50
      PubDate: Tue, 14 Nov 2017 09:04:00 +000
       
  • Portal-Mesenteric Vein Thrombosis as an Unusual Presentation of
           Meckel's Diverticulum Complication

    • Abstract: Ann Saudi Med 2007;27(1):45-48
      PubDate: Tue, 14 Nov 2017 09:00:00 +000
       
  • Pulmonary Amyloidosis in a Patient with Lymphocytic Interstitial Pneumonia

    • Abstract: Ann Saudi Med 2007;27(1):40-44
      PubDate: Tue, 14 Nov 2017 08:54:00 +000
       
  • Unusually Located Thoracic Hydatid Cysts

    • Abstract: Ann Saudi Med 2007;27(1):36-39
      PubDate: Tue, 14 Nov 2017 08:49:00 +000
       
  • Diabetic Neuropathy, Foot Ulceration, Peripheral Vascular Disease and
           Potential Risk Factors Among Patients with Diabetes in Bahrain: A
           Nationwide Primary Care Diabetes Clinic-Based Study

    • Abstract: BACKGROUND: Although epidemiological studies have persistently shown a high prevalence of diabetes in Arabs, the control of diabetes is still poor and complications of diabetes are common. We examined the prevalence of diabetic peripheral neuropathy (DIM), neuropathic foot ulceration (FU) and peripheral vascular disease (PVD), and potential risk factors for these complications among patients attending primary care diabetes clinics in Bahrain. PATIENTS AND METHODS: We studied 1477 diabetic patients (Type 2 diabetes 93%); to, including 635 men and 842 women, with ages ranging from 18-75 years in a cross-sectional study. The main predictor variables were demographic and clinical data, including assessment of foot and blood parameters. RESULTS: Mean age of the patients and duration of diabetes were 57.3±6.32 and 9.5±8.4 years, respectively. DN was present in 36.6% of the population, FU in 5.9%, and PVD in 11.8%. Diabetic patients with neuropathy were older than patients without neuropathy (P=0.001 ) and had had diabetes longer (P=0.002). Diabetic patients with foot ulcers had more severe neuropathy and higher vibration perception thresholds values than patients without foot ulcers (P<0.05). Older age, poor glycemic control, longer duration of diabetes, elevated cholesterol levels, current smoking, obesity defined by body mass index, large waist circumference, elevated triglycerides levels and hypertension but not gender, were significant risk factors for DN in both the univariate and the multivariate analyses (P< 0.05). DN and PVD also remained significant risk factors for foot ulceration in the multiple logistic regression analysis. CONCLUSION: Rates of DN and PVD are high among diabetic patients in Bahrain. Implementation of strategies for prevention, early detection, and appropriate treatment at the primary health care level are urgently needed. Ann Saudi Med 2007;27(1):25-31
      PubDate: Tue, 14 Nov 2017 07:53:00 +000
       
  • Metabolic Syndrome in Normal-Weight Iranian Adults

    • Abstract: BACKGROUND: This study provides the first reported estimates of the prevalence of the metabolic syndrome in a normal-weight Iranian population. SUBJECTS AND METHODS: In this population-based cross-sectional study, the study population consisted of a representative sample of 1737 males and 1707 females aged >20 years with normal body mass index (BMI) (18.5- 24.9 kg/m2 for both genders). The metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. We present means and proportions, and multivariate odds ratios that quantify the association between metabolic syndrome and normal BMI quartiles, controlling for age, physical activity, smoking and education. RESULTS: The overall prevalence of the metabolic syndrome in normal-weight men and women were 9.9% and 11.0% (P=0.2) respectively. Men had a lower BMI than women, while their waist circumference (WC) was higher. The prevalence of high WC and low high-density lipoprotein cholesterol (HDL-C) was higher in women, while high blood pressure, high triglyceride levels and having at least one metabolic risk factor were more prevalent in men. Individuals in the highest category of normal BMI had significantly higher odds for being at risk for metabolic syndrome compared to those in the first category (OR: 5.21 for men and 2.15 for women). There was an increasing trend in odds for having all the metabolic syndrome components except for high fasting blood sugar (FBS) and high WC in men. Women showed a similar increasing trend except for high FBS across normal BMI quartiles. CONCLUSION: The prevalence of the metabolic syndrome in normal-weight Iranian adults is relatively high. Therefore, interventions for prevention of cardiovascular disease could be considered in this population. Ann Saudi Med 2007;27(1):18-24
      PubDate: Tue, 14 Nov 2017 07:34:00 +000
       
  • Insulin Sensitivity Obtained From the Oral Glucose Tolerance Test and Its
           Relationship With Birthweight

    • Abstract: BACKGROUND: Glucose intolerance and insulin sensitivity in preadolescent children might predict the risk of developing type 2 diabetes mellitus in adult life in small for gestational age (SGA) children. We aimed to investigate whether reduced birthweight is related to low insulin sensitivity in preadolescence. SUBJECTS AND METHODS: Twenty-five SGA children and 29 appropriate for gestational age children (AGA) children born between 1993 and 1994 were evaluated for insulin sensitivity in preadolescence. At the beginning of the study, body mass index (BMI) was calculated and an oral glucose tolerance test (OGTT) was performed. Blood samples to measure glucose and insulin were taken every 30 minutes during OGTT. Homeostasis of model assessment-insulin resistance (HOMA-IR) and composite index (Cl) values were measured to assess insulin sensitivity. RESULTS: On the OGTT, 120-minute glucose and insulin levels were higher in SGA than AGA children (P=0.02 and P=0.001, respectively). Although there was no difference between HOMA-IR values, the mean Cl value was lower in SGA than AGA children (P=0.001 ). There was an inverse correlation between birthweight and 120-minute glucose concentrations (r=-0.30, P=0.02). This correlation was stronger between birthweight and 120-minute insulin concentrations (r=-0.50, P=0.001). BMI was positively correlated with 120-minute insulin (r=0.50, P=0.001). There was no relationship between HOMA-IR values and birth size, but the Cl index was positively correlated with birthweight (r=0.40, P=0.002). CONCLUSIONS: Birthweight may be a predictive factor for insulin sensitivity and Cl is more reliable than HOMA-IR to assess this sensitivity in preadolescence. Ann Saudi Med 2007;27(1 ):13-17
      PubDate: Tue, 14 Nov 2017 06:36:00 +000
       
  • Deltamethrin-Impregnated Bed Nets and Curtains In An Anthroponotic
           Cutaneous Leishmaniasis Control Program in Northeastern Iran

    • Abstract: BACKGROUND: Anthroponotic cutaneous leishmaniasis (ACL) has long been a significant public health problem in northeastern Iran. The objective of this study was to determine the efficacy of deltamethrin-impregnated vs. nonimpregnated bed nets (NIBs) and curtains (NICs) in ACL control. PATIENTS: Deltamethrin-impregnated bed nets (IBs) and curtains (ICs) with 25 mg ai/m2 were distributed among 160 households in one district and NIBs and NICs were distributed among the same number of households in another district. A third district with a similar numbers of households served as a control. Health education messages were disseminated to ensure the population's complicance with the proper use of bed nets and curtains. Sticky paper traps were used to assess the effect of insecticide-impregnated bed nets and curtains on the density of Phlebotomus sergenti. Deltamethrin susceptibility and also bioassay tests were carried out on the species by WHO standard method. Case findings were done by house-to-house visits once a season and all the inhabitants of the selected households in each district were examined. RESULTS: IBs and ICs provided good protection against sandfly bites and reduced the transmission of ACL in the intervention district, while NIBs and NICs provided no protection. There was no significant difference in monthly density of P. sergenti indoors and outdoors among the districts (P>0.05). This species was susceptible to deltamethrin in the field population in the area. Bioassays confirmed that the nets treated with deltamethrin remained effective for more than 3 months. CONCLUSION: Personal protection is an effective and sustainable means of preventing and controlling ACL and can reduce dependence on insecticides. We encourage the use of IBs and ICs to control ACL in other high-risk areas of Iran and Afghanistan during the active season of sandflies. Ann Saudi Med 2007;27(1 ):6-12
      PubDate: Tue, 14 Nov 2017 06:08:00 +000
       
  • Human Papilloma Virus-16/18 Cervical Infection Among Women Attending a
           Family Medical Clinic in Riyadh

    • Abstract: BACKGROUND: Prevalence information is lacking on human papillomavirus types 16 and 18 (HPV-16/18) infection in cervical tissues of women residing in Riyadh, Saudi Arabia. In addition, there are no observations on progression to cervical intraepithelial neoplasia (CIN). SUBJECTS AND METHODS: Pap smear and HPV-16/18 DNA detection by PCR followed by Southern blotting was performed on 120 subjects (Saudi and other Arab nationals) during routine gynecological examination. Some HPV-positive subjects were followed for 4 years, by Pap smear every 6 months and by HPV DNA detection at the end of 4 years. RESULTS: Overall HPV-16/18 prevalence was 31.6%. HPV-16 prevalence alone was 13.3%, HPV-16 as a mixed infection with HPV-18 was 15%, and all HPV-16 was 28.3%. HPV-18 alone was 3.3%, HPV-18 as a mixed infection with HPV-16 was 15%, and all HPV-18 was 18.3%. Ten subjects had cervical abnormalities with the Pap smear test, six of whom were HPV-16/18 positive, 1 with HPV-16, 1 with HPV-18, and 4 with a mixed infection of HPV-16/18. Of all 23 HPV-16/18-positive subjects, either as individual or mixed infection, followed for 4 years, 7 showed abnormal cytology, 6 at initial examination and 1 during follow-up. Of these 7, 6 reverted to normal without treatment and 1 was treated and became normal after 3 years. None of the subjects progressed to CIN-III. CONCLUSION: A high prevalence of HPV-16/18 was found, but with a low rate of progression to CIN. A significant association with abnormal cytology was found only in patients with HPV-16/18 mixed infection. Ann Saudi Med 2007;27(1):1-5
      PubDate: Tue, 14 Nov 2017 05:42:00 +000
       
  • Bronchiolitis Obliterans Organizing Pneumonia: Experience at Three
           Hospitals in Riyadh

    • Abstract: BACKGROUND: Because reports of bronchiolitis obliterans organizing pneumonia (BOOP) are lacking from the Middle East, we conducted a retrospective review of of all histopathologically proven cases of BOOP over a 10- year period at three tertiary care hospitals in Riyadh and describe the clinical features and outcome. METHODS: Charts at the three hospitals were searched using a specific code for BOOP or cryptogenic organizing pneumonia (COP). Lung specimens had to show histological proof of BOOP with a compatible clinical picture. Chest radiographs and high-resolution CT scans were reviewed. RESULTS: Twenty cases of biopsy-proven BOOP had well-documented clinical and radiographic data. There were 11 males and 9 females (mean age, 58 years; range, 42-78). The clinical presentation of BOOP was acute or subacute pneumonia-like illness with cough (85%), fever (70%) dyspnea, (85%) and crackles (80%). The most frequent radiological pattern was a bilateral alveolar infiltrate. The most common abnormality on pulmonary function testing (n=14) was a restrictive pattern (11 patients). Most patients (70%) had no underlying cause (idiopathic BOOP). Other associations included thyroid cancer, rheumatoid arthritis, syphilis and Wegner's granulomatosis. Ten patients (50%) had a complete response to steroids, 6 (30%) had a partial response and 3 (15.8%) with secondary BOOP had rapid progressive respiratory failure and died. CONCLUSION: The clinical presentation of BOOP in our patients is similar to other reported series. A favorable outcome occurs in the majority of cases. However, BOOP may occasionally be associated with a poor prognosis, particularly when associated with an underlying disease. Ann Saudi Med 2007;27(1):35-35
      PubDate: Thu, 09 Nov 2017 04:15:00 +000
       
  • Simultaneous Bilateral Spontaneous Pneumothorax: A Case Report

    • Abstract: To the Editor: Pneumothorax is the presence of air in the pleural space with secondary lung collapse. Simultaneous bilateral spontaneous pneumothorax (SBSP), defined as the concurrent
      PubDate: Wed, 08 Nov 2017 08:55:00 +000
       
  • Ibn Sina (Avicenna): The Prince of Physicians

    • Abstract: Abu Ali Al-Hussein Ibn Abdullah Ibn Sina, known in the West as Avicenna, was one of the most eminent Muslim physicians and philosophers
      PubDate: Wed, 08 Nov 2017 07:29:00 +000
       
 
 
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