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Primary leiomyosarcoma of the atrium with heterologous differentiation
We report a case of a 47-year-old female who presented with breathlessness and palpitations for two weeks. On clinical evaluation, bilateral pedal edema was noticed. A CT pulmonary angiogram showed a mass in the left atrium causing significant obstruction to cardiovascular outflow. After extensive work-up, the mass was surgically resected. Histopathological findings from the acquired specimen revealed a high-grade leiomyosarcoma with extensive necrosis and heterologous (cartilaginous) differentiation. The early postoperative period was complicated by cardiac tamponade and the patient died on the second postoperative day du...
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Cardiac rhythm recorded by implanted loop recorder during lightning strike
Lightning strikes cause severe injuries and fatalities. Injuries vary from self-limiting skin manifestations to cardiac arrest and death. Because the event is sudden and unpredictable, assessment of the direct effects of the lightning on the human heart is usually impossible. In this case, a 16-year old boy who had an implanted loop recorder subcutaneous cardiac monitor was hit by lightning during a picnic and survived. A cardiac rhythm strip was recorded live during the strike.  SIMILAR CASES PUBLISHED: 0  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
BACKGROUND:The impact of preoperative thrombocytosis as a prognostic factor in endometrial carcinoma (EC) remains uncertain and has never been examined in Saudi Arabia.  OBJECTIVES:To determine the prevalence of preoperative thrombocytosis (platelet count>400 000/μL), and its prognostic significance for clinicopathological factors and survival in Saudi patients with endometrioid-type EC.  DESIGN:A retrospective cross-sectional study from January 2010 to December 2013.  SETTING:A referral tertiary healthcare institute.  PATIENTS AND METHODS:Patients who underwent staging surgery...
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Prevalence of congenital heart diseases in children with Down syndrome in Mansoura, Egypt: a retrospective descriptive study
CONCLUSION:More than one-third of children with DS have CHD with ventricular septal defect, which is the most common. Avoidance of passive maternal smoking and consanguineous marriage together with maternal folic acid supplementation could contribute to further reduction of CHD in children with DS. LIMITATIONS:Single-center study and retrospective.  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Drug shortages in large hospitals in Riyadh: a cross-sectional study
CONCLUSIONS:The relatively high reported rates of drug shortages in some hospitals should encourage health policymakers to address this serious public health problem.  LIMITATIONS:The generazibility of the study’s findings were limited by the small sample size, convenience sampling technique, self-reported data, and the fact that only pharmacists were invited to participate.  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Efficacy and safety of a generic rosuvastatin in a real-world setting: prospective, observational clinical study in Lebanese patients
BACKGROUND:No published studies have assessed the efficacy and safety of rosuvastatin generics.  OBJECTIVES:Primary objective to assess the safety and efficacy of a generic rosuvastatin in reducing plasma low-density-lipoprotein cholesterol (LDL-C) in Lebanese dyslipidemic patients. Changes in high-density lipoprotein cholesterol, triglycerides and adverse effects were secondary objectives.  DESIGN:Prospective, observational, non-comparative.  SETTING:Multiple outpatient clinics in Lebanon.  PATIENTS AND METHODS:Dyslipidemic patients requiring statin therapy were followed for 2 month...
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Prevalence of glucose-6-phosphate dehydrogenase deficiency in neonates in Egypt
BACKGROUND:Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder which causes neonatal jaundice in most cases, and under certain conditions, can cause a spectrum of hemolytic manifestations.  OBJECTIVE:To determine the local prevalence of G6PD deficiency in newborns. DESIGN:Cross-sectional.  SETTING:University hospital.  METHODS:Infants born during 2015 were prospectively screened for G6PD deficiency. Dried blood spot samples on filter paper were collected in collaboration with the central laboratories of the Ministry of Health. Quantitative measurement of G6PD enzym...
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Validation of the Arabic version of the score for allergic rhinitis tool
This study aimed to translate and culturally adapt the SFAR questionnaire into Arabic, and assess the validity, consistency, and reliability of the translated version in an Arabic-speaking population of patients with suspected AR.  STUDY DESIGN:Cross-sectional.  SETTING:Tertiary care hospital in Riyadh.  PARTICIPANTS AND METHODS:The Arabic version of the SFAR was administered to patients with suspected AR and control participants.  MAIN OUTCOME MEASURE:Comparison of the AR and control groups to determine the test-retest reliability and internal consistency of the instrument. &nb...
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Risk of pneumonia among patients with splenectomy: a retrospective population-based cohort study
CONCLUSIONS:Although not a novel finding, we confirmed that splenectomy increases the relative risk for developing pneumonia in a large study population. Even in the absence of any comorbidity, the risk remains high. Patients with splenectomy should receive preventive interventions for pneumonia, such as vaccination.  LIMITATIONS:ICD-9 codes do not differentiate if pneumonia is caused by a viral, a bacterial or unspecified organisms, and some behavioral factors like smoking could not be ascertained directly.  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Risk of pneumonia among patients with splenectomy: a retrospective populationbased cohort study
CONCLUSIONS:Although not a novel finding, we confirmed that splenectomy increases the relative risk for developing pneumonia in a large study population. Even in the absence of any comorbidity, the risk remains high. Patients with splenectomy should receive preventive interventions for pneumonia, such as vaccination.  LIMITATIONS:ICD-9 codes do not differentiate if pneumonia is caused by a viral, a bacterial or unspecified organisms, and some behavioral factors like smoking could not be ascertained directly.  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

Erratum
In Ann Saudi Med 2016; 36(3) 190-196:“Tocilizumab efficacy and safety in rheumatoid arthritis patients after inadequate response to disease-modifying anti-rheumatic drugs or anti-tumor necrosis (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - August 1, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Reply
We would like to thank the authors of the letter commenting on our recent paper on the association between anti-CCP and the shared epitope status (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - August 1, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Eleven-year review of data on Pap smears in Saudi Arabia: We need more focus on glandular abnormalities!
BACKGROUND:We reviewed data from Saudi Arabia on epithelial cell abnormalities (ECA) detected by Pap smear after noticing a slight increase in the incidence of cervical glandular abnormalities in our regional laboratory in recent years. OBJECTIVE: Clarify data on adenocarcinoma (ADCA) on Pap smears in Saudi Arabia. DESIGN:Descriptive, retrospective study. SETTINGS:Regional laboratory, Riyadh. PATIENTS AND METHODS:We reviewed all Pap smears of adult females between 2006 and 2016 and compared our data with previously published results from Saudi Arabia. MAIN OUTCOME MEASURE(S):Descriptive data on ECA...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Hepatitis B and C virus prevalence in couples attending an in vitro fertilization clinic in a tertiary care hospital in Saudi Arabia: comparison with ten years earlier
BACKGROUND:Viral hepatitis B (HBV) and C (HCV) are a major public health problem in Saudi Arabia. Recent data has indicated a major reduction in viral hepatitis prevalence in Saudi population. However, there is limited data for infertile Saudi couples.  OBJECTIVES: To determine the prevalence of HCV and HBV attending an in vitro fertilization (IVF) clinic in Saudi Arabia between 2012 and 2015 to compare with the prevalence 10 years earlier in the same center.  DESIGN: Retrospective prevalence study. SETTING: Tertiary care center in Riyadh. PATIENTS AND METHODS: Data on the prevalence of HBV an...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Utilization and adherence to guideline-recommended lipid-lowering therapy at an academic medical center
CONCLUSION:Approximately one-third of patients received statin therapy at an inappropriate intensity according to the guideline recommendation. Wide application of the 2013 ACC/AHA cholesterol guidelines in our practice would optimize the utilization of statin therapy at the ideal intensity in high-risk patients.  LIMITATION:Drug-drug interactions and intolerance to statin therapy were not considered when we evaluated adherence among high-risk patients.    (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Five-year epidemiological trends for chemical poisoning in Jeddah, Saudi Arabia
BACKGROUND:Poisoning is a significant global public health challenge in terms of morbidity and mortality. We conducted this study because of the lack of large population-based studies on chemical poisoning in Saudi Arabia. OBJECTIVE: Describe epidemiological trends, associated factors, and outcomes of chemical poisoning cases reported to the Jeddah Health Affairs Directorate, Saudi Arabia.  DESIGN: Descriptive, retrospective medical record review. SETTING: Population database for the Jeddah Governorate. METHODS: For chemical poisoning cases reported from January 2011 to December 2015, data was coll...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Variation in access to pediatric surgical care among coexisting public and private providers: inguinal hernia as a model
BACKGROUND:Faced with growing healthcare demand, the Saudi government is increasingly relying on privatization as a tool to improve patient access to care. Variation in children’s access to surgical care between public (PB) and private providers (PV) has not been previously analyzed.  OBJECTIVES:To compare access to pediatric surgical services between two coexisting PB and PV.  DESIGN: Retrospective comparative study.  SETTINGS:A major teaching hospital and the largest PV group in Saudi Arabia.  PATIENTS AND METHODS: The outcomes for children who underwent inguinal herniotomy (...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Isometric muscle fatigue of the paravertebral and upper extremity muscles after whiplash injury
BACKGROUND:Whiplash-associated disorders (WAD) result from injury of neck structures that most often occur during traffic accidents as a result of rapid acceleration-deceleration. The dominant symptoms manifest in the musculoskeletal system and include increased fatigue. Because of the frequency of whiplash injuries, a simple, cheap and useful diagnostic tool is needed to differentiate whiplash injury from healthy patients or those faking symptoms. OBJECTIVES: To determine muscle fatigue in patients with whiplash injury in six body positions. DESIGN:Analytical cross-sectional study. SETTING: Emergency center...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Comparison of the Trendelenburg position versus upper-limb tourniquet on internal jugular vein diameter
BACKGROUND:Central venous cannulation is a necessary invasive procedure for fluid management, haemodynamic monitoring and vasoactive drug therapy. The right internal jugular vein (RIJV) is the preferred site. Enlargement of the jugular vein area facilitates catheterization and reduces complication rates. Common methods to enlarge the RIJV cross-sectional area are the Trendelenburg position and the Valsalva maneuver. OBJECTIVE:Compare the Trendelenburg position with upper-extremity venous return blockage using the tourniquet technique. DESIGN: Prospective clinical study. SETTING:University hospital. SUBJ...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Indications for enucleation and evisceration in a tertiary eye hospital in Riyadh over a 10-year period
CONCLUSIONS: The majority of the eye enucleation/evisceration surgeries were due to nontraumatic causes, especially postoperative infections. However, severe eye trauma was still a main indication for this destructive procedure. Guidelines are needed to decrease the incidence/severity of work-related eye injuries and to detect and manage eye infections earlier and more promptly. LIMITATIONS: Retrospective study, in one hospital in one area; therefore, results cannot be generalized.    (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Influence of knowledge and beliefs on consumption of performance enhancing agents in north-western Saudi Arabia
BACKGROUND:Consumption of performance enhancing agents (PEAs) has a wide range of negative health consequences, but knowledge of these consequences among gym users of PEAs in Saudi Arabia is not well understood. OBJECTIVES:Identify the knowledge, awareness, beliefs and attitudes of gym users about negative health consequences of using PEAs, and the relationship between these factors and use of these agents. DESIGN:Cross-sectional study. SETTING:Five gyms in Madinah city, Saudi Arabia.  SUBJECTS AND METHODS:Convenience sampling was used to recruit gym users. An electronic self-administered questionn...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Perception of hospital accreditation among health professionals in Saudi Arabia
CONCLUSION:As perceived by health professionals in our survey, accrediation had a positive impact on the process and implementation of change in the hospital that resulted in improvement in the delivery of patient care and other health services.  LIMITATIONS:Single institution study with no comparison made to other small, medium, or large-sized JCI-accredited hospitals in Saudi Arabia. Patient satisfaction before and after accreditation was not included.  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Successful desensitization to radiocontrast media in two high-risk cardiac patients
In conclusion, desensitization to radiocontrast media may be considered in patients with previously unsuccessful premedication and/or severe acute comorbidities.  SIMILAR CASES PUBLISHED: 14  (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Accessory ulna: a rare case in an Asian female
(Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

RE: Association of human leukocyte antigen-DRB1 with anti-cyclic citrullinated peptide autoantibodies in Saudi patients with rheumatoid arthritis
(Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Purine nucleoside phosphorylase deficiency in two unrelated Saudi patients
We report on two Saudi girls with PNP deficiency. Both showed severe lymphopenia and neurological involvement. Sequencing of the PNP gene of one girl revealed a novel missense mutation Pro146>Leu in exon 4 due to a change in the codon from CCT>CTT. Expression of PNP (146L) cDNA in E coli indicated that the mutation greatly reduced, but did not completely eliminate PNP activity. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

The validity and reliability of the Arabic version of the EQ-5D: a study from Jordan
CONCLUSION:The Arabic translation of EQ-5D appears to be valid and reliable in measuring quality of life in Jordanian people. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Prevalence of exercise-induced bronchoconstriction in teenage football players in Tunisia
CONCLUSION:EIB is prevalent among amateur teenage football players in Tunisia. The prevalence differs between regions and seems to be dependent on air humidity levels. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

A screening tool for attention deficit hyperactivity disorder in children in Saudi Arabia
CONCLUSION:The ADHD Rating Scale (Arabic version), in terms of either the grand total score or the total score of each of its two subscales, demonstrated concurrent and discriminant validity by discriminating children with ADHD from other clinical and non-clinical children groups. The study obtained cutoff points for both sexes based only on the grand total score of the scale because of the relatively small sample size. Replication of the study, utilizing a larger sample and eliciting ratings from both parents and teachers, is recommended. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Clinicopathological study of male breast carcinoma: 24 years of experience
CONCLUSION:An incidence of 4.1% for male breast cancer indicates that this disease is not as uncommon as presumed in this part of the world. Breast cancer in men seems more frequently to be hormone receptor positive and the BRCA2 mutation confers a significant risk to men. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Accuracy of the Fischer scoring system and the Breast Imaging Reporting and Data System in identification of malignant breast lesions
CONCLUSION:The MRM BI-RADS lexicon using the Fischer scoring system is useful and has a high predictive value, especially for malignant breast lesions, and is easy to apply. Overlapping features between benign inflammatory and malignant lesions might yield a reduced accuracy in inflammatory pathologies. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Prevalence of psychological symptoms in Saudi Secondary School girls in Abha, Saudi Arabia
CONCLUSION:Psychological symptoms and disorders are prevalent in secondary school girls and health professionals need to be able to recognize, manage and follow-up mental health problems in young people. Further research is needed to explore the magnitude of the problem at the national level. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Factors associated with sexual dysfunction in Jordanian women and their sexual attitudes
CONCLUSIONS:FSD is prevalent in Jordan. Its social aspects are understudied and need more research in the future. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Anthropometry and body composition of school children in Bahrain
CONCLUSIONS:Current study findings for BMI as well as skin fold thicknesses suggest an increased trend toward adiposity among Bahraini adolescents, especially in girls, which puts this age group at a high risk of adult obesity and its consequences. A need for urgent intervention programs is emphasized. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Prevalence and molecular characterization of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Riyadh, Saudi Arabia
CONCLUSIONS:This study confirms the high rate of ESBL in K pneumoniae clinical isolates in hospitals in Riyadh. This study demonstrates the worldwide spread of blaCTX-M genes. This first report of the presence of the blaCTX-M gene in clincial isolates in Saudi Arabia is evidence of the continuing worldwide spread of this gene. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 4 Source Type: research

Extended-spectrum β-lactamase Klebsiella pneumoniae meningitis treated with tigecycline
To the Editor: Multidrug-resistant bacteria are increasing in prevalence, causing sporadic outbreaks of difficult-to-treat infections. Klebsiella pneumoniae is a gram-negative pathogen that is known to cause both community (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Restless leg syndrome in a patient with celiac disease: a coincidence or an association?
We report a case of (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Symptomatic splenoma in a child
To the Editor: Splenoma or splenic hamartoma, described in 1861 by Rokitansky, is a rare benign lesion of the spleen, with only 150 cases having been (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Hepatocellular carcinoma in the absence of liver cirrhosis in a treated hepatitis C virus patient
To the Editor: A 65-year-old male patient was referred to King Faisal Hospital and Research Centre after he presented with jaundice, fever, abdominal discomfort and biochemical (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

A 74-year-old woman with a 1-month history of itching and skin rash
  A 74-year-old woman presented with a 1-month history of itching followed by a rash. The bullous lesions were large and wide-spread (including lesions on the (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Defecation of a “colon cast” as a rare presentation of acute graft-versus-host disease
We report a case of a 23-year-old male who had undergone allogeneic HSCT and presented with bloody diarrhea on the 90th day post-HSCT. On the fourth day of admission, the patient passed per rectum a 27-cm long pinkish colored fleshy material recognized as a“colon cast”. Sigmoidoscopy showed a congested and erythematous rectum with the remaining portion of the“colon cast” attached to the proximal part of the sigmoid colon. A biopsy from the rectal wall was suggestive of grade IV GVHD. The patient was treated with methylprednisolone, cyclosporin and mycophenolate mofetil, with a partial response (diar...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Neonatal familial Evans syndrome associated with joint hypermobility and mitral valve regurgitation in three siblings in a Saudi Arab family
 The occurrence of autoimmune hemolytic anemia and immune thrombocytopenia in the absence of a known underlying cause led to the diagnosis of Evans syndrome in a 9-month-old male. Subsequently, a similar diagnosis was made in two siblings (a 3-year-old boy and a 1-day-old girl). The 9-month-old had a chronic course with exacerbations. He was treated with steroids, intravenous immunoglobulin and colchiccine with a variable response. He died of congestive heart failure at the age of 8 years. The brother's disease course was one of remission and exacerbation. With time, remissions were prolonged and paralleled an improve...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Gastrointestinal angiodysplasia in three Saudi children
We describe three cases (ages 7 days, 2 years, and 5 years) who presented to our unit with gastrointestinal bleeding. One of these patients developed moderate-to-severe symptoms and was blood-transfusion dependent. She was misdiagnosed as having inflammatory bowel disease and underwent a total colectomy and ileoanal anastomosis. The other two patients were managed conservatively for up to 5 years with no further bleeding. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Autologous bone marrow transplanation for extramedullary plasmacytoma presenting as adrenal incidentaloma
We report a A 47-year-old male who presented with bilateral adrenal incidentalomas. After confirming EMP, the patient received two consecutive autologous hematopoietic stem cell transplants (HSCT) using high-dose melphalan. Following HSCT, a serial follow-up helical CT revealed a substantial decrease in the size of both adrenal masses. Serial periodic serum protein and urine electrophoresis and immunofixation showed abrogation of a previously noted monoclonal band. At 50 months follow-up the patient was alive and well. Our patient is the first with EMP to have received an autologous HSCT, which may prove to have a role in ...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Osteoporosis prophylaxis in patients receiving chronic glucocorticoid therapy
CONCLUSIONS:Patients in this study were neither investigated properly nor treated according to the minimum recommendations for the management of GIOP. Physician awareness about the prevention and treatment of GIOP should be a priority for the local health care system. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Prevalence of allergic fungal sinusitis among patients with nasal polyps
BACKGROUND:Nasal polyposis is a common problem in the eastern province of Saudi Arabia. Since allergic fungal sinusitis (AFS) can present with unilateral or bilateral nasal polyps, it is important to be aware of the prevalence of AFS in patients with nasal polyps.PATIENTS AND METHODS:The medical records of 91 patients with nasal polyps admitted for functional endoscopic sinus surgery were reviewed. The diagnosis of AFS was considered if histopathology showed the presence of eosinophillic mucin-containing hyphae. The following data were collected: presence of associated asthma, IgE levels, grading of CT scan findings, and o...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Black ant stings caused by Pachycondyla sennaarensis: a significant health hazard
We present a series of cases of allergic reactions following insect bites or stings that presented to our emergency department and that were caused by the black samsum ant (Pachycondyla sennaarensis). Reactions ranged from mild allergic reactions to severe anaphylactic shock. Patients were treated with subcutaneous epinephrine 0.3 mg, intravenous methylprednisolone 125 mg, intravenous diphenhydramine HCl 50 mg, and intravenous normal saline as appropriate. These cases illustrate the range of clinical presentations to black ant stings, which can include severe reactions, indicating that ant stings are a significant public h...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Electrical cardioversion
External electrical cardioversion was first performed in the 1950s. Urgent or elective cardioversions have specific advantages, such as termination of atrial and ventricular tachycardia and recovery of sinus rhythm. Electrical cardioversion is life-saving when applied in urgent circumstances. The succcess rate is increased by accurate tachycardia diagnosis, careful patient selection, adequate electrode (paddles) application, determination of the optimal energy and anesthesia levels, prevention of embolic events and arrythmia recurrence and airway conservation while minimizing possible complications. Potential complications...
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Anthropometric predictors of incident type 2 diabetes mellitus in Iranian women
CONCLUSIONS:In Iranian women, BMI, WC, WHR, WHtR were predictive of development of type 2 diabetes, but WHtR was a better predictor than BMI. (Source: Annals of Saudi Medicine)
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research