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Experience with oral mexiletine in primary erythromelalgia in children
We present two cases of primary erythromelalgia both of whom presented with a history of several months of severe burning pain in both hands and feet. Both patients had received multiple pain medications with no improvement in symptoms. Rain was relieved by putting affected parts in ice cold water, which resulted in immersion injury of the affected parts. Both patients stopped taking part in school and social activities. We tried oral mexiletine, a class lb antiarrythmic agent, in view of its reported role in various chronic painful conditions. Dramatic improvement was observed with its use. Both patients improved after se...
Source: Annals of Saudi Medicine - March 27, 2018 Category: General Medicine Tags: ISSUE 4 Source Type: research

Recurrent Abdominal Pain in a 16-Year-Old Girl
Ann Saudi Med 2011; 31(3): 314 PMID: 21623062 DOI: 10.4103/0256-4947.81539
Source: Annals of Saudi Medicine - November 21, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Pattern of Presentation in Type 1 Diabetic Patients at the Diabetes Center of a University Hospital
CONCLUSION: The pattern of presentation of type 1 diabetes has changed as the incidence of DKA has decreased; unlike in previous studies, DKA was not the most common presenting symptom in this study. Chronic complications of diabetes, such as retinopathy, neuropathy, coronary heart disease, and nephropathy are mostly rare but still present. These complications might be prevented by achieving better awareness of the need for glycemic control. Ann Saudi Med 2011; 31(3): 243-249PMID: 21623052 DOI: 10.4103/0256-4947.81529
Source: Annals of Saudi Medicine - November 21, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Paget Disease of the Bone: Does it Exist in Saudi Arabia?
We present four cases of Saudi patients with Paget disease with variable presentations. The first case, a 63-year-old woman with a history of papillary thyroid cancer, presented with bone, shoulder and chest wall pain and foci of uptake in the ribs and skull that were thought to be metastases, indicating the possibility of diagnostic difficulty in a patient with history of malignancy. Bone biopsy confirmed the diagnosis of Paget disease. The second case was a 47-year-old asymptomatic woman with an elevated alkaline phosphatase of 427 U/L, a common presentation but at an unusual age. Plain x-rays and bone scan confirmed the...
Source: Annals of Saudi Medicine - November 21, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Percutaneous Vertebroplasty Complications
Percutaneous vertebroplasty, among various other options, has become a mainstay in the management of osteoporotic and malignant vertebral fractures. The purpose of this article is to describe complications arising from the procedure, which can be classified as mild, which may include a temporary increase in pain and transient hypotension; moderate, including infection and extravasation of cement into the foraminal, epidural or dural space; and severe such as cement leakage in the paravertebral veins, leading to pulmonary embolism, cardiac perforation, cerebral embolism or even death. Vertebroplasty is not a procedure witho...
Source: Annals of Saudi Medicine - November 21, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Intra-Articular Lipoma Arborescens of the Knee Joint
We describe a case in a 26-year-old man who presented with intermittent pain and swelling of the left knee joint for the previous 2 years. Physical examination showed only tenderness over the medial line of the left knee joint. MRI found only joint effusion; therefore, the patient was referred to the orthopedic clinic where he underwent arthroscopy, which revealed a diffuse yellow soft tissue synovial papillary growth involving both medial and lateral gutters of the suprapatellar pouch. A biopsy reported intra-articular LA. This is the first case of LA reported in Saudi Arabia. LA should be included in the clinical and rad...
Source: Annals of Saudi Medicine - November 21, 2017 Category: General Medicine Tags: ISSUE 2 Source Type: research

Hepatic Vasculitis Mimicking Liver Abscesses in a Patient with Systemic Lupus Erythematosus
We report a 29-year-old female with SLE who presented with right upper quadrant abdominal pain, thrombocytopenia, elevated liver enzymes and multiple hypodense lesions in the liver on a computed tomography (CT) study that mimicked multiple liver abscesses. A liver biopsy showed mild chronic inflammation. Culture results were negative. With steroid therapy the patient improved clinically, the platelet count returned to the normal range and the multiple liver lesions disappeared radiologicaly. This patient represents a rare case of SLE that had hepatic vasculitis mimicking multiple liver abscesses. Ann Saudi Med 2009; 2...
Source: Annals of Saudi Medicine - November 20, 2017 Category: General Medicine Tags: ISSUE 6 Source Type: research

An Unusual Cause of Gastric Outlet Obstruction: A Pancreaticoduodenal Artery Aneurysm
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 p...
Source: Annals of Saudi Medicine - November 16, 2017 Category: General Medicine Tags: ISSUE 5 Source Type: research

The Role of Endoscopy in Childhood Chronic Abdominal Pain
  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%
Source: Annals of Saudi Medicine - November 14, 2017 Category: General Medicine Tags: ISSUE 1 Source Type: research

Efficacy and safety of a generic rosuvastatin in a real-world setting: prospective, observational clinical study in Lebanese patients
CONCLUSIONS:Generic rosuvastatin was efficacious and safe in reducing LDL-C levels and helping the majority of patients achieve LDL-C targets after a short treatment period.  LIMITATIONS:The observational nature, and a control group, and the relatively short duration of follow-up limit the generalizability of results. The authors received fees for study activities at patient visits from an independent clinical research organization subcontracted by the sponsor. 
Source: Annals of Saudi Medicine - October 8, 2017 Category: General Medicine Tags: ISSUE 5 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 - July 31, 2017 Category: General Medicine Tags: ISSUE 4 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

Oral sucrose and a pacifier for pain relief during simple procedures in preterm infants: a randomized controlled trial
CONCLUSION:The synergistic effect of the combination of sucrose and non-nutritive sucking was clinically effective and safe in relieving the pain of simple procedures such as venipuncture or heel stick in preterm and term infants, but further research is needed on these interventions alone and in combination with other behavioral interventions in neonates.
Source: Annals of Saudi Medicine - July 31, 2017 Category: General Medicine Tags: ISSUE 3 Source Type: research

Transient osteoporosis of the hip
We present a case of transient osteoporosis of the hip in a 33-year-old non-pregnant female patient. This case highlights the importance of considering a diagnosis of transient osteoporosis of the hip in patients who present with hip pain.
Source: Annals of Saudi Medicine - July 30, 2017 Category: General Medicine Tags: ISSUE 2 Source Type: research

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