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A unique presentation of monoplegia in an adult male
(2015) Alkhamis, Fahd
This is a report of a 34-year-old Saudi male who presented to the emergency department of a university hospital in the Kingdom of Saudi Arabia with a 2-day history of sudden left leg weakness and inability to walk. The history was insignificant except for the death of his brother 3 days prior to the onset. His general medical and neurological examinations, lab works, neuroimaging, and electrophysiological studies were all within normal limits. The possibility of a conversion reaction precipitated by grief was considered. Psychiatric evaluation confirmed the diagnosis of a dissociative (conversion) motor disorder. The patient made steady improvement with cognitive behavioral therapy. The possibility of psychogenic origin should be considered in patients presenting with sudden gross neurological symptoms.
The use of nano technology in medicine
(2015) Al Turki, Yousef
Extracorporeal shock wave lithotripsy
(2015) Al-Quorain, Abdulaziz
Unusual cause of solitary pulmonary nodule
(2015) Aljehani, Yasser; El-Ghoniemy, YasserAl-Ghamdi, Zeead
Papillary thyroid carcinoma is a common type of differentiated thyroid neoplasms with metastasis mostly described in the literature as occurring in the thyroid gland or in the surrounding cervical lymph nodes. We report a case of a 40-year-old lady who underwent thyroidectomy for papillary thyroid carcinoma 26 years prior to her presentation for solitary pulmonary nodule. Wedge resection of the nodule is consistent with metastatic papillary thyroid carcinoma. Although it is rare to have a remote history and a solitary lesion, it is vital to keep the possibility of metastasis in mind when such a presentation occurs.
Prevalence of dental anxiety in two major cities in the kingdom of Saudi Arabia
(2015) Al-Khalifa, Khalifa
The aim was to assess the level of dental anxiety in adult patients in two major cities in the Kingdom of Saudi Arabia and identify the etiological factors linked to this condition. Settings and Designs: A cross-sectional study using a questionnaire. Materials and Methods: A self-administered questionnaire based on the modified dental anxiety scale was distributed to dental patients who attended the dental clinics of the University of Dammam and King Abdulaziz University in Jeddah, respectively. The questionnaire included information about socio-demographic factors and other questions indicative of dental anxiety. Results: A total of 132 forms was received from subjects in Dammam and 144 forms from Jeddah. The level of dental anxiety in patients was relatively higher (27.5%) than other studies. In this study, patients in Jeddah showed higher levels of dental anxiety than those in Dammam (31.9% vs. 22.7%). As expected, females demonstrated a higher level of anxiety than males (19.2% vs. 8.3%). Most of the participants who had severe dental anxiety thought a bad experience at the dentist was the main cause of their anxiety. Conclusions: Dental anxiety was perceived as a problem in the sample examined. This was clearly seen irrespective of age, gender, social status, and/or place of residence. Patients' fear of dental treatment continues to pose a great threat to the dental profession. Dental professionals are encouraged to further assess the extent of this problem in order to find methods and techniques to help patients overcome it.
Panniculitis ossificans traumatica of the neck region: Report of a rare case in an unusual location
(2015) Al-Nemer, Areej
Panniculitis ossificans is a rare, self-limiting form of heterotopic ossification that might involve the subcutis as a reaction to trauma. To the best of the author's knowledge, there is no published report in the English literature describing such a case in the neck region. Herein is a report of a 47-year-old male who presented with a well-circumscribed firm mass in the supraclavicular area, a location that led to clinical suspicion of lymphoma. Definite pathological diagnosis was made after excision and no further interventions were needed. Awareness of this pseudomalignant condition is crucial for the clinician, radiologist and pathologist to avoid a diagnosis of malignancy.
Another hazard to laboratory workers
(2015) Bukharie, HudaGhanbar, Mohammad
Needle-stick injuries, unfortunately, are a common occurrence during blood extraction and handling of specimens in the laboratory, which often lead to the contraction of blood-borne viral diseases. Mycobacterium tuberculosis infection also poses a threat to healthcare workers, especially laboratory workers in areas with endemic levels of tuberculosis infections. We present in this report, a case of primary inoculation of tuberculosis of the skin transmitted following a needle-stick injury, which was successfully treated. Reports of such an occurrence are few, and our report further underlines the need to take greater precautions against these accidents. In addition, our case draws attention to the possibility of prophylactic anti-tuberculous treatment in high-risk patients to prevent the progression of an overt illness.
Post laparoscopic cholecystectomy hematemesis
(2015) Alghamdi, Hanan
Assessment of dental students' psychomotor skills using oral surgery simulation models
(2015) Al-Jandan, Badr; Wajid, Gohar; Marei, Hesham; Al-Khalifa, Khalifa; Al-Eraky, MohamedAl-Masoud, Naif
The aim of this study was to determine the validity of using oral surgery simulation models as a tool to assess the psychomotor skills of dental students. Materials and Methods: All students in the 4 ^th year of a 6 years dental program were enrolled in the study. 23 dental students were asked to display their competency in the injection of local anesthesia and dental extraction in two summative testing environments namely; in the simulation and in the outpatient clinic. A panel of four experts assessed the students' performance during the injection of local anesthesia and tooth extraction on patients and simulation using a pre-validated checklist. Students' scores were compared in both settings. Results: The results showed no significant correlation between the scores on patients and simulation in the two settings (P = 0.759). Conclusion: The study revealed that the real patient remains the gold standard in summative assessment of dental students' psychomotor skills.
Perforated duodenal ulcer in the third trimester of pregnancy
(2015) Amdeslasie, Fasika; Gebremariam, TeweldeBerhe, Yibrah
Perforated duodenal ulcer during pregnancy is rare. We report a case of 20-year-old woman who developed perforated duodenal ulcer in the third trimester of pregnancy. Surgical repair was performed with good outcome.
Single visit custom made flexible feeding obturator for an infant with tetralogy of fallot
(2015) Tamrakar, AmitRathee, Manu
Cleft lip and palate prevalence is more in patients with heart diseases than in patients with normal hearts. The co-existence of tetralogy of Fallot and cleft palate undermines the health of the infant by underfeeding and circulation of low arterial oxygen concentration. Early prosthodontic adjuvant therapy with feeding obturator is mandatory for rehabilitation till corrective surgery.
Epidemiology of fractures and dislocations among urban communities of eastern saudi arabia
(2015) Alomran, Abdallah; Kubbara, Ahmed; Al-Dhafer, Basma; Al-Sayed, Hasan; Sadat-Ali, Mir; Azam, QuamerAlShaikh, Sadeq
Fractures and dislocations are a significant public health and economic burden for any country, but current knowledge on the basic epidemiology of fractures in Saudi Arabia is very limited. This retrospective analysis was performed to determine the patterns of incidence of traumatic fractures and dislocations in the urban population of the Eastern Province of Saudi Arabia. Materials and Methods : Data were collected on all fractures and dislocations admitted to the orthopaedic wards between January 1, 2004 and December 31, 2009. The inclusion criteria were all patients admitted after trauma. The data collected included was the type of accident, fracture and dislocations sustained, surgery undertaken either emergency or elective, implants used, associated injuries, complications, status of the union of the fracture at the time of the final review and complications. Results: There were 1428 patients with 2056 fractures and dislocations. Five-hundred and eighty-four (40.89%) of the injuries were sustained in road traffic and motorcycle accidents. Lower extremity fractures were 830, upper extremity fractures were 555 and spinal fractures were 323. Of these, 202 (14.4%) patients had dislocations, a majority of which were hip joint dislocations. The overall complication rate was 166 (11.69%) and infections formed the majority. Delayed union occurred in 32, nonunion in 24 and malunion requiring surgery occurred in 17. Twenty-seven (1.31%) of fractures were missed. Conclusions: This analysis shows that road traffic accidents are still a major cause of trauma in an urban population and lower extremities form the common site of fractures. Fractures and dislocations due to trauma are steadily increasing and the young are the most affected. We believe that injury prevention programs should be made mandatory to limit muskuloskeletal injuries resulting from trauma. In the coming years, the number of these injuries will rise considerably with the increase in population.
Physicians and the social media
(2015) Bella, Hassan
A comparative study of bovine bone used alone and in combination with transforming growth factor-beta for the treatment of periodontal osseous defects in humans
(2015) Alagl, AdelHassan, Khalid
Transforming growth factor-betas (TGF?s) are multifunctional growth factors with a broad range of biological activities in various cell types in many different tissues. The purpose of this study was to evaluate the treatment of intrabony defects with anorganic bovine bone mineral matrix combined with TGF?-1 with the use of anorganic bovine bone alone. Materials and Methods: Thirty-two sites from sixteen patients were selected using a split-mouth study design for each patient, determined randomly through a biased coin randomization. One site received a mucoperiosteal flap, and the osseous defect was filled with the combined therapy (Group 1). The other site treated was with anorganic bovine bone alone and served as a control (Group 2). All the treated sites were covered with a bioabsorbable collagen membrane. The clinical parameters and radiographic follow-up examinations were recorded after 3, 6, 9, and 12 months. Results: Clinically, there was a statistically significant gain in the clinical attachment level (+5.03 ? 0.14 mm) and a statistically significant reduction of pocket probing depth (?5.16 mm ? 0.13) for Group 1 sites compared to sites in Group 2 (P ? 0.01). In addition, there were significant differences in bone density and a significant decrease of marginal bone loss after the combined therapy compared with the use of anorganic bovine bone alone (P ? 0.01). Conclusion: The use of anorganic bovine bone mineral matrix combined with TGF?-1 seemed to be effective in the treatment of intrabony defects. This showed an improvement in the clinical outcome of periodontal therapy superior to the use of anorganic bovine bone on its own.
The evaluation of relationship between abo blood groups and cardiovascular risk factors in patients with acute myocardial infarction in durres population
(2015) Hatellari, Adriana; Zera, ElivertaXinxo, Sonila
Cardiovascular (CV) diseases are the most important causes of morbidity and mortality in many developing and developed countries. An association between ABO blood groups (BGs) and the risk of coronary artery disease (CAD) has been known for many years, although there have not been enough surveys to prove it. However, it is not yet known how significant the association between the ABO BGs and CAD is in the clinical practice. Aim: The aim was to investigate a possible association of ABO (BGs) and CV risk factors among the patients with acute myocardial infarction (AMI) in Durres population. Materials and Methods: This transversal prospective study included 239 patients with AMI admitted to in the Cardiology Department, Regional Hospital of Durres, Albania between January 2012 and August 2013. In patients with AMI were collected data on risk factors such as smoking, age, gender, hypertension (HTN) and blood lipids, diabetes, obesity, family history and previous myocardial infarction(MI). Participants provided blood samples for cholesterol, glucose (fasting blood sugar) and BGs. Standard 12-lead electrocardiograms were obtained immediately after admission. The location and complication of AMI were assessed. Data was analyzed on SPSS version 16 and a P < 0.05 was considered statistically significant. Results: In the present study of 239 patients, 32.6% (78) had BG O, 38,1% (91) had BG A, 17.2%(41) had BG B and 12.1%(29) had BG AB. Of the total of 239, 52,3% (125) were smoker, 66,9% (160) were hypertensive, 51.4% (123) were obese, 30.5% (73) had diabetes mellitus (DM), 71,1% (170) had high serum cholesterol level, 37.6% (90) had positive family history and mean age was 66.1 ? 21 years. In individuals the incidence of AMI was higher in those with BG A than in those with other BG P 0.001. AMI was less frequent in BG AB. The frequency of CV risk factors was similar in patients with different BGs. However, the patients with BG A had a higher incidence of high serum cholesterol level, diabetes and HTN than those with the other BGs but not a statistically significant difference P > 0.05. There were no significant differences between BGs in location of AMI. No significant differences were found between BGs and complications in acute myocardial infarction. Conclusions: Blood group A is related to the higher incidence of AMI, high serum cholesterol level, HTN and DM, while the results did not provide convincing evidence that any BGs were strongly associated with HTN, diabetes and location of MI. Association of ABO BGs distribution with CV risk factors, CAD and MI needs to be clarified with multicenter, prospective and large-scale studies.
Parathyroid carcinoma: Atypical presentation and coexistence with papillary thyroid cancer
(2015) Al-Sulami, Salhah
This is a case of parathyroid carcinoma after investigating for neck mass with surprisingly high parathyroid hormone (PTH) and normal calcium levels. After ultrasound localization, the patient underwent left hemi-Parathyroidectomy and left hemithyroidectomy. The patient's calcium level was normal throughout the follow-up period, but she later developed hypercalcemia, which did not require any specific treatment. Complete surgery was not an option in her case as metastasis work up revealed diffuse metastasis.
A treatise on intestinal duplications
(2015) Pal, Kamalesh
Duplications of the alimentary tract are unusual congenital anomalies that often present a diagnostic, as well as therapeutic challenge to the treating surgeon. These lesions occur infrequently and are often not suspected until encountered intraoperatively. Due to the complicated anatomy and involvement of the adjacent bowel, appropriate management requires familiarity with the anatomy and clinico-pathological characteristics. This review article is a treatise on intestinal duplications which addresses the current understanding, their epidemiology, classification, etiogenesis, management options and prognosis.
How teachers' knowledge of attention deficit hyperactivity disorder makes difference in doctors' diagnostic decisions and management?
(2015) Jenahi, ElhamKhalil, Mohamed
The teacher's knowledge plays a key role in the process of assessing, screening, and diagnosing attention deficit hyperactivity disorder. This was a cross-sectional study aimed at surveying teachers' knowledge about attention-deficit hyperactivity disorder, one of the most prevailing neurodevelopmental disorders. Materials and Methods: One hundred and thirteen female elementary school teachers were randomly chosen from six regular female public and private schools in Al-Khobar in the Eastern Province of Saudi Arabia. They completed a self-reported questionnaire on their general "factual" knowledge of the nature of attention-deficit hyperactivity disorder, and the management "action knowledge" of the condition. Factors which might affect their knowledge were also examined. Results: About 48.7% of the total sample had adequate factual knowledge, but only 27 (23.9%) showed adequate action knowledge about how to deal with attention-deficit hyperactivity disorder. Teachers' knowledge of attention-deficit hyperactivity disorder (factual and action) was not significantly correlated with their years of experience, level of education (qualification) and duration of training in educational methodology. Conclusion: It was concluded that teachers in female primary schools had inadequate knowledge about attention-deficit hyperactivity disorder. Implications and recommendation for health and educational professional are outlined.
Intrathoracic Mass
(2015) Elghoneimy, Yasser
Organophosphate poisoning: A 10-year experience at a tertiary care hospital in the kingdom of saudi arabia
(2015) Al Sulaibeakh, Amal; Al Shahrani, Mohammad; Al Jumaan, MohammedAl Wahhas, Mohey
Toxicity resulting from pesticides is an important global public health hazard concern, particularly in developing countries. The objectives of this retrospective study were to determine the presenting clinical features, complications and length of stay of patients poisoned with organophosphates (OP). Materials and Methods : The medical records of all OP poisoning patients admitted to King Fahd Hospital of the University in the period between 2000 and 2010 were reviewed. Results: There was a total of 50 patients: Thirty-four males (68%) and 16 females (32%), 39(78%) of whom were >18 years of age. The most common route of exposure was ingestion, which was observed in 20 patients; vomiting was the most common clinical presentation. Thirteen patients were intubated at the Emergency Department on account of respiratory failure. Thirty-two patients required admission to the Intensive Care Unit and the mean length of stay in the hospital was 5 days. Two patients had cardiac arrest. Conclusion: This relatively high prevalence of OP poisoning makes it necessary to have tighter governmental controls and awaken public awareness to this problem.

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