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Permanent URI for this communityhttps://repository.iau.edu.sa/handle/123456789/69

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Cyclic vomiting syndrome
(2016) Kundal, Bharti; Chopra, GurikaAiman, Shah
Cyclic vomiting syndrome (CVS) consists of recurrent paroxysms of severe nausea and vomiting separated by symptom-free periods. A 12-year-old boy presented with recurrent vomiting over a period of 3 years. Episodes occurred over a period of 6 months, and the patient remained normal for next 6 months. About 8 such episodes occurred in the last 6 months. Physical and neurological examinations were normal. All routine investigations were normal. He was started on cognitive behavioral therapy and cyproheptadine and improved gradually. CVS is considered a functional brain-gut disorder and is characterized by recurrent, sudden, stereotypical, disabling, discrete episodes of intense nausea and vomiting that can last a few hours to days interspersed with varying weeks of symptom-free intervals. Integrated treatment combining pharmacological, psychotherapeutic, psycho-educational and lifestyle aspects as well as family therapy provides the best chances of successful treatment.
Polycystic liver disease with huge infected cyst displacing the pancreas, inferior vena cava and right kidney
(2016) Al-Harthi, Adil; Al Marwani, MarwanKhan, Patan
Multiple liver cysts can be an isolated disease (isolated polycystic liver disease [PLD]) or they can be part of multi-organ involvement in other diseases, such as adult autosomal dominant polycystic disease (APD), which is the most frequently inherited polycystic disease affecting 1 in 1,000 of the population. About 33% of APD patients are expected to develop PLD. Cysts in the liver, as opposed to cysts in the kidney, grow dramatically in number and size. They are usually asymptomatic but may present with signs and symptoms of compression of adjacent organs as the cysts grow. We present a case of a 73 year-old female patient with PLD and a large (25 × 19 × 18 cm) infected cyst which caused the displacement of the inferior vena cava, right kidney, and pancreas. We also discuss the management of this patient along with a review of the literature.
Systematic review of computer based assessments in medical education
(2016) Al-Amri, SaadAli, Zahid
Medical schools, postgraduate training institutes, licensing and certification bodies have developed and implemented many new methods for accurate, reliable, and timely assessments of the competence of medical professionals and practicing physicians. The underlying objective of all these assessments is to not only evaluate the students' learning and educational goals but also to establish the graduating individual's skills and professionalism. Computer based assessment (CBA) has emerged in recent years as a viable alternative to traditional assessment techniques. It has also infiltrated and influenced the medical curriculum where it has been employed for assessment tasks. This study presents how CBA offers pedagogical opportunities and analyzes its usage pattern over the past three decades. We examined 47 CBAs in medical education and analyzed several assessment components, including application area, assessment purpose, assessment type, assessment format, student level, and emphasized the interplay among these components. Our analysis determined that formative assessment is the most frequently used type and 75% of all assessment types employed used the multiple choice questions format.
From neck swelling to abrupt compromised airway: A case of a hemorrhagic ruptured thyroid cyst
(2016) Sharif, Hiba; AlShehabi, MohamedAl-Khalifa, Muneera
Here, we present a rare case of spontaneous hemorrhagic rupture of a benign thyroid cyst in an adult Indian female who had no history of thyroid gland disease, trauma or coagulopathies. The patient presented to the Emergency Department with a suddenly progressive left-sided neck swelling of short duration. A 36-year-old otherwise healthy female presented to our Emergency Department with a progressive swelling on the left side of her neck that had started 2 days before her visit. Initially, the clinical neck examination revealed a well-defined soft cystic lesion confined to the left side of the neck anteriorly, measuring around 4 cm × 4 cm, tender to touch and moving with deglutition. Preliminary flexible scope examination of her larynx was normal. Within a few hours of having undergone ultrasonography examination, the neck swelling became diffused with increased tenderness. However, the patient remained clinically stable with no signs of airway compromise. A repeat of the fiber optic flexible scope examination showed submucosal hematoma in the left aryepiglottic area that mildly pushed the patient's laryngeal inlet to the contralateral side. Shortly after, the patient's condition worsened with the progression of swelling leading to compression of the airway. This promoted the decision to intubate the patient, who was subsequently, managed conservatively with close monitoring in the intensive care unit. Postintubation ultrasonography and computer tomography scans showed diffused inflammatory changes on the left side of the neck in the superficial and deep planes, mainly confined to the infrathyroid. Spontaneous sudden hemorrhagic rupture of a thyroid gland cyst is a rare condition but should be considered in a massive abrupt neck swelling that could potentially be life threatening.
Non-lupus glomerulonephritis in a patient with systemic lupus erythematosus. Saudi J Med Med Sci 2015;3:241-4
(2016) Al-Rashidi, Abdulrahman; Al-Helal, Bassam; Abdallah, Emad; Shehab, FaisalAsad, Reem
Van der knaap disease: Megalencephalic leukoencephalopathy with subcortical cysts
(2016) Garg, Akash; Sharma, Ankush; Gupta, MunishGupta, Nitin
Pharmaceutical care in the community pharmacies of Saudi Arabia: Present status and possibilities for improvement
(2016) Alanazi, Abdulrahman; Hussain, AbubakerAlfadl, Abubakr
Pharmaceutical care can be given in all settings: The community, hospitals, long-term care, and the clinic. However, published literature indicates that there is a substantial barrier to implementing pharmaceutical care programs in community pharmacies. This review was conducted to discover gaps and limitations in pharmaceutical care services in community pharmacies in the Kingdom of Saudi Arabia (KSA). We searched PubMed and other available scientific website databases using the following key words to retrieve the relevant articles: Community Pharmacy, Healthcare System, Pharmaceutical Care, KSA. Two authors independently screened the titles and abstracts of promising articles. They discarded irrelevant studies and retained studies, and reviews that held the promise of relevant data or information. The review revealed that only one out of the four studies conducted in KSA retrieved by the authors reported pharmaceutical care service other than dispensing. The same results were reported in other studies conducted in some developing countries. All pharmaceutical care services were reported in studies conducted in Europe. The authors came to the conclusion that in KSA, dispensing of medicines is the dominant service provided by community pharmacists and that there was very limited if not a total absence of other pharmaceutical care services.
Scrotal abscess, an unusual manifestation of Crohn's disease
(2016) Kamal, Baher; Elhami, Mohamed; Aldamanhori, ReemElkhouly, Waleed
Crohn's disease (CD) is a chronic inflammatory disorder of the alimentary tract, usually involving the ileum and proximal colon, which is sometimes associated with extra intestinal manifestations. Urologic complications of CD are rarely reported in literature. CD-related complications involving the urinary tract include infections and urolithiasis as the most common manifestations. Rare more serious occurrences associated with penetrating type disease include ureteral obstruction and enterovesical fistulization. Here, a rare case of CD complicated with a recto-scrotal fistula and the scrotal abscess is presented.
Delivering pulmonary rehabilitation for patients with chronic obstructive pulmonary disease at home using telehealth: A review of the literature
(2016) Almojaibel, Abdullah
Pulmonary rehabilitation is recommended to restore chronic obstructive pulmonary disease (COPD) patients' abilities to the highest level of independency and functionality. Telehealth has the potential to improve rehabilitation programs and to enhance patients' participation. However, little is known about the potential benefits of using telehealth in providing rehabilitation for COPD patients at home. The purpose of this review was to provide a narrative synthesis of literature of studies, which use telehealth with video components to provide real-time pulmonary rehabilitation for COPD patients. An electronic database search was performed in the Ovid Medline, CINAHL, and PubMed databases. Seven eligible studies were included based on the inclusion criteria. Based on the included studies, using telehealth to provide real-time interactive pulmonary rehabilitation for COPD patients at home is feasible and acceptable, and can provide clinical and social positive benefits. A knowledge gap regarding feasibility, acceptance, and benefits of using telehealth to provide real-time pulmonary rehabilitation services still exists.
Physical examinations of psychiatric patients who presented at the emergency department of a tertiary-care hospital in Oman
(2016) Al-Madhani, Abdullah; Al-Shehhi, Afaf; Al-Sinawi, HamedAl-Huseini, Salim
The objective of this study was to examine the completeness of physical assessment of patients presenting with psychiatric problems to the Emergency Department (ED). Methods: This was to observational study based on a retrospective review of the medical records of patients who attended the ED of Sultan Qaboos University Hospital and referred to the on-duty psychiatrist for assessment over a 12 months period. All patients aged 16 years and above, who presented to the ED with a psychiatric complaint were included in the study. A data collection sheet was designed to gather each patient's demographic data such as age and gender, past psychiatric history, nature of the presenting complaints, thoroughness of physical assessment, medications prescribed by the ED doctor prior to psychiatric assessment, and whether the patient was discharged, admitted to a psychiatry or medical ward. Results: A total of 202 patients met the inclusion criteria. The mean age of the patients was 34.2 years. Females represented 56% of the sample. The majority of the study group (60.4%) were patients with a documented past psychiatric history. Physical examination was conducted in the ED for 61.4% of the patients, while vital signs were recorded for 68.8% of them. Approximately, 31% of the patients required injectable psychotropic medications as tranquillizers in the ED. Patients with an isolated psychiatric complaint coupled with a documented past psychiatric history were more likely to be referred to the on-call psychiatrist without a physical examination by the ED doctors. Conclusion: In our institution, not all patients with psychiatric presentations had a complete physical examination by the ED doctors.
Microbial pathogens associated with proximal dental caries in the primary dentition and their association with periodontal disease in children
(2016) Alagl, Adel
Certain specific bacterial species from the subgingival biofilm have demonstrated etiological relevance in the initiation and progression of periodontitis. Among all the bacteria studied, three have shown the highest association with proximal caries and bone loss: Fusobacterium nucleatum (Fn), Capnocytophaga (Ca), and Campylobacter rectus (Cr). Therefore, the relevance of having accurate microbiological diagnostic techniques for their identification and quantification is clearly justified. Aim: To identify the bacterial pathogens with alveolar bone loss and proximal caries in primary dentition and their association with periodontal disease utilizing deoxyribonucleic acid (DNA) microbial probe testing. Materials and Methods: Subgingival plaque samples were collected at baseline as well as at 3, 6, and 12 months later. After extracting DNA, Fn, Ca, Cr, Aggrgatbacter actinomycetemcomitans, Porphyromonas gingivalis and several other periodontopathogens were determined by DNA microbial probe testing method. Results: Samples detecting a high bacterial load of Fn, Ca and Cr in children having proximal caries associated with periodontal disease compared to children having proximal caries without periodontal disease (P ≤ 0.01). Conclusions: Results suggested that there was a relationship between microbial pathogens associated with proximal dental caries in the primary dentition and periodontal disease in children. In addition, DNA microbial probe testing technology clearly analyzed the different loads of periodontopathogens in children who had with proximal caries associated with bone loss and is useful in microbial diagnostics for patients in dental practices.
The broken link: Admission criteria for inpatient rehabilitation and some common misconceptions
(2016) Qureshi, Ahmad; Williamson, LaneitaJenkins, Randolph
Chronic foreign body aspiration in a Saudi child - an occult cause of chronic pulmonary disease: Case report and literature review
(2016) Al-Mendalawi, Mahmood
Attitude and experiences of undergraduate dental students and interns towards research
(2016) Rejaie, Aws; Farooqi, Faraz; Moheet, ImranKhan, Soban
This study was designed to evaluate the perception of students and interns toward research. Materials and Methods: The study was conducted in January 2014. Participants of the study were fourth, fifth, and 6 ^th year students and interns. A questionnaire comprised thirteen questions was distributed to evaluate students' and interns' perception about the importance of research in their learning. Results: The results showed that interns and 6 ^th year students were more interested in research as compared to their junior counterparts as they realized the importance of research in their educational growth. This was reflected by the number of interns who completed the questionnaire. Conclusion: Dental students realized the importance of research in the education, but it was found that the proportion of students who did research as part of their course was very low. Students should be actively engaged in research, which can be achieved by introducing research as a compulsory component of their course.
Unusual case of a 13-year-old male with Blount's disease who was unable to walk: A prevention lesson
(2016) AlTurki, Yousef
Unusual cause of retrosternal chest pain
(2016) Aljehani, Yasser
Genitourinary tract involvement in a child with epidermolysis bullosa
(2016) Al-Awam, BashayerAl Moaigel, Hala
Epidermolysis bullosa (EB) is a rare, inherited, bullous disorder of the skin that occasionally involves the urinary tract. We report a 3-month-old, premature infant with EB, who presented with gross hematuria. Urine analysis revealed macrohematuria and proteinuria. The urine culture was negative. On ultrasonic evaluation, there was bilateral hydronephrosis and the distal ureters had echogenic shadows, suggestive of clotted blood. This case is consistent with the rare involvement of the urinary tract with hydronephrosis and bullous lesions.
Etiology of recurrent pregnancy loss in Saudi females
(2016) Al-Ghamdi, AhlamMakhashen, Sawsan
The aim of our retrospective study was to assess the etiology of recurrent pregnancy loss (RPL) in Saudi couples attending a specialized RPL clinic at King Fahad Hospital of the University, Al-Khobar, Saudi Arabia. Patients and Methods: A total of 59 couples attending the RPL clinic between January 2010 and December 2013 and who had completed their workup and investigations for RPL were included in the study. Data were collected from patients' charts and computer-based laboratory results. Results: Protein S deficiency was found in 47% of patients, a chromosomal abnormality in 6.7%, uterine abnormality in 12%, antiphospholipid syndrome (APS) in 12%, and antithrombin III and Protein C deficiency in 1.7%. However, no patient had Factor V Leiden mutation. In 39% of the patients, there was no identifiable cause, and therefore, they had been diagnosed as unexplained RPL. Conclusion: The most common cause of RPL was Protein S deficiency followed by congenital uterine anomalies and APS. Almost 40% of couples with RPL remain with unknown etiology.
Role of various potassium channels in caffeine-induced aortic relaxation in rats
(2016) Badar, AhmedLatif, Rabia
Studies done on caffeine-induced changes in aortic rings have demonstrated inconclusive results. Moreover, the role of various potassium channels in caffeine-induced effects has not been explored so far. The present in vitro study was designed to explore the direct effects of caffeine on rat aortic rings and the role of various potassium channels in those changes/effects. Materials and Methods: This study was carried out in College of Medicine, University of Dammam. Aortic rings obtained from Sprague Dawley rats were mounted in the organ bath. Tension in the aortic rings was measured with an isometric force transducer and recorded with a PowerLab data-acquisition system. Aortic rings in relaxed and contractile state were exposed to caffeine and various potassium channel blockers (glyburide, 4-aminopyridine, or tetraethylammonium). Results: Caffeine produced significant relaxation of isolated aortic rings (baseline tension: 1.26 ± 0.30 g, tension after adding cumulative concentrations of caffeine: 1.12 ± 0.31 g,P< 0.05) in the absence or presence of norepinephrine (NE) (tension induced by NE: 1.06 ± 0.37 g, tension after adding cumulative concentrations of caffeine: 1.01 ± 0.36 g,P< 0.05). Caffeine's vasodilatory effects were, however, blocked in aortic rings pretreated with different types of potassium channel blockers such as 4-aminopyridine (tension induced by NE: 1.52 ± 0.41 g, tension after adding cumulative concentrations of caffeine: 1.50 ± 0.37 g,P> 0.05), glyburide (tension induced by NE: 0.82 ± 0.35 g, tension after adding cumulative concentrations of caffeine: 0.79 ± 0.42 g,P> 0.05), and tetraethylammonium (tension induced by NE: 0.68 ± 0.34 g, tension after adding cumulative concentrations of caffeine: 0.67 ± 0.33 g,P> 0.05). Conclusion: Caffeine causes significant dilation of aortic rings, and this vasodilatory effect may involve ATP-dependent, calcium-mediated, or voltage-dependent potassium channels.
Adrenal insufficiency and mild rhabdomyolysis revealing a human immunodeficiency virus infection: A case report
(2016) Berkhli, Hayat; Haddiya, Intissar; Hamaz, SihamBentata, Yassamine
The spectrum of human immunodeficiency virus (HIV) endocrinopathy is large. Adrenal insufficiency (AI) is common in both early and late stages of HIV syndrome, resulting in significant morbidity and mortality. However, rhabdomyolysis is a muscle disease in which striated muscle fibers disintegrate, excreting myoglobin in the urine, leading to acute kidney failure. It is currently reported that rhabdomyolysis may be a direct result of the HIV infection, especially in the advanced stages of HIV/AIDS disease. This case study reports AI and a mild rhabdomyolysis in a patient with no medical history and no medicine or toxic intake. Laboratory assessment revealed HIV infection.

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