The different clinical presentations of pediatric allergic fungal sinusitis.

In this paper, we aim to study the different clinical presentations of pediatric allergic fungal sinusitis (AFS) in the Eastern Province of Saudi Arabia, and to review the experience in the diagnosis & management of AFS in children at King Fahad Specialist Hospital. This study is a retrospective case series of pediatric patients diagnosed and managed as AFS at a tertiary referral hospital in Saudi Arabia. The clinical presentation of pediatric AFS varies widely and includes unilateral, unilateral with proptosis, bilateral, alternating, isolated sphenoid and extensive with intracranial & intraorbital involvements.

Prevalence of bleeding symptoms among young adults in Saudi Arabia, a national survey.

Prevalence of bleeding disorders vary due to several factors including geographical location. Mild bleeding disorders can lead to iron deficiency, morbidity, and in severe cases mortality. Quantification of haemorrhagic symptoms is a key component in management of bleeding disorders and a challenging task for clinicians.

The endonasal endoscopic management of pediatric lateral frontal mucocele.

Objectives: The aim of this report is to show the usefulness of endoscopic sinus surgery in management of lateral frontal mucocele in pediatric patient.

Case Presentation: A 14 years old girl presented with right frontal bone depression and headache. CT and MRI showed lateral mucocele occupying the right frontal sinus.

Prevalence of Coagulation Factors Deficiency among Young Adults in Saudi Arabia: A National Survey.

 Inherited bleeding disorders vary in prevalence due to genetic disparity and ethnicity. Little is known about the prevalence of coagulation factor deficiency and bleeding disorders in middle-eastern population.  Young Saudi adults with at least one positive bleeding symptom reported in semi-structured validated condensed MCMDM-1vWD questionnaire were tested for complete blood count, routine and special coagulation tests, serum ferritin level, and capillary zone electrophoresis.

Pediatric allergic fungal rhinosinusitis with extensive intracranial extension - Case report and literature review.

Introduction: Over the last two decades, allergic fungal sinusitis (AFRS) has become increasingly common. It's defined as a noninvasive, benign inflammatory fungal disease of the sinuses which develops in young adults and adolescents. Patients often complain of symptoms like nasal obstruction, congestion, purulent or clear rhinorrhea, anosmia, and headache.

Bilateral simultaneous sino-nasal inverted papilloma; A report of two cases and literature review.

Introduction: Inverted Papilloma is a benign sinonasal tumor with a high recurrence rate and potential for malignant transformation, it typically presents as an obstructing unilateral nasal mass, atypical presentations include bilateral involvement which occurs in up to 5 % of cases.

Case Presentation: Here we present two different cases of bilateral inverted papilloma, both presented complaining of bilateral nasal obstruction, the second case also had associated nasal polyposis and history of multiple previous endoscopic sinus surgeries, both cases were managed with endoscopic medial maxillectomy and tumor removal, with no signs of recurrence on follow up.

Conclusion: Bilateral involvement is an uncommon, atypical presentation of inverted papilloma, endoscopic surgery is a safe, reliable approach and it is the mainstay of treatment, regular endoscopic and clinical follow up is important for detection of recurrence.

Endoscopic endonasal removal of a large fibrous dysplasia of the paranasal sinuses and skull base.

Fibrous dysplasia is a rare condition. We present a case of a 34-years-old man presented with left-sided facial pain, headache and nasal obstruction for a long duration. CT scan of the sinuses showed a mass occupying the left ethmoidal region abutting the orbit and skull base obstructing the left frontal sinus.

Ectopic intranasal canine tooth in a child: A rare case report and literature review.

Introduction: Intranasal teeth are a rare form of ectopic teeth. Their clinical manifestation are truly variable. In children, intranasal teeth are typically associated with cleft lip and alveolus.

Bilateral dentigerous cysts and ectopic teeth in the maxillary sinuses: A case report and literature review.

Introduction: Dentigerous cysts are the second most common form of benign odontogenic cysts. These cysts are commonly single lesions. Bilateral and multiple dentigerous cysts are very rare.

Pediatric alternating allergic fungal rhinosinusitis: A case report and literature review.

Objectives: to report the alternating nature of allergic fungal rhinosinusitis in children in the Eastern part of Saudi Arabia and to review the experience of King Fahad Specialist Hospital in the diagnosis and management of alternating allergic fungal rhinosinusitis in children. An 8 years old Saudi girl with alternating allergic fungal rhinosinusitis was diagnosed and managed. The patient was diagnosed to have unilateral left allergic fungal rhinosinusitis and underwent endoscopic sinus surgery and cleaning of the left sinuses from polyps, mud and mucin.

Prevalence of Bleeding Symptoms among Adolescents and Young Adults in the Capital City of Saudi Arabia.

Background: Bleeding disorders vary in prevalence. While some are rare, some can be common in both sexes. Most bleeding disorders manifest as chronic bleeding tendencies or as an increase in bleeding during surgical procedures or trauma.

Influence of ABO blood group on von Willebrand factor tests in healthy Saudi blood donors.

: Von Willebrand disease is a common bleeding disorder. The wide variation in von Willebrand factor (VWF) levels between and within normal individuals highlights the clinical challenge of defining its cutoff value. Although studies on the influence of ethnicity on ABO phenotypes and the levels of VWF have been carried out on different ethnicities, there is a lack of such data among Arab population.

Long-term audit of the use of fresh frozen plasma in a university hospital.

Objectives: There is universal concern about the inappropriate use of fresh frozen plasma (FFP). This study aimed to determine the extent of the inappropriate use of FFP at a university hospital in KSA.

Methods: Medical records on the annual use of FFP were analysed from 1986 to 2007.

Long-term audit of platelet consumption in a university hospital.

Objectives: To determine the long-term trend in platelet consumption in a university hospital.

Materials And Methods: The annual consumption of platelets concentrate (PC) was analyzed over 23 years (1985-2007) in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia.

Results: The total 23 years consumption was 100,466 units of PC.

The Levels of Tissue Factor Pathway Inhibitor in Sepsis Patients Receiving Prophylactic Enoxaparin.

Objective: Sepsis syndrome is usually accompanied by activation of blood coagulation mechanisms. Earlier studies found deficiencies of the 3 main natural anticoagulants, antithrombin, protein C, and protein S. However, none of these inhibitors block tissue factor, the prime trigger of coagulation during sepsis that is controlled specifically by the tissue factor pathway inhibitor (TFPI).

Prophylaxis and treatment of venous thromboembolism in patients with cancer: the Saudi clinical practice guideline.

Background And Objectives: Venous thromboembolism (VTE) is commonly encountered in the daily clinical practice. Cancer is an important VTE risk factor. Proper thromboprophylaxis is key to prevent VTE in patients with cancer, and proper treatment is essential to reduce VTE complications and adverse events associated with the therapy.

The Saudi Clinical Practice Guideline for the treatment of venous thromboembolism. Outpatient versus inpatient management.

Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is commonly encountered in daily clinical practice. After diagnosis, its management frequently carries significant challenges to the clinical practitioner. Treatment of VTE with the inappropriate modality and/or in the inappropriate setting may lead to serious complications and have life-threatening consequences.

A 23 years audit of packed red blood cell consumption in a university hospital in a developing country.

Background: There is paucity of information on the blood transfusion practice in developing countries. The current audit aims to find out the long term trend in the consumption of packed red blood cells (PRBCs) in a large Saudi teaching hospital in Riyadh

Materials And Methods: We analyzed the annual consumption of PRBCs from 1985 to 2007 in seven major hospital divisions (Medicine, General Surgery, Pediatrics, Obstetrics and Gynecology, Cardiac Surgery, Accident and Emergency and Renal Dialysis Unit) at the 850-bed King Khalid University Hospital (KKUH), Riyadh.

Results: Grand total consumption of PRBCs was 345,642 units.

Immunological evaluation of β-thalassemia major patients receiving oral iron chelator deferasirox.

Objective: To determine the immune abnormalities and occurrence of infections in transfusion-dependent β-thalassemia major patients receiving oral iron chelator deferasirox (DFX).

Study Design: An observational study.

Place And Duration Of Study: Hematology Clinics, King Khalid University Hospital, Riyadh, Saudi Arabia, from July to December 2010.

Bemiparin, an effective and safe low molecular weight heparin: a review.

Bemiparin is a low molecular weight heparin (LMWH) indicated for the acute treatment of deep vein thrombosis with or without pulmonary embolism, for the prophylaxis of venous thromboembolism in surgical and non-surgical patients and for the prevention of clotting in the extracorporeal circuit during hemodialysis. Due to its excellent pharmacological profile-the second-generation LMWH with the lowest molecular weight, the longest half-life and the highest anti-Factor Xa/anti-Factor IIa activity ratio-it can be safely used in special categories of patients (children, elderly, patients with renal impairment and congestive heart failure). Several studies demonstrated its safety and efficacy, while cost analyses show the economic benefits of bemiparin treatment as compared to other heparins.

Clotting factor VIII (FVIII) and thrombin generation in camel plasma: A comparative study with humans.

The objective of this study was to characterize the highly elevated levels of clotting factor VIII (FVIII) in camel plasma. Whole blood was collected from healthy camels and factor VIII clotting activity (FVIII:C) assays were conducted using both the clotting and the chromogenic techniques. The anticoagulant citrate phosphate dextrose adenine (CPDA) produced the highest harvest of FVIII:C, the level of plasma factor VIII, compared to heparin:saline and heparin:CPDA anticoagulants.

Sickle cell disease subphenotypes in patients from Southwestern Province of Saudi Arabia.

Sickle cell disease (SCD) is common in the Eastern and Southwestern (SW) Provinces of Saudi Arabia. We studied 159 patients with SCD to better characterize its phenotype in the SW Province, where patients usually have a HBB haplotype of African origin. All cases had history and examination, chart review, and laboratory testing.

Heparin-induced thrombocytopenia: comparison between response to fondaparinux and lepirudin.

Background: Patients with heparin-induced thrombocytopenia (HIT) require anticoagulation with alternative immediate acting anticoagulants such as lepirudin. Lepirudin may generate antibodies that increase risk of bleeding. Fondaparinux, on the other hand, is structurally too short to induce antibody formation, and therefore, it could be a useful agent for the treatment of HIT.

Attitude to blood donation in Saudi Arabia.

Background And Objectives: The blood donor system in the Kingdom of Saudi Arabia depends on a combination of voluntary and involuntary donors. The aim of this study is to explore the attitudes, beliefs and motivations of Saudis toward blood donation.

Materials And Methods: The study was conducted at the Donor Centers at King Khalid University Hospital (KKUH) Blood Bank and King Saud University Students Health Center, Riyadh.