Role of Multimodality Imaging in Transcatheter Structural Interventions.

Cardiac imaging is the backbone for safe and optimal transcatheter structural interventions. Transthoracic echocardiogram is the initial modality to assess valvular disorders, while transesophageal echocardiogram is best to delineate the mechanism of valvular regurgitation, preprocedural assessment for transcatheter edge-to-edge repair, and for intraprocedural guidance. Cardiac computed tomography is the modality of choice for assessing calcifications, maneuvering multiplaner reconstruction of different cardiac structures, preprocedural planning for various transcatheter valve replacement, and assessing for hypoattenuated leaflet thickening and reduced leaflet motion.

Type A Aortic Dissection with Antegrade Intimointimal Intussusception.

We describe a 60-year-old man with a history of hypertension who presented to an outside emergency department with chest pain and left lower extremity numbness and weakness. Computed tomography (CT) revealed Stanford type A aortic dissection (TAAD), and he was transferred to our institution for emergent open surgical repair. Review of the outside CT showed no dissection flap in the ascending aorta and a complex flap in the proximal descending thoracic aorta consistent with complex intimal transection at the sinotubular junction and intimointimal intussusception.

Influence of Cardiac Remodeling on Clinical Outcomes in Patients With Aortic Regurgitation.

Background: Quantitative cardiac magnetic resonance (CMR) outcome studies in aortic regurgitation (AR) are few. It is unclear if volume measurements are beneficial over diameters.

Objectives: This study sought to evaluate the association of CMR quantitative thresholds and outcomes in AR patients.

Patterns of Functional Gastrointestinal Disorders Among Children in Makkah City: A Single Institutional Experience.

Background Functional gastrointestinal disorders (FGIDs) are syndromes identified based on a group of symptoms defined according to the criteria of the Rome Foundation. The most commonly observed disorders among the pediatric population are functional abdominal pain disorders and functional constipation. This study aims to identify the patterns of FGIDs among children in Makkah, Saudi Arabia.

Ventricular Septal Rupture Complicating Silent Myocardial Infarction.

A 55-year-old gentleman presented to the emergency department with shortness of breath for the past 3 days. Cardiac magnetic resonance imaging assessed intracardiac shunting and a mechanism of ventricular septal rupture (VSR), showing significant left-to-right shunting and Qp:Qs of 4:1. There was transmural myocardial infarction as well as an aneurysm at the diaphragmatic inferior wall of the left ventricle.

Surgical Salvage of Annular Rupture After Transcatheter Aortic Valve Implantation by Conversion Into Annular Enlargement.

We describe an 88-year-old woman who experienced annular rupture during transcatheter aortic valve replacement despite preventative measures. She underwent Y incision and rectangular patch for the double purpose of repairing the rupture and enlarging the aortic root. We highlight the heart team's role in confronting this potentially catastrophic complication.

A Patient with Dyspnea and an Enlarged Right Ventricle.

Case report of a patient with no significant past medical history who presented with reports of dizziness, dyspnea on exertion, and palpitations that had been ongoing for at least 5 years. It demonstrates the importance of considering the presence of an inter-atrial shunt when evaluating a patient with an unexplained dilated right atrium and right ventricle.

A Pediatric Case of Basidiobolomycosis Presenting With an Abdominal Mass.

Basidiobolomycosis is a rare fungal infection caused by The condition has been reported in children and adults presenting with abdominal pain, weight loss, abdominal distension, vomiting, diarrhea, fever, and an abdominal mass. We report a case of a previously healthy 2.5 years old male who presented to the ER complaining of abdominal pain and distension for two weeks together with significant weight loss.

An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography.

A left atrial ridge is an anomaly of irregular fusion between the septum primum and septum secundum.1 Aberrant fusion of the septa results in thickened and fibrotic tissue along the region of the fossa ovalis that will occasionally protrude into the left atrium.2 The presence of a left atrial ridge has multiple clinical implications due to its close proximity to the fossa ovalis.

Adjunctive rifampin therapy for native valve endocarditis in a neonate: A case report and literature review.

Infective endocarditis in neonates can be fatal. Adjunctive rifampin therapy might be effective as salvage therapy in critically ill patients with native valve endocarditis (NVE). We present a case of a full-term neonate with NVE who had a favorable clinical outcome after adding rifampin to standard therapy.

Community- versus nosocomial-acquired severe sepsis and septic shock in patients admitted to a tertiary intensive care in Saudi Arabia, etiology and outcome.

Background: Sepsis syndrome is a major worldwide cause of morbidity and mortality. While community-acquired severe sepsis and septic shock constitutes a major cause of admission to the intensive care unit, hospital-acquired severe sepsis and septic shock remain major preventable causes of ICU admission. This study evaluates the rate, etiology, complication and outcome of community- and hospital-acquired sepsis in a tertiary care hospital in Saudi Arabia.

Incidence of pediatric inflammatory bowel disease in Saudi Arabia: a multicenter national study.

Background: Pediatric inflammatory bowel disease (IBD) is increasingly recognized in developing countries; however, the incidence and trend over time have not been reported.

Methods: This retrospective study included children diagnosed with IBD in gastroenterology centers in the Kingdom of Saudi Arabia between 2003 and 2012. The date of birth, date and age at diagnosis, gender, and final diagnosis were collected on special forms.

Knowledge and practice styles of pediatricians in Saudi Arabia regarding childhood constipation.

Objectives: The aim of the present study was to evaluate knowledge and practice styles among medical providers working in 5 regions of Saudi Arabia regarding their approach to childhood constipation.

Methods: A survey of 850 pediatric providers (PPs) conducted in 5 regions of Saudi Arabia. PPs included pediatric specialists (PSs), pediatric consultants (PCs), general practitioners (GPs), family physicians (FPs), and pediatric gastroenterologists (PGs).

Comparison of jeopardy game format versus traditional lecture format as a teaching methodology in medical education.

Objective: To compare students` performance, satisfaction, and retention of knowledge between a `jeopardy game format` and a `didactic lecture format` in teaching viral exanthema to fifth-year medical students.

Methods: We conducted a parallel-group randomized controlled trial in the Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia from November 2008 to January 2009. We randomized fifth-year medical students into 2 groups.

Medical education in Saudi Arabia: a review of recent developments and future challenges.

Medical education has been changing rapidly in Saudi Arabia. Within a decade, the number of medical colleges increased from 5 medical schools with traditional disciplined-based curricula to 21 medical colleges with varied curricula ranging from the traditional to more innovative, problem-based, community-oriented programmes. The private sector has started investing in higher education generally and medical education in particular.

Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea.

Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS) mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 2).

Background: The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1).

Background: The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country.

Helicobacter pylori: prevalence and relationship with abdominal pain in school children in Makkah City, western Saudi Arabia.

Background/aim: The published data on Helicobacter pylori (H. pylori) prevalence and its relationship with abdominal pain in Saudi Arabia is scarce. This study was carried out to determine the prevalence of H.

Rotavirus infection in infants and young children in Makkah, Saudi Arabia.

Objective: To determine the prevalence of rotavirus in infants and young children in Makkah, Saudi Arabia.

Methods: A population-based prevalence study was done in randomly selected infants and young children suffering from acute diarrhoea. Faecal specimens were collected from 479 patients.

TORCH agents in pregnant Saudi women.

Objective: To determine the seroprevalence rates of IgG to common TORCH agents in pregnant Saudi women using indirect enzyme-linked immunosorbent assay.

Subjects And Methods: A total of 926 samples of sera were tested for antibodies to TORCH agents known to cause serious congenital infections: Toxoplasma gondii, rubella, cytomegalovirus (CMV), herpes simplex viruses (HSV-1 and HSV-2), varicella zoster virus (VZV) and human immunodeficiency virus (HIV-1 and HIV-2).

Results: Toxoplasma IgG antibodies were detected in 35.

A study of group a streptococcal bacteria isolation from children less than 12 years with acute tonsillitis, pharyngitis and healthy primary school children.

Aim: This study was carried out to assess the prevalence of Group A Streptococcal (GAS) bacteria in the throat specimens of children with tonsillitis and pharyngitis compared to healthy children of the same age group.

Methodology: The study was a prospective one. Throat swabs were obtained from 73 children aged 1-12 years diagnosed with acute tonsillitis and pharyngitis (sore throat and pyrexia >38.

CD4+ Th2 cell response cytokine production in bacterial meningitis.

There has been a growing body of evidence suggesting that CD4+ Th1/Th2 cell responses participate in pathologic and immunologic processes in infectious disease. Bacterial meningitis is a fatal disease of children and is associated with a spectrum of clinical syndromes. This study provides evidence of CD4+ enhanced interleukin (IL)-4 and IL-6 but decreased IL-2 and interferon-gamma (IFN-gamma) production, the induction of characteristic Th2 cell response cytokines in bacterial meningitis, which may play an important role in disease mechanism.

Gamma delta T lymphocytes and proinflammatory cytokines in bacterial meningitis.

Background: Patients with bacterial meningitis have a T-cell defect and impaired cytokine production.

Methods: The phenotype and percentage of circulating alpha beta and gamma delta T-cell receptor-bearing lymphocytes were determined from patients with bacterial meningitis (Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis), patients with bacterial infection but without meningitis, and healthy control subjects by a monoclonal antibody staining method. The in vitro production of cytokines, interleukins (IL-2, IL-6), interferon-gamma and tumor necrosis factor-alpha was measured by the bioassay or ELISAs.