Retromaxillary Pneumatization of Posterior Ethmoid Air Cells: Novel Description and Surgical Implications.

Objective: Retromaxillary pneumatization of posterior ethmoid (PE) air cells is an area that is yet to have appropriate description in rhinologic literature.

Study Design: Case series with chart review.

Setting: Tertiary care hospital.

Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia.

Objectives: To estimate the prevalence of intimate partner violence (IPV) among female patients, age 18-60 years, attending primary health care centers (PHCCs) and to measure its determinants, and reporting behavior.

Methods: A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA) from January to February 2015 was employed. A 2-stage probability sampling was adopted for selection of PHCCs in the first stage, and then participants in the second stage.

Predictors of European League Against Rheumatism (EULAR) good response, DAS-28 remission and sustained responses to TNF-inhibitors in rheumatoid arthritis: a prospective study in refractory disease.

The aim of this study was to survey factors related to EULAR good response, the DAS-28 definition of remission, ACR 50 response, sustained response to tumor necrosis factor inhibitors (TNF-I) therapy in biologic naïve patients with refractory rheumatoid arthritis. This was a single center observational clinical prospective 2 years' study, EULAR response criteria, DAS 28, HAQ and radiographic changes were recorded. Eighty patients included (64 females and 16 males, mean age was 48.

Metformin-associated lactic acidosis in a peritoneal dialysis patient.

Metformin is one of the commonly used drugs in type-2 diabetes mellitus. It reduces glucose levels by increasing insulin sensitivity, reducing hepatic glucose release and increasing muscle uptake. One of the serious complications associated with metformin use is lactic acidosis, and it is associated with high morbidity and mortality.

Cinacalcet in pediatric and adolescent chronic kidney disease: a single-center experience.

Cinacalcet, a calcimimetic drug, has been shown to be efficacious in adult chronic kidney disease (CKD) patients; however, it was not fully studied in pediatric CKD patients. We aimed at assessing the effect of cinacalcet on intact parathyroid hormone (iPTH) secretion in children with CKD-4/5 with iPTH consistently ≥ 300 pg/mL refractory to conventional treatment. This is a prospective cohort analysis of 28 children with uncontrolled hyper-parathyroidism secondary to stage 4 and 5 CKD admitted to a tertiary center during the period from April 2012 to April 2014.

Pediatric air gun shot injury.

Air guns (AGs) use air or another compressed gas to propel a projectile. Different injuries may occur in children due to their body structure, which is less-resistant with thin soft tissue coverage that can be easily penetrated by an AG shot. We present 3 cases of pediatric AG shot injury.

Phantom tumour of the lung in a patient with renal failure misdiagnosed as chest infection.

Phantom or vanishing tumour of the lung is a rare finding on chest radiographs that has been reported secondary to heart failure or chronic kidney disease. It has been described as an interlobular effusion of the transverse or oblique fissure of the right lung. Although it is uncommon, it should always be considered as a differential diagnosis for a radiographic opacity of the right-middle lung zone because it can be easily mistaken for a lung mass or infiltration.

Formative assessment in undergraduate medical education: concept, implementation and hurdles.

Formative assessment, described as "the process of appraising, judging or evaluating students' work or performance and using this to shape and improve students' competence", is generally missing from medical schools of Pakistan. Progressive institutions conduct "formative assessment" as a fleeting part of the curriculum by using various methods that may or may not include feedback to learners. The most important factor in the success of formative assessment is the quality of feedback, shown to have the maximum impact on student accomplishment.

Late response to rituximab in a dialysis patient with severe lupus nephritis.

Although recently completed controlled trials failed to demonstrate a significant effect of rituximab on the clinical outcome in non-renal and renal lupus, there is growing evidence from case reports and open-label trials that the use of this medication is successful in certain subgroups of patients including refractory cases and helps in reducing the dose of steroids. We present a 26-year-old female who failed to respond to a long-course treatment with prednisolone, cyclophosphamide, mycophenolate mofetil and azathioprine and who went on to develop end-stage renal disease requiring commencement of regular maintenance hemodialysis. Ten days before starting dialysis, she was given rituximab, and a second dose was given 17 days after starting dialysis.

Pattern of psychiatric illnesses among long-stay patients at Mental Health Hospital, Taif, Saudi Arabia: a 10-year retrospective study.

To identify the pattern and determinants of psychiatric illness and the predictors of long stay among long-stay patients at the Mental Health Hospital, Taif, Saudi Arabia, we examined a total of 430 records of patients who had been admitted during the period January 1999-January 2009 and had stayed for > 9 months. More than half these patients had a history of drug addiction (60.7%).

Troponin-I is not falsely elevated in asymptomatic dialysis patients.

Dialysis patients with troponin-I levels above the cut-off value diagnostic for acute myocardial event (AME) are sometimes labeled as having "renal cause" of elevated troponin-I. Patients with troponin-I levels above 0.0 ng/mL, but below the cut-off level for an AME, are reported to have increased risk for coronary heart disease and mortality.

Benign intrascrotal lipoblastoma in a 4-month-old infant: a case report and review of literature.

Lipoblastomas are rare benign soft tissue tumors that occur primarily in young children. Most lipoblastomas occur in the extremities, trunk, head, and neck. An intrascrotal location is unusual.

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child.

Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal (GI) tract. We report a 10-year-old boy diagnosed as suffering GI basidiobolomycosis after being misdiagnosed first as suffering intestinal malignancy then schistosomiasis. The patient presented with fever, abdominal pain, vomiting, abdominal tenderness and rigidity with marked blood eosinophilia.

Quantitative DNA analysis of very low-level hepatitis B viremic patients reporting to the gastroenterology clinic.

Objective: To examine data on very low-level viremic hepatitis B virus (HBV) infections in patients reporting to a gastroenterology clinic, and to investigate methods to improve analysis to avoid missing follow-up data and improve the management of HBV infection, and minimize morbidity and mortality outcomes.

Methods: A total of 104 patients with very low-level viremic HBV whom reported to the gastroenterology clinic at Al-Hada Armed Forces Hospital, Taif, Saudi Arabia and had a reading of <12 IU/mL on the real time (RT) polymerase chain reaction (PCR) detection system were enrolled in this study. For serological testing (for example, hepatitis B surface antigen [HBsAg]), we examined patients' results recorded in the laboratory information system since early 2007.

Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly.

Context: Little is known about the relationship between sedative drugs used preoperatively and postoperative delirium. Melatonin is a drug used to sedate patients preoperatively and is hypothesized by recent works to have a curative effect on postoperative delirium.

Aims: The incidence of postoperative delirium will be tested if affected by three different sedative drugs including melatonin.

Difficulties facing first-year medical students at Umm Alqura University in Saudi Arabia.

This study investigated medical students' study habits and perceptions of learning difficulties during their first year of study. A specially-designed questionnaire was answered by 165 second-year medical and medical science students at Umm Alqura University in Saudi Arabia. Out of the 7 difficulties listed in the questionnaire, students ranked peer competition first, followed by poor English language skills.

Methods used to reduce the prevalence of hepatitis C in a dialysis unit.

In the present study, we report on the follow-up of the epidemiology of hepatitis C viremia in our dialysis unit after our previous report, over the period from July 1, 2003 to December 31, 2005. The methods to reduce the prevalence of hepatitis C viremia in our center included: strict adherence to universal infection control precautions, separation of hepatitis C virus (HCV) positive patients from the negative patients and using specially designated machines for them, and from July 2003, periodic testing of all patients for HCV-RNA. Following the application of the above mentioned methods, we have not had, since 31 December 2005, any case of sero-conversion from HCV-negative to HCV-positive in our dialysis unit and the only HCV-positive patients present were those who were already positive at entry.

Nucleic acid amplification technology for hepatitis B virus, and its role in blood donation screening in blood banks.

Objective: To investigate the performance of hepatitis B virus polymerase chain reaction (HBV PCR) using one of the commercial methods used around the world to screen for HBV in some blood donors where other conventional serological assays have limitations to detect the virus.

Methods: This study was designed to use Amplicor AmpliScreen for HBV testing to detect the presence of the HBV DNA in the specimens tested by COBAS AmpliPrep system using a modified manufacture protocol COBAS AmpliPrep of total nucleic acid isolation (TNAI) kit. All serological tests were carried out on the donors' samples to detect the hepatitis B surface antigen (HBsAg), Australian antibody anti-HBs (AUSAB) and hepatitis B core antigen (HBcAg) in the 2 periods of the study.

Community-based screening for pre-hypertension among military active duty personnel.

Objective: To determine the prevalence of both pre-hypertension and hypertension, and risk factors associated with the newly diagnosed Saudi military active duty personnel.

Methods: A community-based cross-sectional screening of 1238 Saudi military active duty service personnel was conducted during the period from September to December 2007 at the military units of Taif region, western Saudi Arabia. Screening tools included self-administrated questionnaire, general physical examination, anthropometric measurements, and assessment of blood pressure.

Does the use of radiofrequency ultrasonic dissector in tonsillectomy have a beneficial effect over the use of laser?

Objective: To compare the intra- and post- operative morbidities on the use of radiofrequency ultrasonic dissector (US) with the use of laser during tonsillectomy in the same patients.

Methods: A randomized comparative study was implemented where all patients underwent tonsillectomy at Al-Hada Armed Forces Hospital, Taif, and Aouhod Hospital, Al-Madinah, Kingdom of Saudi Arabia during the period January 2000 to December 2005 were recruited for the study. Radiofrequency US was used in one side, and laser was used in the other side of the same patient.

Cefepime-induced nonconvulsive status epilepticus: case report and review.

Introduction: A case of cefepime-induced nonconvulsive status epilepticus in a 15-year-old child with end stage renal disease on hemodialysis is reported. Clinical symptoms and EEG dramatically improved 48 h after discontinuation of cefepime.

Methods: Twenty-five cases of nonconvulsive status epilepticus associated with cefepime that have been reported in the literature are reviewed.

Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease.

Diabetes mellitus (DM) is known to cause microvascular and possibly macrovascular complications. This study was performed to find the association between glycosylated haemoglobin (HbA1C) level and the severity of coronary artery disease. One hundred and ten consecutive patients admitted to hospital with acute myocardial infarction were studied.

Nosocomial pneumonia: risk factors, rates and trends.

This study aimed to estimate the rate of and risk factors for nosocomial pneumonia of patients admitted to hospitals in Taif, Saudi Arabia. A case-control study was conducted of 211 discharged patients with confirmed pneumonia and 633 controls without pneumonia and a review was made of hospital records during 1999-2003. Multiple logistic regression showed that duration of hospital stay, unit of admission, chronic obstructive pulmonary diseases, coma, nasogastric tube, endotracheal tube, debilitating diseases and mechanical ventilation were independently associated with increased risk of pneumonia.

Exercise capacity of Saudi with symptoms suggestive of cardiovascular disease in a military hospital in Western Saudi Arabia.

Objective: To analyze the results of exercise tolerance test (ETT) of Saudi women and assess their exercise capacity.

Methods: A hospital based retrospective cohort analysis was carried out on all Saudi women referred to the Cardiology Department for ETT from February 2005 to June 2007. They underwent symptom limited treadmill test according to the standard Bruce protocol with exercise electrocardiogram monitoring.