Culture-related service expectations: a comparative study using the Kano model.

Objective: To compare service expectations between Arab and Austrian patients.

Methods: We used a Kano model-based questionnaire with 20 service attributes of relevance to the dialysis patient. We analyzed 530, 172, 60, and 68 responses from Saudi, Austrian, Syrian, and UAE patients, respectively.

Post Transplant Acute Tubular Necrosis - How Long you can Wait?: A Case Report.

Delayed graft function (DGF) is a common clinical problem occurring after cadaveric renal transplantation. Acute tubular necrosis (ATN) is one of the main causes of the DGF. Protracted recovery from ATN may continue for several weeks.

Appointment system in primary care: opinion of consumers and providers.

Background: The appointment system in primary care is widely used in developed countries, but there seems to be a problem with its use in Saudi Arabia.

Objectives: (1) To explore opinions and satisfaction of consumers and providers of care in Primary Health Care regarding walk-in and the introduction of the appointment system. (2) To examine factors which may affect commitment to an appointment system in PHC.

Neurological disorders and travel.

Travel is associated with a number of neurological disorders that can be divided into two categories: (1) Neurological infections including encephalitides, neurotuberculosis, neurobrucellosis, cysticercosis and trichinosis. Some of these disorders can be prevented by vaccinations, such as Japanese B encephalitis and rabies, some by the use of insect repellents and some by avoiding raw milk products and undercooked meat. (2) Non-infective neurological disorders, such as acute mountain sickness and high altitude cerebral oedema, problems occurring during air travel such as syncope, seizures, strokes, nerve compression, barotrauma and vertigo, motion sickness and foodborne neurotoxic disorders such as ciguatera, shellfish poisoning and intoxication by cassava.

Headache syndromes amongst schoolchildren in Riyadh, Saudi Arabia.

We evaluated 1,400 randomly selected Saudi children in grades 1 through 9 to determine the prevalence of migraine and tension-type headache. Of the 1400 distributed questionnaires, 1,181 (84.3%) were completed properly and so served as the basis for analysis.

[Rapidly evolving diabetic mononeuritis multiplex. Favorable outcome after immunosuppressive treatment].

A 61 year-old man with type 2 diabetes mellitus presented with an extremely rapid and aggressive mononeuritis multiplex. Four months after onset, he had severe postural hypotension and at least 6 cranial nerves and 4 somatic nerves were involved. Extensive work-up failed to discover any etiology for the neuropathy apart from diabetes.

The first-of-Ramadan headache.

This study was designed to estimate the frequency and characteristics of headaches occurring on the first day of Ramadan (Moslems' fasting month) and to determine possible causes. One hundred fifty copies of a specially designed questionnaire were distributed on the second day of fasting to a random sample of hospital staff. Completed questionnaires were obtained from 116 subjects (77%).

Carpal Tunnel Syndrome in type 2 diabetic patients.

Objective: To determine the frequency of carpal tunnel syndrome in type 2 diabetic patients, its clinical profile and its other predisposing factors.

Methods: One hundred and forty six consecutive patients (57 male, 89 female) with type 2 diabetes mellitus seen in the diabetic clinic were examined prospectively and submitted to comprehensive electrophysiological studies to detect carpal tunnel syndrome and sensorimotor neuropathy. Those with carpal tunnel syndrome were compared to others to determine the additional predisposing factors for carpal tunnel syndrome in diabetic patients.

The Saudi Stroke Data Bank. Analysis of the first 1000 cases.

Objectives: To determine the types of stroke, their risk factors and their most likely causes in Saudi patients.

Methods: Data on stroke cases admitted to 2 major hospitals in Saudi Arabia since 1982 were collected retrospectively up to 1991 then prospectively since then. By January 1995, the number of cases with first-ever-stroke stored in our Saudi Stroke Data Bank reached 1280.

[Residual cerebellar ataxia following acute phenytoin intoxication].

A 30-year-old man was given high doses of phenytoin together with 4 antituberculous drugs for a seizure associated with a probable brain tuberculoma. He developed hepatic toxicity and his serum phenytoin reached the high level of 298 mumol/l (therapeutic range 40-79 mumol/l). All drugs were stopped and the biological parameters returned progressively to normal over the next 15 days.

Late epileptic seizures after cerebral infarction.

Objectives: To determine the profile of late epileptic seizures following cerebral infarcts and the predictive clinical and radiological factors associated with their development.

Methods: We compared 86 patients who developed late seizures after cerebral infarction with 285 similar patients who did not develop seizures for at least 1 year after their stroke. Patients who had seizures only at the onset of the stroke were excluded.

Atypical brachial plexopathy with pseudotumor cerebri.

A 24-year-old woman with previously known pseudotumor cerebri syndrome (PTCS) presented with severe pain in the neck and shoulders followed by the classical symptoms and signs of bilateral brachial neuritis. At the same time, there was a recurrence of the PTCS which had been in remission for more than one-and-a-half years. Despite treatment with high doses of methylprednisolone, intravenous immunoglobulins and repeated cerebrospinal fluid drainage, both brachial plexopathy and the PTCS continued to worsen.

Carpal Tunnel Sydrome: A prospective clinical study of one hundred cases.

Full text is available as a scanned copy of the original print version.

Spontaneous cervical epidural hematoma: case report.

Spontaneous spinal epidural hematoma (SSEH) is an uncommon cause of acute nontraumatic myelopathy. We report a 14 year-old boy who had tetraplegia on awakening. Diagnosis of spinal epidural hematoma was made by magnetic resonance imaging.

Pseudotumor cerebri in renal transplant recipients: a diagnostic challenge.

We describe two patients with renal transplants who developed pseudotumor cerebri (PTC) in the course of their follow-up. They illustrate the diagnostic challenge in such situations. Patients with renal transplants usually have many other associated conditions which may lead to headache, visual disturbances or papilledema.

Cavernous angioma presenting as pregnancy-related seizures.

Purpose: To determine the reason that one-quarter to one-third of epileptic women experienced an increased number of seizures during pregnancy. The cause of this increase is not always clearly understood and the principle emphasis of the literature is on the pregnancy-associated changes of anticonvulsant pharmacokinetics.

Methods: Two patients presented with recurrent seizures occurring only during pregnancy.

[Blepharospasm caused by bilateral paramedian thalamic infarction].

A 67 year-old woman developed a small infarct in the superficial anterior territory of the left middle cerebral artery, then 2 other successive infarcts in the left then right thalamic paramedian territories. Left thalamic infarct was associated with right hemiparesis and speech disorders of the subcortical type. The occurrence of the additional right thalamic infarct was associated with stupor, left hemiparesis and oppositional behavior.

[Uncommon reflex automatisms after brain death].

Two cases of unusual complex movements observed in brain dead patients are described. Rapid and sustained flexion of the neck induced slow abduction of the arms with flexion of the elbows, wrists and fingers over 5 to 10 seconds. These movements have been rarely described and although they have similar clinical patterns, they are pathophysiologically different from the Lazarus sign which is observed few minutes after respiratory support cessation.

The treatment of the scorpion envenoming syndrome: the Saudi experience with serotherapy.

A protocol for treatment of scorpion sting based mainly on antivenom therapy was applied nation-wide in Saudi Arabia. At least 5 x 1 ml ampoules of antivenom diluted in 20-50 ml saline were injected slowly i.v.