Caseating granulomas in cutaneous leishmaniasis.

Background: Caseating granulomas are often associated with a mycobacterial infection (TB) and are thought to be exceedingly rare in cutaneous leishmaniasis (CL). However, no large series has accurately documented the incidence of caseating granulomas in CL.

Methods: A multiregional cohort consisting of 317 patients with CL [Syria (157), Pakistan (66), Lebanon (47), Saudi Arabia (43), Ethiopia (2) and Iran (2)] was reviewed.

In vivo surface dose measurement using GafChromic film dosimetry in breast cancer radiotherapy: comparison of 7-field IMRT, tangential IMRT and tangential 3D-CRT.

Purpose: The purpose of this study was to compare the surface dose of 7-field IMRT (7 F-IMRT), tangential beam IMRT (TB-IMRT), and tangential beam 3D-CRT (3D-CRT) of breast cancer patients receiving adjuvant radiotherapy by means of in vivo GafChromic film dosimetry.

Material And Methods: Breast cancer patients receiving adjuvant radiotherapy of the whole breast or the chest wall were eligible for the study. Study patients were treated with a treatment plan using two different radiotherapy techniques (first patient series, 3D-CRT followed by TB-IMRT; second patient series, TB-IMRT followed by 7 F-IMRT).

Identification of breast cancer patients with a high risk of developing brain metastases: a single-institutional retrospective analysis.

Background: The objective of this study was to identify breast cancer patients with a high risk of developing brain metastases who may benefit from pre-emptive medical intervention.

Methods: Medical records of 352 breast cancer patients with local or locoregional disease at diagnosis were retrospectively analysed. The brain metastasis-free survival was estimated using the Kaplan-Meier method and patient groups were compared using the log rank test.

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Eastern Saudi Arabia cohort of the A1chieve study.

Background: The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents.

Materials And Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Eastern Saudi Arabia.

Value of neuroimaging in epilepsy: An experience from Pakistan.

Purpose: To detect the possible structural brain lesions in the patients suffering from various kinds of epilepsy during the routine neuroimaging.

Materials And Methods: Prospective study of 366 epileptic patients conducted at epilepsy clinic, Rawalpindi-Islamabad Pakistan in an outpatient setting. MRI or CT scan of the brain without contrast was advised in all patients to detect any underlying pathology.

Clinical practice guidelines for the management of invasive Candida infections in adults in the Middle East region: Expert panel recommendations.

Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East.

Intensity modulated radiotherapy of upper abdominal malignancies: dosimetric comparison with 3D conformal radiotherapy and acute toxicity.

Background: The goal of this study was to assess a possible dosimetric advantage of intensity modulated radiotherapy (IMRT) of upper abdominal malignancies compared to three-dimensional conformal radiotherapy (3DCRT), and to assess the impact of IMRT on acute toxicity.

Methods: Thirty-one unselected consecutive patients with upper abdominal malignancies were treated with definitive (n =16) or postoperative (n =15) IMRT. Twenty-one patients (67.

BRAF analysis on a spectrum of melanocytic neoplasms: an epidemiological study across differing UV regions.

BRAF mutation has been linked to the development of melanocytic tumors in homogeneous Caucasian cohorts. The role of solar UV radiation (UVR) in BRAF mutation status is poorly understood. We studied the epidemiology of BRAF mutation across a spectrum of melanocytic neoplasms in populations with differing UVR rates.

Long-Term Complications of Chronic Traumatic Paraplegia: An Experience from Pakistan.

Objective: This study was conducted to ascertain the long-term complications of chronic traumatic paraplegia and the quality of life of paraplegic patients.  Study Design: A retrospective descriptive study.

Place And Duration Of Study: Conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan.

Perforated appendicitis in a neonate presenting with intestinal obstruction.

We report a case of neonatal perforated appendicitis presenting with an early picture of intestinal obstruction secondary to entrapment of small bowel under inflamed appendix vermiformis.

Successful pregnancies after combined human leukocyte antigen direct genotyping and preimplantation genetic diagnosis utilizing multiple displacement amplification.

Objective: To devise a new and simple technique to help select normal embryos that are human leukocyte antigen (HLA) matched to their affected siblings for diseases, such as beta-thalassemia or sickle cell anemia, which are common in this part of the world.

Methods: This study was conducted between March 2008 and April 2011 at the preimplantation Genetic Diagnosis Laboratory, Saad Specialist Hospital, Al-Khobar, Kingdom of Saudi Arabia. Embryos were obtained after 7 in vitro fertilization preimplantation genetic diagnosis (IVF-PGD) cycles.

Role of conventional lumbar myelography in the management of sciatica: An experience from Pakistan.

Objectives: A prospective study of 80 patients suffering from sciatica was conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan. The aim of this study was to select patients for lumbar myelography on clinical grounds in the absence of magnetic resonance imaging (MRI)/computerized tomography (CT) facilities and to know the causes of sciatica.

Materials And Methods: All patients underwent conventional lumbar myelography due to lack of MRI facility at a local hospital as well as financial constraints.

Age of 40 years or younger is an independent risk factor for locoregional failure in early breast cancer: a single-institutional analysis in saudi arabia.

Background. This study was undertaken to evaluate the impact of prognostic factors on the locoregional failure-free survival of early breast cancer patients. Methods.

Epidemiology of breast cancer patients at a tertiary care center in the Eastern Province of Saudi Arabia.

Background: Breast cancer is the most common cancer in Saudi Arabia. However, detailed published epidemiologic data are scarce. In this study, breast cancer patients at a tertiary care hospital were characterized and compared with data from the United States.

Impact of the frequency of online verifications on the patient set-up accuracy and set-up margins.

Purpose: The purpose of the study was to evaluate the patient set-up error of different anatomical sites, to estimate the effect of different frequencies of online verifications on the patient set-up accuracy, and to calculate margins to accommodate for the patient set-up error (ICRU set-up margin, SM).

Methods And Materials: Alignment data of 148 patients treated with inversed planned intensity modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3D-CRT) of the head and neck (n = 31), chest (n = 72), abdomen (n = 15), and pelvis (n = 30) were evaluated. The patient set-up accuracy was assessed using orthogonal megavoltage electronic portal images of 2328 fractions of 173 planning target volumes (PTV).

CSF shunt complications in infants--an experience from Pakistan.

Aims And Objective: The main aim of the study was to find out the postoperative complications and long-term outcome of cerebrospinal fluid-shunted patients in an infantile age group with a poor socioeconomic background.

Material And Methods: A prospective study of 100 cases of infantile hydrocephalus was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan. All selected patients suffering from congenital and post-meningitic hydrocephalus were operated on for ventriculoperitoneal shunt.

The effect of timing and temperature of oral fluids ingested after minor surgery in preschool children on vomiting: a prospective, randomized, clinical study.

Background: The time at which children should resume oral intake after surgery is controversial. No information has been published about the relationship between postoperative vomiting and the temperature of the fluid ingested. This study was designed to analyze the effect on postoperative vomiting of the timing and temperature of the fluids ingested in the first oral intake.

Tangential beam IMRT versus tangential beam 3D-CRT of the chest wall in postmastectomy breast cancer patients: a dosimetric comparison.

Background: This study evaluates the dose distribution of reversed planned tangential beam intensity modulated radiotherapy (IMRT) compared to standard wedged tangential beam three-dimensionally planned conformal radiotherapy (3D-CRT) of the chest wall in unselected postmastectomy breast cancer patients

Methods: For 20 unselected subsequent postmastectomy breast cancer patients tangential beam IMRT and tangential beam 3D-CRT plans were generated for the radiotherapy of the chest wall. The prescribed dose was 50 Gy in 25 fractions. Dose-volume histograms were evaluated for the PTV and organs at risk.

A patient with metastatic colon cancer to the liver presenting with cardiac arrest status post receiving combination irinotecan-panitumumab: a case report.

Panitumumab is a recombinant human Immunoglobulin G antibody. Irinotecan is an S-phase cell cycle specific plant alkaloid. Life threatening adverse events occur with Panitumumab-chemotherapy combination.

Obesity in Saudi children: a dangerous reality.

Obesity among children is an increasing concern. This cross-sectional study in 2006 determined the prevalence and demographic characteristics of overweight and obesity in children in the Eastern province of Saudi Arabia. A total of 7056 children (aged 2-18 years) were selected from schools and the outpatient department of a hospital.

Oculomotor nerve palsy associated with bortezomib in a patient with multiple myeloma: a case report.

Introduction: Bortezomib is a proteasome inhibitor used in the treatment of multiple myeloma. A newly recognized oculomotor nerve palsy related to bortezomib is described.

Case Presentation: A 54-year-old Caucasian woman with immunoglobulin G kappa multiple myeloma on single-agent bortezomib given by intravenous push once weekly developed isolated unilateral partially reversible left sided oculomotor nerve palsy during the first cycle of treatment.

A mutation in PEX19 causes a severe clinical phenotype in a patient with peroxisomal biogenesis disorder.

Peroxisomal biogenesis disorders (PBD) are groups of inherited neurometabolic disorders caused by defects in PEX genes. We report on a female infant, born to a consanguineous parents (first degree cousins), who presented with inactivity, poor sucking, and hypotonia early in the neonatal period. She had subtle dysmorphic features.