Primary angioplasty and later elective multivessel stenting in a patient with dextrocardia: a case report and literature review.

Dextrocardia is a rare congenital anomaly with a prevalence of 1 in 10,000 births. The incidence of coronary artery disease in such patients is thought to be similar to that of the general public, however, patients are seldom seen during routine clinical practice and at the cardiac catheterization laboratory. Patients with this condition and acute myocardial ischemia may pose challenges at presentation, clinical and diagnostic findings and at cardiac catheterization.

Medical management of spinal tuberculosis: an experience from Pakistan.

Study Design: A prospective study on spinal tuberculosis conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan, with 1 year of follow-up.

Objective: The main aim was to diagnose spinal tuberculosis on clinical grounds and with simple noninvasive laboratory and radiology investigations and to treat the patients with antituberculosis drugs.

Summary Of Background Data: Spinal tuberculosis associated with any neuro deficit is usually treated by surgery.

Review of positron emission tomography tracers for imaging of tumor hypoxia.

Hypoxia plays a critical role in tumor development and aggressiveness and is an important prognostic factor for resistance to antineoplastic treatments; therefore, it is required to measure the hypoxic level of tumor for a favorable outcome. The pretherapy information on the oxygenation status of a tumor microenvironment should also have implications for treatment selection. A diffuse distribution of hypoxia in a tumor might suggest a benefit from a systemic approach, such as a hypoxic cell cytotoxin, tirapazamine, or antigrowth factor drugs to combat the limitations of hypoxia.

Long-term outcome of lumbar disc surgery: an experience from Pakistan.

Object: The author conducted a study to determine the long-term outcome of lumbar disc surgery on relief of sciatic leg pain.

Methods: This was a retrospective observational study conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan. The author reviewed medical records of 68 patients who underwent lumbar disc surgery for sciatic pain during the period 1995-2004.

A t(5;16)(p15.32;q23.3) generating 16q23.3 --> qter duplication and 5p15.32 --> pter deletion in two siblings with mental retardation, dysmorphic features, and speech delay.

We report on two siblings (half brothers on the paternal side) with a syndrome consisting of delayed development, cardiac anomalies, chest deformity, hip rotation, metatarsus adductus, genital hypoplasia, dysmorphic face, depressed nasal bridge, mental retardation, and speech delay. All metaphases examined showed a normal karyotype in the patients, their father, and both mothers. High-resolution array CGH examination revealed a 16q (6 Mb) duplication dup(16)(16q23.

PET and PET/CT in the clinical management of colorectal cancer.

PET/CT is a new imaging technology that has already found a number of clinical applications in oncologic imaging. Widespread introduction into clinical practice started approximately 5 years ago. It can already be stated that the synthesis of structural and metabolic information improves the accuracy of primary staging and the detection of recurrent disease and has the realistic potential to change patient management in up to 30% of cases.

G6PD Mediterranean S188F codon mutation is common among Saudi sickle cell patients and increases the risk of stroke.

Aim: To describe the molecular spectrum of G6PD gene mutation(s) in a population sample of Saudi Arabian Hemoglobin S (HBS) patients versus normal control from matching ethnicity. Additionally, we aim to investigate whether HBS patients with G6PD mutation(s) are at higher risk of developing a stroke.

Methods: DNA was extracted from 48 HBS patients and 42 controls.

Molecular spectrum of alpha-thalassemia mutations in microcytic hypochromic anemia patients from Saudi Arabia.

Aim: To describe the molecular spectrum of alpha-thalassemia molecular defects in a population sample of Saudi Arabian patients from the eastern province.

Methods: DNA was extracted from 41 patients suffering from microcytic, hypochromic anemia. We screened the alpha-globin gene for deletional and nondeletional mutations.

Combination effect of low dose fentanyl and propofol on emergence agitation in children following sevoflurane anesthesia.

Objective: To investigate the combination effect of low dose fentanyl and subhypnotic dose of propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure.

Methods: After ethical approval, a prospective, randomized, clinical study was performed in Saad Specialist Hospital, Al-Khobar, Kingdom of Saudi Arabia in 2007-2008. One hundred and twenty children in physical status of I according to the American Society of Anesthesiologists, aged 2-6 years, scheduled for adentonsillectomy under general anesthesia were allocated into 3 groups randomly.

Pregnancy after preimplantation genetic diagnosis for brachydactyly type B.

Brachydactyly type B (BDB) is an autosomal dominant disease caused by mutations in the ROR2 gene. Truncating mutations lead to the severe form of the disease, which is characterized by terminal deficiency of fingers and toes. Preimplantation genetic diagnosis (PGD) was carried out in a family suffering from severe BDB.

Comparison of the effect of sevoflurane and halothane anesthesia on the fall in heart rate as a predictor of successful single shot caudal epidural in children.

Objective: To investigate the effect of sevoflurane anesthesia on heart rate HR fall with the injection of the initial drug in caudal space to confirm the correct needle placement.

Methods: After the ethical approval was obtained from the hospital's ethics committee, a prospective, randomized, clinical study was designed in Yeditepe University Hospital, in 2007. Children aged 1-12 years, scheduled for infraumbilical surgery under general anesthesia, and caudal block were included in the study.

The -17 T/C chemokine receptor 3 genetic polymorphism is associated asthma but not atopy: transmission and association studies.

We genotyped and identified the asthma and atopic status and related phenotypes of 154 nuclear families (453 individuals) each containing at least two affected children with physician-diagnosed asthma (PDA) in order to confirm or refute the possible relevance of known single nucleotide polymorphisms (SNPs) in the gene coding for the CCR3 receptor. Allelic quantification for each SNP by DNA pooling identified -17/TC as the only allele with a clinically relevant frequency in this population with a frequencies of 0.142 in cases of PDA and 0.

Successful pregnancies after application of array-comparative genomic hybridization in PGS-aneuploidy screening.

Recurrent IVF failure, implantation failure and early embryo demise can be attributed to the high frequency of chromosomal aneuploidy observed in human embryos. Preimplantation genetic screening (PGS) using multiple displacement amplifications (MDA) and array comparative genomic hybridization (aCGH) was successfully performed on eight patients with a minimum of seven recurrent IVF failures with the aim of detecting aneuploidy and ameliorating pregnancy rate. A total of 41 embryos with eight or more cells were biopsied by taking two blastomeres from each embryo.

Incidence and predictive factors of isolated neonatal penile glanular torsion.

Purpose: To determine the incidence of isolated neonatal penile glanular torsion, describe the basic characteristics, and explore the relationship between foreskin and glans torsion.

Methodology: A prospective survey was conducted of all male newborns admitted to nursery after delivery, or neonates less than 3 months presenting for circumcision. Cases with associated genital malformations were excluded.

Delivery of a normal baby after preimplantation genetic diagnosis for non-ketotic hyperglycinaemia.

Non-ketotic hyperglycinaemia (NKH), or glycine encephalopathy, is an autosomal recessive neurometabolic disease caused by defective activity of the glycine cleavage system. Up to 80% of NKH cases are caused by mutations in the P protein encoded by the glycine decarboxylase (GLDC) gene. GLDC deletions were identified in approximately 20% of NKH mutant alleles and resulted in a severe neonatal form of the disease.

Design and dosimetry of a few leaf electron collimator for energy modulated electron therapy.

Despite the capability of energy modulated electron therapy (EMET) to achieve highly conformal dose distributions in superficial targets it has not been widely implemented due to problems inherent in electron beam radiotherapy such as planning dosimetry accuracy, and verification as well as a lack of systems for automated delivery. In previous work we proposed a novel technique to deliver EMET using an automated "few leaf electron collimator" (FLEC) that consists of four motor-driven leaves fit in a standard clinical electron beam applicator. Integrated with a Monte Carlo based optimization algorithm that utilizes patient-specific dose kernels, a treatment delivery was incorporated within the linear accelerator operation.

Does epidural increase the incidence of cesarean delivery or instrumental labor in Saudi populations?

Background: This is a retrospective review of the medical records of 861 patients admitted for vaginal delivery. Patients were randomized to either epidural analgesia or other analgesic methods of pain relief for labor pains. The primary purpose of this study was to evaluate the effect of epidural analgesia on the rate of cesarean section delivery.

Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass.

Background: Obese patients may be sensitive to the respiratory depressant effect of opioid analgesics. Alternative methods for analgesia may be beneficial for management of bariatric surgery. We evaluated the effect of dexmedetomidine on anesthetic requirements during surgery, hemodynamic, recovery profile and morphine use in the postoperative period.

Minimally invasive right posterior minithoracotomy for open-heart procedures.

A right posterior minithoracotomy was evaluated in 123 selected patients between November 2002 and August 2006. Their ages ranged from 1.5 to 32 years (mean, 7.

Risk factors for wound complication in pilonidal sinus procedures.

Background: Pilonidal disease is a common condition among young people. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation. The aim of our study is to report our experience with Karydakis procedure and explore the risk factors associated with infection and poor healing in pilonidal operation.

131I-MIBG in the diagnosis of primary and metastatic neuroblastoma.

Objective: Neuroblastoma is the third most common malignancy of childhood. 131I-MIBG scintigraphy must be performed in patients with neuroblastoma at the time of staging. The aim of this study is to identify the role of 131I-MIBG scintigraphy in neuroblastoma patients in correlation with other diagnostic modalities for staging of the disease.

Cervical radiculopathy secondary to Hodgkin's lymphoma.

Background: Spinal cord/root compression is a rare complication of HL and usually seen in the setting of progressive, advanced disease. It is extremely rare to occur as an initial presentation of HL. We report a case of HL presented with bilateral cervical radiculopathy.