Saudi Med J
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We are presenting a monozygotic twin brothers presented at different ages with different presentations. Twin-A presented at age of 18 days with salt losing crisis. Investigations revealed high plasma renin with low-normal aldosterone. ⋯ Both were having unilateral undescended testes. Adrenal hypoplasia congenita (AHC) was suspected after his twin's presentation. Molecular analysis for gene study for both of them revealed adrenal insufficiency, NR0B1 (DAX1) gene mutation. In conclusion, gene analysis is important for the diagnosis of AHC and for genetic counseling.
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To perform a meta-analysis for celiac diseases (CD) among at-risk populations in Kingdom of Saudi Arabia (KSA), as well as a comparison with our previously reported meta-analysis in the normal population. ⋯ In March 2018, at King Abdulaziz University, Jeddah, KSA we commenced a retrospective comprehensive database and journal search for CD among at-risk populations in SA. Data from each of the relevant articles were analyzed using the Statistical Package for Social Science Version 20 (Armonk, NY: IBM Corp.). and the comprehensive meta-analysis program (CMA). The collected data were part of a retrospective literature review and analysis. Thus, a written ethical approval was not obtained before commencing the study. Results: Sixteen articles were found covering type-1 diabetes mellitus (DM), short stature (SS), and down syndrome (DS). Ages 1-50 years . The prevalence of seropositive-CD was 15.6% with high heterogeneity (I2=80.353), while prevalence of biopsy-proven CD was 10.6% with high heterogeneity (I2=73.359). Another article reported the CD prevalence in the at-risk population as 18.4% for the seroprevalence and 6.9% for the biopsy-proven CD. Anti-transglutaminase (anti-tTG) was used in 12 studies; in the remaining 4 studies (EMA in 2, ARA with AGA in one and no details given in one study). Conclusion: Both the prevalence of biopsy-proven CD (10.6%) and seroprevalence (15.6%) were higher than those we previously reported in the normal population (1.4% and 2.7%). The female-to-male ratio (1.9/1) of CD patients was the same in normal and at-risk populations in SA. Meta-analysis for prevalence of CD in DM, SS, and DS separately in SA is recommended.
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To report robotic partial nephrectomy (RPN) outcomes from a single tertiary hospital in Saudi Arabia. Methods: We retrospectively reviewed consecutive cases of patients undergoing RPN at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, between January 2008 and January 2018. The study reports patient's demographics, tumor characteristics, operative details, and perioperative outcomes, using descriptive statistics of median and range values. Results: One hundred and one patients underwent RPN during the study period. Average tumor size was 3 (1.3-6.4) cm and average radius exophytic nearness anterior/posterior location (RENAL) score was 6 (4-10). ⋯ Conversion to open partial nephrectomy occurred in 9 (8.9%) patients, major complications in 3 (3%) patients, positive surgical margins in 5 (5%) patients, and the hospital stay was 4 (2-14) days. A total of 73 (73%) patients achieved a trifecta of freedom from any complication, negative surgical margins, and ischemia time ≤25 minutes. Study limitations included the retrospective design and small cohort size. Conclusions: The initial experience of robotic partial nephrectomy was associated with a surgical outcome comparable to that reported by higher-volume centers.
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Randomized Controlled Trial
Is prilocaine safe and potent enough for use in the oral surgery of medically compromised patients.
To investigate the potency and speed of action of 2% lidocaine and 3% prilocaine for upper teeth extractions. ⋯ This prospective clinical study was conducted from November 2016 to May 2017. Ninety-six patients, aged between 16 to 70 years old were recruited in this study. Two regimens were randomly administered over one visit. Patients, treatment group I, received 2% lidocaine with 1:00.000 adrenaline. Patients treatment group II received prilocaine 3% and felypressin 0.03 I.U. per ml. The efficacy of pulp anesthesia was determined by electronic pulp testing. At any point of trial (10 minutes), the anesthetized tooth becomes unresponsive for maximal pulp stimulation (64 reading), the extraction was carried out. Results: There were no significant differences in the mean onset time of pulpal anesthesia and extraction between the prilocaine and lidocaine buccal infiltration groups (p=0.28). However, clinically, the patients in prilocaine group recorded faster onset time of anesthesia and teeth extraction than those in lidocaine group. Conclusion: Prilocaine has a better clinical performance in terms of providing rapid dental anesthesia and earlier teeth extraction than lidocaine but the differences were not significant. Prilocaine with felypressin could be a good choice for patients who have contraindication to the use of lidocaine with adrenaline.
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To assess the effects of immediate and delayed loadings of dental implants on the overall quality of life (QoL) of patients. Methods: The prospective analysis was conducted in the Department of Periodontology Clinics, Faculty of Dentistry Hospital, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. The study was conducted from November 2013 to August 2016 and was according to the principles of the Helsinki Declaration. Quality of life in 24 patients (10 males and 14 females), aged between 18-60 years were assessed. ⋯ The quality of life was analyzed using a QoL assessment scale before and after the implant loading. Results: Overall assessment revealed that the QoL among the patients immediately after loading of dental implant (Group I) was better as compared to the delayed loading of dental implant (Group II). The differences of functional and financial aspects were significant between both groups. The majority of the immediate implant's loadings have been performed in the anterior aesthetic zone and has a significant impact on the QoL. Conclusion: The results concluded that immediate loading of dental implant is better than the delayed loading of a dental implant with a prosthesis.