The usefulness of zinc protoporphyrin as iron deficiency screening tool for Saudi children

Blood samples from 240 Saudi children aged 1 day-72 months old were analysed for zinc protoporphyrin (ZPP), lead (Pb) and hematological parameters. Elevated blood zinc protoporphyrin concentrations ( >3.3 mug/g Hb) were found in 50.8%. These children had a mean blood ZPP concentration of 6.857 4.925 mug/g (3.35-43.7 mug/g). Blood lead levels >10 mug/dl were found in 8 children in the range of 10.45-61.08 mug/dl. On the other hand, Hb less than 11 g/dl were found in 51.6%. The correlation coefficient between the concentration of ZPP and the hematological parameters and age were tested. Significant negative correlation were found between ZPP concentrations and Hb, HCT, RBC and age. We conclude that the use of hematofluorometer to measure ZPP proved to be an effective and inexpensive screening tool for iron deficiency in children especially in communities where the prevalence of iron deficiency is high.     

沙特工程承包市场开发的几点体会

结合作者在沙特乙烯项目中的工作，重点介绍了开拓沙特工程承包市场需要注意和借鉴的五个方面。     

The assessment and manipulation of personal diet: an undergraduate practical in human nutrition

The Department of Paediatrics at King Saud University, Riyadh, Saudi Arabia offers to medical undergraduates an optional course in nutrition and growth. This paper describes the practical experiences offered in dietary assessment and manipulation which was one component of the course, together with an assessment of its value by the students and the authors. Generally, it seemed that the component had been successful but three changes might be considered: although hand analysis of crude dietary data to determine nutrient intakes is a useful exercise, computer analysis should also be included; the principles of dietary manipulation (in effect, the principles of therapeutic dietetics) will require more emphasis; the students should make a detailed analysis of a patient's diet as well as their own. Regarding the nutrition and growth course as a whole: assessment of clinical skills would probably benefit from the same structured approach as used in the dietetic assessment; a preliminary assessment of the students' nutritional knowledge at the start of the course should be incorporated.     

Training primary health care physicians in Saudi Arabia to recognize psychiatric illness

In order to evaluate the effect of training primary health care (PHC) physicians to recognize mental disorders, an intervention randomized controlled trial was conducted. Three categories of PHC physicians were selected: the index group (n=12 doctors), control group 1 (n=12) and control group 2 (n=4). For 1 week randomly selected patients from all trial centres were asked to complete the General Health Questionnaire (GHQ-28), and the three groups of doctors were asked to identify the presence of and rate the severity of any mental disorder in these patients. The same process was repeated for all three groups after a 6-month training course which was provided for the index group only. The doctors’ ability to detect mental disorders was measured by calculating Spearman's correlation coefficient between their severity rating and the GHQ scores of their patients. Training produced a noticeable improvement in the diagnostic accuracy of the index group, whereas there was minimal improvement in control group 1 and deterioration in control group 2. Recommendations to improve the ability of PHC physicians to detect mental disorders are discussed.     

Inguinal hernia in Saudi Arabia. A 10 year experience

There are differing opinions regarding the cause of inguinal hernias in adults. It seems that a patent vaginal process may determine the type of herniation that occurs in an adult but may not actually cause the hernia. Also, altered collagen metabolism seems to play a significant role in many cases of hernias in adults. Thus, most of these hernias are actually caused by a mixture of congenital and acquired factors. Consequently, it follows that there are a variety of opinions regarding surgical repair. This follow-up study on recurrence after inguinal hernia repair in Saudi Arabia was aimed at testing the effectiveness of Bassini's repair and the results achieved when it is employed for primary inguinal hernia repair in adults. One hundred forty patients (95 with indirect and 45 with direct hernias) who had Bassini's repair were studied. Only pure direct or indirect hernias were included. Combined direct, indirect bilateral, recurrent, or femoral hernias were not investigated. All the patients were followed for 2 years after repair, with a total recurrence rate of 2.14 percent. The projected recurrence rate at 25 years is 5.3 percent. These results are comparable to those achieved with other techniques. Therefore, I believe that the criticisms of Bassini's repair are based on theoretic grounds only. Bassini's repair has stood the test of time, is easier to teach and to perform by junior surgeons, and the chance of being complicated by thrombophlebitis and pulmonary embolism is less than the chance with Cooper's ligament repair.     

Childhood renal disorders in Saudi Arabia

An overview of childhood renal disorders in Saudi Arabia is presented, based largely on the experience in a large teaching hospital. The pattern of disorders is similar to that in other parts of the world, but the relative frequency of the various diseases appears to be different. Heredofamilial disorders are common, renal calculi are relatively frequent, and mesangioproliferative glomerulonephritis is a frequent cause of nonminimal change nephrotic syndrome. Preventable causes of end-stage renal failure include reflux nephropathy and posterior urethral valves. Although nephropathy associated with collagen vasculitides is not frequent, the prognosis of the disease is poor. IgA nephropathy appears to be a rarity.     

Nonpain Symptoms of New and Follow-up Cancer Patients Attending a Palliative Care Outpatient Clinic in Saudi Arabia

Background:

Epidemiology of cancer-related nonpain symptoms receives less attention in literature as compared with cancer pain.

Objective:

This paper aims at exploring the prevalence and severity of nonpain symptoms in cancer patients attending a palliative care (PC) outpatient clinic.

Materials and Methods:

Over a 5 months period, consecutive adult cancer patients attending PC outpatient clinic at a tertiary hospital were evaluated for the presence and severity of 10 nonpain symptoms. Patients were grouped to new or follow-up cases and were also grouped according to performance status and cancer type. Prevalence and severity of symptoms were compared between groups using t test or analysis of variance as appropriate.

Results:

Fifty-one males and 73 females were interviewed. The most common cancer is female breast (27.4%) followed by head and neck (15.3%). Majority of patients (67%) were new to PC clinic. Patients had 5.1 nonpain symptoms on average, with most common symptoms being tiredness (79.8%), loss of appetite (71.8%), dry mouth (69.4%), anxiety (60.5%), and depression (50.8%). The least common symptoms were confusion and nausea (22.6% each). The median scores of severity were highest for tiredness, loss of appetite, dry mouth, and insomnia (5 points each). Symptoms were fewer among patients with good performance status (P = 0.002), whereas age, gender, cancer type, and encounter type were not associated with difference in symptom prevalence. Younger patients, females and those with poor performance status have shown a tendency toward higher severity scores for several symptoms.

Conclusion:

The significant prevalence and severity of nonpain symptoms among new and follow-up cancer patients seen in a PC outpatient clinic emphasizes the need for comprehensive assessment and routinely audited symptom management plans.     

Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces

Objectives

The aims of the present study were (1) to determine ethnic differences in craniofacial dimensions between Turkish and Saudi populations and (2) to identify possible gender differences between males and females, based on a sample of untreated young adult subjects with normal occlusions and well-balanced faces.

Methods

In total, 163 cephalometric radiographs were traced and evaluated to compare untreated adults of Turkish and Saudi ethnicity. The Turkish group comprised 86 subjects; 45 females and 41 males. The Saudi group comprised 77 subjects; 39 females and 38 males. For statistical evaluation, an independent-samples t-test was performed.

Results

The Turkish sample had a more retrognathic maxilla and mandible (p < 0.001 for SNA and SNB) and a more vertical direction of facial development (p < 0.001), with Turkish males having more retrusive lips (p < 0.001). Distinctive ethnic differences were found in craniofacial structures between Turkish and Saudi young adults.

Conclusions

It is appropriate to consider these aesthetic differences when a Turkish or a Saudi patient is being evaluated during routine diagnosis and treatment planning.