Application of double sandwich enzyme-linked immunosorbent assay for the diagnosis of foot-and-mouth disease in Saudi Arabia

A case of Hemangiopericytoma at the thigh is reported. The Hemangiopericytoma is a rare tumour made with pericyties. This neoplasia is usually benign and it is located in the soft tissues. Tumour is profusely irrigated. The most common locations of the Hemangiopericytoma are the lower limbs and the abdominal cavity. The Hemangiopericytoma is difficult to be recognized by histological criteria. The high number of relapses and metastasis involve to an extent surgical ablation of the tumour and its borders. Present literature is reviewed and the different diagnostic and therapeutic options are discussed.     

Gas bubble disease in farmed fish in Saudi Arabia

Four outbreaks of gas bubble disease were encountered among farmed fish in Saudi Arabia. Two of them occurred among subadult (52.5 g) saltwater tilapia (Oreochromis spilurus), the first affecting about 50 per cent of the stock and resulting in about 30 per cent mortality, and the second affecting about 25 per cent of the population with about 5 per cent mortality. Another outbreak occurred among adult (270 g) brackish water (0.5 per cent salinity) tilapia (Oreochromis niloticus), affecting about 40 per cent of the population with about 25 per cent mortality. The fourth outbreak occurred among three-month-old (15 g) grouper (Epinephelus fuscogutiatus) and resulted in 10 per cent mortality. In all cases the total water gas pressure ranged between 111.2 and 113.4 per cent saturation and nitrogen was supersaturated while oxygen was undersaturated. The outbreaks were alleviated by reducing the gas pressure by splashing the source water or by switching to a source of water with lower gas pressure. However, in O niloticus the conditions of gas supersaturation resulted in a heavy infection by monogenetic trematodes which was treated with formalin at 40 mg/litre for seven hours on five successive days.     

Inflammatory bowel disease in Saudi Arabia: presentation and initial management

Elective cholecystectomy in the asymptomatic patient has elicited considerable controversy, going back to the prelaparoscopy cholecystectomy era. Surgical services often see patients with known or unidentified cholelithiasis who, having been asymptomatic, present with serious complications, potentially lethal, in whom emergency operations are associated with technical difficulties that lead to high conversion rates and significant mortality and morbidity. Elective cholecystectomy is a safe procedure associated with low morbidity and no mortality. Based on an analysis of our experience and a review of the literature, we discuss the indications for elective laparoscopic cholecystectomy in asymptomatic patients at high risk of developing complications of their asymptomatic disease. The following high-risk criteria are proposed for elective cholecystectomy: life expectancy > 20 years; calculi > 2 cm in diameter; calculi < 3 mm and a patent cystic duct; radiopaque calculi; polyps in the gallbladder (GB); nonfunctioning GB; calcified ("porcelain") GB; concomitant diabetes; women < 60 years; and individuals in geographic regions with a high prevalence of GB cancer.     

Epidemiologic aspects of pre-eclampsia in Saudi Arabia

Pre-eclampsia is pregnancy induced hypertension of unknown aetiology. There is a paucity of maternal data on the disease from this region and this study was undertaken to identify maternal and possible aetiologic factors associated with the disease in the north western region of Saudi Arabia. Seven hundred and five consecutive maternities which delivered from October 1990 till January 1991 at the Armed Forces Hospital were analysed. 2.8% of women in this community study developed pre-eclampsia. Women at extremes of maternal age, the nulliparous and high parity women; women with high body mass index, blood group O and those with no antenatal care or late booking in this study were at greater risk of developing pre-eclampsia when compared with controls who delivered in the same period. Of the babies born to mothers with pre-eclampsia, 46.7% were of low birthweight (< 2500g) while only 10.4% of controls were low birthweight. It is concluded that mothers with pre-eclampsia have to be identified early. Potential modifiable factors include reducing pregnancies at extremes of maternal age, among high parity women and encouraging early booking as well as regular attendance at the antenatal clinic.     

Psychotherapy in the Eastern Province of Saudi Arabia.

Discusses the meaning of psychotherapy within the Saudi Arabian cultural context and examines the special manner in which psychotherapy is practiced. Issues regarding culture-related transference and countertransference, the sick role in a society, culturally appropriate denial of anger, and differences in therapeutic procedures and activities are discussed. It is suggested that issues of trust and identity must be discussed openly early in therapy so that the therapy will be grounded in reality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some aspects of cutaneous leishmaniasis in Riyadh. Saudi Arabia

One hundred and sixty nine out of 310 outpatients of Riyadh's hospitals and 104 out of 209 inhabitants from El Kharj showed Leishmania bodies in smears obtained by puncture of indurated edge of sores. Collection of sand flies yielded P. papatasi, Paraphlebotomus caucasicus and S. squamipleuris. The results were discussed.     

Ethnic differences in the severity of varicella in adults in northern Saudi Arabia

The severity of varicella infection in 124 expatriates from the Asian continent was compared to that in 120 Saudi nationals, seen in Arar Central Hospital, Arar, Saudi Arabia, between January 1992 and December 1994. Persistent fever (defined as a raised body temperature more than 37.4 degrees C lasting more than 5 days), extensive skin eruptions (defined as extensive, when more than 50% of the body surface was affected) and transient elevation of hepatic enzymes (aspartate transaminases > 37 U/L and alanine transaminases > 40 U/L) after excluding other possible causes, occurred significantly more in expatriates than in Saudis. The mean duration of the illness in expatriates was 15.9 +/- 3.41 days as compared to a mean duration of 13.1 +/- 3.52 days in Saudis. This difference was statistically significant (p < 0.01 Student's t-test). The findings in this study suggest that varicella infection runs a more severe course in expatriates from the Asian continent as compared to the Saudis. Treatment with the antiviral agent acyclovir may be indicated in this group of expatriates with varicella infection.     

Electroencephalographic findings in epilepsy in Asir region of southern Saudi Arabia

People recovering from pneumonia are often weak for no apparent reason. Clinical features such as postural hypotension, arrhythmia and syndrome of inappropriate ADH have, in other circumstances, been attributed to impaired autonomic function. The aim of this study was to see whether elderly patients with pneumonia had impaired autonomic cardiovascular reflexes and, if so, how long this persisted. We compared healthy elderly controls, elderly controls with trauma (fractured femoral neck) and elderly patients with pneumonia. Thirty-eight subjects were studied in a series of cardiovascular autonomic function tests. Results suggest that elderly people have a high prevalence of impaired cardiovascular autonomic reflexes in the immediate post-pneumonic phase, and that this improves significantly after six weeks, with a further improvement by six months. Elderly patients recovering from pneumonia are predisposed to the adverse effects of drugs and other factors which can further impair autonomic cardiovascular reflexes.     

Isolation of enterotoxigenic Escherichia coli from British troops in Saudi Arabia

Specimens from 181 patients with diarrhoea were examined by a Military General Hospital in a 3-month period during deployment of troops to Saudi Arabia in 1990/1. DNA probes for heat labile (LT) and heat stable (ST) enterotoxin genes identified enterotoxigenic Escherichia coli (ETEC) in 47 of the specimens (26%) and 49 ETEC strains were isolated. The majority (55%) belonged to a novel ETEC serotype having the O-antigen 159 and a flagellar antigen designated as a provisional new type. They produced ST and the coli surface associated antigen (CS)6. Strains of serotype O6:H16 represented 22% of the ETEC examined. They produced ST, LT and CS3 together with either CS1 or CS2. The remaining ETEC belonged to seven O:H serotypes. Overall, ST was the only enterotoxin gene identified in 73% of the ETEC and 67% of the strains expressed CS6 in the absence of other colonization antigens. Resistance to three or more antibiotics was observed in 53% of the ETEC, including most of the O159 strains.     

Modelling the spread of foot-and-mouth disease virus

Foot-and-mouth disease is an economically important viral disease in animals. It is shown that airborne diffusion is one of the main sources of contamination between animals and between herds. Epidemiological data linked to viral particle excretion can thus be used in a predictive model, added to meteorological data related to the few days before the slaughter of animals. The model computes, on a 10 km radius around the outbreak and in every space direction, the quantity of viral particles that a sensitive animal could have breathed. The aim is to define a risk area, and, according to the number and size of farms in the surrounding, to give arguments for the best sanitary decision within the emergency plan.     

Antibiotic sensitivity of isolates of Pseudomonas aeruginosa in Buraidah, Saudi Arabia

To help account for the variable quality and quantity of RNA in human brain, we have studied the effect of premortem (agonal state) and postmortem factors on the detection of poly(A)+mRNA and eight mRNAs. For comparison, the influence of the same factors upon gene products encoded by the mRNAs was studied immunocytochemically or by receptor autoradiography. Brain pH declined with increasing age at death and was related to agonal state severity, but was independent of postmortem interval and the histological presence of hypoxic changes. By linear regression, pH was significantly associated with the abundance of several of the RNAs, but not with poly(A)+mRNA, immunoreactivities, or binding site densities. Postmortem interval had a limited influence upon mRNA and protein products. Freezer storage time showed no effect. Parallel rat brain studies showed no relationship between postmortem interval (0-48 h) and amounts of total RNA, poly(A)+RNA, or two individual mRNAs; however, RNA content was reduced by 40% at 96 h after death. pH is superior to clinical assessments of agonal state or mode of death in predicting mRNA preservation. It provides a simple means to improve human brain gene expression studies. pH is stable after death and during freezer storage and can be measured either in cerebrospinal fluid or in homogenised tissue.     

Projected needs of health manpower in Saudi Arabia, 1974-90

Although our projections are not completely accurate, due to inadequate data and crude methods of approximation, three conclusions are inescapable: 1. The nation should give priority to planning new schools for health administrators and rural health workers, and to generally expanding present schools for paramedicals. 2. Plans should proceed rapidly for the two new medical schools. 3. A Health Manpower plan based on census information and special studies should be developed over the next 2 years. This plan should have input from all concerned ministries. (The Ministry of Health has regarded a proposal from University Associate "a group of Harvard, Johns Hopkins and A.U.B. professors" for technical cooperation in health services planning.)     

Integration of schistosomiasis-control activities into the primary-health-care system in the Gizan region, Saudi Arabia

This study compares the effects of polyethylene glycol (PEG) modified bovine hemoglobin on vascular half-life and renal function in rabbits to those of unmodified bovine hemoglobin. Renal function was assessed by the measurement of the glomerular filtration rate, urinalysis, blood chemistries, hemoglobin (Hb) excretion rates, and tissue histology. The influence of infusion rates on hemoglobin excretion rates and organ morphology was also examined. The mean half-life of unmodified bovine hemoglobin was 3.0 +/- 0.1 (mean +/- SEM) h, which was extended 14-fold to 43.2 +/- 1.7 h following PEG conjugation. The glomerular filtration rate, urinalysis, and blood chemistries were not greatly affected by either the unmodified bovine hemoglobin or the PEG modified bovine hemoglobin. However, unmodified bovine hemoglobin did demonstrate significant hemoglobinuria (Hb excretion levels in excess of 1.0% of the infused dose [p < 0.05]) at all infusion rates given while PEG modified bovine hemoglobin did not. In addition, histological examination by light microscopy indicated that the most severe morphological changes occurred in animals that received unmodified bovine hemoglobin. This data suggests that PEG modification of bovine hemoglobin significantly reduced some of the adverse effects of bovine hemoglobin on renal physiology and morphology.     

Protection of swine by live and inactivated vaccines prepared from a leader proteinase-deficient serotype A12 foot-and-mouth disease virus

Previously, we demonstrated that a genetically engineered variant of foot-and-mouth disease virus (FMDV) serotype A12 lacking the leader proteinase-coding region (A12-LLV2) was attenuated and induced an immune response that partially protected cattle from FMD. In this study, A12-LLV2 was tested in swine as a live or chemically inactivated vaccine. Animals vaccinated with chemically inactivated A12-LLV2 or wild-type (WT) virus in oil adjuvant developed high levels of neutralizing antibodies and were protected from FMD upon challenge. Animals vaccinated with live A12-LLV2 did not exhibit signs of FMD, did not spread virus to other animals, developed a neutralizing antibody response and antibodies to nonstructural protein 3D, and were partially protected from FMD. Animals given a similar dose of chemically inactivated A12-LLV2 in the absence of adjuvant developed a poor immune response and were not protected from FMD, indicating that limited replication was responsible for the improved immune response found in animals vaccinated with live A12-LLV2. The results demonstrate the potential of A12-LLV2 as a live-attenuated vaccine as well as a safe source of antigen for chemically inactivated vaccines.     

Genetic and antigenic analysis of human rotavirus prevalent in Al-Taif, Saudi Arabia

The subgroup, serotype and electropherotype diversity of human rotavirus strains was investigated in Al-Taif, Saudi Arabia. Out of 349 faecal samples collected from diarrhoeic children, 150 (43 percent) tested rotavirus positive by a group-A specific enzyme-linked immunosorbent assay (ELISA). The majority (87 percent) of the infected children were below 2 years of age. Subgrouping and serotyping of rotaviruses with specific monoclonal antibodies showed that of the 150 rotavirus positive specimens, 17 percent belonged to subgroup I, 59 per cent belonged to subgroup II, and 24 percent were neither subgroup I nor subgroup II. The specimens were typed, as serotype 1 (43 percent), serotype 2 (5 percent), serotype 3 (11 percent), serotype 4 (10 percent) or mixed serotypes (3 percent). The remaining 41 (27 percent) specimens were untypeable. None of the serotypes showed association with a particular age group. An electrophoretic analysis of viral RNA revealed 11 distinct patterns (six long and five short). The majority, 78 percent were long patterns and 22 percent were short patterns. Analysis of the specimens for which subgroups, serotypes and electropherotypes were available indicated that a given RNA pattern does not correspond to a particular subgroup or serotype.     

Intestinal absorption in Saudi Arabia: an evaluation of the one hour blood xylose test

The screening value of the one-hour blood xylose test, corrected for body surface area, was prospectively studied in Saudi Arabian adults and children under investigation for suspected intestinal malabsorption. Sensitivity of discrimination between patients with and without upper small bowel disease was 91%, compared to 85% for the five-hour urine xylose test. Primary small bowel disorder was rare. In a three-year review, no cases of adult coeliac disease or tropical sprue were found. The most common causes of malabsorption were intestinal tuberculosis, abdominal lymphoma and immunoproliferative small intestinal disease. Despite its acceptability as an index of proximal small bowel function, the blood xylose test alone is an inadequate screening test for any of these conditions.     

Self-reported symptoms of temporomandibular dysfunction in a female university student population in Saudi Arabia

The symptoms of temporomandibular dysfunction (TMD), reported by 705 female university students of Riyadh, Saudi Arabia, are analysed. The population is representative of the educated class of Saudi Arabia. The most frequently reported symptoms were jaw feeling tired (34.5%), awareness of uncomfortable bite (31.3%), pain in front of the ear (22.4%) and discomfort upon wide opening (22.4%). The frequency of subjective reactions was, pain interferes with activity (42%), disturbed sleep (40.6%), taking of medication (27.8%) and pain being frustrating or depressing (26.8%). Some interesting relationships were found between the reported symptoms and marital status, residence and college of education. These findings are similar to those reported in a Bedouin community in Egypt, but lower than that in a Saudi Arabian population attending dental clinics, Saudi male dental students and high school students.     

Contractors’ Views of the Potential Causes of Inconsistencies between Design and Construction in Saudi Arabia

The study identifies the causes of inconsistencies between the design and construction of large building projects. To achieve the study objectives, a questionnaire survey was carried out to collect information on potential causes of inconsistencies at the project design and construction interface. Responses from 27 contractors were analyzed. The results suggest that the involvement of designer as consultant, communication gap between constructor and designer, insufficient working drawing details, lack of coordination between parties, lack of human resources in design firm, lack of designer’s knowledge of available materials and equipment, and incomplete plans and specifications were considered as the most important causes of the project design and construction interface inconsistencies. On the other hand, project management as a professional service, weather conditions, nationalities of participants, involvement of the contractor in design conceptual phase, unforeseen problems, involvement of the contractor in design development phase, and government regulations were the least important causes of inconsistencies between professionals at the project design and construction interface in large building projects.     

Detection of Crimean-Congo haemorrhagic fever virus antibodies in humans and imported livestock in Saudi Arabia

Reptiles are a growing part of the exotic pet trade, and reptile bites have been considered innocuous in the emergency medicine literature. Two cases are reported of reptile bites, one from a green iguana and the other from a reticulated python. The treatment concerns associated with reptile bites are discussed.     

Zoonotic intestinal parasites of hamadryas baboons Papio hamadryas in the western and northern regions of Saudi Arabia

Six hundred and thirty-three faecal samples were randomly collected and examined for ova and cysts of intestinal parasites from five groups of hamadryas baboons of different population densities, with different human contact and in different ecological conditions (Al-Baha, Turabah and Al-Taif in south-western and Al-Rihat and Al-Akhal in north-western Saudi Arabia). Nine parasites were recorded (Giardia lamblia, Entamoeba histolytica, Escherichia coli, Balantidium coli, Enterobius sp., Trichuris sp., Hookworm, Hymenolepis nana and Schistosoma mansoni) in 274 samples (43.28%). The prevalence of parasites was high (36.0-58.5%) in areas of mild, cool climatic conditions, where baboons were at high density and had maximum human contact. However, in an area (Al-Akhal) of hot, dry climatic conditions, low baboon density and minimum human contact, the parasites' prevalence was very low (9.5%). The concentration of parasites (ova or cysts per g of faeces) was medium. Post-mortem examination of 24, 20, 19 and 13 baboons from Al-Baha, Al-Taif, Turabah and Al-Rihat revealed most of the parasites recorded in random faecal samples at prevalence rates of 37.5, 30.0, 36.0 and 23.0% respectively. The overall prevalence rate was 32.9%. Most of the parasites recorded in baboons were also recorded in humans in the areas of study.