Smoking behaviour and attitudes among adult Saudi nationals in Riyadh City, Saudi Arabia

Nine massive hemipelvic allografts were used to reconstruct the pelvic ring and the hip articulation after resection of malignant tumors. At follow up of 3 to 10 years, six patients were free of oncologic disease. In the 3 acetabular massive allografts, functional results were close from those standard THR. After resection of hemipelvis and adjacent muscles, patients resume a normal family life (painless hip, poor active motion, walking with a crutch) with a functional result much better than after amputation. Considering these encouraging results in oncologic surgery, we used similar technics for reconstruction of very severe bone loss after iterative failures of THR revisions: some examples are reported at medium follow up.     

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.     

Pharmacokinetic monitoring of anticancer drugs at King Faisal Specialist Hospital, Riyadh, Saudi Arabia

Pharmacokinetic monitoring of anticancer agents has the potential to become of considerable clinical value. Recognizing this and the leading role of the King Faisal Specialist Hospital and Research Centre (KFSH & RC) in healthcare delivery in the Kingdom of Saudi Arabia, particularly in oncology, the authors have established a pharmacokinetics service and research laboratory equipped with the state-of-the-art analytical instrumentation. After the acquisition of these instruments, we initiated research work that lead to the development of improved analytical methods for methotrexate and 7-OH methotrexate (high-performance liquid chromatography [HPLC]), doxorubicin (HPLC), etoposide (HPLC), 5-fluorouracil (HPLC), mitoxantrone (HPLC), mesna and dimesna (HPLC), taxol (HPLC), aminoglutethimide (HPLC), tamoxifen (HPLC), and acrolein (HPLC), cisplatin or carboplatin (electrothermal atomic absorption spectrophotometry, ETAAS), cyclophosphamide (gas chromatography) and CCNU and BCNU (gas chromatography). Currently, most of these drugs are monitored selectively as requested by oncologists at the KFSH & RC. The authors are aware that controlled, randomized studies of the concentration-effect relationships for many of these drugs are still missing. However, the authors hope that once these studies become available, this service will be used more fully.     

Allergic contact dermatitis from cobalt in animal feed

A 39-year-old woman with systemic lupus erythematosus suffered a prolonged neurological illness associated with very low levels of glucose in her cerebrospinal fluid (CSF). Six months later, and after numerous CSF investigations, Histoplasma capsulatum was cultured. To our knowledge, this is the first report of cerebral histoplasmosis in Australia in a patient who is not HIV positive.     

Allergic contact dermatitis from ethyl sebacata in haloprogin cream

A 13-year-old girl developed contact dermatitis to haloprogin (Halotex) cream. Patch tests incriminated ethyl sebacata, a solubilizer, as the allergen. To our knowledge, this is the second reported case of contact dermatitis attributable to this substance.     

Allergic and systemic contact dermatitis from Matricaria chamomilla tea

A screening programme was carried out among school-going children in Al-Ain, United Arab Emirates (UAE), to identify children with learning disorders. During the course of one academic year, 34 such children were identified. The cause was considered preventable in around half of the cases. In a third of cases with a genetic cause, prevention was possible with existing knowledge and practice.     

Allergic contact dermatitis to quinones in Paphiopedilum haynaldianum (Orchidaceae)

An eczematous eruption developed on the hands and forearms of a 68-year-old man after frequent contact with homebred specimens of the lady slipper Paphiopedilum haynaldianum. Patch tests with leaves, petals, and stems, as well as with two quinones isolated from the plant by thin-layer chromatography, gave strongly positive reactions. The results demonstrated that the recurrent skin lesions were the expression of an allergic contact dermatitis due to the quinoid constitutnets, which are the main contact allergens in this orchid species.     

Allergic contact dermatitis and stomatitis caused by a cinnamic aldehyde-flavored toothpaste

A patient had acute stomatitis and dermatitis due to a popular toothpaste containing cinnamon oil flavor. Cinnamon cassia oil is known as a topical sensitizer and was demonstrated to be the offending allergen. Cinnamic aldehyde and related chemicals are used widely, so that patients having cinnamon allergy may be exposed to many sources. There is difficulty in diagnosing allergic contact stomatitis.     

Oral and epicutaneous desensitization in urushiol contact dermatitis in guinea pigs sensitized by 2 methods of different sensitizing potency

This investigation was conducted to study the relationship between the different intensities of sensitization to urushiol induced by the maximization test method (MT) or by the ear-flank method (EF) in guinea pigs, and hyposensitization induced by repeated oral and/or epicutaneous administration of the allergen, and to compare the immune tolerance achieved between these routes of dosing. During the observation period of 10 weeks, both oral and epicutaneous administration produced hyposensitization to urushiol after weak sensitization by EF; however, only combined administrations via the oral and epicutaneous routes achieved hyposensitization after potent sensitization, while inadequate tolerance was induced by oral dosing and none by epicutaneous dosing. Thus, it is indicated that difficulty in establishing immune tolerance may increase with increasing intensity of primary sensitization, and that hyposensitizing potency tends to increase in the order epicutaneous, oral and combined (e.p.+p.o.) administrations of urushiol.     

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.     

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.     

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.     

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.)