Saudi Med J
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Observational Study
Coronavirus Disease 2019 (COVID-19) in pediatric emergency. Presentation and disposition.
To examine the demographics and common presentations of pediatric coronavirus disease 2019 patients in the emergency department (ED), as well as their contact with positive COVID-19 cases, return visits, and patients' disposition from the ED. Methods: A retrospective chart review of confirmed cases of COVID-19 presenting to the Pediatric ED from March 2020 until June 2020 was conducted. ⋯ Fifty-two patients were identified, with a higher frequency of male patients. Forty-four (85%) patients were discharged from the ED, and 8 (15%) required admission. Three patients were admitted to the pediatric intensive care unit and 2 died, resulting in a mortality rate of 3.8%. The most frequent presentations were fever (85%), cough (48%), and diarrhea (23%). Conclusion: In our study, the second most affected system after the respiratory tract was the gastrointestinal tract, which was also the system responsible for the most return visits due to diarrhea. Coronavirus disease 2019 poses clinical and operational challenges given its variable clinical presentations.
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To identify how children and adolescents with type 1 diabetes were coping with their condition during the COVID-19 lockdown, by detecting differences in blood glucose control and in lifestyle, including diet, physical activity, and mood deterioration, before and during the lockdown. ⋯ The total sample size was 150 patients, 48 (28%) of whom were males and 102 (72%) females. The mean age of the patients was 12.45 years. The lockdown was associated with a significant increase in patients' weight (p=0.001), body mass index (p=0.001), and blood glucose readings (p=0.007) compared to their values before the lockdown. Conclusion: A negative impact of the COVID-19 lockdown was found on blood glucose values and BMI, which may correlate with a lack of physical activity, increased consumption of carbohydrates and fast food, and mood deterioration.
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Proteus syndrome (PS) is a rare overgrowth disorder that presents with asymmetrical growth of the bone and fat tissues following a mosaic pattern mutation. The estimated worldwide incidence is approximately one in one million live births. Proteus syndrome causes disfigurement and psychological impact through its effects on somatic tissue. ⋯ This mass was identified as a growing cystic hygroma, and she had features of overgrowth and hemangiomas. Whole exome sequencing was negative from the blood lymphocytes and affected tissue sample. However, deletion duplication analysis from tissue shows a novel mosaic somatic mutation of the AKT1 gene. Somatic mutation remains an obstacle, and the geneticist has an essential role in its management, providing an established genetic diagnosis, prognosis, and family counselling.
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To assess the prevalence of anosmia in coronavirus-19 (COVID-19) patients. Coronavirus-19-related anosmia and hyposmia is a new emerging concept in the medical literature. ⋯ Half of our COVID-19 patients presented OD (anosmia/hyposmia), which often associated with ageusia and many neurological symptoms.
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To describes the epidemiology of cancer in patients with idiopathic inflammatory myopathies (IIM) treated at 2 tertiary centers in Riyadh, Saudi Arabia. ⋯ In total, 60 patients were included. Four had neoplasms (6.7%), 2 men had lymphoma, a woman had breast cancer and a second, ovarian cancer. Two patients died due to cancer or its complications. Older age (age greater than 40 years), dysphagia, necrotic rash, absence of interstitial lung disease, high erythrocyte sedimentation rate and a negative anti Jo-1 antibody were potentially predictive risk factors for neoplasm. All patients diagnosed with cancer-associated myositis were investigated with routine and invasive modalities. Three of the 4 patients had abnormal findings in both modalities. One patient, the routine investigations were unremarkable, but a computed tomography of the pelvis revealed an ovarian mass that was subsequently diagnosed as malignant. Conclusion: An individualized approach might be more appropriate for high risk patients. Larger prospective studies are required to confirm the findings of the current study.