Saudi Med J
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To present our experience of treating steroid-dependent nephrotic syndrome (SDNS) in children with repeated doses of rituximab (RTX) with a relatively long follow-up, and to discuss the role of the histopathology type and previous immune-suppressor (IS) drugs on the outcome of these patients. ⋯ Compared to other IS used to treat SDNS, RTX showed a significant decrease in relapse rate with fewer side effects. The dose and interval should be modified according to the patient's characteristics, such as medical history, pathology type, and previous IS agents.
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Genital lymphedema usually develops after 4-30 years of chronic hidradenitis suppurativa (HS). However, our patient exhibited signs of it as early as 2 years after being diagnosed with HS. Renal amyloidosis is a rarely reported complication of HS. ⋯ We report a case of a 42-year-old Indian gentleman who had HS for 9 years presenting with 2 rare complications: penoscrotal lymphedema and end-stage renal disease secondary to renal amyloidosis. The patient was treated with prednisolone and adalimumab to treat both his HS and renal amyloidosis, and was referred to general surgery to manage his genital lymphedema. We recommend following adult patients with moderate-to-severe HS and clinical duration of greater than 3 years and screening for amyloidosis before they reach end-stage organ disease, similar to what happened to our patient with end-stage renal disease.
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To assess the cytological pattern of thyroid lesions in Najran, Saudi Arabia. ⋯ Most of thyroid lesions in Najran were benign, and females were more affected by thyroid lesions than males. However, papillary carcinoma was the 4th most frequent thyroid lesion in females, while it was the 2nd most frequent in males and diagnosed mainly in younger males (21-40 years). Finally, ages 21-60 years were associated with most of the thyroid lesions in both males and females.
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To compare the bone mineral density and the fracture risks in Saudi women with and without type 2 diabetes mellitus (T2DM). ⋯ In Saudi women with T2DM, unadjusted FRAX underestimated the risk of MOF and HF. Type 2 diabetes mellitus should be included as one of the clinical risk factors for fracture in future versions of the FRAX score.
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Observational Study
Endothelial dysfunction predicted cardiovascular events in patients with paroxysmal atrial fibrillation.
To examine the relationship between endothelial dysfunction and adverse cardiovascular events in patients with paroxysmal atrial fibrillation (AF). ⋯ In patients with paroxysmal AF, endothelial dysfunction was associated with composite cardiovascular events. Flow-mediated dilation was a significant predictor of cardiovascular events in patients with paroxysmal AF.