Saudi Med J
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The clinical, laboratory and cytological features of 2 Bahraini infants with Wolman's disease are described. While one of the cases showed the classical diagnostic features, the other case exhibited a few atypical features such as lack of adrenal calcification and unusual morphology of vacuolated marrow macrophages. Literature review shows that this disorder may not be rare in this region.
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To assess the value of cardiac troponin I in the initial management of acute myocardial infarction and unstable angina, as well as the concordance between creatine phosphokinase-cardiac isoenzyme and cardiac troponin I. ⋯ Cardiac troponin I levels are not helpful in the initial management of patients with acute myocardial infarction. Thrombolytic therapy should be therefore instituted before the availability of cardiac troponin I results. However, cardiac troponin I results are concordant with creatine phosphokinase-cardiac isoenzyme in retrospective confirmation of the diagnosis of acute myocardial infarction a few hours after onset. In patients with unstable angina, cardiac troponin I should be used mainly for risk stratification.
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To evaluate urinary iodine excretion during the course of pregnancy and postpartum in relation to maternal and neonatal thyroid function parameters in Saudi women living in Jeddah, Kingdom of Saudi Arabia. ⋯ The changes in urinary iodine excretion during the course of pregnancy were documented. The decrease in free thyroxine and free tri-iodothyronine and the increase in reverse tri-iodothyronine concentrations during pregnancy resemble the changes in thyroid hormones seen in non-thyroidal illness. Moreover, the changes in thyrotropin in relation to that of human chorionic gonadotropin support the view that the thyroid gland is not primarily thyrotropin driven in early pregnancy. The results suggest that a more complex control may finally regulate maternal thyroid activity; the pituitary and the chorionic systems both function in an independent way in response to possible different feedback stimuli. This could be a physiological adaptation enabling energy conservation during the high metabolic demands of pregnancy. Finally, the results of the present study point to the need of an increased iodine supply in Saudi pregnant women living in Jeddah, Kingdom of Saudi Arabia to decrease the potential consequences of low iodine intake on maternal thyroid economy.
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Bile duct injuries after blunt abdominal trauma are rare in children. This report describes 2 cases of blunt bile duct injuries in children, which were managed non-operatively. One patient sustained partial tear in the right hepatic duct, which was managed successfully by passing a stent into the injured duct during endoscopic retrograde cholangio pancreatography. ⋯ Both children are symptom free with normal liver function tests and normal liver ultrasound. With the advancement in radiological and endoscopic techniques, some of the bile duct injuries can be managed conservatively. Conservative treatment must be individualized according to the site and extent of injury.
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Congenital lobar emphysema is a very rare congenital cystic malformation of the lung that can cause acute respiratory distress in early life. This paper reviews 6 cases of congenital lobar emphysema seen over a period of 10 years. The medical records of children with the diagnosis of congenital lobar emphysema were retrospectively reviewed for age at diagnosis, sex, presenting symptoms, investigations, treatment and outcome. ⋯ Three presented with recurrent chest infection, while the other 3 had acute respiratory distress soon after birth. In all, the diagnosis was confirmed by chest x-ray, and the left upper lobe was affected in all of them. Although congenital lobar emphysema is rare, clinical awareness of this condition is important for early diagnosis and effective surgical treatment.