Tarif H. Zawawi

Pericardial effusion in normal pregnant women

Fifty‐two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n=8) in the first trimester, 19.2% (n=10) in the second trimester and 44.2% (n=23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n=U). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p < 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p < 0.025).

Circadian rhythm of granulocyte-macrophage colony-stimulating factor in normal subjects and neutropenic hospitalised patients

BackgroundGranulocyte-macrophage colony-stimulating factor (GM-CSF), one of the haemopoietic growth factors, has rarely been detected in human serum. It has, therefore, been suggested that a paracrine model can explain its behaviour where the substance is produced and acts locally. An alternative explanation might be due to blood sampling time with GM-CSF concentrations undetectable at the nadir of secretion.HypothesisWe hypothesised that endogenous production of GM-CSF in humans is subject to diurnal rhythm.MethodsBlood samples were obtained from 17 healthy individuals and 17 neutropenic hospitalised patients with haematological malignancies on myelosuppressive therapy at 6, 12, 18 and 24 hours. In the neutropenic patients, samples were collected at the nadir of the neutrophil count (ANC <0.2 × 109/L). Serum was assayed for GM-CSF levels using an enzyme-linked immunosorbent assay method.ResultsThere were significant differences in the mean levels of GM-CSF within the two groups (P<0.001). In normal subjects, peak GM-CSF levels were reached at six hours (mean = 10.1 pg/ml). Peak levels were reached in hospitalised neutropenic patients at 18 hours (mean = 13.7 pg/ml). The difference between the peak GM-CSF levels in the two groups was not significant (P=0.11). On factorial design analysis, there was a significant interaction between the time of blood collection and the subject groups (P<0.001).ConclusionsOur data are consistent with a diurnal secretion pattern for GM-CSF in both normal and neutropenic patients. As this finding might have practical implications, including timing of administration of GM-CSF in neutropenic patients, further studies are suggested.

Wet vs. dry chemical analysis of renal stones

SummaryAnalysis of renal stones may help in elucidating the pathogenesis of nephro-lithiasis. This study compared the use of 2 methods for the analysis of renal stones. One method is qualitative dry ‘spot tests’ whereas the other is quantitative ‘wet chemistry.’ In the wet chemistry method, dissolved stone material were analysed using automated chemistry analysers, whereas, the dry method involved spot colour end-point detection.Stones (n=64) were analysed by both methods. The majority of stones were calcium oxalate as determined by wet chemistry (57.4 per cent) and spot tests (50.0 per cent). Fewer mixed stones were obtained by the wet chemistry method (16.8 per cent) compared with the spot tests method (39.0 per cent), whereas, more uric acid stones were obtained by the wet chemistry method (5.6 per cent) compared with the spot tests method (1.9 per cent). ‘Pure’ calcium phosphate stones (3.0 per cent) were only obtained by the wet chemistry method.In the wet chemistry method, dissolved stone material did not show significant deterioration on storage for up to 9 days.

ROUTINE PREOPERATIVE SCREENING FOR HUMAN IMMUNODEFICIENCY VIRUS IN A GENERAL HOSPITAL, SAUDI ARABIA

Published data suggest that surgeons experience intraoperative skin penetration once every 40 cases. A 1-year trial of routine preoperative patient screening for HIV antibodies was started in October 1991 at King Khalid National Guard Hospital (KKNGH) in Jeddah. At the same time a prospective study was launched to determine whether there were benefits to the screening program. 65% of patients seen at KKNGH are Saudi the rest are expatriate. 5 of the 6739 patients who underwent surgery at the hospital from October 1991 to October 1992 were infected with HIV. 4 of those 5 would have been suspected to be HIV-positive based upon their medical histories and clinically indicated tests. The actual cost for the routine preoperative HIV screening in 1992 US dollars was

Level of serum fructosamine in Saudi diabetic patients.

101 per test or

Tachycardia: A Presenting Feature of Wernicke's Encephalopathy@@@تسارع ضربات القلب أحد أمراض التهاب المخ ( فيرنكس )

680639 for all patients evaluated over the course of the year. This study found some evidence that routine screening for HIV infection may induce a false sense of security among surgeons leading to a relaxation of Universal Precautions. The authors recommend the discontinuation of the screening program at KKNGH instead testing only high-risk patients.

Subclinical diabetic neuropathy: a common complication in Saudi diabetics.

SummaryFructosamine, a compound used to measure serum glycosylated proteins was assayed in 105 Saudi diabetic subjects and 54 healthy non-diabetic Saudi subjects. Fructosamine concentrations in diabetics were significantly higher than in healthy controls (p<0.0005). Fructosamine concentrations correlated significantly with fasting blood glucose and HbA1 in diabetics (r=0.677, p<0.0005, and r=0.598, p<0.0005, respectively). The correlation between fructosamine and HbA1 was significant in the oral hypoglycemic-treated diabetics and poor in the insulin-treated diabetic group (r=0.568, p<0.0005, and r=0.526, p=0.01). Fructosamine concentrations correlated poorly with the duration of diabetes (r=0.221, p<0.05).

Diagnosis of Helicobacter Pylori infection: a study in the Western Province of Saudi Arabia

Tachycardia as a presenting symptom and part of Wernicke’s encephalopathy was detected in ahtient who was having a discharging fistula from the small bowel for which he received total parenteral nutrition for approximately five weeks. Thiamine deficiency is known to occur during total parenteral nutrition and this case report describes the evolution of the cardiac and neurological manifestations of this disorder.