Heart disease during pregnancy in the KSA: A suggested plan

AbstractObjectivesCongenital heart disease in pregnancy is a leading cause of maternal death in developed countries while rheumatic fever is the commonest cause of valvular disease in pregnancy in developing countries. Improvement in neonatal and paediatric cardiac surgery has increased the incidence of congenital heart disease in pregnancy worldwide. Published data regarding heart disease in pregnancy (HDP) in KSA are scant and relatively old. This study examines the current status of HDP in KSA and describes the rationale and design of the suggested plan for HDP in KSA, i.e., the Registry Of Saudi Heart Disease And Pregnancy (ROSHDAP).MethodsA systematic search was conducted through the ProQuest MEDLINE® database using the keyword phrase “cardiovascular disease in pregnancy”. An extensive literature review about heart disease in pregnancywas performed.ResultsThere are only 4 available Saudi studies of HDP. The ROSHDAP study is expected to establish a foundation for Saudi research in this field and will create an extensive database that will enrich knowledge about HDP. All Saudi women with HDP who wish to participate are eligible for enrolment in the registry. Five phases are planned for the registry, and data will be collected prospectively, confidentially, and electronically. The data will be transmitted from participating centres to a central coordinating office for data management and analysis.ConclusionThe ROSHDAP study suggested in this article will provide contemporary data on HDP in KSA that will promote research and encourage evidence-based medical care of pregnant women with heart disease

Adherence to antidiabetic medication during the month of Ramadan among diabetes mellitus patients in the kingdom of Saudi Arabia

Background: Ramadan may lead to reduced adherence to antidiabetic medications among Saudi diabetes patients due to fasting, changes in daily routine, social and cultural influences, health risks, and inadequate awareness. This study aimed to assess the Saudi population adherence to the diabetes management medication in Ramadan. Methodology: A convenience sampling method was used to recruit participants for the study. Participants were sourced from social media platforms, diabetes mellitus patient groups, and healthcare providers groups. The Medication Adherence Rating Scale (MARS), a tool, was used to assess medication compliance. Results: A total of 384 individuals were included in this study, 20.3% were from Riyadh, 52.3% were males, 35% aged 31-50 years, and 64.1% had type 2 diabetes mellitus of participants. Age between 31-50 years was negatively associated with compliance (β = -1.06, p = 0.002), while age between 51-65 years is positively associated ((β= 1.00, p = 0.003). Being male was negatively associated with compliance (β= -0.72, p = 0.001). Different fasting behaviors like non-fasting one day or more (β = -2.92, p < 0.001) and fasting all month (β = -2.90, p < 0.001), significantly affect compliance scores with negative associations indicating lower compliance during fasting periods. Various HbA1c levels were significant predictors of compliance. Higher HbA1c levels were associated with increased compliance. Conclusions: The study reveals that age, gender, fasting behaviors and HbA1c levels significantly impact medication compliance among patients with diabetes mellitus during Ramadan

Mitral valve annular caseous calcification causing severe mitral valve stenosis and familial multiple lipomatosis: Case report and literature review

تقدم رجل في سن الـ ٥٥ بتضيّق شديد في الصمام التاجي، سببه حالة نادرة تعرف بالتكلس الجبني لحلقة الصمام التاجي. تم تشخيص الحالة مبدئيا باستخدام طرائق تصويرية متعددة، وبعدها تم تأكيد التشخيص بالتشريح النسيجي. احتاج المريض للاستئصال الجراحي للتكلس الجبني لحلقة الصمام التاجي، واستبدال الصمام التاجي. كما أن المريض نفسه أظهر صورة تقليدية لحالة نادرة أخرى، تعرف بتعدد الشحميات العائلي. لم يتم مسبقا تسجيل ارتباط كهذا بين هاتين الحالتين النادرتين. ينبغي أخذ الحالات النادرة مثل التكلس الجبني لحلقة الصمام التاجي في الاعتبار كتشخيص محتمل لأي كتلة متكلسة تشمل حلقة الصمام التاجي٬ سواء شمل ذلك اعتلالا وظيفيا للصمام أو لم يشمل

Prevalence of pulmonary hypertension in patients with chronic kidney disease on and without dialysis

Background: Pulmonary arterial hypertension is a newly recognized disease in patients with renal disease. In a recent review, the prevalence of PHT in ESRD patients was reported to be around 40–50%. Aim of the work: To evaluate the prevalence of primary pulmonary hypertension among CKD patients on and without dialysis and to compare clinical, hemodynamic, and metabolic variables among patients with and without PH to search for possible etiologic factors. Patients and methods: Our study included 99 CKD patients; 65 patients on hemodialysis, 12 on peritoneal dialysis and 22 on conservative management. Detailed medical history, examination, and complete laboratory investigations were obtained. Systolic PAP, EF% and cardiac output were evaluated by Doppler echocardiography and AVF flow by Doppler ultrasound. Results: A high prevalence of pulmonary hypertension was demonstrated among 27 patients (41.53%) receiving long-term hemodialysis with a mean systolic PAP of 49.33 ± 9.18 mmHg; as well as in two patients (16.66%) receiving peritoneal dialysis 43 ± 1.41 mmHg, and in five patients ((22.72%) receiving conservative management 44.8 ± 5.89 mmHg. Conclusion: This study demonstrated a high prevalence of pulmonary hypertension among patients with CKD on and without dialysis. The prevalence was highest among patients with ESRD receiving long-term hemodialysis (41.53%) especially in patients with older age, longer duration of dialysis treatment, higher AV fistula flow, cardiac output