Coronary artery bypass grafting in a patient with polycythaemia rubra vera - a rare indication with a spectrum of complication: a case report

Coronary artery bypass surgery for coronary artery thrombosis in patients with polycythaemia rubra vera has been rarely described. The main issue with such patients is their risk of both bleeding and thrombosis and as such the ideal postoperative management of such cases is unknown. Hereby, we describe a case of a 62-year-old man with polycythaemia rubra vera who underwent coronary artery bypass surgery. Although his initial postoperative course was complicated, his long-term outcome was good

Rh alleles and phenotypes among Saudi women in Hail Region, Saudi Arabia

Background: The Rh system is considered as the most complex among the human blood group systems, with 61 antigens identified to date. This study aimed to provide preliminary data on the distribution of Rh alleles and phenotypes among Saudi women and compare them with other ethnic groups.Methods: This retrospective cross-sectional study was conducted among Saudi women who visited the Maternity and Children Hospital of Hail from November 2019 to March 2020. A fully automated blood bank analyzer was used in determining the Rh subgroups (D, C, c, E, e) and phenotypes. Inferential statistics and chi-square tests were used appropriately for comparisons.Results: The study included a total of 500 Saudi female patients. The most prevalent antigen found was the “e” antigen, while phenotype CcDee has shown to have the highest frequency. A significant difference exists in comparison with the other studies from various ethnic groups.Conclusions: The prevalence and distributions of Rh alleles and phenotypes among Saudi women were revealed in this study. The findings showed that Rh alleles and phenotypes are diverse across various races and regions globally.Keywords: Rh allele; Rh phenotype; Rh system; Saudi Arabi

Clinical, epidemiological, and laboratory characteristics of mild-to-moderate COVID-19 patients in Saudi Arabia: an observational cohort study

Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged from China in December 2019 and has presented as a substantial and serious threat to global health. We aimed to describe the clinical, epidemiological, and laboratory findings of patients in Saudi Arabia infected with SARS-CoV-2 to direct us in helping prevent and treat coronavirus disease 2019 (COVID-19) across Saudi Arabia and around the world. Materials and methods Clinical, epidemiological, laboratory, and radiological characteristics, treatment, and outcomes of pediatric and adult patients in five hospitals in Riyadh, Saudi Arabia, were surveyed in this study. Results 401 patients (mean age 38.16 ± 13.43 years) were identified to be SARS-CoV-2 positive and 80% of cases were male. 160 patients had moderate severity and 241 were mild in severity. The most common signs and symptoms at presentation were cough, fever, fatigue, and shortness of breath. Neutrophil and lymphocyte counts, aspartate aminotransferase, C-reactive protein, and ferritin were higher in the COVID-19 moderate severity patient group. Mild severity patients spent a shorter duration hospitalized and had slightly higher percentages of abnormal CT scans and X-ray imaging. Conclusions This study provides an understanding of the features of non-ICU COVID-19 patients in Saudi Arabia. Further national collaborative studies are needed to streamline screening and treatment procedures for COVID-19

Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report

Abstract Introduction Prosthetic valve thrombosis is a rare but life-threatening condition that requires careful evaluation and prompt treatment. While surgical intervention remains the gold standard, thrombolytic therapy is now emerging as a potential substitute. Various thrombolytic treatments including streptokinase, urokinase and recombinant tissue plasminogen activators have been reported with variable success rates. However, the data on the use of tenecteplase (a synthetic tissue plasminogen activator) is limited. Case presentation A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient. Conclusion Prosthetic valve thrombosis is a rare but life threatening condition, the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient.</p

Before the Holocene humid period: Life-sized camel engravings and early occupations on the southern edge of the Nefud desert

The Neolithic of northern Arabia is characterised by monumental stone structures, ephemeral ‘hearth sites’ indicative of a highly mobile lifestyle, and a rich rock art heritage with iconic representations of domesticated livestock. However, the character and timing of occupation prior to the spread of pastoralism (ca. 6000 BCE) remains elusive, with only one stratified Epipalaeolithic site and two surface early Neolithic sites so-far known in the Jubbah Oasis. Here we present Sahout, a newly documented rock art site with Neolithic and earlier occupations, on the southern edge of the Nefud desert. The rock art is dominated by life-sized, naturalistic, engravings of camels, which are in some cases superimposed with Neolithic imagery of domesticated sheep. Surveys and test excavations carried out in the vicinity of the rock art revealed a lithic assemblage with similarities to the late Epipalaeolithic and Pre-Pottery Neolithic of the Levant. Radiocarbon ages from two test trenches and two hearths indicate repeated occupation at Sahout between the Terminal Pleistocene and the Middle Holocene, which partly mirror the rock art sequence. Investigations at Sahout indicate that rock art production in northern Arabia may have begun earlier than previously thought. Research also suggests a broader geographical extent to human occupations prior to the Holocene humid period