A dramatic decline in university hospital admissions of acute rheumatic fever in the eastern region of Saudi Arabia

AbstractBackgroundsAcute rheumatic fever (ARF) and its sequel, chronic valvular heart disease are the most important causes for cardiovascular morbidity and mortality worldwide and mainly in developing countries. However, the incidence of ARF has declined in developed countries during the second half of 20th century.Material and methodsThe case files of all patients admitted as new cases of ARF over ∼11 years and 8 months, both in pediatric and medical departments of a university hospital located in the eastern region of Saudi Arabia were reviewed. The demographic and clinical data and the frequency of the new cases were compared with the data that have been published by us 10 years ago from the same hospital during a similar period of time (11 years and 8 months).ResultsIn the current study there was a significant decline in the frequency of admission of cases of ARF as compared to our previous study during a similar period of time, with a frequency rate of 12 cases per 100.000 hospitalizations versus 45 cases per 100.000 hospitalizations, respectively, P<0.001. Dyspnea and chest pain as clinical features of acute rheumatic carditis (ARC) were less frequent in the current study as compared to the previous study (35% versus 44%, P=0.02 and 10% versus 28.6%, P=0.031). The subgroup analysis revealed also a decreased frequency of the clinical features of ARC in pediatric age group in the current study as compared to our previous study.ConclusionThere is a significant decline in the frequency of new hospital admissions due to ARF. This decline was associated with similar decline in the frequency of the manifestations of ARC especially in pediatric age group (1–12 years)

Date-leaf carbon particles for green enhanced oil recovery

Green enhanced oil recovery (GEOR) is an environmentally friendly enhanced oil recovery (EOR) process involving the injection of green fluids to improve macroscopic and microscopic sweep efficiencies while boosting tertiary oil production. Carbon nanomaterials such as graphene, carbon nanotube (CNT), and carbon dots have gained interest for their superior ability to increase oil recovery. These particles have been successfully tested in EOR, although they are expensive and do not extend to GEOR. In addition, the application of carbon particles in the GEOR method is not well understood yet, requiring thorough documentation. The goals of this work are to develop carbon nanoparticles from biomass and explore their role in GEOR. The carbon nanoparticles were prepared from date leaves, which are inexpensive biomass, through pyrolysis and ball-milling methods. The synthesized carbon nanomaterials were characterized using the standard process. Three formulations of functionalized and non-functionalized date-leaf carbon nanoparticle (DLCNP) solutions were chosen for core floods based on phase behavior and interfacial tension (IFT) properties to examine their potential for smart water and green chemical flooding. The carboxylated DLCNP was mixed with distilled water in the first formulation to be tested for smart water flood in the sandstone core. After water flooding, this formulation recovered 9% incremental oil of the oil initially in place. In contrast, non-functionalized DLCNP formulated with (the biodegradable) surfactant alkyl polyglycoside and NaCl produced 18% more tertiary oil than the CNT. This work thus provides new green chemical agents and formulations for EOR applications so that oil can be produced more economically and sustainably

Thalassemia minor presenting with vitamin B12 deficiency, paraparesis, and microcytosis

Arwa Lardhi,1 Rania Alhaj Ali,1 Rola Ali,2 Tarek Mohammed1 1Internal Medicine Department, Doctor Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 2Umm al-Qura University, Mecca, Saudi Arabia Abstract: Vitamin B12 is essential for proper neurological functioning, and its deficiency may cause a wide range of neuropsychiatric and hematological manifestations. We report a case of a previously healthy 32-year-old female who was admitted to our hospital with sudden onset of bilateral lower limb paraparesis and loss of sensation. The serum level of vitamin B12 was mildly decreased with high methylmalonic acid and homocysteine levels. However, her complete blood count showed no evidence of anemia or macrocytosis; instead, her mean corpuscular volume was low. Hemoglobin electrophoresis showed thalassemia trait, and that probably masked the megaloblastic features of vitamin B12 deficiency. She responded fully to vitamin B12 replacement therapy. Keywords: thalassemia trait, microcytosis, pernicious anemia, paraparesis, cobalamin deficienc

Rosai-Dorfman Disease Complicated by Autoimmune Hemolytic Anemia in a Child: A Case Report and Review of the Literature

Rosai-Dorfman disease is a rare histiocytic proliferative disorder that commonly presents with a massive lymphadenopathy and a variety of constitutional symptoms. Severe hemolytic anemia is an infrequent complication of this disease. Although the etiology of the condition is unknown, infectious agents including viruses have been implicated. We describe a 2-year-old female child who presented with fever, pallor, and generalized lymphadenopathy complicated by the development of autoimmune hemolytic anemia. A review of the literature of this condition is also provided

The use of laryngeal mask airway during transesophageal echocardiography in pediatric patients

Background: Transesophageal echocardiography (TEE) in the cardiac lab is usually performed in pediatric patients under general anesthesia with an endotracheal intubation (ET). This study was performed to investigate the safety and efficacy of using the laryngeal mask airway (LMA) as an alternative to ET to maintain pediatric airway during the general anesthesia for TEE. Materials and Methods: A total of 50 pediatric patients undergoing TEE in the cardiac lab were randomized to have their airway maintained during the procedure with either LMA (LMA group) or ET (ET group). Hemodynamic, respiratory parameters, time to extubation, recovery time, the incidence of complication and operator satisfaction were compared between the two groups. Results: There were no differences between both groups in hemodynamic and respiratory parameters. Laryngeal spasm was reported in one patient in the LMA group and two patients in the ET group. TEE operators were equally satisfied with the procedure in groups. The time to extubation was shorter in the LMA group (P < 0.01). The mean recovery time was also significantly shorter in the LMA than in the ET group (44 ± 8 min and 59 ± 11 min, respectively; P < 0.001). Conclusion: The LMA is safe and effective in securing the airway of children undergoing diagnostic TEE