Case report: Restrictive cardiomyopathy presenting with complete thromboembolism occlusion of the terminal part of the abdominal aorta in a preadolescent Saudi girl

Restrictive cardiomyopathy (RCM) is a rare disease in children, accounting for <5% of all pediatric cardiomyopathies. It may be idiopathic or may be a secondary to a systemic disease. The disease is characterized by normal systolic function with impaired ventricular filling caused by stiff ventricular walls. Children with RCM often present with symptoms of exercise intolerance, shortness of breath, weakness, and chest discomfort. Thromboembolism events are an unusual presentation of RCM. We are reporting a preadolescent female from the eastern province of Saudi Arabia who presented with sudden right lower limb swelling, paresthesia, and pain caused by a complete occlusion of the terminal part of the abdominal aorta and both common iliac arteries. Echocardiography revealed dilated atria, normal ventricle dimensions and two floating thrombi in the left atrium. The patient was successfully managed with an anticoagulant, surgical thrombectomy and cardiac transplantation

Health education to diabetic patients before the start of Ramadan: Experience from a teaching hospital in Dammam

BACKGROUND AND OBJECTIVE: Studies have shown that pre-Ramadan structured educational program for patients with diabetes mellitus (DM) is beneficial. In this study, our aim was to evaluate the degree of adherence of treating physicians to such programs and their influence on the patient's knowledge and behavior. MATERIALS AND METHODS: This cross-sectional study was carried out on adult patients with DM attending a university hospital, who were observed while fasting during Ramadan 1436/2015. Data was collected using a questionnaire-based interview. Baseline characteristics were obtained, and patients were asked whether they had had pre-Ramadan education or not and who the provider was. Patients' knowledge of the components of the recommended structured pre-Ramadan educational program was also tested. Comparison between patients who had the education and those who did not was done using Chi-square test and independent samples Student's t-test; p ≤ 0.05 was considered statistically significant. RESULTS: A total of 298 patients with type 1 or type 2 DM were included in the study; 75.5% of the patients were aged 40 years or older. Only 30% had pre-Ramadan education delivered mainly by diabetic educators or the treating physicians (52% and 44%, respectively). Patients who had the education were younger (mean age: 45.6 ± 17.4 vs. 50.3 ± 14.4, respectively, p = 0.0048), had higher educational qualifications, were more likely to be employed, and self-monitored their blood glucose more frequently (p = 0.0001). There was no difference between the two groups with regard to their knowledge of diet and exercise. CONCLUSION: The adherence to the pre-Ramadan educational program by the treating physician was low. It is necessary to increase the awareness about the importance of these programs among health-care professionals. The programs should target the less educated, the unemployed, and older patients