Jeddah, Saudi Arabia
Jeddah, Saudi Arabia

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PubMed | American Hospital, Bahrain Defense Force Hospital, Ministry of Health, UAE University and 13 more.
Type: Journal Article | Journal: Journal of clinical lipidology | Year: 2016

Atherogenic dyslipidemia is highly prevalent in the Arabian Gulf. Non-high-density lipoprotein cholesterol (non-HDL-C) reduction has been proposed as an additional goal to low-density lipoprotein cholesterol (LDL-C) lowering to prevent atherosclerotic cardiovascular disease (ASCVD). Data on non-HDL-C goal attainment in patients with high triglycerides (TGs) on lipid-lowering drugs (LLDs) in the region is scarce.Evaluate non-HDL-C target attainment according to the National Lipid Association in patients on LLDs stratified by TG (<150 [1.69], 150-200 [1.69-2.26], >200 [2.26] mg/dL [mmol/L]) levels in the Arabian Gulf.Overall, 4383 patients on LLD treatment from 6 Middle Eastern countries participating in the Centralized Pan-Middle East Survey on the Undertreatment of Hypercholesterolemia study were evaluated. Patients were classified according to TG levels and ASCVD risk.The overall non-HDL-C goal attainment was 41% of the subjects. Non-HDL-C goal was less likely attained in patients with high TGs (12% vs 27% vs 55%; P < .001). Very high ASCVD risk patients with high TGs attained less their non-HDL-C targets compared with those with lower TG levels (8% vs 23% vs 51%; P < .001). Similarly, high ASCVD risk patients with high TGs also failed more in attaining non-HDL-C targets compared with those with lower TGs (26% vs 42% vs 69%; P < .001). In addition, those with high TG also succeeded less in attaining LDL-C and apolipoprotein B goals (P < .001).A large proportion of very high and high ASCVD patients on LLDs in the Arabian Gulf are not at recommended non-HDL-C targets and hence remain at a substantial residual risk.


PubMed | King Saud bin Abdulaziz University for Health Sciences, King Fahad General Hospital and Research Promotion and Education Section
Type: Journal Article | Journal: Urology annals | Year: 2015

Emphysematous pyelonephritis (EPN) is associated with high mortality rate, up to 25%. There is still conflicting reports regarding the most appropriate management, conservative versus nephrectomy.To describe the outcome of patients with EPN.We retrospectively reviewed the medical records of patients diagnosed with EPN by computed tomography from three tertiary institutes in Jeddah, Saudi Arabia. Type of management was classified as conservative and surgical. The conservative includes medical and minimally invasive procedures, such as percutaneous drainage and nephrostomy. The surgical which is nephrectomy. The outcome observed was preservation of the kidney function or patients life.A total of 10 patients were included (9 females and 1 male), median age was 55 years and 63% were diabetic. The most common presentation was flank pain (100%), fever (75%), and vomiting (63%). The most common organism isolated was Escherichia coli. Nephrectomy was not associated with increased survival rate, while conservative management was associated with a good outcome, less morbidity (not dialysis-dependent).Nephrectomy was not associated with high survival rate. Patients managed conservatively had a better overall performance and better survival. This study will add to other studies, which are encouraging conservative management.


PubMed | Cardiac center, King Salman Heart Center, King Fahad General Hospital, National Guard Hospital and 6 more.
Type: | Journal: European journal of heart failure | Year: 2016

The aim of this study was to compare the clinical features, predictors, and clinical outcomes of patients hospitalized with acute heart failure (AHF), with and without worsening heart failure (WHF).We used data from a multicentre prospective registry of AHF patients created in Saudi Arabia. WHF was defined as recurrence of heart failure symptoms or signs-with or without cardiogenic shock. In-hospital short- and long-term outcomes, as well as predictors of WHF are described. Of the 2609 AHF patients enrolled, 33.8% developed WHF. WHF patients were more likely to have a history of heart failure and ischaemic heart disease. Use of intravenous vasodilators, inotropic agents, furosemide infusions, and discharge beta-blockers was significantly higher in WHF patients, while use of discharge ACE inhibitors was higher in patients without WHF. Length of hospital stay was significantly longer for WHF patients than for those without WHF [median (interquartile range) 13 (14) vs. 7 (7) days, P < 0.001]. In-hospital, 30-day, 1-year, and 2-year mortality rates were higher in WHF patients than in non-WHF patients. The adjusted odds ratios for in-hospital, 30-day, and 1-year mortality were 4.13 [95% confidence interval (CI) 2.74-6.20, P < 0.001], 3.17 (95% CI 2.21-4.56, P < 0.001), and 1.34 (95% CI 1.04-1.71, P = 0.021), respectively. The strongest predictors for WHF were having ischaemic cardiomyopathy, AHF with concomitant acute coronary syndrome, and low haemoglobin.In real-world clinical practice, WHF during hospitalization for AHF is a strong predictor for short- and intermediate-term mortality, and a cause for longer hospital stays.


Shaheen R.,King Faisal Specialist Hospital And Research Center | Al-Owain M.,King Faisal Specialist Hospital And Research Center | Al-Owain M.,Alfaisal University | Faqeih E.,King Fahad Medical City | And 6 more authors.
American Journal of Medical Genetics, Part A | Year: 2011

Bruck syndrome (BS) is an autosomal recessive syndromic form of osteogenesis imperfecta (OI) that is characterized by the additional presence of pterygium formation. We have recently shown that FKBP10 previously reported as a novel autosomal recessive OI gene also defines a novel Bruck syndrome locus (BKS3). In this manuscript, we extend our analysis to describe a mutation previously described in isolated OI patients and show that it results in BS phenotype in a Saudi family. More interestingly, we describe a novel FKBP10 mutation that results in isolated OI as well as BS phenotype in the same family. These results, combined with recently published work, confirm that FKBP10 is a bonafide BS locus and lay the foundation for future research into modifiers that underlie the phenotypic heterogeneity of FKBP10 mutations. © 2011 Wiley-Liss, Inc.


Aldahmesh M.A.,King Faisal Specialist Hospital And Research Center | Li Y.,Yale University | Alhashem A.,Deparment of Pediatrics | Alhashem A.,Alfaisal University | And 14 more authors.
Human Molecular Genetics | Year: 2014

Bardet-Biedl syndrome (BBS) is an autosomal recessive ciliopathy with multisystem involvement. So far, 18 BBSgenes havebeen identified andthe majorityofthem are essential for the function ofBBSome, a protein complex involved in transporting membrane proteins into and from cilia. Yet defects in the identified genes cannot account for all the BBS cases. The genetic heterogeneity of this disease poses significant challenge to the identification of additional BBS genes. In this study, we coupled human genetics with functional validation in zebrafishandidentifiedIFT27 as a novelBBSgene(BBS19). This is the first time anintraflagellar transport (IFT)geneis implicated in the pathogenesis of BBS, highlighting the genetic complexity of this disease. © The Author 2014. Published by Oxford University Press. All rights reserved.


Shaheen R.,King Faisal Specialist Hospital And Research Center | Faqeih E.,Section of Medical Genetics | Ansari S.,King Faisal Specialist Hospital And Research Center | Abdel-Salam G.,National Research Center of Egypt | And 6 more authors.
Genome Research | Year: 2014

Primordial dwarfism (PD) is a disease in which severely impaired fetal growth persists throughout postnatal development and results in stunted adult size. The condition is highly heterogeneous clinically, but the use of certain phenotypic aspects such as head circumference and facial appearance has proven helpful in defining clinical subgroups. In this study, we present the results of clinical and genomic characterization of 16 new patients in whom a broad definition of PD was used (e.g., 3M syndrome was included). We report a novel PD syndrome with distinct facies in two unrelated patients, each with a different homozygous truncating mutation in CRIPT. Our analysis also reveals, in addition to mutations in known PD disease genes, the first instance of biallelic truncating BRCA2 mutation causing PD with normal bone marrow analysis. In addition, we have identified a novel locus for Seckel syndrome based on a consanguineous multiplex family and identified a homozygous truncating mutation in DNA2 as the likely cause. An additional novel PD disease candidate gene XRCC4 was identified by autozygome/exome analysis, and the knockout mouse phenotype is highly compatible with PD. Thus, we add a number of novel genes to the growing list of PD-linked genes, including one which we show to be linked to a novel PD syndrome with a distinct facial appearance. PD is extremely heterogeneous genetically and clinically, and genomic tools are often required to reach a molecular diagnosis. © 2014 Hansen et al.


Jfri A.,King Saud bin Abdulaziz University for Health Sciences | Rajeh N.,King Fahad General Hospital | Karkashan E.,King Fahad General Hospital
Case Reports in Dermatology | Year: 2015

Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body. © 2015 S. Karger AG, Basel.


PubMed | University of Umm Al - Qura, King Fahad General Hospital, University of Selangor, Universiti Sains Malaysia and Shaheed Benazir Bhutto University
Type: | Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases | Year: 2016

To identify commonly reported community-acquired organisms and antimicrobial resistance patterns exhibited by Gram-positive and Gram-negative pathogens among pilgrims visiting emergency care departments in Makkah.The study was designed as a retrospective audit of all patients (pilgrims) admitted to two hospitals and residing in the city of Makkah, SaudiArabia.Among 374 isolates, Gram-negative pathogens accounted for 280 (75%), while the remaining 94 (25%) were Gram-positive organisms. Among all isolated pathogens, the highest resistance was observed for amoxicillin-clavulanic acid. Klebsiella pneumoniae had the highest resistance to amoxicillin-clavulanic acid and ampicillin. Most of the organisms were sensitive to tobramycin except Acinetobacter baumannii (n=3, 50%), Escherichia coli (n=4, 57%), and K. pneumoniae (n=6, 46%).Overall, a high resistance was observed for beta-lactam antibiotics. In addition, a high resistance was noted for ceftazidime with A. baumannii species (n=16, 77%). However, for quinolones, the highest resistance to ciprofloxacin was observed for E. coli, A. baumannii, methicillin-resistant Staphylococcus aureus, and K. pneumoniae.


PubMed | King Abdulaziz University, Kuwait University, King Fahad General Hospital, National Guard Hospital and 6 more.
Type: Journal Article | Journal: Angiology | Year: 2016

We assessed sex-specific differences in clinical features and outcomes of patients with acute heart failure (AHF). The Heart function Assessment Registry Trial in Saudi Arabia (HEARTS), a prospective registry, enrolled 2609 patients with AHF (34.2% women) between 2009 and 2010. Women were older and more likely to have risk factors for atherosclerosis, history of heart failure (HF), and rheumatic heart and valve disease. Ischemic heart disease was the prime cause for HF in men and women but more so in men (P < .001). Women had higher rates of hypertensive heart disease and primary valve disease (P < .001, for both comparisons). Men were more likely to have severe left ventricular systolic dysfunction. On discharge, a higher use of angiotensin-converting enzyme inhibitors, -blockers, and aldosterone inhibitors was observed in men (P < .001 for all comparisons). Apart from higher atrial fibrillation in women and higher ventricular arrhythmias in men, no differences were observed in hospital outcomes. The overall survival did not differ between men and women (hazard ratio: 1.0, 95% confidence interval: 0.8-1.2, P = .981). Men and women with AHF differ significantly in baseline clinical characteristics and management but not in adverse outcomes.


PubMed | King Salman Heart Center, King Saud University, National Guard Hospital, King Fahad General Hospital and 5 more.
Type: | Journal: BMC cardiovascular disorders | Year: 2016

Little is know about the outcomes of acute heart failure (AHF) with acute coronary syndrome (ACS-AHF), compared to those without ACS (NACS-AHF).We conducted a prospective registry of AHF patients involving 18 hospitals in Saudi Arabia between October 2009 and December 2010. In this sub-study, we compared the clinical correlates, management and hospital course, as well as short, and long-term outcomes between AHF patients with and without ACS.Of the 2609 AHF patients enrolled, 27.8 % presented with ACS. Compared to NACS-AHF patients, ACS-AHF patients were more likely to be old males (Mean age = 62.7 vs. 60.8 years, p = 0.003, and 73.8 % vs. 62.7 %, p < 0.001, respectively), and to present with De-novo heart failure (56.6 % vs. 28.1 %, p < 0.001). Additionally they were more likely to have history of ischemic heart disease, diabetes, dyslipidemia, and less likely to have chronic kidney disease (p < 0.001 for all comparisons). The prevalence of severe LV systolic dysfunction (EF < 30 %) was higher in ACS-AHF patients. During hospital stay, ACS-AHF patients were more likely to develop shock (p < 0.001), recurrent heart failure (p = 0.02) and needed more mechanical ventilation (p < 0.001). blockers and Angiotensin Converting Enzyme inhibitors were used more often in ACS-AHF patients (p = 0.001 and, p = 0.004 respectively). ACS- AHF patients underwent more coronary angiography and had higher prevalence of multi-vessel coronary artery disease (p < 0.001 for all comparisons). The unadjusted hospital and one-month mortality were higher in ACS-AHF patients (OR = 1.6 (1.2-2.2), p = 0.003 and 1.4 (1.0-1.9), p = 0.026 respectively). A significant interaction existed between the level of left ventricular ejection fraction and ACS-AHF status. After adjustment, ACS-AHF status was only significantly associated with hospital mortality (OR = 1.6 (1.1-2.4), p = 0.019). The three-years survival following hospital discharge was not different between the two groups.AHF patients presenting with ACS had worse hospital prognosis, and an equivalent long-term survival compared to AHF patients without ACS. These findings underscore the importance of timely recognition and management of AHF patients with concomitant ACS given their distinct presentation and underlying pathophysiology compared to other AHF patients.

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