Behcet's disease (BD) is a rare multisystem chronic vasculitis of variable clinical presentation and unknown origin. Pulmonary involvement in BD is uncommon, with pleural effusion being an even rarer and difficult to diagnose manifestation. Herein, we report a challenging case of a young man who presented with recurrent pleural effusion and hepatic vein thrombosis and a recent history of papilledema with idiopathic intracranial hypertension. The patient was hospitalized for diagnostic and therapeutic thoracocentesis. Biochemistry and cytological analysis showed an exudative aspect of the collected pleural fluid with lymphocyte-dominated cytology. A multidisciplinary discussion was held, and thorough investigation was carried out to rule out malignant and infectious etiologies, among other differentials. During the second hospitalization, the patient complained of genital ulcers, which were verified to be recurrent along with oral ulcers. The diagnosis of BD was established based on the International Classification Criteria for BD, and the symptoms improved significantly upon using colchicine and immune-suppressive drugs.
Background: End-stage heart failure patients awaiting heart transplant often require Ventricular Assisted Devices (VAD) to support systemic and pulmonary circulation and to improve ventricular function, symptoms, and Health-Related Quality of Life (HRQoL). This study evaluates the health-related quality of life in patients with VAD and was conducted at the Cardio Ventricular Assisted Devices Clinic at King Faisal Specialist Hospital and Research Centre, Riyadh. Methods: This retrospective cohort study design included all eligible VAD patients who were still attending the cardio ventricular assisted devices clinic at KFSHRC, Riyadh. Each study participant was assigned a detailed questionnaire to assess and evaluate HRQoL outcomes measured in physical limitations, emotional stress, sexual activity, and social function from the date of device insertion to the time of data collection. Data were analyzed using the Statistical Package for Social Studies (SPSS 22; IBM Corp., New York, NY, USA). Results: Between February 2016 until June 2020, 26 patients were eligible for the study. The patients' support scores were moderate to high, indicating a positive effect on their HRQoL, with a mean score of 57.69 in emotional activity, a mean score of 34.07 in physical activity, and a mean score of 83.17 in social activity. The study's results show that the level of HRQoL varies among patients with VADs. Conclusion: Participating patients with VAD reported excellent health-related quality of life in all domains, with moderate to high support scores indicating a positive effect on their HRQoL. There is currently a lack of study on HRQoL in patients with VADs in Saudi Arabia. Therefore, this study may provide a baseline understanding of current challenges in the care of heart failure patients with VAD awaiting a heart transplant.
Background: Single ventricle heart disease can be left or right ventricle dominant congenital heart disease mostly associated with other risk factors like low birth weight, Preterm, chromosomal abnormality and all these risk factor associated with increase mortality. Methods: A retrospective chart review of paediatric patients from neonatal age to 14 years since 2012 to 2021, with supported by extracorporeal membrane oxygenation (ECMO) including both single ventricle heart physiology and biventricular heart, admitted in paediatric cardiac surgical intensive care unit in our hospital was conducted. All data were compared between single ventricle heart physiology and biventricular heart. Data was performed using commercially available software (SPSS), with statistical significance set p<0.05. Results: We enrolled total 124 patients who underwent ECMO cannulation. 68 children had single ventricle, while 56 being biventricular heart. Most children acquired ECMO cannulation in CICU 63 (50.8%). Male to female ratio was 74:50. 70.2% children got the ECMO cannulation when they had already been operated for surgical repair. Conclusions: Paediatric ECMO utilization in SV is valuable and recently its utilization has been increased in it with improve survival.
Purpose: Pancreatic cancer is the fourth leading cause of cancer death in the U.S. and leads to an estimated 22 7,000 deaths per year worldwide. Majority of pancreatic cancer are adnocarcinoma which account 96% of cases with remaining 4% are indolent neuroendocrine tumors. Pancreatic neuroendocrine tumors (PNETs) are uncommon tumors which arise from endocrine cell of the pancreas. We report a case of coincidence of neuroendocrine tumor at the tail of pancreas and adenocarcinoma of the body of pancreas in an elderly patient, which we believe that a rare synchronous finding. Case: An 81 year-old man was admitted to the hospital for evaluation of three months history of weakness, upper abdominal pain, watery diarrhea and 20 lbs weight loss. Past medical and surgical history significant for diabetes, hypertension, coronary artery disease and inguinal hernia repair. He is a former smoker of 1 pack per day for approximately 20 and had no history of alcohol use. Physical examination was unremarkable. Liver function tests revealed Total Bilirubin of 0.7 mg/dl Alkaline phosphatase of 219 U/L, Alanine aminotransferase of 104 U/L and Aspartate aminotransferase of 62 U/L. Ultrasound of the abdomen showed mass in the mid body of the pancreas measured 30.1 x 30 x 40 mm in size. Computed tomography showed two masses in the pancreas. The first mass located at the mid body of the pancreas and was large, bi-lobed and the entire size of the mass measured 55.7 x 50.6 mm. The second mass was rounded and located at the distal tail of the pancreas, close to the spleen and measured 20.8 x 26.4 mm. The endosonographic examination of the pancreas was performed and revealed a large bi-lobed pancreatic body mass. The right lobe of the mass measured 29.5 x 32.8 mm and was hypoechoic, round and obstructed the pancreatic duct and invaded the splenic artery. The left lobe of the mass measured 36.4 x 43.5 mm and was hypoechoic, heterogeneous with an anechoic, necrotic center. Fineneedle aspiration with 25 gauge needle of both lobes of the mass was performed. The second pancreatic mass was seen at the tail of the pancreas measuring 20.6 x 18.9 mm. The mass was hypoechoic, round and had a well demarcated boarder. Fine needle aspiration was performed using a second 25 gauge needle. The results of fine needle aspirations of the pancreatic body and tail masses revealed moderately differentiated adenocarcinoma and neuroendocrine tumor respectively. Conclusion: Coexistence of adenocarcinoma and neuroendocrine neoplasm of the pancreas is a rare entity. The findings of more than one pancreatic mass, as in our patient, may prompt an EUS with FNA of each of the masses to make the definite diagnosis of potential coexisting neoplasms.
Background: The Ventricular Assist Device (VAD) Coordinator Nurse plays a vital role in managing patients with end-stage heart failure requiring mechanical circulatory support. However, limited research exists on the specific responsibilities and contributions of VAD coordinators, particularly in Saudi Arabia. Understanding their roles and impact on patient care and organizational outcomes is crucial for healthcare improvement. Objective: This study examined the role of VAD Coordinator Nurse in Saudi Arabia by describing the role characteristics, including demographic information, qualifications, compensation, job preparation, work setting and responsibilities, scope of practice, contributions to patient care, and organizational outcomes. Methods: A descriptive study was conducted to explore the roles of VAD Coordinator Nurses in Saudi Arabia. A survey instrument developed by Casida (2011) was used to collect data from VAD coordinators working in Saudi Arabian centers offering VAD services. Convenience sampling was employed, and the survey was distributed electronically through the hospital's email system. Descriptive statistics, including percentages and frequencies, were calculated using the Statistical Package for the Social Sciences (SPSS). Results: The study involved VAD coordinators with an average age of 36.47 years, predominantly male (60%), and Arab (80%). Most participants held a bachelor’s degree (60%) and had previous experience as staff nurses. Findings revealed that VAD Coordinator Nurses have diverse responsibilities, including patient monitoring, VAD performance evaluation, medical emergency management, and coordination of ancillary tasks. Conclusions: This study highlights the dynamic and multifaceted roles of VAD Coordinator Nurses in Saudi Arabia. They play a crucial role in bridging the technical and clinical aspects of VADs, ensuring optimal patient care, and contributing to positive organizational outcomes. Understanding their demographics, qualifications, responsibilities, and contributions is essential for healthcare policies and job preparation enhancements. Future research should address challenges faced by VAD coordinators and support their professional growth in delivering high-quality care to patients with end-stage heart failure.
Background: Healthcare workers in direct contact with confirmed COVID-19 patients often face a negative impact on psychological health. This study aims to examine the prevalence of anxiety and depression among nurses caring for COVID-19 patients. Methods: A cross-sectional survey was conducted during the COVID-19 pandemic from January 2022 to April 2022 at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. The prevalence of depression and anxiety was assessed using the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Kruskal–Wallis’s test was used to compare the total scores of the PHQ-9 and GAD-7 with respect to demographic characteristics. P<0.05 was considered statistically significant. Results: A total of 123 nurses were included in the study. Most of them were females (69.92%), aged 30–39 years (45.53%), had a bachelor's degree in nursing (75.61%), and had more than ten years of experience (3830.89%). The depression and anxiety prevalence in the study was 78.1% and 72.4%, respectively. Nurses aged 30–39 years were significantly associated with depressive symptoms. Female nurses showed significantly higher scores for depression and anxiety than males 74.42% and 67.45%, respectively. Conclusion: The findings suggest that nurses are at risk for developing depression and anxiety. Therefore, regular mental health screening is necessary for nurses, particularly during a pandemic.
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