Diagnosis of glomus tumor of the elbow: A case report.

INTRODUCTION: Glomus tumors are rare and often benign vascular lesions that present classically in the subungual region of the hand. Nonetheless, presentations in atypical sites have been reported over the years. However, the classic symptoms of typical glomus tumors are often absent in tumors of atypical sites. CASE PRESENTATION: We present a case of an extradigital glomus tumor with a 3-year history of pain in the lateral aspect of the elbow. DISCUSSION: The case we present took three years and multiple visits to different clinics and specialties to reach the final diagnosis and management. It often takes longer to diagnose Glomus tumors of atypical sites and presentations. The causes could be related to the rare incidence, the atypical presentation in site and symptoms, or the diagnostic methods. CONCLUSION: This case report discusses the possible causes behind the diagnostic delay in extradigital glomus tumors, aiming to raise clinical awareness among primary health care physicians.

Parental attitude and knowledge towards asthma care measures for their children in Saudi Arabia.

BACKGROUND: Appropriate asthma management in children reduces emergency department visits, hospitalization, and improves the quality of life. We aim to assess the level of children asthma control and its association with parental knowledge. METHODS: A prospective study conducted to measure childhood asthma control with a validated childhood asthma control test (C-ACT), and to assess asthma knowledge among the parents of children aged 4-11 years and their parents upon asthma clinic visits. C-ACT score ≤ 19 is considered as uncontrolled child asthma. RESULTS: We have invited 238 parents to participate in the study; 177 (74.4%) completed the survey. The mean age of the parents and their children were 38.8 ± 7.6 and 7.8 ± 2.7 years, respectively; 28.2% of parents were smokers, and 46.3% of them were college graduated. Nearly 61.6% of the parents and children scored ≤ 19 on C-ACT; 54.2% and 37.9% of parents knew how inhaled salbutamol and corticosteroids work, respectively. A quarter of the parents received an asthma action plan. Multinomial logistic regression analysis showed that parents who did not know their children's medications name (OR, 6.1; 95% CI, 2.15-17.29), and when to use inhaled corticosteroid (OR, 2.1; 95% CI, 1.32-3.45) were independent factors predicting uncontrolled asthma in children with score ≤ 19. CONCLUSIONS: The study indicated that there is an association between poor asthma control (scored ≤ 19 on C-ACT) and parental knowledge of asthma medications. The parents should be educated thoroughly on asthma care, including medications used to minimize asthma exacerbations in their children.

ANTXR1 Intronic Variants Are Associated with Fetal Hemoglobin in the Arab-Indian Haplotype of Sickle Cell Disease.

Disease severity of sickle cell anemia is highly variable, and it is commonly accepted that fetal hemoglobin (HbF) levels play a major role as an ameliorating factor. Investigation of genetic variants have identified several genes to be the principal influencers of HbF regulation. Here, we further elucidated the association of rs4527238 and rs35685045 of ANTXR1 genes in the context of HbF level variance in sickle cell anemia patients of the Arab-Indian haplotype. Samples from 630 sickle cell anemia patients were analyzed for the mutations at 2 specific locations of the ANTXR1 gene by TaqMan®-based real-time PCR. The CC genotype (p = 0.018) of rs4527238 and the TT genotype (p = 0.048) of rs35685045 of ANTXR1 were found to be significantly associated with low HbF expression. The frequency of the CC genotype of rs4527238 was observed to be high in the low HbF patient group compared to the high HbF group (p = 0.009). Likewise, the frequency of the TT genotype of rs35685045 was also high among the low HbF group (p = 0.017). The ANTXR1 genetic mutations and the association with HbF expression in the Arab-Indian haplotype sickle cell patients revealed that the ANTXR1 gene may be a major HbF modulator leading to potential therapeutic options that should be further explored.

Atomic absorption spectroscopic, conductometric and colorimetric methods for determination of some fluoroquinolone antibacterials using ammonium reineckate.

Three accurate, rapid and simple atomic absorption spectrometric (AAS), conductometric and colorimetric methods were developed for the determination of gatifloxacin (GTF), moxifloxacin (MXF) and sparfloxacin (SPF). The proposed methods depend upon the reaction of ammonium reineckate with the studied drugs to form stable precipitate of ion-pair complexes, which was dissolved in acetone. The pink coloured complexes were determined either by AAS or colorimetrically at lambda(max) 525 nm directly using the dissolved complex. Using conductometric titration, the studied drugs could be evaluated in 50% (v/v) acetone. The optimizations of various experimental conditions were described. Optimum concentration ranges for the determination of GTF, MXF and SPF were 5.0-150, 40-440 microg mL(-1) and 0.10-1.5 mg mL(-1) using atomic absorption (AAS), conductometric and colorimetric methods, respectively. Detection and quantification limits are ranges from 1.5 to 2.3 microg mL(-1) using AAS method or 30-45 microg mL(-1) using colorimetric method. The proposed procedures have been applied successfully to the analysis of these drugs in pharmaceutical formulations and the results are favourably comparable to the reference methods.

A simple spectrophotometric method for the determination of beta-blockers in dosage forms.

A simple, extraction-free spectrophotometric method is proposed for the analysis of some beta-blockers, namely atenolol, timolol and nadolol. The method is based on the interaction of the drugs in chloroform with 0.1% chloroformic solutions of acidic sulphophthalein dyes to form stable, yellow-coloured, ion-pair complexes peaking at 415 nm. The dyes used were bromophenol blue (BPB), bromothymol blue (BTB) and bromocresol purple (BCP). Under the optimum conditions, the three drugs could be assayed in the concentration range 1-10 microg ml(-1) with correlation coefficient (n = 5) more than 0.999 in all cases. The stoichiometry of the reaction was found to be 1:1 in all cases and the conditional stability constant (K(F)) of the complexes have been calculated. The free energy changes (DeltaG) were determined for all complexes formed. The interference likely to be introduced from co-formulated drugs was studied and their tolerance limits were determined. The proposed method was then applied to dosage-forms the percentage recoveries ranges from 99.12-100.95, and the results obtained were compared favorably with those given with the official methods.

Effect of direct relining on stresses at the denture base and the metal frame of removable partial dentures.

The Kennedy Class I removable partial denture (RPD) can cause stress to supporting hard and soft tissues and may lead to harmful effects. The purpose of this study is to investigate the pattern of these stresses in three different positions before and following a relining procedure. Ten patients, five males and five females, with a lower distal extension RPD and an opposing upper class III type RPD were selected for this study. Strain gauges together with a strain gauge indicator were used to study the pattern of stresses in three selected positions. Some changes were significantly different at the site of the denture base and at the metal frame near the direct retainer. After relining, the stresses were shared partially by the abutments and partially by the tissues. Maximum stresses were reported during swallowing. No significant difference was noticed between males and females.

Spectrophotometric determination of clozapine based on its oxidation with bromate in a micellar medium.

A simple and sensitive spectrophotometric method was developed for the determination of clozapine in its dosage forms. The method is based on the reaction of the drug with potassium bromate in a perchloric acid medium to produce an intense yellow colored species exhibiting a maximum absorption at 308 nm. Beer's law is obeyed for up to 12.0 microg ml(-1) with a correlation coefficient (n = 6) of 0.9998 and a detection limit (3S(b)) of 0.1 microg ml(-1). The molar absorptivity is 1.986 x 10(4) l mol(-1) cm(-1). The various experimental parameters affecting the development and stability of the colored oxidation product were carefully studied and optimized. The proposed method was successfully applied to the determination of clozapine in its dosage forms. The results obtained were in good agreement with those obtained using the B.P. official method.

Differential electrolytic potentiometric determination of some amino acids in dosage forms.

The application of direct-current differential electrolytic potentiometry to the nonaqueous titration of amino acids was investigated. The basic character of amino acids in acetic acid was enhanced to permit their direct titration with perchloric acid. A pair of antimony electrodes was used as an indicating system. The shapes of the titration curves obtained were almost symmetrical with sharp peaks. The optimum current density for those titrations was found to be 1-2 microA/cm2. The procedure was applied successfully to the determination of certain amino acids in drug formulations, and the results were favorably compared statistically with those obtained by official methods.

Differential electrolytic potentiometric determination of some thiol compounds in their dosage forms.

The application of direct current differential electrolytic potentiometry to an aqueous titration of L-cysteine hydrochloride, captopril and D-penicillamine has been investigated. The basic character of thiol compounds in nitric acid is enhanced to permit their direct titrations with silver nitrate. A pair of silver amalgam electrodes was used as an indicating system. Titration curve shapes obtained are almost symmetrical with sharp peaks. The optimum current density for those titrations was found to be 0.2-2 microA/cm2. The procedure was applied successfully to the determination of certain thiol compounds in drug formulations and the results were favorably compared statistically with those obtained from official methods.

Differential electrolytic potentiometric titration method for the determination of ciprofloxacin in drug formulations.

A simple and rapid differential electrolytic potentiometric titration method for the determination of ciprofloxacin was developed. The work is based on the fast complexation reaction between iron(III) and ciprofloxacin in a ratio of 1:3, respectively, in sulfuric acid media of 0.09 mol dm(-3). Among the electrodes tested silver amalgam electrodes were found to be a suitable indicating system. By applying a current density of 0.5 muA cm(-2) to these electrodes and using iron(III) solution of 0.097 mol dm(-3) as a titrant, normal titration curves were obtained. The method was successfully applied for the determination of ciprofloxacin in drug formulations as low as 4.0 ppm.

Fluorimetric determination of some thiol compounds in their dosage forms.

A simple fluorimetric procedure was adopted for determination of three pharmaceutical compounds containing thiol groups namely, captopril, D-penicillamine and N-acetylcysteine. In this method, the drugs are treated with 1,2-naphthoquinone-4-sulfonic acid. The latter is reduced to 1,2-dihydroxynaphthalene-4-sulfonic acid which has a maximum fluorescence intensity at 480/318 nm (lambdaEm/Ex). The method is sensitive to 0.5-4.5 pg ml(- 1) with minimum detectability 0.05 microg ml(-1) (S/N = 2), and has been applied to determine these three thiols in their dosage forms. The results obtained are compared favourably with those obtained by their pharmacopeial methods.

Spectrophotometric determination of three anti-ulcer drugs through charge-transfer complexation.

A simple charge-transfer complexation method is described for the spectrophotometric assay of nizatidine, ranitidine, and famotidine. This method is based on interaction of these drugs, as n-electron donors, with 7,7,8,8-tetracyanoquinodimethane, as the pi-acceptor, in acetonitrile to give highly colored green radical anions that are measured at 840 nm. Calibration graphs for the 3 compounds are linear over the concentration ranges of 1-6 microg/mL for nizatidine and ranitidine and 1-7 microg/mL for famotidine, with correlation coefficients (n = 6) of >0.999. The conditioned stability constants and the free energy changes were measured; the values obtained were generally high and negative, respectively, suggesting highly stable complexes. The proposed method was successfully applied to the determination of the drugs in pharmaceutical preparations. The assay results were in accordance with those obtained by using reference methods.

Prosthetic dental treatment needs in Eastern [corrected] Saudi Arabia.

OBJECTIVE: The objective of this study was to determine the prosthetic treatment needs of an adult population in Al-Ahsa Area, Kingdom of Saudi Arabia. METHODS: A sample of adults attending the King Fahad Hospital Dental Center, Al-Ahsa, Kingdom of Saudi Arabia were examined for prosthetic treatment needs utilizing the World Health Organization criteria during 1999. Statistical analysis system was utilized to generate frequencies, means and standard deviations, and various statistical tests were carried out. RESULTS: A total of 435 adults, 192 (44.1%) males and 243 (55.9%) females with a mean age of 47.7 (standard deviation 15.4) years were examined for prosthetic treatment needs. About two-thirds (64.8%) of the sample were in need of an upper denture. A significantly higher number of males (68.8%) needed an upper denture as compared to the females (61.7%). About three-quarters (73.8%) of the sample were in need of a lower denture. The need for lower denture was similar among the males (75.0%) and females (72.8%). About one-sixth (17.2%) of the sample was in need of an upper bridge. A higher number of females (18.9%) needed an upper bridge as compared to the males (15.1%). About one-quarter (22.5%) of the sample was in need of a lower bridge. A higher number of females (25.5%) needed lower bridge as compared to the males (18.8%). The need for upper denture was similar in both urban (64.7%) and rural (65.1%) dwellers. The need for lower denture was also similar in both urban (73.2%) and rural (75.2%) dwellers. A higher number of rural dwellers needed an upper (20.2%) and lower (26.4%) bridge as compared to the upper (16%) and lower (20.9%) bridge in urban dwellers. CONCLUSION: The results indicate that more than one- quarter of the sample needs a denture. A significantly higher number of males needed dentures than females. More females were in need of a bridge as compared with males. A significantly higher percentage of urban population needed full dentures as compared with rural population.

Kinetic spectrophotometric determination of atenolol in dosage forms.

A simple kinetic procedure is described for the determination of atenolol in its dosage forms. The procedure is based on coupling the drug with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole in pH 8 borate buffer at the boiling temperature for a fixed time of 30 min, and then measuring the absorbance of the reaction product at 460 nm. The absorbance-concentration plot is rectilinear over the range 5-50 microg/mL with a minimum detection limit of 1.3 microg (4.9 x 10(-6) M). The determination of atenolol by the fixed-concentration and rate-constant methods is also feasible with the calibration equations obtained, but the fixed-time method proved to be more applicable. The procedure was applied successfully to commercial tablets, and statistical analysis showed that the results compared favorably with those obtained by the official methods. The interference likely to be introduced from some coformulated drugs and the effect of sensitizers and surfactants on the performance of the proposed method were also studied. A proposed reaction pathway is presented.

Caries prevalence, severity and pattern in pre-school children.

OBJECTIVE: To determine the prevalence, severity and pattern of caries in preschool children of Al-Ahsa, Kingdom of Saudi Arabia. METHODS: Three hundred and twenty two randomly selected pre-school children were examined in kindergartens of Al-Ahsa, Kingdom of Saudi Arabia for dental caries using World Health Organization criteria for the diagnosis of caries. The study was completed in 2000. RESULTS: The mean decayed missing and filled teeth score in the 322 pre-school children examined was 2.92 (standard deviation 3.51) with decay component as the major contributor in the decayed missing and filled teeth score. The difference between mean decayed missing and filled teeth scores was not significant in relation to gender, type of kindergarten (government or private) and area (urban or rural). The difference between mean decayed missing and filled teeth scores of 4-year-old and 5-year-old children was statistically significant. Of the 322 children examined, 202 (62.7%) were caries positive. There was no significant difference for caries prevalence in relation to gender, type of kindergarten and area. But, the difference in caries prevalence between various age groups was statistically significant. The mandibular first molars were the most carious teeth followed by mandibular 2nd molars and maxillary central incisors. The least affected teeth were mandibular central incisors. CONCLUSION: The mean decayed missing and filled teeth score and caries prevalence in the studied pre-school children is high as compared with children from developed countries. A major decay component indicates a high percentage of untreated caries. A high percentage of carious maxillary incisors indicate a nursing caries pattern.

High-performance liquid chromatographic determination of some amino acids after derivatization with 2-hydroxy-1-naphthaldehyde.

2-Hydroxy-1-naphthaldehyde (HNA) was investigated as a derivatizing reagent for the fluorescence detection of histidine, methionine and tryptophan at 385 and 265 nm. The separation of HNA-derivatized amino acids on a conventional reversed-phase column was achieved in less than 40 min. This method was compared with the reported o-phthaldialdehyde (OPA) method. The procedure was successfully applied to the assay of the pure amino acids in a mixture and their pharmaceutical dosage forms.

Colorimetric determination of some amino acids containing a sulfur group.

A simple and rapid colorimetric method for the determination of some amino acids containing a sulfur group is described. The studied compounds are cysteine, cystine and methionine. The method is based on the formation of ferroin, from the reaction of the studied drugs with a mixture of iron(III) and 1,10-phenanthroline and measurement of the absorbance at 512 nm. The procedure has been successfully applied to the assay of the pharmaceutical preparations of the studied drugs after thin-layer chromatographic separation and the results of the studied compounds compare favourably with the official methods.