Thromboembolic events in Sudanese patients with rheumatic mitral stenosis

Background: Rheumatic mitral stenosis (MS) is a common problem in the Sudanese community, usually affecting the younger population. It can be a crippling condition with many complications, thromboembolism being one of the most serious. Objective:The aim of this study is to quantify the prevalence of thromboembolism and to identify its risk factors in Sudanese patients with MS at Ahmed Gasim Cardiac Centre. Methodology:Records of patients admitted from Jan 1999-Jan 2003, were retrospectively reviewed and data from various clinical and echocardiographic variables were recorded. Results:A total of 412 patients were studied, 142 (34.5%) were males, 270 (65.5%) were females. There were no significant differences in the gender (P = 0.606) or severity of symptoms between patients with and without thromboembolism. Patients with thromboembolism were older (P < 0.016), had more frequent atrial fibrillation (P = 0.017), smaller mitral valve area (P = 0.021) and higher pulmonary artery pressure (P = 0.012) compared to patients without thromboembolism. Dilated left atrial (LA) size was significantly associated with thromboembolism (P = 0.034), spontaneous echo contrast (P = 0.048) and the presence of LA or left atrial appendage (LAA) thrombus (P = 0.029). The presence of LA/LAA thrombus was significantly associated with both thromboembolism (P = 0.05) and spontaneous echo contrast (P < 0.0001). Transoesophageal echocardiography was more sensitive in detecting both spontaneous echo contrast (P < 0.0001) and LA/LAA thrombus (P < 0.0001) than transthoracic echocardiography. Conclusion: These results highlight the clinical and echocardiographic risk factors for thromboembolism, the sensitivity of transoesophageal echo for assessment of those patients, and the need for early referral for percutaneous transvenous mitral commisurotomy (PTMC)

The effect of wearing the veil by Saudi ladies on the occurrence of respiratory diseases.

It is customary in clinical practice and elsewhere to put on a mask for protection against infection, dust, and so forth. The veil, which is traditionally worn by women in many Muslim countries, especially in Saudi Arabia, may have a similar effect. The study was carried out during 1998-1999 in the eastern province of Saudi Arabia. Adult women were asked to answer a structured questionnaire related to the occurrence of respiratory tract problems and about veil wearing. Veil wearing was practiced by 58% of the sample. Respiratory infections and asthma were significantly more common in veils users (p < 0.00001 and p < 0.0003, respectively). This unexpected finding was probably secondary to infection. More and bigger studies are recommended.