A Pediatric Case of Basidiobolomycosis Presenting With an Abdominal Mass.

Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum. The condition has been reported in children and adults presenting with abdominal pain, weight loss, abdominal distension, vomiting, diarrhea, fever, and an abdominal mass. We report a case of a previously healthy 2.5 years old male who presented to the ER complaining of abdominal pain and distension for two weeks together with significant weight loss. He looked ill and cachectic. He had tachycardia but was afebrile. His abdominal examination showed a right-sided abdominal mass. His initial abdominal ultrasound (US) suggested an abdominal tumor. The patient was referred to a tertiary center where he had an ultrasound-guided biopsy that showed fungal hyphae consistent with basidiobolomycosis.

Patterns of Functional Gastrointestinal Disorders Among Children in Makkah City: A Single Institutional Experience.

Background Functional gastrointestinal disorders (FGIDs) are syndromes identified based on a group of symptoms defined according to the criteria of the Rome Foundation. The most commonly observed disorders among the pediatric population are functional abdominal pain disorders and functional constipation. This study aims to identify the patterns of FGIDs among children in Makkah, Saudi Arabia. Methods A retrospective cohort study was conducted at pediatric gastroenterology clinics from 2015 to 2019 in a tertiary centre in Makkah, Saudi Arabia. The FGID outcomes were compared with the patient's gender, age, and other characteristics using Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) software to analyze the data. Results One hundred and fifty-two participants met the inclusion criteria, with a mean age of 5.49 ± 3.27 and an average weight of 20.68 ± 12.15 kg. Male patients account for 59.2% of the total population. The prevalence of abdominal pain was 17.84%, while constipation was 50.93%. There was a statistically significant association between abdominal pain and independent variables such as family history (p=0.004) and age, particularly in older children (5-12 years; p=0.001). A statistically significant correlation was found between constipation with gender (p=0.032) and family history (p<0.001). Conclusion The prevalence of functional constipation and abdominal pain increased with age among children in Makkah City, with constipation being significantly more prevalent than functional abdominal pain. There is a significant relationship between age and family history with abdominal pain, whereas gender and family history are associated with a greater likelihood of constipation.

Adjunctive rifampin therapy for native valve Staphylococcus aureus endocarditis in a neonate: A case report and literature review.

Infective endocarditis in neonates can be fatal. Adjunctive rifampin therapy might be effective as salvage therapy in critically ill patients with Staphylococcus aureus native valve endocarditis (NVE). We present a case of a full-term neonate with NVE who had a favorable clinical outcome after adding rifampin to standard therapy.

Incidence of pediatric inflammatory bowel disease in Saudi Arabia: a multicenter national study.

BACKGROUND: Pediatric inflammatory bowel disease (IBD) is increasingly recognized in developing countries; however, the incidence and trend over time have not been reported. METHODS: This retrospective study included children diagnosed with IBD in gastroenterology centers in the Kingdom of Saudi Arabia between 2003 and 2012. The date of birth, date and age at diagnosis, gender, and final diagnosis were collected on special forms. Clinical, laboratory, imaging, endoscopy, and histopathology results were reviewed to confirm the final diagnosis. Descriptive statistics were used to compare ulcerative colitis and Crohn's disease in different age groups, and significance was assessed by the chi-square test. Incidence rates and trend over time were analyzed with the assumption of Poisson distribution. The incidence rate over time was compared in 2 periods (2003-2007 and 2008-2012). A P value of <0.05 and 95% confidence intervals were used to assess the significance and precision of the estimates. RESULTS: A total of 340 Saudi Arabian children aged 0 to 14 years were diagnosed. The mean incidence rate per 100,000 individuals was 0.2, 0.27, and 0.47 for ulcerative colitis, Crohn's disease, and IBD, respectively. Except for the 0- to 4-year age group, there was a significant increase in incidence over time. CONCLUSIONS: Although the incidence of pediatric IBD in Saudi Arabian children is lower than suggested in the Western literature, there is a significantly increasing trend over time. However, decreased trend in the younger age group over time is identified. Prospective studies will be important to identify the risk factors for IBD in different age groups.

Knowledge and practice styles of pediatricians in Saudi Arabia regarding childhood constipation.

OBJECTIVES: The aim of the present study was to evaluate knowledge and practice styles among medical providers working in 5 regions of Saudi Arabia regarding their approach to childhood constipation. METHODS: A survey of 850 pediatric providers (PPs) conducted in 5 regions of Saudi Arabia. PPs included pediatric specialists (PSs), pediatric consultants (PCs), general practitioners (GPs), family physicians (FPs), and pediatric gastroenterologists (PGs). They were asked anonymously about definition, causes, diagnosis, and management of constipation. Information about family concerns regarding constipation and the source of constipation-related information was also collected. RESULTS: A response rate of 73% yielded 622 questionnaires. Among respondents, 61.2% were aware of the Rome definition of functional constipation. More pediatricians (PSs and PCs) than other physicians (GPs and FPs) reported the definition of constipation correctly (P > 0.05). Stool withholding was reported as the most common cause of constipation by 27% of pediatricians (PSs and PCs), 24% of other physicians (GPs and FPs), and 50% of PGs (P = 0.097). Rectal examination was performed by 39% of all PPs and 78.6% of PGs (P = 0.009). Pediatricians prescribed lactulose significantly more often than physicians (P = 0.001). Pediatricians recommended disimpaction before maintenance treatment significantly more than other physicians (P = 0.001). Twenty-three percent of families believed that constipation was caused by a stricture and 10% feared it was caused by a malignancy. CONCLUSIONS: Significant differences in knowledge and practice patterns exist regarding the approach to pediatric constipation. Identification of knowledge gaps may be useful to develop educational materials to improve proper diagnosis and treatment of childhood constipation.

Comparison of jeopardy game format versus traditional lecture format as a teaching methodology in medical education.

OBJECTIVE: To compare students` performance, satisfaction, and retention of knowledge between a `jeopardy game format` and a `didactic lecture format` in teaching viral exanthema to fifth-year medical students. METHODS: We conducted a parallel-group randomized controlled trial in the Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia from November 2008 to January 2009. We randomized fifth-year medical students into 2 groups. We taught viral exanthema to group one in lecture format, while group 2 received the same instruction in a jeopardy style game format. Both groups underwent a pretest, post-test I, and satisfaction survey. We conducted post-test II after 2 months to assess the retention of knowledge. The satisfaction survey consisted of 5 questions using a 5 point Likert scale. We used the paired sample t-test, and independent sample t-test to compare the results. RESULTS: Eighty-two students participated in the study (41 in each group). Both groups showed significant improvement in their knowledge on the post-test I compared with the pre-test scores. However, the post-test II conducted after 2 months showed that retention of knowledge was significantly better in the game format. The satisfaction survey showed that the game format was more enjoyable and fun. CONCLUSION: The game format teaching strategy has an added advantage in retaining knowledge of the subject for a longer time compared with a lecture format.

Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea.

Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS) mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.

Helicobacter pylori: prevalence and relationship with abdominal pain in school children in Makkah City, western Saudi Arabia.

BACKGROUND/AIM: The published data on Helicobacter pylori (H. pylori) prevalence and its relationship with abdominal pain in Saudi Arabia is scarce. This study was carried out to determine the prevalence of H. pylori and its relationship with chronic recurrent abdominal pain (RAP) among school students in Makkah City, Saudi Arabia. MATERIALS AND METHODS: Three hundred and fourteen school students, 103 at the intermediate level (grades 7-9) aged 12-15 years and 211 at the secondary level (grades 10-12) aged 15-18 years were tested for H. pylori. Urea breath test (UBT) was used for this purpose. Children with chronic RAP were identified as per the Apley criteria. RESULTS: Overall, the UBT was positive in 86/314 (27.4%) students. It was positive in 45/103 (43.7%) intermediate school students and 41/211 (19.4%) secondary students. Out of the 55 students with chronic RAP, 40 (73%) were positive for H. pylori. Further, 62.9% and 82.1% were positive among the intermediate and secondary school students with RAP, respectively. The overall and specific odds ratios of RAP were 12.35 [95% confidence interval (C.I.) 6.30-24.22] and 10.40 (95% C.I. 1.75-11.73) for the intermediate school students and 22.69 (95% C.I. 7.99-64.44) for the secondary school students. CONCLUSION: The prevalence of H. pylori among the school children in Makkah, Saudi Arabia, is relatively low compared with developing countries. The prevalence was found to be higher among the younger age group. Further, there was a significant relation between H. pylori infection and RAP among the school students.

Rotavirus infection in infants and young children in Makkah, Saudi Arabia.

OBJECTIVE: To determine the prevalence of rotavirus in infants and young children in Makkah, Saudi Arabia. METHODS: A population-based prevalence study was done in randomly selected infants and young children suffering from acute diarrhoea. Faecal specimens were collected from 479 patients. A latex agglutination test was used for rotavirus detection. All positive and 10 negative samples for rotavirus by latex agglutination were also tested by enzyme-linked immunosorbent assay (ELISA). RESULTS: Rotavirus was detected in 48 (10%) patients using latex agglutination test. ELISA detected 46/48 positive samples. Ten samples that tested negative with latex test were also negative with ELISA. Infection with rotavirus was more frequent among infants and children < 2 years old, with a maximum incidence among children 0-12 months. Rotavirus infection was 3.1% in Saudi nationals, compared to 6.9% in other nationalities. CONCLUSION: In this study the prevalence rate of 10% was low compared to other studies done in different regions of Saudi Arabia. This low rate could be due to the geographical location of Makkah with very hot and dry summer, and mild winter and almost no rain throughout the year.

TORCH agents in pregnant Saudi women.

OBJECTIVE: To determine the seroprevalence rates of IgG to common TORCH agents in pregnant Saudi women using indirect enzyme-linked immunosorbent assay. SUBJECTS AND METHODS: A total of 926 samples of sera were tested for antibodies to TORCH agents known to cause serious congenital infections: Toxoplasma gondii, rubella, cytomegalovirus (CMV), herpes simplex viruses (HSV-1 and HSV-2), varicella zoster virus (VZV) and human immunodeficiency virus (HIV-1 and HIV-2). RESULTS: Toxoplasma IgG antibodies were detected in 35.6%, CMV total IgG antibodies were found in 92.1%, rubella IgG antibodies in 93.3%, HSV-1 IgG antibodies in 90.9%, HSV-2 IgG in 27.1%, and VZV IgG antibodies in 74.4%. A 0% seroprevalence rate for HIV-1 and -2 was found. CONCLUSION: Pregnant Saudi women commonly have IgG antibodies to rubella, CMV, HSV-1 and -2, VZV, and T. gondii. Serological evidence of HIV infection was not observed.

A study of group a streptococcal bacteria isolation from children less than 12 years with acute tonsillitis, pharyngitis and healthy primary school children.

AIM: This study was carried out to assess the prevalence of Group A Streptococcal (GAS) bacteria in the throat specimens of children with tonsillitis and pharyngitis compared to healthy children of the same age group. METHODOLOGY: The study was a prospective one. Throat swabs were obtained from 73 children aged 1-12 years diagnosed with acute tonsillitis and pharyngitis (sore throat and pyrexia >38.5°C) visiting a pediatric outpatient clinic between December, 1999 and April, 2000. In the same period throat swabs were obtained from 465 healthy primary school children aged 6-12 years. GAS from patients was tested for sentivity to penicillin, erythromycin, and cefaclor. RESULTS: In children with tonsillitis and pharyngitis GAS was found in 29 out of 73 (40%). In healthy school children GAS was found in 15 out of 465 (3%).In the patients group GAS was sensitive to penicillin in 14(48%), erythromycin in 27(93%), and cefaclor in 28(96%) CONCLUSION: Although the prevalence of GAS among healthy children was similar to international studies, the GAS infection was high among children with acute tonsillitis and pharyngitis. Sensitivity to penicillin was less than 50% and more than 90% for erythromycin and cefaclor. We recommend routine throat swab for children with acute tonsillitis and pharyngitis and the proper treatment of GAS positive patients to prevent further complications.