One hundred and thirty-six (25%) had a family member with epilepsy. The most-reported trigger factor was sleep deprivation reported by 285 (52%), followed by stress 225 (41%), missed medication 210 (38.5%), anxiety 209 (38.3%), and fatigue 184 (33.7%). Conclusions Sleep deprivation is the most reported trigger factor for seizures in the KSA, followed by stress, followed by missed medication.

To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with pre-hospital delay.

A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, and multivariate analysis were used to examine factors associated with pre-hospital delay.

The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9).

Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the bene ts of availing an ambulance service.

Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the bene ts of availing an ambulance service.

To determine the prevalence of Fabry disease (FD) among Saudi patients on hemodialysis.

This prospective study was conducted in 3 major hospitals in the Kingdom of Saudi Arabia (KSA). All adult patients (greater than 18 years old) attending the dialysis unit who have end-stage renal disease (ESRD) and on hemodialysis were included. Known patients with FD and those who refused to participate in the study were excluded. All eligible patients were screened for FDusing dry blood spot (DBS) for alpha-galactosidase A (α-Gal A). A positive DBS (enzyme activity less than 40%) was followed by another con rmatory enzyme assay. When the second DBS sample was also positive (enzyme activity less than 40%), a Sanger sequencing of the GLA gene was performed.

A total of 619 patients with ESRD and on hemodialysis were screened for FD using DBS for α-Gal A enzyme level. Enzymatic activity was below 40% in 11 samples. On retesting, 3 females had less than 20% enzymatic activity suggesting FD. Sanger sequencing of these 3 females showed the variant c.1055C greater than G (p.Ala352Gly) confirming the diagnosis of FD. Family screening of one of these 3 patients revealed one asymptomatic female carrying the same variant.

The prevalence of FD in this cohort was 4.8 per 1000 patients. Screening of Fabry patients with ESRD seems to be a cost-effective strategy. Furthermore, relatives of the patients identified by screening enhances this screening strategy.

The prevalence of FD in this cohort was 4.8 per 1000 patients. Screening of Fabry patients with ESRD seems to be a cost-effective strategy. Furthermore, relatives of the patients identified by screening enhances this screening strategy.

To study which factors increase the risk of persistent disease in differentiated and poorly differentiated thyroid carcinoma.Methods A retrospective chart review of all consecutive differentiated and poorly differentiated thyroid cancer patients from King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, a tertiary care center, between 2004 and 2018. Logistic regression analysis was performed to predict factors associated with less than excellent response to treatment.Results We included 186 patients with complete data records; 81.1% were females. Papillary thyroid carcinoma comprised 88.1% of the neoplasms. Selleckchem Amredobresib In total, 55.9% of patients attained an excellent responseto treatment by the end of the first year following treatment. All patients with distant metastasis had persistent disease. On univariate analysis, female gender was associated with excellent response (p=0.002). Lymph node metastasis, extrathyroidal extension, vascular invasion, and cancer multifocality were all found to be inverself patients attained an excellent response to treatment by the end of the first year following treatment. All patients with distant metastasis had persistent disease. On univariate analysis, female gender was associated with excellent response (p=0.002). Lymph node metastasis, extrathyroidal extension, vascular invasion, and cancer multifocality were all found to be inversely related to excellent response (p less than 0.05 for all). On multivariate analysis only lymph node metastasis was associated with a decreased adjusted odds of an excellent response (p=0.007). Conclusion Patients with lymph node metastasis are at high risk for persistent disease following initial thyroid cancer management. Careful monitoring of these patients is warranted.

To describe the incidence of pulmonary embolism (PE) in sickle cell disease (SCD) patients admitted to the intensive care unit (ICU).

A retrospective descriptive analysis was conducted with 124 SCD patients diagnosed with PE or suspected PE admitted to the ICU of Salmaniya Medical Complex, Manama, Bahrain between May 2017 and April 2018. A data collection form was used to obtain information on the history and demographics of PE patients.

A total of 124 patients diagnosed with SCD were admitted to the ICU during the study period.Male patients slightly outnumbered (n=75; 56.4%) female patients, and the average age was in the mid- thirties (mean=37.4 years). The main diagnosis leading to ICU admission was vaso-occlusive crisis. The average hemoglobin level was 8.6 mg/dl, hemoglobin S% was 55.8%, and the length of stay in the ICU was 5.3 days. A total of 5 patients were diagnosed with PE with an incidence rate of 3.8%. All PE patients were females, which resulted in a significant relationship between gender and the likelihood of developing PE.