In this issueREVIEW ARTICLEORIGINAL ARTICLES
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# REVIEW ARTICLE {#article-title-2}

**Diagnostic accuracy of coronary angiography using 64-slice computed tomography in coronary artery disease**

This review by Yang et al investigates the diagnostic value of 64-slice CT angiography for diagnosing coronary artery disease (CAD)using the meta-analysis methods. Researchers perform a comprehensive search from March 2005 to August 2014, and screen qualified 8 studies for analysis using the STATA software. Diagnostic values include sensitivity, specificity, positive likelihood ratio and negative likelihood ratio values at segment-level analysis. This research use the area under the curve (AUC) value and summary receiver operating characteristics (SROC) curves to evaluate diagnostic accuracy. The 64-slice CT angiography is a reliable tool for detection of CAD when using a cut-off of ≥50% diameter stenosis in elderly population. The study results has a high clinical value.

***see page 1156***

# ORIGINAL ARTICLES {#article-title-3}

**Can mean platelet volume and mean platelet volume/platelet count ratio be used as a diagnostic marker for sepsis and systemic inflammatory response syndrome?**

This study by Ates et al aim to determine whether the mean platelet volume (MPV) and MPV/platelet (PLT) values can be used in the study of sepsis and systemic inflammatory response syndrome (SIRS). A statistically significant difference was found between sepsis, SIRS, and control groups when they compare the MPV and MPV/PLT ratio. This study shows that although there was no significant reduction in the PLT values between the sepsis and SIRS patients, the MPV and MPV/PLT ratio values were found to have significant differences. However, the specificity and sensitivity of the values were not reliable standard to be used as a test.

![Figure1](http://smj.org.sa/https://smj.org.sa/content/smj/36/10/1147/F1.medium.gif)

[Figure1](http://smj.org.sa/content/36/10/1147/F1)

>Receiver operating characteristic curve for mean platelet volume value in sepsis. Diagonal segments are produced by ties. Area under the curve - 0.728, cut-off - 8.915, sensitivitiy - 63.9%, specificity - 71%

***see page 1186***

#  {#article-title-4}

**Health care services provided to type 1 and type 2 diabetic patients in Saudi Arabia**

According to a study by Al Rubeaan et al, diabetes in Saudi Arabia is creating major pressure on the health care system and economy, where most health services are provided for by the government. The SAUDI-DM study analyzed data on health care services provided to 5983 patients, where approximately 90% of health services are governmental, and provided mainly through primary health care centers and by general practitioners. Health insurance carries only 2.3% of the total diabetes bill. Adopting proper management guidelines and empowerment of the private sector and insurance companies’ role will reduce the burden on the government and improve quality of care.

![Figure2](http://smj.org.sa/https://smj.org.sa/content/smj/36/10/1147/F2.medium.gif)

[Figure2](http://smj.org.sa/content/36/10/1147/F2)

Flow chart of diabetic patients recruited by the Saudi Abnormal Glucose Metabolism and Diabetes Impact (SAUDI-DM) Study cohort

***see page 1216***

#  {#article-title-5}

**Co-existence of lip and epiglottis Kimura’s disease**

Kimura’s disease (KD) of the lip and epiglottis is extremely rare, and poses a diagnostic challenge. Further, the coexistence of lip and epiglottic KD is not previously reported. It must not be confused with angiolymphoid hyperplasia with eosinophilia, which occurs predominately in females and present with small, superficial dermal papulo-nodules, frequently erythematous, accompanied by bleeding, pruritus and without regional lymphadenopathy, serum eosinophilia, and elevated IgE levels. In contrast, KD invariably is associated with peripheral eosinophilia and elevated serum IgE levels. Solitary lesions are usually in the deep subcutaneous tissues, frequently associated with regional lymphadenopathy and salivary glands involvement.

![Figure3](http://smj.org.sa/https://smj.org.sa/content/smj/36/10/1147/F3.medium.gif)

[Figure3](http://smj.org.sa/content/36/10/1147/F3)

An image showing: A) the sagittal view of MRI of the head showing upper lip mass; and B) CT scan of the neck showing epiglottic mass

***see page 1226***

*   Copyright: © Saudi Medical Journal

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