REVIEW ARTICLE

Predictors of diastolic dysfunction in rheumatoid arthritis

This systematic review highlights a significant association between the disease duration in rheumatoid arthritis (RA) and diastolic dysfunction based on the E/A ratio determined on echocardiography. The prevalence of diastolic dysfunction in RA is approximately 37%. The main purpose of this review is to evaluate the published literature to determine the predictors of diastolic dysfunction in RA. Our findings depict a significant inverse relationship between E/A ratio and the duration of RA; although the strength of the relationship was weak (r=-0.385). There is no robust data to suggest the role of other clinical or biochemical factors in this regard.

see page 525

ORIGINAL ARTICLES

Genetic polymorphisms in paraoxonase 1 and G protein-coupled receptor 77, and the risk of glucose-6-phosphate dehydrogenase deficiency in a Saudi population

A case-control study was carried out in 200 Saudi male individuals: 100 patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, and 100 control subjects collected between July and August 2011 in the Taif region of Saudi Arabia. The study investigates the role of amino acid substitution variants Q192R and C698T in the development of G6PD deficiency in a Saudi male population. The findings suggest the association of PON1 with G6PD deficiency in the Saudi male population studied herein. Future studies, including correlation analyses between the clinical features and genotypes in populations of different ethnicities, are warranted to confirm the disease association with these genetic mutations.

see page 544

Visual and neurologic sequelae of methanol poisoning in Saudi Arabia

A study is conducted on 50 patients with methanol poisoning seen at the King Khaled Eye Specialist Hospital and King Saud University Hospitals in Riyadh. All admit to drinking unbranded alcohol before profound bilateral visual loss. Mean visual acuity is hand motions. All patients have optic atrophy bilaterally. In 11 out of 30 patients who had neuroimaging performed, there is evidence of putaminal necrosis. Methanol intoxication causes visual loss within 12-48 hours due to bilateral optic nerve damage. The coincidence of bilateral optic nerve damage and bilateral putaminal necrosis is very suspicious for methanol-induced damage.

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Flair image showing additional foci of demyelination in the subcortical and deep white matter sparing the thin rim of white matter adjacent to the cortex (present in 2 patients) (arrow).

see page 568

CASE REPORTS

Sigmoid colon endometriotic mass. A rare cause of complete large bowel obstruction

Endometriosis is a rare cause of complete large bowel obstruction. We reported a 32-year-old woman with complete large bowel obstruction. She presented with diffuse abdominal pain, and constipation for 10 days with progressive abdominal distention and vomiting. Flexible sigmoidoscope revealed non-ulcerating sigmoid mass with complete sigmoid obstruction. She underwent exploratory laparotomy, sigmoidectomy with left iliac fossa colostomy (Hartmann’s procedure). Final histopathology of sigmoid mass revealed the presence of endometrial glands with stroma in muscularis propria of sigmoid colon mass.

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Grossly distended large bowel up to the sigmoid colon with no gas in the rectum (arrows).

see page 630