The Relationship between ABO Blood Group Type and the COVID-19 Susceptibility in Qatif Central Hospital, Eastern Province, Saudi Arabia: A Retrospective Cohort Study

Introduction: It has been found that the viral infection is linked to the ABO blood group. Limited studies investigated the relationship of the ABO blood group and susceptibility to COVID-19 infection. Objective: To investigate the association between the ABO blood group and the COVID-19 susceptibility. Material & Methods: The study is a retrospective cohort study. It included all hospitalized confirmed COVID-19 patients in Qatif central hospital, Eastern province, Saudi Arabia. We included both genders and people who are older than 14 years of age. The study was conducted in the period between 15th March, and 15th April, 2020. Results: Our sample consists of 72 patients;we found a percentage distribution of 23.62%, 33.33%, 9.72%, and 33.33% for blood groups A, B, AB and O, respectively. Our results showed significantly increased risk for AB blood groups (P < 0.05) and significantly lower risk for the O blood group (P < 0.05). Although there was a higher percentage distribution of the B blood group among COVID-19 patients as compared to the blood donors’ groups, this difference did not reach statistical significance. There was no significant difference in the risk of COVID-19 in blood group A with a distribution of 23.60% in blood donors’ group, and 23.62% in COVID-19 patients. Conclusion: Our findings suggest that among confirmed COVID-19 patients, patients with AB blood group have higher susceptibility while patients with O blood group have lower susceptibility to COVID-19 infection. Our study has limitations and further studies are needed.

Acute Soft Head Syndrome in Sickle Cell Disease in Qatif Central Hospital, Saudi Arabia—Case Report and Review of the Literature

Acute soft head syndrome or sickle cell cephalohematoma is not a common sequel or complication of Sickle cell disease (SCD). Here we describe a case report of a 15-year old Saudi male with sickle cell disease who presented with generalized vaso-occlusive crisis. 48 hours post admission, he developed generalized scalp swelling which is consistent with one of the rare complications of sickle cell disease, acute soft head syndrome. The patient was treated conservatively, without aspiration of the scalp swelling. This case draws attention that acute soft head syndrome should be one of the differential diagnoses of scalp pain and swelling in patients with sickle cell disease.

Psychological and Mental Health among Isolated Hospitalized Suspected and Confirmed COVID-19 Patients, Qatif Central Hospital, Eastern Province, Saudi Arabia: A Single-Center Descriptive Study

Introduction: During COVID-19 pandemic, isolation and quarantine as preventive measures have been implemented. Isolation is often a bad experience for isolated people and it could affect the psychological and mental health. Objectives: To study the impact of isolation on the psychological and mental health of isolated hospitalized suspected and confirmed COVID-19 patients. Material & Methods: A single-center cohort, descriptive survey involving isolated confirmed and suspected COVID-19 patients in Qatif central hospital, Eastern province, Saudi Arabia. The study was conducted between March 22 and April 18, 2020. Information was collected through an online Arabic-language questionnaire. Our sample included both male and female. Anxiety and depression symptoms during hospitalization were evaluated with the Hospital Anxiety and Depression Scale. Results: A total of 52 questionnaires were returned completed. The majority of the respondents were females (65.4%). Most of the participants were less than 60 years of age (90.4%). Three patients were known to have previous mental illness. About two-thirds of the participants were isolated in shared rooms. The duration of isolation was less than 10 days in 72.3% of our sample. Borderline and abnormal scores for depression and anxiety were observed in about 38.4%, and 17.3% of patients, respectively. Three patients had both abnormal depression and anxiety scores. Conclusion: Isolation for contagious infections such as COVID-19 could cause severe psychological health problems, though this was not supported by our study due to the small sample size. Further studies are needed to address this important issue which results from isolation during infectious outbreaks.

Evaluating the around and after Menopausal Symptoms and Personal Perception of Quality of Life among Women in Qatif, Saudi Arabia, Attending the Hospital and PHCs

Background: Menopause is a period where natural cessation of menses occurs, some quality of life characteristics changes with some symptoms associated with this time such as hot flushes and anxiety. Objective: To evaluate and specify the level of impact of these symptoms on the quality of life among women in the Qatif area, Saudi Arabia and to study the factors that may involve in their perception. Methods: A cross-sectional study was conducted of 151 women aged 40 - 60 years old interviewed at either hospital or PHCs, a translated and revised questionnaire of other studies with some adoption. Results: 151 women out of 200 participated in questionnaires, majority of them were highly educated having at least a bachelor’s degree around 80%, and around 75% of participants were either working or retired, with a moderate level of income and enjoying a good lifestyle 93% in around and 97% in the after menopause. With the majority, were not used hormones 95% or conceptive pills 91%, personal perception of health were high around 93% for around and 97.2% for after menopause with no significant statistical difference between the two groups. Conclusion: Perception and knowledge of menopause were very high, with no differences in the severity of symptoms of the four QOL domains for the around or after menopause among the participants. High level of education and increased level of income and knowledge of the participants may play an important role in the result, so further investigation is advised.

Sickle cell cholangiopathy:An endoscopic retrograde cholangiopancreatography evaluation

AIM:To evaluate the role of endoscopic retrograde cholangiopancreatography(ERCP) in patients with sickle cell disease(SCD) .METHODS:Two hundred and twenty four SCD patients with cholestatic jaundice(CJ) had ERCP.The indications for ERCP were based on clinical and biochemical evidence of CJ and ultrasound findings.RESULTS:Two hundred and forty ERCPs were performed.The indications for ERCP were:CJ only in 79,CJ and dilated bile ducts without stones in 103,and CJ and bile duct stones in 42.For those with CJ only,ERCP was normal in 42(53.2%) ,and 13(16.5%) had dilated bile ducts without an obstructive cause.In the remaining 22,there were bile duct stones with or without dilation.For those with CJ,dilated bile ducts and no stones,ERCP was normal in 17(16.5%) ,and 28(27.2%) had dilated bile ducts without an obstructive cause.In the remaining 58,there were bile ducts stones with or without dilation.For those with CJ and bile duct stones,ERCP was normal in two(4.8%) ,and 14(33.3%) had dilated bile ducts without an obstructive cause.In the remaining 26,there were bile duct stones with or without dilatation.CONCLUSION:Considering the high frequency of biliary sludge and bile duct stones in SCD,endoscopic sphincterotomy might prove helpful in these patients.

Alternating Hyperthyroidism and Hypothyroidism in Graves’ Disease: A Case Report and Literature Review

Background: Alternating thyroid function between hypo- and hyperthyroidism is a very rare phenomenon attributed to the switch between the types of thyroid stimulating hormone receptor autoantibodies;thyroid stimulating antibody and thyroid stimulating hormone blocking antibody. Case Presentation: We report an 18 years old male who presented with hyperthyroidism attributed to Graves’ disease. He was treated with antithyroid medication. During follow up, his thyroid function was switching between hyper- and hypothyroidism which was difficult to treat with antithyroid medication. His laboratory investigations revealed high thyroid stimulating immunoglobulin and TSH binding inhibitory immunoglobulin. Due to the difficultly of managing him with antithyroid medication, he was offered a definitive management for his Graves’ disease. Conclusion: This case demonstrates a rare challenging presentation of Graves’ disease. Patients presenting with fluctuation in thyroid function between hyper-and hypothyroidism need a definitive management for Graves’ disease.

Selected Aspects of Camel Immune System and Immune Responses

The camel economy is of considerable importance for arid countries. In the last decade, studies about camel immune system and immune responses have recorded increasing interest. However, drawing a comprehensive picture of the camel immune system remains far from reached. A major part of this review is to cover the studies of the primary and secondary immune organs and the markers of the camel immune cells and certain lymphoid tissues. At the same time, immune responses to different diseases and the nature of effective immunity were included, with an emphasis on the most important zoonotic diseases in camels such as MERS CoV;brucellosis. New findings on the diversity mechanisms of camel immunoglobulin genes were addressed. However, detail of the mechanism of MHC-restricted cellular immunity and the mechanism of B lymphocyte activation in camels await further attention. Interestingly, the gross and the histological structure of the lymphoid tissues of the camel’s thymus, tonsils, and peyer’s patches have indicated significant differences from other animals in terms of structure and function. The most peculiar CD expression, such as LPAM-I, MAdCAM-1 and CX3CR1, in certain camel cells and tissues refers to possible extraordinary mechanisms of immune hemostasis in camel in comparison to other ruminants. The widely applied immunodiagnostic techniques to control camel diseases and to assist in improving the camel resistance were considered. Extensive studies of the camel immune system were greatly hampered by lack of specific reagents to camel markers and low funds in the field of camel immunology.

Rituximab Induced Vasculitis: Dose the Antigen-Antibody Complex of Rituximab Play a Role in Developing Leukocytoclastic Vasculitis?—A Case Report and Review of the Literature

Rituximab is a monoclonal antibody that targets CD20, which is a specific B-cell surface antigen. It was the first monoclonal antibody that was approved for the treatment of non-Hodgkin lymphoma, rheumatoid arthritis, and other cutaneous lymphoid malignancies. There are many off-label uses of rituximab, such as systemic lupus erythematosus, autoimmune hemolytic anemia, multiple sclerosis, graft-versus-host disease, chronic lymphocytic leukemia, and chronic immune-mediated thrombocytopenia. Among the rare side effects associated with rituximab treatment is vasculitis, more specifically, leukocytoclastic vasculitis. Here, we describe a 21-year-old Saudi female with leukocytoclastic vasculitis occurring three months after treatment with rituximab.