Correlates of age at menopause and osteoporosis in Saudi women

OBJECTIVE

To evaluate the age of menopause among Saudi Arabian women and to predict the local trend in the prevalence of osteoporosis.

MATERIAL & METHOD

All menopausal women who had bone mineral density studies at King Khaled University Hospital, Riyadh, Saudi Arabia, between 1999 to 2003. Correspondence and logistic regression analysis were conducted to identify variables that were positively associated with age of menopause.

RESULTS

935 postmenopausal females were included. The mean age of menopause was 48.1 +/- 5.9 years. Early and late onset of menopause were associated with osteoporosis, while normal onset of menopause was associated with osteopenia or remained normal. There was no association between age of menopause and parity or body mass index.

CONCLUSION

The age of menopause among Saudi women is lower than in Western countries but similar to other Arabic countries. In addition to cultural differences genetics play a role in determining the age of menopause and the development of osteoporosis.

Hemiconvulsion-hemiplegia-epilepsy syndrome. A clinical, electroencephalographic and neuroradiological study

Six patients (4 boys and 2 girls) with hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome are described. They had prolonged seizures, lasting from 30 min to 12 h, at ages 1-4 years. These took the form of hemiconvulsion in three of the children and generalized tonic-clonic seizures in the others, being preceded by hemifacial twitching or head and eye deviation in two. They were followed by hemiplegia, which cleared with time in five patients, apart from subtle pyramidal tract signs. One child had spastic quadriparesis, choreiform movements, contracture deformities and severe mental retardation following repeated status epilepticus. Subsequent epilepsy developed in five patients and was satisfactorily controlled with carbamazepine and/or phenobarbitone. Cerebral hemiatrophy was documented in all patients by cranial computed tomography and/or magnetic resonance imaging. Single photon emission computed tomography (done in 4 patients) showed ipsilateral hypoperfusion (of the damaged hemisphere). Electroencephalography showed ipsilateral slowing and low voltage of background activity. Epileptiform discharges were found on the ipsilateral side in two cases and the contralateral side (the undamaged hemisphere) in one.

Hepatobiliary scintigraphy in the diagnosis of choledochal cysts in children

The objective is to present the usefulness of hepatobiliary scintigraphy in the investigation of children with suspected choledochal cysts through our experience in King Khalid University Hospital at King Saud University, Riyadh. Seven patients aged between I and 10 years (average 4.8 yrs) comprising six females and one male were investigated. Laboratory tests, abdominal Ultrasound and/or CT, and cholangiography were performed whenever indicated. Persistent activity in a dilated common bile duct, with or without dilatation of intrahepatic bile ducts, was considered a positive indicator for choledochal cyst disease. Four children with cystic dilatation (type I) were diagnosed by hepatobiliary scintigraphy, one saccular (type II), and two cases of Caroli's disease (type V). The diagnosis of choledochal cyst was proven by surgery with histological confirmation. Visualization of the gallbladder occurred in one case only. The common bile duct was seen in four cases. Late activity in the bowel was noted in two cases.