the extensive examination of family health files coupled with door-to-door survey identified 1736 patients with CMs. The results showed that the prevalence of CMs was 6.9/1000 population. The male to female ratio was 1.3:1. The patient's age, sibling order, co-morbid disorders of CMs, parental age, chronic maternal diseases, and the family history of CMs were significantly associated with groups of arbitrarily classified CMs. The most frequently encountered CMs were of central nervous system (39.2%) followed by cardiovascular (22.3%), alimentary (13.1%), musculoskeletal (6.85%), urogenital (6.16%), communicative and audiovisual (5.5%), and miscellaneous (6.9%). Further one-way ANOVA found significant differences among CM categories and age of patients and parents. Unlike Western trends, our study tentatively concludes that overall the inheritance rather than socioenvironmental factors contributes significantly in the etiology of different congenital malformations. We further suggest that the basic information of this research might be useful foundation data in future analytic studies on congenital malformations. Ann Saudi Med 1995;15 (1) Major congenital malformations are. the leading cause not only of perinatal deaths 1,2 but also of infant mortality and morbidity.3,4 They have multifactorial origin and about 40% of cases have idiopathic etiology. The major, minor, and variant features of CMs 5 occur during the process of organogenesis. During the last two decades there have been several anecdotal case reports and reports of case series of different congenital malformations. Additionally, the large hospital-based studies carried out among neonates have explored the patterns of CMs and also made references to the CMs as the prime contributors to perinatal deaths.1,2,6,7 Furthermore, some studies have explored the individual specific body system's CMs. [8][9][10][11] The former studies have, however, some limitations as a majority of these are hospital-based, do not reflect the prevalence of CMs in the general population, are carried out in neonates only, and moreover do not provide data regarding other age groups surviving with congenital malformations. Notably, as a result of multiple favorable factors, the perinatal and infant mortality and morbidity rates attributable to major congenital malformations have considerably decreased in the developing world, though not as sharply as in developed countries. Consequently, it is expected that survival rates of neonates born with CMs would increase in underdeveloped nations, hence posing a major chronic sociomedical health problem. To our knowledge, there is no study which has explored the epidemiological parameters of CMs among different age strata in Saudi Arabia. Therefore, we piloted this study with the goals of finding out the prevalence, possible etiological correlates, and the patterns of congenital malformations in a population less than 20 years of age in the Al-Qassim Region. Material and MethodsThe Al-Qassim Region is geographically located in the center of...

It was hypothesized that the recent outbreaks of measles in a geographically defined area of Al-Qassim might reflect significant changes in the epidemiology of measles and cast doubt upon the real protective value of measles vaccines. Therefore, the two objectives of this research were to study some epidemiological parameters of cases of measles (n=993) and the current immunological status of immunized children (n=2810). The crossmatched data about measles patients were collected on an official proforma and 3 mL of blood were extracted from each child for determining the measles IgG and IgM antibodies. The results showed that female patients were significantly overrepresented (51.3%). The majority of patients encountered at primary health care centers (PHCCs) (81.3%) were more than five years of age (76.5%). Among nonvaccinated measles cases, 54.9% (n=402) were from rural/desert areas. The measles vaccine failure rate was 26.3%. The results of the surveyed children showed that 2% of them were not vaccinated. The measles IgM levels were detected significantly in recently vaccinated females (n=29/51, 56.9%). The measles IgG positivity unaffected by age, sex, and residence was found in 87.4% of children. A significant portion of children from rural/desert areas were not vaccinated (n=44/57, 77.2%). Though there were apparently high seroconversion rates in children under two years of age following Edmonston-Zagreb vaccine, overall it did not achieve any statistical significance when compared with seroconversion rates in all children following Schwartz vaccine. We conclude that besides at age six months, and MMR containing measles vaccine at 12 months, children at school entry (six years) should also be considered for measles vaccination. Ann Saudi Med 1994;14(5):399-404.