Introduction: Atrial fibrillation (AF) is associated with atrial thrombus formation and peripheral embolization, which leads to ischemic stroke or systemic thromboembolism. The CHADS2 score is tool for estimating risk of stroke in nonvalvular atrial fibrillation (NVAF) patients. Obesity and Low density lipoprotein (LDL) are modifiable risk factors pose a great risk for stroke and venous thromboembolism. However, data on their implication in identify thromboembolic events in patients with NVAF are quite limited. Objective: To determine whether body mass index (BMI) and Serum LDL would be give incremental information with CHADS2 scheme in predicting thromboembolic event in NVAF Saudi patients. Methodology: The study consisted of 541 patients with AF seen in our institution from 2008 to 2013 were identified in database, 175 were NVAF. Thromboembolic end points were defined as ischemic stroke and systemic embolism. During follow- up period of 730 days. BMI, LDL and CHADS2 components associated with thromboembolic end points identified by Cox regression analysis. Results: Of 175 patients with NVAF, 26 (14.9 %) patients were identified to have thromboembolic events. Majority of them had stroke. Age (>or =75 years) and Peripheral vascular disease were significant factors for thromboembolic events. Thromboembolic risk in patients had previous stroke or TIA was 38.5% (P value = .000). Events rate of thromboembolic increased when CHADS2 score increased. No statistically significant associations were observed with BMI and thromboembolic risk. Study showed LDL associated with an increased risk of thromboembolic events (P value = .009) despite 61.5% of patients were in desirable level of LDL. Using a Combination of serum LDL and CHADS 2 score give additional implication on thromboembolism risk assessment (p value =.005) of NVAF patient. Conclusion: Study demonstrated LDL associated with thromboembolic risk among NVAF Saudi patients. So keeping this association in consideration during thromboembolism risk assessment In addition to the conventional CHADS2 scheme is recommended. Further study is needed to search for modifiable risk factors that are associated with increased risk thromboembolism in NVAF patient.

Background: Video capsule endoscopy (VCE) is a valuable diagnostic tool for the evaluation of the small intestine. Evidence shows that it is effective in the diagnosis of occult bleeding and superficial lesions that are not radiographically observed. We evaluated the efficacy and safety of the capsule endoscopy in the diagnosis and management of the common gastrointestinal disorders.Methods: A retrospective chart review of a total of 326 candidates who have met the inclusion criteria and who underwent VCE from the period from January 2006 till December 2018.Results: The main indication for Video Capsule Endoscopy was small bowel overt gastrointestinal bleeding with 106 cases (32.6%) followed by iron deficiency anemia with 104 cases (32%). Capsule retention rate was observed in 11 cases (3.4%) 4 of which were crohn’s disease patients (22.2%). Overall diagnostic yield was 36%, 64% for overt gastrointestinal bleeding and 41% for occult gastrointestinal bleeding. The most common reported positive finding was Angiodysplasia in 19.9% of cases, followed by ulcers in 13.8% of cases, followed by polyps in 8.3% of cases and erosions in 8% of cases.Conclusions: Video capsule endoscopy proved to be an essential diagnostic tool in gastrointestinal bleeding. Advantages of VCE include; less labor, higher resolution examination of mucosa, relative safety, and noninvasiveness. On the other hand, it does not offer intervention capabilities when compared with enteroscopy and its interpretation was sometimes difficult and time consuming. Risk of capsule retention remains significant especially in patients suffering from crohn’s disease.