We aimed to assess depressive symptoms in caregivers of patients with dementia, taking into account variables such as severity of dementia, sex, age, and financial state of the patient. We recruited 222 caregivers of patients with dementia from King Abdulaziz Medical City, Saudi Alzheimer’s Disease Association, and online, from February to June 2017, and employed the Patient Health Questionnaire to assess depression, and the Blessed Dementia Scale to assess severity of dementia. The prevalence of clinical depression among the caregivers was 14.9%. Minimal symptoms of depression were experienced by 96 caregivers (43.2%), moderate by 45 (20.3%), moderate-severe by 15 (6.8%), and severe by 8 (3.6%). Forty-six patients had mild dementia (22%), 73 had moderate (34.9%), and 90 had severe (43.1%). Caregivers of patients with dementia experience considerable burden and lower level of health-related quality of life and may be predisposed to developing clinical depression.

Background: Implantable cardiac defibrillators use has been increasing for the last two decades and they are prone to infections. ICD device infection risk factors are many, some are host related while the others are procedures related.Staphylococcus aureus and staphylococcus epidermidis are accountable for 65 to 75% of the total cases of Implantable cardiac devices infections. Case presentation: A 50 years old male presented to our emergency department with ICD pocket migrated through the skin. The symptoms started over 2 weeks, started as gradual feeling of foreign body moving underneath the skin, associated with mild pain and 3 days before presentation, the ICD penetrated the skin. The patient denied any history of fever, bleeding, pus discharge, palpitations, abnormal shocks or syncope. He was admitted to the hospital, treated for a presumed infection and his ICD device was removed. Conclusion: ICD devices complications are many, including infections. But, to have an infected device protruded through the skin is not a common presentation. We outlined the approach that was taken for this patient and his management in order to enhance the literature in terms of the above mentioned rare presentation