ABSTRACT
Background: Cirrhosis is the irreversible fibrosis of liver, it continues to be a common cause of morbidity and mortality. It is accompanied by inflammation and malnutrition and thus can have a negative effects on bone metabolism and promote fractures accordingly
Aim of the study: to evaluate the risk of fractures among patients with cirrhosis
Methods: A systematic review of the scientific literature following PRISMA/STROBE guidelines, Medline Cochrane Library and Embase s were retrieved using an algorithm comprising relevant MeSH terms from 1980 to 2017. Publications on the association of cirrhosis/bone fracture were ed independently by the authors and included in both gender and gender-specific meta-analyses, following recalculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies
Results: [st] 8 udies met the inclusion criteria enrolling 988 patients [286 of which are diagnosed with al coholic liver disease [ALD]. Overall, ALD demonstrated a el r ative risk [] RR of 1.825, 95%CI: 1.370 2.28, - < 0.001 P for the development of bone fractures. Bone mineral density [BMD] was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD. Sensitivity analyses showed consistent results
Conclusion: in accordance to the present meta-analysis, there is a significant correlation between bone fractures and ALD independent of BMD
ABSTRACT
Background: in the past, and until the end of the twentieth century, TB was one of the major causes of death. Nowadays, the world is still challenging with TB control, even though the percentage of TB has been decreased. In Saudi Arabia, annual TB incidence rate is 12/100,000 population. Even though incidence rate of TB has been decreased in Saudi Arabia, still TB not fully control. Getting the world free from TB will not happen if general populations don't aware about TB
Aim: to evaluate knowledge, attitude and practice towards TB among general populations in Riyadh region of Saudi Arabia
Method: this is a cross-sectional study done by selection of general populations in Riyadh region by random sample. The study was done by a self-administrated questionnaire that contains demographic data part and other parts that evaluate the awareness of TB. Comparison of results between many variables by Chi-Square Test and P-value < 0.05 was considered as a significant level
Result: around 519 participants in this study [Response rate 94.36%] by mean age 33. Only 3.3% have a history of TB and 21.1% have relative with a history of TB. Only 19.4% of participants have good knowledge, only 18.0% have favorable attitude and most of the participants have a good practice [67.6%]. People with high degree educational level have better knowledge than others. Non-Saudi people are better than Saudis in practice and people who have relative with a history of TB are better in attitude than others. In practice, Female are better than male, married people also better than single, people with a history of TB or relative with a history of TB are better than others
Conclusion: papulations in Riyadh and its surroundings have a very low level of knowledge toward TB. Most people have unfavorable attitude level. Even though there is a high level of good practice but still it needs to be increased. Education has an important role to increase the level of knowledge about TB
ABSTRACT
Background: defect of use of antibiotics is bothering pediatricians. This defect is participating in the prevalence of one of global health problem called antibiotic Resistance. Many articles are supporting the idea that use of antibiotics is positively related to antibiotic resistance and this problem is increasing and growing up. By the way, incorrect use of antibiotics has many factors that contribute on, like patient attitude and deficiency of education from the physician who prescribed the antibiotic. Also, patient's knowledge and practice with the antibiotic like self-prescription. What is patient expecting from antibiotic and previous experience with antibiotics? Parents are responsible to give medications to children. So, we need to increase parents' knowledge, attitude and practice [KAP] toward antibiotics to reach new generation without antibiotic resistance. Regarding Saudi Arabia, antibiotic resistance already exists and the rate of resistance is increased in the last decade
Aim of the work: to assess how parents are aware of antibiotics those given to their children by evaluating knowledge, attitude, and practice of parents in Riyadh region, central Saudi Arabia
Methods: this is questionnaire based cross-sectional study. Authors were circulating on Riyadh Region to find volunteers to fill questionnaires among parents of children in public places by selecting parents of children up to 12 years old by choosing random samples from each place. The questionnaire has two parts: the first part, as usual, is containing demographic data. While the second part: is the part that is evaluating KAP of parents towards antibiotics. Then we compared the final results by Chi-Square test and p-values less than 0.05 was considered as significant value
Results: around 1058 parents volunteered to participate in this study [response rate was 88.16%] by mean age of 38. Around 89.6% used antibiotics for their children before. There are 9.5% of parents were believe that their children need antibiotics each time they get sick. More than 35% of our participants don't complete period of antibiotic use to their child as what is mentioned on prescription. About 82.3% believe that antibiotics can harm children. There are 41.7% of parents bought antibiotics to their children from the previous prescription. Around 61.1% don't know the term antibiotic resistance. There are 28.4% of participants could change their doctors if they don't prescribe antibiotics easily, while only 642[60.7%] could change their doctors if they prescribe antibiotics excessively. About 68.1% of participants believe that doctors prescribe antibiotics excessively. Nearly 49% have good KAP, 41% of participants have intermediate KAP and remaining 10% have poor KAP. Females are better than male in KAP, people with high degree education are better than other and parents who used antibiotics before are better than those who didn't [p-value < 0.05]
Conclusion: level of knowledge, attitude, and practice of people in Riyadh region is ranging between good to moderate, and tends to be good. We can expect antibiotics resistance to happen among new generation in Riyadh region. There is an unacceptable idea that is highly prevalent among parents that doctors excessively prescribe antibiotics. Moreover, mothers have better awareness than fathers. People with high degree level of education have better awareness than others
ABSTRACT
Background: Informed consent has become a vital factor for the clinical treatment of modern practice in the medical field, it is participating in legal, ethical and administrative compliance side. However, informed consent is variably applicable and rarely fulfills its theoretical ideal. Disclosure of adequate information is very important before signing informed consent. It is important to make patient enable to take a proper decision with good knowledge about his/her case. Informed consent for the surgical procedure is consent that taken from the patient before surgical operations and invasive procedures after explaining advantages and disadvantages. Getting patient's signature for the consent of operations and the surgical procedure is surgeon's job. The opinion of the surgeon about informed consent is important, as that may affect the performance of surgeon in explaining procedure with its risks and benefits
Aim: Assessment of knowledge, opinion, and attitude of surgeons towards informed consents. Find out how to improve the quality of informed consent from surgeons' suggestions
Method: This cross-sectional study is questionnaire-based study. Our target was to reach many surgeons in Saudi Arabia with different specialties, different status and from different hospitals. We take our sample using random sampling technique. We selected surgeons from each hospital that our data collector can reach and enter easily. Collection of data was done by interview. Our questionnaire contained four parts in addition to demographic data part. The first part was asking about surgeons' opinions regarding informed surgical consent process. The second part was responsible for inquire about obtaining informed surgical consent. The third part is about the refusal to sign informed surgical consent. Last part is to ask about surgeons' suggestions to improve informed surgical consent
Result: Total number of respondents was 140 [Response rate is 93.3%]. Around 34% of participants agreed that surgeons don't give adequate information about the surgical procedure. 33.6% insisted to know about their surgery. After asking each surgeon about the importance of informed surgical consent they selected the following answers in descending order; informing patients about advantages, hazards and alternatives [81.4%], Medico-legal importance [79.3%], decision taking about procedure [72.1%], hospital policy [50.7%] and surgical tradition [19.3%]. Most of the doctors [85%] complained that sometimes, their patients refused to sign consent. Fear was the most common cause of singing consent refusal according to opinions of 62.9% of surgeons
Conclusion: Surgeons in Saudi Arabia have acceptable knowledge about informed surgical consent and how to obtain it. But still there were some opinions of surgeons opposite to what is practiced, and also some of them practiced something not ideal while obtaining informed surgical consents. However, most of the surgeons know the importance of consent and what is important to be disclosed in it. In general, the frequency of consent refusal was low
ABSTRACT
A twenty-seven-year-old female diagnosed with renal cell carcinoma presented post-radical nephrectomy with bilateral breast lesions. Clinically, the lesions appeared malignant. Core biopsy confirmed a metastatic secondary breast cancer from primary medullary renal cell carcinoma. Metastatic breast cancer from renal cell carcinoma is extremely rare; very few cases were reported in the literature. There are no clear guidelines on the management of such cases. The prognosis is very poor and the treatment remains controversial