Drug poisoning and associated factors in Western Saudi Arabia: a five-year retrospective chart review [2011-2016]

Objective: Drug poisoning is a globally common cause of emergency-room admissions. This study explores drug-poisoning prevalence patterns, associated risk factors [gender, age and exposure circumstances], and outcomes in western Saudi Arabia

Methods: Retrospective analysis of Clinical drug poisoning cases [2011-2016]. The data were retrieved from the Saudi Ministry of Health's record and Patients' medical charts were analyzed

Results: The Ministry of Health received 1,474 reports of drug poisoning during 2011-2016.More than half involved females [n=885, 60%] or young children [0-4 years old] [n=764, 51.8%] and occurred accidentally [n=786, 53.3%]; almost all had an oral route of poisoning [n=1,466, 99.5%]. The cases most frequently involved analgesic and non-steroidal anti-inflammatory drugs [n=373, 25.2%]; antiepileptic, antipsychotic, psychoactive, and anxiolytic drugs [n=229, 16.3%]; antihistamine, asthma, flu, and cough drugs [n=157, 12.0%]; and antibiotic, anti-fungal; and antiprotozoal drugs [n=74, 5.0%]. Antidotes were administered in only 2.2% of cases, and no deaths were reported

Conclusion: The drug poisoning cases involved females and young children [younger than 5 years old] and the most cases were accidental, and the most commonly used drugs were analgesics [Panadol], followed by antipsychotics, antihistamines, and antiepileptics [Tegretol]

Prevalence and preventability of sentinel events in Saudi Arabia: analysis of reports from 2012 to 2015

This study aimed to assess the pattern of sentinel events reported to Ministry of Health of Saudi Arabia from January 2012 to June 2015. Sentinel event reports were examined for patient characteristics, type of event, outcome, cause and preventability. There were 433 sentinel events: 58.2% were deaths, 14.8% were unexpected loss of a limb or a function, 7.4% major medication errors and 7.4% retained instruments or sponges. Among the reported events, 44% were associated with surgical interventions and most were classified as preventable [91.6%]. Age 19-64 years was significantly associated with death as an outcome [P = 0.02]. Non-preventable sentinel events were significantly more likely among women than men [P = 0.01]. Unavailability of policy and procedures and/or failure to implement them [55%], and lack of proper communication [35%] and training [33%] were the main causes for the adverse events. Efforts should focus on enhancing the National Sentinel Events Reporting System, adopting criteria for effective reporting and ensuring availability and implementation of policies and procedures

Pattern and determinants of poisoning in a teaching hospital in Riyadh, Saudi Arabia

The Drug and Poison Information Center [DPIC] at King Khalid University Hospital, Riyadh, Saudi Arabia, was founded in 1983. Since then it has responded adequately to queries from medical and non-medical callers from all over the Kingdom. Queries ranged from simple material identification to poisoning cases. To assess the pattern and circumstances of poisoning in the Kingdom of Saudi Arabia through reviewing data from DPIC in King Khalid University hospitals. This is a retrospective study of referred cases and calls received by DPIC. All records and documentation forms during the study period were investigated. This study included 1161 cases. There were 7.9% infants, 52.9% under 5 years old, 7.2% between 6-12 years old and 32.0% more than 12 years old. Number of males with toxic exposure was almost equal to that of females. More than 92% of cases were toxic exposure through oral route. Causes of poisoning include drugs among 76.7% of cases followed by household chemicals [6.8%]. Suicidal intention was reported among 25.6% of cases. Using multivariate regression analysis, significant predictors of suicidal attempts are more than 12 years old, patients who were exposed to more than one toxin and patient who came to the hospital within 1-3 h since poisoning. Establishing and operating DPIC centers throughout the kingdom, in addition to implementing of legislations to ban over the counter selling of medications and to sell potentially dangerous chemicals in childproof containers

Neurobehavioral performance among tobacco industry workers

Although health disorders of active and secondhand smoking have been extensively investigated, researches on tobacco industry workers with special emphasis on neurobehavioral deficits are very limited. Previous reported disorders have been attributed to workplace related factors [e.g., ill-ventilation, damp conditions and dust from grinding tobacco leaves]. Tobacco industry workers are usually young adults with a significant proportion of females. This occupational group is at high exposure risk that necessitates early intervention policies especially in the developing countries. This study aims to assess neurobehavioral performance among tobacco industry Egyptian workers, and its relation with biomarkers of exposure. This is a cross-sectional study. Exposed participants [n= 80] were randomly recruited among workers in a tobacco processing plant at Menoufia governorate. Control participants were selected among workers' relatives who never worked in tobacco industry. All participants filled a predesigned questionnaire on personal and occupational histories and completed a battery of neurobehavioral tests. Pulmonary function tests [FEV 1%] were performed to all participants. Laboratory examination to measure carboxy haemoglobin and urinary cotinine levels was done. Performance on five out of eight administered neurobehavioral tests was significantly lower among exposed than control participants. These tests showed significant dose-response relationship with urinary cotinine levels [ng/mL] and not with carboxy Hb% after controlling for the potential confounders of age, sex, education, and smoking also no statistical difference was detected between both groups regarding FEV1%. Neurobehavioral tests can be used as an intervention tools for earlier detection and evaluation of health effects in tobacco industry than pulmonary function tests

Normal parathyroid hormone among patients with unexplained myalgia, Does it excludes vitamin D deficiency?

Undiagnosed vitamin D deficiency is not uncommon. Serum PTH has been addressed as a biomarker that usually increase in case of low vitamin D. The present study aimed at evaluating the vitamin D status among patients with chronic unexplained myalgia considering the diagnostic help of secondary hyperparathyroidism as a surrogate marker. Among 360 cases with unexplained myalgia 297 revealed secondary increase in serum PTH level. Among 63 cases with normal serum PTH 31 [49.21%] cases showed vitamin D deficiency [< 20 nmol / L] and 30 [47.62%] patients showed vitamin D insufficiency [20 - 63 nmol / L] and it was sufficient in 2 [3.17%] cases only. Exclusion of vitamin D inadequacy is a must in any case with chronic unexplained muscle pains. Secondary hyperparathyroidism though a good biomarker for vitamin D inadequacy, yet, the reverse is not true. So, still serum 25 [OH] D 3 level is the gold standard test to evaluate the vitamin D status of the patients

Behavioral-based educational intervention directed towards agricultural families to protect children from pesticide exposure

Background: Culturally appropriate educational intervention was devetoped and directed towards agricultural families to improve knowledge and practice of agricultural families in order to protect their children from exposure to pesticides

Methods: Parents [n=297] were randomly assigned into either lecture or video training group. Ability to recall information or improve practrces among parents was evaluated in 3 consecutive sessions [2 weeks and 1 month apart]

Results: All participating families were using pesticides inside homes and in the fields, All tamrlies were using space insect killers inside homes [main ingredients include tetramethrin, sumithrin, pyrethrin, and piperonyl butoxide] in different forms. Pesticides appIied in the fields are organophosphates [57.9%], carbamates [41.4%], and pyrethroids [28.5%]. In both lecture and video training groups, knowledge scores of participants improved significantty in the second and third sessions, as compared to the first session. Although practice scores of both groups improved in subsequent sessions, the changes were not significant

Discussion: Using non-traditional appropriately designed educational interventions that depend more on eral memory is more likely to ensure sustainability of the gained knowledge as well as practice