ABSTRACT
Background: the occurrences of diabetes mellitus and diabetic nephropathy have increased quickly in the past few decades and have become an economic burden to the healthcare system in KSA. Diabetic nephropathy is a major complication of diabetes mellitus and is a primary cause of end-stage renal disease [ESRD]. The occurrence of non-diabetic renal disease [NDRD] in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse diabetic nephropathy, whereas some cases of non-diabetic renal disease are readily treatable and remittable. However, diabetic nephropathy is known to co-exist with non-diabetic renal disease in a poorly defined population of patients with type 2 diabetes mellitus. This study estimated the pervasiveness of co-existing diabetic nephropathy and non-diabetic renal disease in Saudi patients
Methods: data were retrospectively analyzed from 122 patients with type 2 diabetes mellitus who had experienced a renal biopsy between February 2014 and June 2017 at King Abdulaziz Hospital, region[s], KSA. Male patients numbered 75 [61.5%] of the study population. The biopsies were performed as urinary abnormalities or renal functions were atypical of a diagnosis of diabetic nephropathy. Biopsy samples were examined using light, immunofluorescence [IF] and electron microscopy [EM]. Clinical parameters were recorded for each patient at the time of biopsy
Results: nineteen of 122 diabetic patients [8%] had co-existing diabetic nephropathy and non-diabetic renal disease. These patients showed clinical features and pathologic characteristics of diabetic nephropathy, containing a high prevalence of diabetic retinopathy [88.8%], a long duration of diabetes, increased thickness of the glomerular basement membrane [GBM] and mesangial expansion. Nonetheless, they similarly presented with clinical findings which were inconsistent with diabetic nephropathy, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A [IgA] nephropathy was apparent in 5 out of the 10 patients [50%], tubulointerstitial lesions were found in two patients [20%], membrano-proliferative glomerulonephritis [MPGN] in two patients [20%] and membranous nephropathy [MN] in one patients [10%]
Conclusion: retrospective analysis of biopsy data suggests that approximately 8% of Saudi patients with type 2 diabetes mellitus may have co-existing diabetic nephropathy and non-diabetic renal disease. The most common histological diagnosis in our small series was IgA nephropathy
ABSTRACT
Background: Spinal cord injuries [SCI] are life threatening and most prevalent crises around the world thus the first aid from society population could be helpful for proper management by health care professionals Objectives: Evaluate the KAP of Saudi adults toward CSIs in Dammam City, Kingdom of Saudi Arabia [KSA]
Methods: A cross sectional community questionnaire based survey that was carried out in 30 shopping malls of Dammam City among 700 Saudi subjects from May to July 2017
Results: Most of the subjects [90.4%] had excellent and good knowledge about CSI, 58.9% had positive attitude, 7.3% showed a right practice, while practice of 69.5% was right but not complete and the rest had poor practice. There was a significant relation between knowledge score and Attitude score but not with the practice score. Also, there was a positive relation between the practice score and the attitude score. The older age and working status showed a significant relation with the knowledge score and the male showed a more significant right practice compared to females
Conclusion: Most of the subjects had significant knowledge, attitude. However, low level of right and complete practices was obvious due to inadequate educational training programs attended by the participants about first aid of CSI patients
ABSTRACT
Background: Subsyndromal delirium [SSD] is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit [ICU] remains unclear
Aim of the study: To evaluate the significance of SSD on adverse clinical outcomes especially mortality and length of hospital stay
Methods: A systematic search was performed in the scientific database particularly MEDLINE [2000-2017], EMBASE [2000- 2017], Cochrane Central Register of Controlled Trials, CINAHL [2000-2017], Google Scholar, and individual journals to identify publications that evaluated SSD in ICU patients
Results: The search yielded five studies involving 2453 patients. SSD was detected in 849 patients [34.6%]. Three studies evaluated only surgical patients. Three studies used the Intensive Care Delirium Screening Checklist [ICDSC] and two used the Confusion Assessment Method [CAM] score to diagnose SSD. The meta-analysis showed an increased hospital length of stay [LOS] in SSD patients [0.29 [95% CI 0.11-0.48], p = 0.002; I [2] = 33%]. Hospital mortality was described in two studies but it was not significant [hazard ratio 0.93 [0.58-1.43], p = 0.88 and [4 [1.0-6.9] vs 9 [3.6-20.4], p = 0.05]. The use of antipsychotics in SSD patients to prevent delirium was evaluated in one study but it did not modify ICU LOS [6.2 [4-8] vs 7 [4-9] days, p = 0.63 and 2 [2-3] vs 3 [2-3] days, p = 0.517] or mortality [9 [25.8%] vs 7 [20.4%], p = 0.51]
Conclusion: Subsyndromal Delirium is a common and adverse condition that is manifested in almost one-third of ICU patients. According to our findings, SSD has increased the length of hospital stay only with low impact on the other outcomes. Nevertheless, studies on a bigger sample size and larger scale are needed for a better understanding of the relevance of SSD in ICU patients as well as its treatment