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Background: Atrial fibrillation (AF) is an irregular and often rapid heart rate that can increase the risk of stroke, heart failure and other heart-related complications. The acute coronary syndrome is a potential risk factor for atrial fibrillation. The aim of this work was to evaluate the impact of atrial fibrillation on in-hospital and short-term outcomes of patients with acute coronary syndrome. Methods: This prospective cohort study was carried out on 80 patients with acute coronary syndrome with or without AF. Patients were classified into 3 groups: group I (50 patients) with acute coronary syndrome without AF, group II (15 patients) with acute coronary syndrome with new onset AF and group III (15 patients) with acute coronary syndrome with pre-existing AF. All patients were subjected to laboratory investigations (CBC, kidney functions and liver function tests) and twelve-lead surface ECG. Results: ACEI, warfarin, amiodarone and PCI were significantly different among studied groups. ACEI was significantly lower in group 3 when compared to group 1. Warfarin, amiodarone, HF and AKI were significantly higher in group 2 and group 3 compared to group 1. PCI was significantly higher in group 1 and group 2 compared to group 3. Conclusions: New-onset and pre-existing AF remained associated with an increased risk of in-hospital complications as heart failure and acute renal failure compared to patients presented with acute coronary syndrome without AF. Anticoagulation as warfarin and antiarrhythmic drugs as amiodarone were largely used in patients with AF during hospitalization.
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Background: Kaposi Sarcoma [KS] is a rare neoplastic vascular disorder. The pathogenesis of KS remains controversial. However, suppression of the immune response was almost necessary. Classical KS most likely affects the male genitalia. Penile KS is the most common, while isolated scrotal KS has been unusual to see. In this case report, we review a rare case of scrotal KS in a non-HIV patient with history, clinical, laboratory, imaging findings
Presentation of Case: A 60 years old male patient, known to have ischemic heart disease. Presented with progressive painful scrotum swelling for 3 weeks. He had dysuria and gave a history of weight loss. Not complaining of prostate disease. By examination, there were swelling, warmness, tenderness to palpation in his scrotum. A biopsy was taken which was shown a Kaposi sarcoma
Discussion: Despite it names as a sarcoma, it is not considered a real sarcoma because the tumour does not arise from mesenchymal tissue. It arises from endothelium tissue. The pathogenesis of KS still not clearly understood and remains controversial. However, what we know is all forms of KS are strongly associated with HHV-8 infections. The partial or complete suppression of the immune response was almost necessary. Therefore, KS is usually associated with HIV infection. KS of the scrotum has been reported in non-HIV patients. Very few cases have been presented with scrotal KS. First reported case of an isolated scrotal KS around the world was in 1976. While In 1979 had been the first time to performed total scrotectomy and bilateral orchiectomy for scrotal KS patient. A Turkish study In 2011 reviewed only one patient had scrotal KS out of 32 cases with HIV-negative KS in the Middle East. In this case, the patient received 3 cycles of chemotherapy with no improvement so we preferred local excision because these lesions were small and stable for about 3 years. After 3 years of follow-up no recurrence was observed
Conclusion: Classical KS is generally observed in the lower extremities, it can rarely affects scrotal skin as isolated lesions. Thus. Genital examination should also include for those patients. In addition, the isolated scrotal Kaposi sarcoma is absolutely cannot be cured by medication. Adjuvant chemotherapy still in many cases show incomplete improvement. Orchiectomy might be the conclusive curative option
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Background: Oman is a high-income country having a relatively small population scattered over large sparsely populated areas. This presents challenges to the provision of health services. It is important to ensure that all health facilities at all levels of care have the right number and skills mix of health workers to deliver quality health care.
Aims: The main aim was to develop national staffing norms to ensure adequate numbers, appropriate skills mix and equitable distribution of health professionals in primary health care [PHC] using the workload indicators of staffing needs [WISN] method.
Methods: All types of PHC services were itemized [promotive, preventive, curative, and rehabilitative and support services]. We used 2014 data from the health information system and the human resources management information system to develop staffing norms using the WISN method. First we set the norms based on the national average for the activity standards, then simulated the norms in Muscat governorate, which has 32% of the population.
Results: We calculated the required numbers of GPs and specialists for PHC centres providing core as well as core and supplementary services and the expected annual outpatient attendance. The simulation showed that doctors were less workload stressed [WISN ratio 1.02] than nurses [WISN ratio 0.66] on average, although some variations between health centres were noted.
Conclusions: Additional parameters [e.g. planned new services; local disease profile; change in health policies] may be added in future to re-adjust the calculation method once the health services mapping and human resources for health profiles for each governorate is completed.
Subject(s)
Primary Health Care , Health Personnel , Workload , Health Services Needs and Demand , Needs Assessment , Health Services , WorkforceABSTRACT
Aim of the work: basic life support [BLS] refers to the skills that require few tools to save lives of the victims of cardiac or respiratory arrests. All healthcare providers are required to master these skills in order to maximize the care to those who experience such emergencies. This study aimed to assess the knowledge and attitude toward BLS in King Abdul-Aziz University among 3[rd] to 6[th] year medical students
Methods: this is a retrospective cross-sectional study conducted in King Abdul-Aziz University, College of Medicine in Jeddah-Saudi Arabia among the medical students, from June to October 2016 lasting for a period of 4 months. Data were gathered by using electronic Google forms questionnaires that were distributed to 3[rd], 4[th], 5[th] and 6[th] year's medical students. Data analysis was done by using SPSS version 17 in July 2017
Results: 370 medical students at King Abdul-Aziz University [KAU] were participated to evaluate their knowledge and attitude toward Basic Life Support [BLS]. 190 of the students were male students. 43% and 38.5% of female and male students scored all the right answers respectively. Both the total mean of correct answers of knowledge and attitude toward BLS were 40% for both variables. Students who had BLS courses other than the mandatory ones scored 41.5% of the correct answers, while the students who had only mandatory BLS courses scored 39% of the correct answers
Conclusions: among KAU medical students, the data showed poor essential knowledge toward BLS. Overall attitude towards BLS was negative. However, the data also showed slight improvement when students had BLS courses other than the mandatory ones. Therefore, more focus may be placed for strengthening BLS skills. In addition, it is recommended to have an annual BLS simulation for all medical students to consolidate their skills and knowledge. We also recommend adding active learning to all medical students
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A study on chronic denture stomatitis was presented and two current methods of management were evaluated. The concept of use of hygenic regimen for dentures was discussed and proved to be helpful among 15 patients representing the control group. Bis-triazole, a new oral antifungal drug was used in the treatment of 15 patients suffering from denture sore mouth. Drug syrup used intra-orally under dentures was found to be effective in the treatment of denture stomatitis [50 mg on a divided dose of 5 mg/ml, 150 ml/bottle]; the daily dose for a fortnight was suggested as an adequate course of treatment. The achieved clinical improvement during the follow-up periods was proved to be statistically highly significant. For quantifying this improvement, st and ard subjective criteria were developed; namely, lesions, pain, duration and inflammation. C and ida albicans was isolated from all cases of denture sore mouth [30 patients]. Although mycological assessment showed a high rate of negativism at the 7th day of therapy, recolonization was observed in 2 patients at the end of 14th day of therapy, giving a satisfactory mycological cure. The drug therapy did not induce changes in blood picture as well as renal and liver function tests. The drug was well tolerated in almost all cases, mild and transient nausea and diarrhea were reported in only one patient. Finally, the disorders which may result from a persistent oral infection by C and ida should be considered the main target of management and underline the necessity for adequate treatment of this disease entity