ABSTRACT
To examine and test the possible association between boarding time and stroke patients' outcome. This study is a retrospective review of stroke patients presenting to the Emergency Department [ED] of King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia from 2007-2010. We excluded thrombolysis cases and those deemed critically ill. We collected time of stroke onset, ED arrival, decision to admit, and arrival to ward. Boarding time [BT] was defined as time of arrival to ward minus time of decision to admit. Primary outcome [PO] was defined as a composite of mortality, and/or any of post-stroke complications. We included 300 patients with a mean age +/- standard deviation of 69 +/- 12 years, and 66.3% were men. The PO occurred in 37.7%. There was no association between BT and PO [odds ratio [OR] =0.9, p=0.3[, or any of the secondary outcomes, such as, death [OR=0.97, p=0.5], severe disability [OR=0.97, p=0.3], pneumonia [OR=1, p=0.9], urinary tract infection [OR=1,p=0.9], or neurological deterioration [OR=0.8,p=0.1]. Multivariate analysis included gender, age, stroke severity, subtype, hypertension, diabetes, coronary disease, atrial fibrillation, heart failure [HF], onset to ED, BT and ED wait time; only moderate to severe stroke, HF, and previous stroke predicted poor outcome. Although [admit no bed] was not associated with adverse effects, the results should be interpreted with caution, and early admission to the stroke unit should be encouraged
ABSTRACT
Prevalence information is lacking on human papillomavirus types 16 and 18 [HPV-16/18] infection in cervical tissues of women residing in Riyadh, Saudi Arabia. In addition, there are no observations on progression to cervical intraepithelial neoplasia [CIN]. Pap smear and HPV-16/18 DNA detection by PCR followed by Southern blotting was performed on 120 subjects [Saudi and other Arab nationals] during routine gynecological examination. Some HPV-positive subjects were followed for 4 years, by Pap smear every 6 months and by HPV DNA detection at the end of 4 years. Overall HPV-16/18 prevalence was 31.6%. HPV-16 prevalence alone was 13.3%, HPV-16 as a mixed infection with HPV-18 was 15%, and all HPV-16 was 28.3%. HPV-18 alone was 3.3%, HPV-18 as a mixed infection with HPV-16 was 15%, and all HPV-18 was 18.3%. Ten subjects had cervical abnormalities with the Pap smear test, six of whom were HPV-16/18 positive, 1 with HPV-16, 1 with HPV-18, and 4 with a mixed infection of HPV-16/18. Of all 23 HPV-16/18-positive subjects, either as individual or mixed infection, followed for 4 years, 7 showed abnormal cytology 6 at initial examination and 1 during follow-up. Of these 7, 6 reverted to normal without treatment and 1 was treated and became normal after 3 years. None of the subjects progressed to CIN-III. A high prevalence of HPV-16/18 was found, but with a low rate of progression to CIN. A significant association with abnormal cytology was found only in patients with HPV-16/18 mixed infection