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Guillain-Barré syndrome (GBS) is a complex autoimmune disorder characterized by the rapid onset of motor weakness and sensory disturbances, often precipitated by preceding infections. GBS is considered a rare disorder, with an estimated annual incidence ranging from 0.6 to 4.0 cases per 100,000 individuals. It constitutes a medical emergency due to its potential for severe disability or mortality. The hallmark clinical features of GBS include progressive symmetric muscle weakness and sensory disturbances. Diagnosis relies on clinical evaluation, cerebrospinal fluid analysis, and electrodiagnostic studies, with the Brighton criteria providing standardized diagnostic criteria. The hallmark clinical features include progressive symmetric muscle weakness, sensory deficits, and areflexia or hyporeflexia. The management of GBS primarily involves supportive care and immunomodulatory therapies. Plasmapheresis, or plasma exchange, and intravenous immunoglobulin (IVIG) are the mainstay treatments aimed at modulating the immune response and shortening the illness duration. Rehabilitation, encompassing physical and occupational therapy, is pivotal for restoring functionality and improving long-term outcomes.
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Aging brings about various changes in the brain, leading to cognitive alterations that are increasingly relevant with extended life expectancy. Dementia, characterized by chronic cognitive impairment, is on the rise due to longer life expectancy, imposing a substantial burden on healthcare systems. Dementia encompasses conditions like Alzheimer's disease (AD), vascular dementia (VaD), Lewy body dementia (LBD), and frontotemporal dementia, each with its distinct symptoms and progression. Magnetic resonance imaging (MRI), especially 3T MRI, plays a crucial role in monitoring and diagnosing dementia, aiding in patient selection for emerging therapies. Study involves a comprehensive literature search without restrictions on date, language, age/publication type. Dementia can be divided into neurodegenerative and nondegenerative categories, with AD being the most prevalent. Diagnosis relies on clinical evaluation, supported by neuroimaging techniques like MRI. Various MRI findings, such as cerebral atrophy, microbleeds, white matter hyperintensities, lacunes, and strategic infarcts, offer insights into dementia-related brain changes. These findings facilitate early diagnosis, prognosis, and treatment monitoring, with standardized assessment tools and volumetric analysis enhancing diagnostic accuracy. As life expectancy continues to rise, MRI's role in assessing cognitive impairment changes becomes increasingly vital in addressing the growing challenge of dementia.
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Co-morbidities are characterized by the presence of multiple chronic diseases within a single individual. They pose an escalating healthcare challenge and managing this growing burden, particularly with non-communicable diseases, has become a major concern. However, a significant impediment to effective management lies in medication nonadherence. The importance of medication adherence has long been a focus of healthcare literature, yet many comorbid patients tend to underestimate its significance, leading to health deterioration. Research studies indicate alarmingly low adherence rates in comorbid patients. To address this issue, patient education and healthcare campaigns have become essential tools in enhancing adherence. The research, which commenced on October 19, 2023, was initiated after an exhaustive review of existing academic literature. Multiple databases, such as PubMed, Web of Science, and Cochrane, were employed for this comprehensive literature review, utilizing a wide array of medical terminology combinations. The study aims to shed light on potential strategies and educational approaches to enhance medication adherence in comorbid patients. Findings from this research have the potential to influence healthcare policy, the design of tailored interventions, and overall healthcare delivery improvements for co-morbid patients, ultimately leading to enhanced health outcomes, reduced costs, and an improved quality of life.
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Screen time in young children is associated with emotional, behavioral, and sleep problems that impact children's growth and development. Data regarding television (TV) screen time among preschool-age children in Saudi Arabia are scarce. We aimed to assess the relationship between parents' sociodemographics, sedentary behaviors, and TV screen time among preschool-age children in Saudi Arabia. An online-based cross-sectional study using a previously validated survey was conducted through August and September 2021. Chi-square and binary linear logistic regression tests were used to examine the relationship between parents' sociodemographics and sedentary lifestyles with TV screen time among preschool-age children. Of 1269 parents who completed the survey, 1103 met the inclusion criteria. 761 (69%) were mothers, 1040 (94.3%) were married, 903 (81.9%) had at least a bachelor's degree, and 663 (57.7%) of the study participants' preschool-age children were not enrolled in any educational institution. 861 (78.1%) of preschool-age children watched TV for ? 1 hour daily. Children of university graduates and children who enrolled in full-time preschool programs were more likely to watch TV for ? 1 hour daily (OR 1.45, 95% CI 1.01–2.11, p=0.049; OR 2.22, 95% CI 1.45–3.41, p=0.001). Eating snacks while watching TV and leaving the TV on regardless of being watched or not are positively associated with TV screen time (OR 1.78, 95% CI 1.07–2.97, p=0.026; OR 1.41, 95% CI 1.29–1.54, p=0.001). This study showed significant TV screen time among preschool-age children in Saudi Arabia.
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Clear aligners have gained popularity in orthodontic treatment as a comfortable and aesthetically pleasing alternative to traditional braces. The use of clear aligners has increased due to their advantages, including improved aesthetics, easy removability, and minimal soft tissue irritation. The treatment process involves sequential aligners custom-made for each patient, using computer-aided design and manufacturing technology. Clear aligners employ controlled forces to gradually move teeth into proper alignment. However, clear aligners have limitations, such as the need for patient compliance and their effectiveness in addressing complex malocclusions. Clinical considerations include thorough assessment, regular follow-up visits, and patient education. Treatment outcomes vary depending on the specific malocclusion characteristics. Clear aligners have demonstrated benefits in treating mild malocclusions, spacing issues, and certain types of malocclusion corrections. Treatment duration may be shorter compared to fixed appliances in mild cases. Stability and periodontal health can be influenced by clear aligner therapy, which has effects on plaque levels and gingival inflammation. Root resorption is a concern, but aligners have shown a lower prevalence compared to fixed appliances. Compliance, eruption of permanent teeth, and limitations in visualizing hard and soft tissues are important considerations. Overall, clear aligners offer an aesthetic orthodontic treatment option for a variety of dental abnormalities and mild to moderate orthodontic issues.
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Open ankle fractures are uncommon (3-6%) among all ankle fractures. Emerging trends show that the incidence of low-energy open ankle fractures is prevalent in older women. The mechanism of open fracture management continues to pose difficulties for orthopaedic surgeons. A simple fall is responsible for just under half of all fractures caused by motor vehicle collisions (MVCs). Despite technological advancements and surgical methods, infectious and non-infectious rates remain problematic. The mainstay of care is to combine antibiotic therapy with thorough irrigation and debridement. To prevent additional soft tissue and vascular damage, these fractures must be stabilized immediately, preferably with an external fixator. When the residual infection has cleared and the soft tissue envelope is adequate, do a definitive open reduction and internal fixation, adapting the procedure to the patient and type of fracture. Functional outcomes could be enhanced by taking safeguards against preventable comorbidities to reduce postoperative complications.
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Vasopressors and inotropes are often administered to critically ill patients in intensive care unit for the management and treatment of haemodynamic impairment, heart failure, septic and cardiogenic shock, trauma among certain other diseases. In patients with shock, vasopressors and inotropes are used to induce vasoconstriction or enhance cardiac contractility. Vasopressors induces vasoconstriction, which causes systemic vascular resistance, leading to increase in mean arterial pressure and elevates organ perfusion. While inotropes raise cardiac output, which helps maintain mean arterial pressure and body perfusion. Due to a decreased risk of side effects compared to other catecholamine vasopressors, norepinephrine is considered a first-line vasopressor titrated to attain an optimal arterial pressure. An inotrope such as dobutamine may be given to raise cardiac output to a sufficient level to fulfil tissue demand if tissue and organ perfusion still is not enough. Due to their strengthening effect on cardiac contractility, inotropes have been utilized in the care of patients with heart failure for decades, particularly for patients with systolic dysfunction, or heart failure with reduced ejection fraction. Along with their beneficial inotropic impact, they also have chronotropic and peripheral vascular effects. For patients with severely reduced cardiac output and peripheral organ hypoperfusion, they are most frequently employed in intensive care unit. Along with their benefits they are also associated with certain considerate side-effects. The purpose of this research is to review the available information about role of inotropes and vasopressors therapy in the intensive care unit.
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Obesity and its associated comorbidities, such as diabetes mellitus, hypertension, and cardiovascular disease, are one of today's most pressing health issues and increasing incidence of obesity has marked it a global health challenge. For obese individuals with a high risk of morbidity and mortality who have not lost enough weight with lifestyle and medicinal care and who are experiencing the repercussions of obesity, bariatric surgery should be taken into consideration. Significant weight loss, the remission of coexisting diseases, and an improvement in quality of life are all possible outcomes of bariatric surgery. Laparoscopic procedures account for 96% of all bariatric procedures performed globally, with laparoscopic sleeve gastrectomy (LSG) being the most popular and prevalent. The current gold standard for bariatric surgery is LSG, since it is associated with significant complications such as gastroesophageal reflux disease hence a less invasive replacement for LSG was developed, which is endoscopic sleeve gastroplasty (ESG). In the past few years, ESG, a relatively new technique of endoscopic bariatric therapy, has become more well-known. Several multi-center studies have established the safety, viability, repeatability, and potential for reversibility of ESG. Although it is inferior to LSG in terms of percentage of total body weight loss (TBWL), but within a year of follow-up, it carries a reduced risk of unfavourable outcomes than other surgical procedures. The purpose of this research is to review the available information about advantages and disadvantages of ESG versus LSG.
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Background: The success of preventive measures against COVID-19 depends on the knowledge level and attitude among the public. This study aimed to assess the knowledge and adherence to preventive measures against COVID-19 among Alnakasah residents in Makkah. Methods: This is a cross-sectional study used a structured questionnaire. Data were collected from the residents of Alnakasah slum in Makkah. Responses related to the medical status, knowledge level, attitude, and barriers to preventive measures were analyzed. Results: The study indicated a low knowledge level among participants regarding the transmission mode. Fever and shortness of breath were the most common chosen symptoms with 60.8% and 34.1%, respectively. The current study also reported perceptions related to preventive measures including wearing facemasks 67.2% and vaccination 57%. The most common sources of information were family and friends 60.8%, followed by SMS and WhatsApp messages 41%. Conclusions: A relatively lower knowledge of the mode of transmission of COVID-19 was reported in the present study. However, a positive attitude toward preventive practices was exhibited in the findings. Good adherence to preventive measures was reported by the participants.
RESUMEN
Background: Antibiotic resistance of Acinetobacter baumannii causes various communicable diseases and increases the risks of admission to intensive care units [ICUs] with high morbidity and mortality rates
Objectives: Evaluating the efficacy of colistin usage guidelines and recommendations among critically ill patient infected by a multidrug-resistant Acinetobacter baumannii
Methods: An observational cross sectional study that was performed during the period from June to August 2017 among 127 critically ill patients who were treated with colistin for multidrug-resistant Acinetobacter baumannii using bacterial culture and proper identification methods. Evaluations of CRP, bacterial culture, BUN and serum creatinine level were routinely done pre- and post-treatment
Results: The method of administrating colistin was through intravenous infusion among all the patients and the most common indication of colistin usage were pneumonia followed by UTI. All the patients were susceptible to colistin and shown a negative bacterial cultures among most of the patients. The creatinine level was elevated [>2 mg/dL] showing nephrotoxicity among 11% of the patient. No allergic, neurological effects or mortality rates were observed in the study
Conclusion: The findings of the recent study revealed that colistin is the best therapeutic treatment for A. baumannii in KSA hospitals due to their broad-spectrum activity that may make them the most important choice for serious communicable and hospital acquired infections. Proper monitoring of the side-effects of colistin especially nephrotoxic effects through routine evaluation of creatinine level to detect the renal injury and adjusting the doses or combination of colistin low dose with other antibiotics