RESUMO
Background: Upper gastrointestinal bleeding is the most common gastrointestinal cause of admission in emergency departments worldwide with about 10% inpatient mortality rate that has not decreased during the last three decades
Aim: In this review, we aim to study the pathophysiology behind the development of upper gastrointestinal bleeding, and explore the approach to its management in emergency situation
Materials and Methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: upper gastro intestinal bleeding, variceal bleeding, emergency management of gastrointestinal hemorrhage, varices, esophageal bleeding
Results: Managing patients with bleeding varices must have two goals that should be considered: to stop the bleeding, and to prevent rebleeding since 60% of patients will rebleed after the acute bleeding was stopped leading to a mortality rate of 33%, unless adequately treated
Conclusion: Bleeding varices are always considered urgent emergencies due to associated morbidity and mortality. Moreover, bleeding varices can cause hemodynamic instability and end-organ failure. The most important intervention is therapeutic endoscopy. Other approaches include vasoactive drugs, and prophylactic antibiotics. After acute management of the bleeding, patients should undergo further evaluation and treatment to prevent the recurrence of another bleeding
RESUMO
Mental illnesses or psychiatric disorders are very common worldwide although, a lot of patients might go undiagnosed and untreated due to the stigma towards mental illness that drives the patients away from seeking medical help
Aim of the work: this study aimed to evaluate the background and attitude of the general population throughout Saudi Arabia about mental illnesses
Method: a cross sectional study analyzed data from 5850 participants aged 18 and up. From all 13 districts of Saudi Arabia. The data were collected using self-administered anonymous electronically distributed questionnaire, between the months of April- May of 2017. The data were analyzed using the statistical analysis system [SAS version 9.1; SAS Institute, Cary, NC]. Crude associations were assessed using Pearson Chi -square test. P value of less than 0.05 was used to indicate statistically significant differences
Result: the mean age of the studied subjects was 28.7 +/- 9.8 years. Subject's background about the general nature of psychiatric disorders was high and exceeding 90% regarding the nature of psychiatric disorders and whether they were similar or not, a very low percent [7%] showed that psychiatric patients cannot socially adapt, while 96.9% believed that psychiatric patients were considered insane. [52%] believed psychiatrists are affected by their patients on long term exposure
Conclusion: he background of Saudi population regarding mental illnesses is considered fair, the attitude towards psychiatric patients need further education to minimize the stigma towards them