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1.
Clin Med Insights Case Rep ; 15: 11795476221088472, 2022.
Article in English | MEDLINE | ID: mdl-35342317

ABSTRACT

COVID-19 shares some features of giant-cell arteritis, in which the diagnosis needs a high suspicion for prompt investigation and therapy. When the diseases coexist this might lead to diagnosis delay with grave consequences. We reported a case of a post-COVID-19 giant cell arteritis and polymyalgia rheumatica with visual loss. We treated the patient with pulse methylprednisolone 1 gm daily for 3 consecutive days followed by 60 mg prednisolone for 4 weeks until normalization of ESR, and then, gradual withdrawal. Oral Paracetamol, vitamin-D3, and calcium carbonate were added to the treatment regimen. The headache continued, so, we started perineural injection therapy (PIT) once daily, for 6 sessions, at which the headache was completely resolved after the third injection. The vision was regained completely after the sixth injection.

2.
Cureus ; 13(3): e13750, 2021 Mar 07.
Article in English | MEDLINE | ID: mdl-33842127

ABSTRACT

INTRODUCTION: Atopic dermatitis (AD) is associated with various systemic diseases. However, its association with diabetes mellitus (DM) was discussed controversially. Few researchers reviewed the association of these two common morbid disorders. This meta-analysis aimed to assess the relationship between AD and DM. METHODS: We systematically searched PubMed including Epub and ahead of print (198 articles identified) and Cochrane (13 articles) databases. The searching engine was set to include case-control, prospective and retrospective cohorts, and cross-sectional studies from the first published up to February 12, 2021. Two hundred and eleven were identified, eighteen full texts were screened; of them, six were included in the final meta-analysis. The keywords used were AD, diabetes mellitus, type 1 diabetes, and type 2 diabetes. A datasheet was used to record the author's name, year of publication, country and type of the studies, number of events, and total number in the two arms (patients and controls). RESULTS: Out of the 211 references identified, six studies were pooled to test the association between diabetes mellitus and AD. The studies showed that AD is lower among patients with DM, odds ratio, 0.69, 95% CI, and 0.67-0.72. No heterogeneity was observed (Chi-Square, 4.12, degree of freedom (df.)= 5, and I2 = 0%, P-value), 0.53 and P-value for overall effect, <0.001. The included studies were published in Europe (five) and Canada (one study) and included 162,882 patients and 12,164 events, four of the studied articles were case-control studies, one retrospective, and one cross-sectional. CONCLUSION: AD was lower among patients with DM compared to their counterparts without the disease. Further studies focusing on the genetic and environmental factors linking AD and diabetes are needed.

3.
Middle East Afr J Ophthalmol ; 27(2): 105-109, 2020.
Article in English | MEDLINE | ID: mdl-32874043

ABSTRACT

PURPOSE: Retinopathy of prematurity (ROP) is becoming a leading cause of preventable blindness. The current study aimed to assess ROP and its risk factors in Tabuk City, Northern Kingdom of Saudi Arabia. METHODS: A retrospective study was conducted in King Khalid Hospital, Tabuk City, Saudi Arabia. The premature infants' records during the period of January 2016 to April 2018 were approached. One hundred and eight records were eligible; the infants' gestational age, weight, if received oxygen, surfactant use, blood transfusion, intraventricular hemorrhage, and patent ductus arteriosus were reported. Chi-square test was used to compare premature infants and their counterparts regarding various risk factors. P < 0.05 was considered statistically significant. RESULTS: Out of 108 premature infants, 33.3% had ROP (Many were sightthreatening [stages required treatment] and more than twothirds involving both eyes); a statistically significant difference (P < 0.05) was evident between infants with prematurity, and low birth weight. No significant differences were found regarding other risk factors (P > 0.05). Only 8.3% received interventional therapy. CONCLUSION: ROP is common in King Khalid Hospital, which is the referral tertiary hospital in Tabuk city, KSA . The low birth weight is a significant risk factor to develop ROP. Many of ROP cases were sightthreatening (cases that required treatment) and most cases involving both eyes. Treatment availability at Tabuk city is recommended, instead of referral to another centers especially among those with low weight at birth.


Subject(s)
Retinopathy of Prematurity/epidemiology , Birth Weight , Female , Gestational Age , Humans , Incidence , Infant , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Male , Retrospective Studies , Risk Factors , Saudi Arabia/epidemiology , Tertiary Care Centers/statistics & numerical data
4.
J Taibah Univ Med Sci ; 13(6): 557-563, 2018 Dec.
Article in English | MEDLINE | ID: mdl-31435378

ABSTRACT

OBJECTIVES: The date fruit has been shown to possess several health benefits. This study aims to determine the effects of date fruit consumption on the onset and progression of labour. METHODS: A randomised controlled clinical study was conducted on 89 participants to assess the effects of date fruit consumption on the onset and progression of labour. Twenty-six participants consumed date fruits alone, and 32 consumed date fruits followed by drinking of water. Thirty-one served as controls. RESULTS: There was a significant positive impact of consuming (rutab) date fruits on maternal outcomes in both the first and third stages of labour (p < 0.05 and p < 0.001, respectively). In addition, there was a significant relationship with the foetal well-being factors, such as healthy liquor, foetal heart rate, presence of caput, and Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score at 5 min (p < 0.05). The other maternal and foetal well-being factors showed no significant relationship with consumption of date fruits during labour. CONCLUSION: The present study showed a promising effect of (rutab) date fruit consumption on the duration of the stages of labour. No significant differences were observed between the date fruit consumers and their counterparts regarding cervical dilatation; rupture of membranes; strength, frequency, and regularity of uterine contractions; tocometric reports; and maternal progression factors. Additionally, the APGAR score at 5 min was better among the infants whose mothers consumed date fruits.

5.
Open Access Maced J Med Sci ; 5(2): 266-270, 2017 Apr 15.
Article in English | MEDLINE | ID: mdl-28507640

ABSTRACT

BACKGROUND: Methotrexate (MTX) is the most commonly used disease-modifying drug in the treatment of rheumatoid arthritis (RA); however, it causes many side effects, including pulmonary lesions. In this review, we characterised the histopathological features of MTX-induced pulmonary lesions in RA patients. AIM: We carried out an electronic search of the relevant literature published during the period from 1990 to 2016. We included only the cases with definitive histo-pathological findings caused by MTX therapy. MATERIAL AND METHODS: The total number of cases is 27. Male: female ratio was 1:3, and ages ranged from 48 to 87 years old, with a mean (SD) = 65.7 (1.0). The cases were originally from Asia (55%), Europe (41%), and America (4%). The major complications of methotrexate therapy were lymphoproliferative disorders (42%) followed by interstitial fibrosis (33), and infections (25%). The incidence of these complications significantly increases with the duration of MTX treatment (p = 0.044). Among the infections, the most common causative organism was pneumocystis jiroveci. The majority of patients who developed infections following methotrexate therapy were from Europe whereas the majority of those who developed lymphoproliferative disorders were from Asia (p = 0.003). CONCLUSION: In conclusion, methotrexate therapy in rheumatoid arthritis patients causes different types pulmonary complications.

6.
J Taibah Univ Med Sci ; 12(4): 298-303, 2017 Aug.
Article in English | MEDLINE | ID: mdl-31435255

ABSTRACT

OBJECTIVES: The link between diabetes control and depression is contradictory and inconsistent. Emotional distress is a single and continuous characteristic that has two primary components: content and severity. This finding could provide a link between major depression, diabetes distress, and depression symptoms. In the present study, we aimed to investigate the relationship between depression and diabetes distress and glycaemic control. METHODS: This cross-sectional descriptive study was conducted at a diabetes centre in Omdurman, Sudan, from June to August 2016. Eighty-nine patients with type 2 diabetes and 29 control subjects for psychopathology were interviewed using an English version of the structured 12-item diabetes distress general health questionnaire. Glycaemic control was assessed by measuring glycated haemoglobin in a blood sample drawn from each participant. RESULTS: Eighty-nine diabetic patients and 29 age- and sex-matched controls compose the study cohort. As many as 87.6% of diabetic patients scored >3 for diabetes distress, and psychopathology was reported in 78.8% of diabetic patients vs. 21.2% in control subjects. Emotional burden was most correlated among the components of diabetes distress followed by the physician-related domain. HbA1c level was related to the emotional burden and regimen-related domains of diabetes distress (P-value <0.05). No relationship was evident among other distress domains, psychopathology, or the duration of diabetes. CONCLUSION: Diabetes distress and depression are prevalent among Sudanese diabetic patients. Glycated haemoglobin level was related to the emotional burden of diabetes distress and the regimen-related domain but not to depression or diabetes duration.

7.
J Taibah Univ Med Sci ; 12(6): 512-516, 2017 Dec.
Article in English | MEDLINE | ID: mdl-31435287

ABSTRACT

OBJECTIVES: There is increasing awareness about the effects of circadian misalignment on health and work. In the present study, we aimed to investigate the effects of chronotype on academic achievement among medical students. METHODS: A cross-sectional comparative study was conducted among 140 medical students (64 who averaged an A grade and 76 who averaged a C grade) completing the clinical phase at the medical college of Omdurman University, Sudan. The participants were asked to sign a written informed consent and to keep a diary detailing their bedtime, wake-up time, sleep latency, and sleep duration during working days and weekends. Then, the participants were invited to respond to a questionnaire. The chronotype was calculated from the mid-sleep time during the weekend and sleep debt. Various sleep parameters were then compared between the two groups. A t-test and logistic regression analysis were used to test the statistical significance. RESULTS: The medical students with average grades were more of the evening chronotype than the students with excellent grades (p < 0.05). Significant differences were found between the two groups regarding weekend bedtime, wake-up time, and sleep duration. In addition, significant differences were evident for weekday bedtime, sleep latency, and wake-up lag between weekdays and weekends. No differences were observed between the two groups during weekday wake-up time and sleep duration, chronotype between gender, and bedtime delay between weekdays and weekends (p > 0.05). CONCLUSION: Students whose average grade was a C were more likely to have a later bedtimes during weekdays and weekends, sleep more during weekends, and were more evening.

8.
J Family Community Med ; 23(2): 100-4, 2016.
Article in English | MEDLINE | ID: mdl-27186156

ABSTRACT

BACKGROUND: Gender differences among patients with the acute coronary syndrome is still being debated, no research has been done on gender inequality among coronary syndrome patients in Sudan. OBJECTIVES: To study gender differences in presentation, management, and outcomes of acute coronary syndrome in Sudan. SUBJECTS AND METHODS: This cross-sectional descriptive longitudinal study was conducted in Omdurman Teaching Hospital between July 2014 and August 2015. Patients were invited to sign a written informed consent form, were interviewed and examined by a physician, and then followed during their hospital stay. Information collected includes coronary risk factors, vital signs, echocardiography findings, arrhythmias, heart failure, cardiogenic shock, and death. The Ethical Committee of Omdurman Teaching Hospital approved the research. RESULTS: A total of 197 consecutive acute coronary syndrome patients were included, 43.1% were females. A significant statistical difference was evident between males and females regarding the type of acute coronary syndrome, its presentation, and time of presentation to the hospital, smoking, and receipt of thrombolysis (P < 0.05). No differences were found with regard to age, hypertension, diabetes, family history of myocardial infarction, percutaneous coronary intervention, and in-hospital acute coronary complications (P > 0.05). CONCLUSION: Women were less likely to receive thrombolytic therapy, present with chest pain, and diagnosed with ST-segment elevation myocardial infarction. No gender differences were found in acute coronary syndrome risk factors apart from smoking, which was more common in males, and there were no differences between males and females as regards in-hospital complications.

9.
Br J Surg ; 101(7): 836-46, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24760705

ABSTRACT

BACKGROUND: The mechanisms that underlie the association between high surgical volume and improved outcomes remain uncertain. This study examined the impact of complications and failure to rescue patients from these complications on mortality following hepatic resection. METHODS: The Nationwide Inpatient Sample was used to identify patients who had liver surgery between 2000 and 2010. Hospital volume was stratified into tertiles (low, intermediate and high). Rates of major complications, failure to rescue and mortality following hepatic surgery were compared. RESULTS: Some 9874 patients were identified. The major complication rate was 19.6 per cent in low-volume, 19.3 per cent in intermediate-volume and 16.6 per cent in high-volume hospitals (P < 0.001). Most common major complications included respiratory insufficiency or failure (8.8 per cent), acute renal failure (4.2 per cent) and gastrointestinal bleeding (3.9 per cent), with each of these complications being less common in high-volume hospitals (P < 0.050). The incidence of major morbidity following hepatectomy remained the same over the past decade, but failure to rescue patients from these complications decreased (P = 0.011). The overall inpatient mortality rate following liver surgery was 3.2 per cent (3.8, 3.6 and 2.3 per cent for low-, intermediate- and high-volume hospitals respectively; P < 0.001). The rate of failure to rescue (death after a complication) was higher at low- and intermediate-volume hospitals (16.8 and 16.1 per cent respectively) compared with high-volume hospitals (11.8 per cent) (P = 0.032). After accounting for patient and hospital characteristics, patients treated at low-volume hospitals who had a complication were 40 per cent more likely to die than patients with a complication in a high-volume hospital (odds ratio 1.40, 95 per cent confidence interval 1.02 to 1.93). CONCLUSION: The risk of death following hepatic surgery is lower at high-volume hospitals. The reduction in mortality appears to be the result of both lower complication rates and a better ability in high-volume hospitals to rescue patients with major complications.


Subject(s)
Hepatectomy/mortality , Hospital Mortality , Hospitals, High-Volume/statistics & numerical data , Hospitals, Low-Volume/statistics & numerical data , Liver/surgery , Acute Kidney Injury/etiology , Aged , Female , Gastrointestinal Hemorrhage/etiology , Hepatectomy/adverse effects , Humans , Male , Middle Aged , Regression Analysis , Respiratory Insufficiency/etiology , Risk Factors , Salvage Therapy
10.
Br J Surg ; 100(5): 711-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23364914

ABSTRACT

BACKGROUND: Postoperative complications may have an adverse effect not only on short-term but also long-term outcome among patients having surgery for cancer. A retrospective series of patients who had surgery for colorectal liver metastases (CLM) was used to assess this association. METHODS: Patients who had surgery with curative intent for CLM from 2000 to 2009 were included. The impact of postoperative complications, patient characteristics, disease stage and treatment on long-term survival was analysed using multivariable Cox regression models. RESULTS: A total of 251 patients were included. The median age was 58 (interquartile range 51-68) years and there were 87 women (34.7 per cent). A minor or major postoperative complication developed in 41 and 14 patients respectively, and five patients (2.0 per cent) died after surgery. The 5-year recurrence-free (RFS) and overall survival rates were 19.5 and 41.9 per cent respectively. Multivariable analysis revealed that postoperative complications independently predicted shorter RFS (hazard ratio (HR) 2.36, 95 per cent confidence interval 1.56 to 3.58) and overall survival (HR 2.34, 1.46 to 3.74). Other independent predictors of shorter RFS and overall survival included lymph node metastasis, concomitant extrahepatic disease, a serum carcinoembryonic antigen level of at least 100 ng/dl, and the use of radiofrequency ablation (RFS only). The severity of complications also correlated with RFS (P = 0.006) and overall survival (P = 0.001). CONCLUSION: Postoperative complications were independently associated with decreased long-term survival after surgery for CLM with curative intent. The prevention and management of postoperative adverse events may be important oncologically.


Subject(s)
Colonic Neoplasms , Liver Neoplasms/mortality , Liver Neoplasms/surgery , Postoperative Complications/mortality , Rectal Neoplasms , Aged , Disease-Free Survival , Female , Humans , Liver Neoplasms/secondary , Male , Middle Aged , Multivariate Analysis , Neoplasm Recurrence, Local/mortality , Retrospective Studies , Treatment Outcome
11.
East Mediterr Health J ; 18(7): 707-11, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22891517

ABSTRACT

Stethoscope diaphragms are frequently colonized by bacteria. This cross-sectional study described the frequency and factors associated with reporting ever cleaning stethoscopes among 408 medical students and doctors at a medical college and 2 teaching hospitals in Rawalpindi, Pakistan. A minority of the respondents (37.7%) reported having ever cleaned their stethoscope. Following normal clinical use, wiping with a dry cloth was the most frequently reported method of cleaning (53.2%). After contamination of the diaphragm with blood or secretions, cleaning with an alcoholic swab was the most common method (64.3%). In univariate and multivariate analyses, history of receiving information on stethoscope cleaning, utilization of personal stethoscope at last use and affiliation with internal medicine department were factors strongly associated with ever cleaning of stethoscope. Future research for improving stethoscope cleaning practices should explore educational interventions aimed at health care professionals.


Subject(s)
Physicians , Stethoscopes/statistics & numerical data , Students, Medical , Cross-Sectional Studies , Disinfection/statistics & numerical data , Equipment Contamination/prevention & control , Equipment Contamination/statistics & numerical data , Female , Humans , Infection Control , Male , Pakistan , Surveys and Questionnaires
12.
(East. Mediterr. health j).
in English | WHO IRIS | ID: who-118172

ABSTRACT

Stethoscope diaphragms are frequently colonized by bacteria. This cross-sectional study described the frequency and factors associated with reporting ever cleaning stethoscopes among 408 medical students and doctors at a medical college and 2 teaching hospitals in Rawalpindi, Pakistan. A minority of the respondents [37.7%] reported having ever cleaned their stethoscope. Following normal clinical use, wiping with a dry cloth was the most frequently reported method of cleaning [53.2%]. After contamination of the diaphragm with blood or secretions, cleaning with an alcoholic swab was the most common method [64.3%]. In univariate and multivariate analyses, history of receiving information on stethoscope cleaning, utilization of personal stethoscope at last use and affiliation with internal medicine department were factors strongly associated with ever cleaning of stethoscope. Future research for improving stethoscope cleaning practices should explore educational interventions aimed at health care professionals

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