RESUMO
Nonaccidental injuries (NAI) in pediatric primary care in the Gulf Cooperation Council (GCC) region refer to intentional injuries inflicted on children, usually by a caregiver or a family member. The region has seen an increase in nonaccidental injuries in recent years, and healthcare providers have a crucial role in identifying and managing the cases. The aim of research on nonaccidental injuries in pediatric primary care in the GCC region is to identify objective assessment tools and evaluate trends in the region. PubMed, Google Scholar, and EMBASE databases were searched using search string keywords. The search was conducted on 7th February 2023. The keywords included in the search included the search terms: nonaccidental injuries, pediatric, and GCC. All the studies were published between 1990 and 2023. The articles that passed the eligibility criteria were read fully to examine whether they would be relevant to the current systematic literature review. An initial search identified 3059 studies (Google Scholar = 6, EMBASE =12, PubMed = 4732). After the deletion of similar articles, only 3613 articles were left for further screening. The abstracts and titles of the left articles were scanned and screened to decide whether they were included in this systematic review. After deletion, 16 papers were inspected and read fully based on predefined eligibility criteria. Eventually, 11 papers were recognized and identified that passed the eligibility criteria of this systematic review. The studies reviewed in this analysis highlight the significant problem of child abuse in the GCC region, particularly neglect as the most common form of abuse. The studies also suggest that parents are the most frequent perpetrators of abuse. The need for policies and interventions to prevent child abuse and support victims is paramount.
RESUMO
PURPOSE: The prevalence of metabolic syndrome (MetS) increases in parallel with the increasing incidence of obesity. Hence, bariatric surgery is potentially curative in obese patients with MetS. We aim to measure the effect of bariatric surgery as well as the potential factors leading to MetS resolution in the Saudi population. METHODS: A retrospective review of three tertiary care centers in Saudi Arabia was done. We identified 386 patients who have MetS and underwent bariatric surgery during the period between January 2016 and December 2018. After exclusion of patients with insufficient follow-up, data from 275 patients was analyzed. MetS diagnosis, persistence, and resolution were determined using the International Diabetes Federation consensus worldwide definition. RESULTS: MetS resolution was achieved in 78%, 79%, 73%, and 82% at 1, 2, 3, and 4 years after bariatric surgery, respectively. Accumulatively, 80% achieved MetS resolution with an average follow-up period of two and a half years. Patients who experienced resolution had younger age, lower BMI, lower systolic blood pressure, lower triglycerides, lower fasting plasma glucose, and lower HbA1c preoperatively in addition to a higher percentage of excess weight loss after bariatric surgery when compared to those who had persistence of MetS. CONCLUSION: More than three fourths of patients with MetS achieved resolution after bariatric surgery. Certain patient characteristics, such as young age and higher excess weight loss postoperatively, were associated with a higher chance of MetS resolution.
