Refractory Hypokalemia in Secretory Diarrhea Phenotype of Colonic Pseudo-Obstruction (Ogilvie's Syndrome).

Colonic pseudo-obstruction is an acute non-obstructive colonic dilation associated with constipation or secretory diarrhea. The secretory diarrhea phenotype is associated with refractory hypokalemia that may require different interventions to treat. We present a case of a 51-year-old male who was admitted with a hemorrhagic stroke whose hospital course was complicated by severe abdominal distension, diarrhea, and hypokalemia. Initial investigations excluded infectious causes. Imaging confirmed colonic pseudo-obstruction. The hypokalemia was severe and refractory, requiring daily potassium replacement along with rectal tube decompression and spironolactone. Despite these interventions, the hypokalemia persists and requires nearly 100 days to resolve completely.

Physicians' and nurses' perceptions and attitudes toward sickle cell disease patients in Jazan, Saudi Arabia.

OBJECTIVES: To explore physicians' and nurses' perceptions and attitudes toward sickle cell patients in Jazan, Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional study conducted in Jazan, KSA from November 2018 to March 2019. A convenience sample of nurses and physicians (N=244) from 12 hospitals in Jazan region completed the general perceptions about sickle cell disease patients scale questionnaire. Inferential statistics were conducted as appropriate to compare attitudes among groups within all variables. A p less than 0.05 was considered significant. RESULTS: The response rate was 81%. The mean age was 33.73±7.89 years. Approximately, half of the participants were nurses (54.9%) and 40.8% were males. In comparison with physicians (39.6%), approximately two-thirds (65.7%) of nurses have more negative attitudes (p=0.000). Emergency healthcare providers have more negative attitudes than providers in the pediatric department (p=0.043). Those treating primarily children had higher positive attitude than those treating adults (p=0.013) or treating both, (p=0.017). Emergency providers (p=0.000), and internal medicine providers (p=0.001), had higher concern-raising behaviors' scale scores than pediatric providers. CONCLUSION: Findings highlight a significant proportion of providers in Jazan region, KSA, to have negative attitudes toward and high concerns about drug-seeking behaviors among sickle cell patients. These attitudes can contribute to lower quality of care for people with sickle cell disease. Further studies are recommended to nd out the factors behind these attitudes as well as the adherence to guidelines in the management of sickle cell disease.

Knowledge and attitude towards hematopoietic stem cell transplantation among medical students at Jazan University, Saudi Arabia.

OBJECTIVES: To identify the knowledge and attitudes of medical students at Jazan University towards hematopoietic stem cell transplantation (HSCT). Methods: This cross-sectional study involved all medical students at the Faculty of Medicine, Jazan University, Jazan, Saudi Arabia, between October 2018 and February 2019. Data were collected using a questionnaire that has been  used in a previous study conducted at Mayo Medical School, Minnesota, USA. Results: Out of 800 students, 744 completed the questionnaire (the response rate was 93%). Sixty-seven students (9%) were already registered in the Saudi stem cell donor registry (SSCDR). The participants' knowledge on donor eligibility was 37.4% and the donation process was 23.6%. Registered students were more likely to join the registry if there was a drive in their area (n=65 [97%], p=0.000), and more likely to donate stem cells to any matched patient (n=58 [86.6%], p=0.000). The main concern of the participants was the long-term side effects (48%). Conclusion: Most students lack the knowledge on HSCT. However, the students who registered in SSCDR had better knowledge and attitudes towards HSCT than the unregistered. Long-term side effects of HSCT were the most common concern of the participants. However, time commitment was the major concern of the registered students.