Saudi Med J
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To analyze predictors of death in elderly patients diagnosed with acute coronary syndrome (ACS). Methods: A record-based study carried out between January 2016 and January 2018 at The central province in Saudi Arabia. All elderly patients (greater than 75 years) with definite diagnosis of ACS were retrospectively included. Demographic data, echocardiographic, and angiographic parameters were reported. Results: A total of 179 patients were enrolled, 129 (72%) were male. ⋯ In addition we found that ejection fraction was lower in death group (30.2%±10.7) vs. (36.5%±1.1) in survivors, p=0.017); STEMI was more common in death group (90.5%) vs. (52.5%) in survivors, p=0.001); similarly, the prevalence of 3VD was higher in death group (38.1%) vs. (20.9%) in survivors, p=0.018). Importantly, PCI was not significantly different between death and survival groups (40% vs. 53.8%, p=0.177). A multivariate regression analysis demonstrated that predictors of death were: age (hazard ratio [HR], 1.214; 95% confidence interval [CI], 1.122-1.384; p less than 0.0001), intubation (HR, 10.106; 95% CI, 9.844-10.792; p less than 0.0001), and raised creatinine kinase-MB (CK-MB) (HR, 1.005; 95% CI, 1.002-1.013; p=0.04) predicted in hospital death. Conclusion: Older age, mechanical ventilation and raised CK-MB can significantly predict death in elderly patients (greater than 75-year-old) diagnosed with ACS; nevertheless, PCI showed no survival benefits.
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To examined the safety of schools, availability of school personnel to help in diabetes management, glycemic control, absenteeism, and differences in diabetes care between public and private schools. Methods: This cross-sectional study used an online platform to circulate surveys to parents of children with type 1 diabetes mellitus (T1DM) attending school or kindergarten in all regions of Saudi Arabia from February to May 2019. Results: The 411 questionnaires received were completed mostly by mothers (80.8%). Limited trained staff were found to be responsible for management of diabetes at school, and parents had relatively poor perceptions regarding the care of children with diabetes at school. Glucagon availability, trained staff, possibility of contacting a treating physician during school hours, a written plan for diabetes, and parents' confidence in schools all scored low and were significantly related to school type. Hemoglobin A1c (HbA1c) level was significantly related to insulin regimen. ⋯ Parents had poor perceptions regarding diabetes care at school. There was no or very limited availability of glucagon kits and trained staff for management of children with T1DM. This study suggests a need to improve the management of diabetes at schools.
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To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. ⋯ A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%). Conclusion: We found that the 24-hour on-call system negatively impacts residents' well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.
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To provide a comprehensive summary of brucellosis incidence, prevalence, risk associated factors, and impact on the Saudi population. ⋯ Brucellosis poses a considerable impact on human and has a higher prevalence in developing countries as compared to developed countries. Our results revealed that brucellosis is a risk factor for adverse reproductive outcomes.
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The Precice nail is used to treat limb length discrepancies and has a low complication rate and a high patient satisfaction rate. While the Precice nail can be used for lengthening, unlike other lengthening nails, it can also be used for shortening. ⋯ The distal interlocking screws were then reattached to continue lengthening. This surgical technique can be used safely and satisfactorily in cases with more shortness as we can correct the extremity length discrepancy using only one nail.