Saudi Med J
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To systemically review the evidence concerning the prevalence and reported risk factors of smoking among adolescents in Saudi Arabia. Methods: Following the PRISMA guidelines, studies that examined the prevalence and risk factors of smoking among adolescents in Saudi Arabia were identified through a computerized literature search using the following databases up to March 2018: PubMed, SCOPUS, Web of Science, and BIOSIS. The following search terms were used: smoking OR smok* OR tobacco OR cigar* OR shisha OR shesha OR sheesha AND Saudi Arabia OR KSA. Peer-reviewed articles published within the period from 2007 to 2018 were selected. Studies that reported prevalence data, patterns, and risk factors of smoking among adolescents were included. Extracted data from each study were tabulated, and data were narratively synthesized. ⋯ Thirty-two studies that reported the prevalence of smoking in the adolescent age group were included in the narrative evidence synthesis. These studies were conducted on secondary school students (n=11), college students (n=14), and an adolescent age group without educational specifications (n=7). According to published reports between 2007 and 2018, the prevalence of tobacco smoking among adolescents in Saudi Arabia ranged from 2.4% to 39.6%. Influence of friends, and family negligence were the most commonly reported risk factors for smoking. Conclusion: The prevalence of smoking is relatively high among adolescents in Saudi Arabia. The social influence of friends, teachers or parents, low academic performance, having spare time, living away from home, and the desire to relieve stress were the most commonly reported risk factors for smoking.
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To examine the androgen receptor (AR) status in colorectal cancer (CRC) patients by the immunohistochemical method and to correlate the findings with all available clinicopathological parameters of prognostic significance. ⋯ There is a complete lack of AR expression in normal colonic mucosa; however, AR was expressed in 16 cases (40%) of colorectal adenoma. In CRC, AR expression was high in 118 cases (36.4%). There were no significant correlations between AR expression and gender, age, tumor histologic type, and tumor location. However, AR expression revealed a significant correlation with tumor size (p=0.026), tumor differentiation (p=0.047), American Joint Committee on Cancer (AJCC) staging (p=0.043), lymph node positivity (p=0.018), lymphovascular invasion (p=0.018), and distant metastasis (p=0.049). In univariate Kaplan-Meier survival analysis, there was a significant (p=0.002) difference in overall survival between AR positive and negative tumors in favor of the latter. In multivariate (COX) models, high AR expression (p=0.002), AJCC (p less than 0.001), and lymphovascular invasion (p less than 0.001) were the only significant independent prognostic indicators of overall survival in CRC.Conlusion: Our study showed that the patients with higher AR expression had a significantly poorer survival rate, AR expression had the potential to be a prognostic marker of CRC.
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To determine the prevalence and risk factors for burnout in the intensive care units (ICU) staff in Turkey. Burnout is prevelant in physicians and nurses in the ICU worldwide. Most ICU workers with burnout plan to leave their professions. Frequent replacement of ICU staff increases cost and decreases the quality of care. Prevalence and risk factors of burnout in ICU staff in Turkey are largely unknown. ⋯ Burnout was detected in at least one subscale in 99% of participants and in all 3 subscales in 15% of the participants. Risk factors for emotional exhaustion included female gender (odds ratio [OR]=1.87 [95% CI: 1.26-2.78]; p less than 0.01), alternate-day shift (OR=3.93 [95% CI: 1.66-9.30]; p less than 0.01), and incidence of end of life care (OR=1.01 [95% CI: 1.00-1.03]; p less than 0.01). For depersonalization it included alternate-day shift (OR=2.22 [95% CI: 1.15-4.26]; p less than 0.05), incidence of end of life care (OR=1.02 [95% CI: 1.01-1.03]; p less than 0.01), and for reduced personal accomplishment it included incidence of end of life care (OR=0.97 [95% CI: 0.96-0.98]; p less than 0.01). Conclusion: The results indicated that ICU staff in Turkey had a high rate of burnout.
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Case Reports
Surgical repair of bilateral congenital diaphragmatic hernia associated with hepatopulmonary fusion.
Bilateral congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with high neonatal mortality. The condition is rarely associated with hepatopulmonary fusion (HPF). We reported the surgical repair of bilateral CDH in a male infant aged 6 weeks. ⋯ The medial portion was left intact to avoid injury of the anomalous pulmonary venous drainage. After 2 weeks, the patients had a surgical repair of the cardiac defects, and the postoperative course was complicated by bleeding and prolonged ventilation. No hernia recurrence was observed after 9 months.
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To investigated the diagnostic performance of circumpubertal eruption stages which identify skeletal maturity stages using the cervical vertebral maturation (CVM) method in a Saudi population. ⋯ In treatment planning for cases that require identifying the growth peak, the use of eruption stages is not recommended as an indicator of skeletal maturity except for the early permanent dentition stage where strong diagnostic performance for identifying post-pubertal skeletal growth stage has been shown.