Saudi Med J
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To assess the acceptance among the developing country urban paramedics towards pre-hospital continuous positive airway pressure (CPAP) ventilation. ⋯ Developing country urban ambulance paramedics possessed adequate knowledge, positive attitudes, and demonstrated good CPAP application skills. However, lack of confidence towards decision to initiate and troubleshoot of potential complications were the main obstacles hindering its use.
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To determine the percentage of deaths in the pediatric intensive care unit (PICU) attributed to do not resuscitate (DNR) orders, and to compare our DNR practice with the international experience. ⋯ The DNR is the most common cause of death in the PICU in tertiary hospitals in Saudi Arabia. To minimize the suffering of the dying child, life support limitation should be considered for children with terminal or untreatable diseases with low chances of survival.
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To determine factors affecting smoking cessation success in different age groups. ⋯ Different variables in different age groups may affect successful smoking cessation. These should be taken into consideration in efforts at smoking cessation.
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Case Reports
Hemobilia due to liver abscess. A rare cause of massive upper gastrointestinal bleeding.
Massive hemobilia is a rare complication of liver abscess. A 48-year-old male presented with massive hemobilia due to liver abscess. He had been complaining of right upper quadrant abdominal pain, fever, and jaundice for 10 days. ⋯ Drainage of the large liver abscesses was achieved under ultrasound guidance. Diagnostic modalities and management of hemobilia are discussed along with a review of the literature. A high index of suspicion, and the use of appropriate diagnostic tools can help diagnose and treat this rare cause of upper gastrointestinal bleeding.
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Adefovir dipivoxil (ADV) at a low-dose (10 mg daily), which was previously considered not nephrotoxic, was reported to have induced acquired Fanconi syndrome (FS). We report one 64-year-old Chinese woman and 2 Chinese men (ages 45 and 63 years) with bone pain, and/or muscle weakness on ADV therapy were diagnosed with low-dose ADV-induced FS. ⋯ Regular monitoring of urine and serum phosphate is necessary during therapy with ADV. Prognosis was favorable, however, tenofovir is not a suitable replacement for ADV.