Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea, with no effect on respiratory illnesses. These effects were more prominent with L reuteri, which was also the only supplement to improve additional morbidity parameters.

The use of formula supplemented with either Lactobacillus reuteri or Bifidobacterium lactis in early infancy, was safe, well tolerated and did not adversely affect growth, stooling habits or infant behavior.

Background/Aims: Colorectal cancer (CRC) is the most frequent cancer and a leading cause of cancer death in the Kingdom of Saudi Arabia (KSA). To date, no nationwide screening programs have been adopted. This prospective, longitudinal study investigated factors influencing the outcome of CRC in Saudi patients. Methods: Patients completed a CRC awareness questionnaire. Colonoscopy, CT/MRI, histopathology of tumor biopsies, and KRAS and BRAF testing were performed. Patients were treated according to their stage. All patients were followed until the end of the study and 3- and 5-year survival was assessed. Results: Sixty percent of study patients with sporadic CRC presented with significantly advanced disease (stages III and IV) with or without metastases at entry. Patients showed low levels of awareness of the risk factors and signs of CRC. Patients presented at a median age of 50 years. Family history of CRC and ulcerative colitis were positive in 11 and 6% of patients, respectively. Stage III/IV tumors with distant metastases at enrollment, right-sided tumors, mucinous tumors, lymphovascular invasion, and KRAS (51%) or BRAF (28%) mutations predicted poor prognosis and survival. Conclusion: CRC in KSA is usually diagnosed at advanced stages with metastases and KRAS/BRAF, and is associated with poor prognosis and short survival. Nationwide awareness campaigns and screening programs for CRC are critical for prevention, early detection and adequate management of CRC.

Although alcohol and/or substance use disorders have been significantly associated with depression, data on the treatment outcomes of depression in this patient population are still scarce, especially among the higher risk of resistance to treatment. This study examines the management outcomes of depression in patients with alcohol and substance dependence during the last decade by searching the medical literature. The literature was searched through Medline, PsycInfo, Embase, and Ovid database from 2010 to 2020. Searching terms included were a combination of ‘’treatment’’ AND ‘’Depression’’ AND ‘’alcohol’’ OR “substance abuse". A total of 617 articles were retrieved. After this, original articles investigating depression treatment outcomes in patients with alcohol or substance use disorders or both were selected. Following the exclusion of review studies and including only original research studies, 23 articles appeared. We selected eight articles as eligible, covering a total of 132,373 patients with depression and either alcohol dependence or substance use disorder. Anti-depressants (mainly selective serotonin reuptake inhibitors) combined with psychotherapy and alcohol or substance abuse treatment represent the best treatment modality for depression in this clinical setting. In conclusion, patients with alcohol or substance dependence usually suffer from treatment-resistant depression. However, the treatment of depressive symptoms would help in substance or alcohol abstinence and reduce recurrent substance abuse.

Background: Delivery bleeding is still a major catastrophe that facing most of obstetricians, leading to global maternal exhaustion and fatality. So estimation of the blood loss and the changes occurring during the procedure are important in the management of the bleeding. Aim of the study: : Comparing loss of blood during Cesarean Delivery, Intra and post-operative in parturients, injected by Oxytocin versus Tranexamic acid with Ethamsylate. Patients and Methods: Blinded randomized controlled trial, whereas 200 of Gravid women shared and equally distributed to double collections, each collection includes 100 of women and Each of them is injected with Syntocinon 5 IU infusion on 500 cc saline 0.9%, at rate of 100cm/hour Or Tranexamic acid with Ethamsylate, 5 to 10 min IV slowly before the abdominal delivery, with evaluation of the bleeding amount.Results: Blood loss amount, participants requiring for blood transfer OR more intervention, were minimal in the tranexamic acid and ethamsylate collection than in the oxytocin collection. Moreover the results of hemoglobin and hematocrit postoperatively were elevated in the participants who injected by both tranexamic acid and ethamsylate comparing with the participants who injected by the Syntocinon. Conclusion:The Evaluated variables with the positive and negative results of the research medications, demonstrated the following: Both Tranexamic acid and Ethamsylate could be effective than Oxytocin in minimizing the demand for blood transfer, with the stability of both hematologic profile and the hemodynamics. And both too, appear to be safe and efficient option in the management of the abdominal delivery.

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Background: Neonatal respiratory distress syndrome (RDS) is a common and challenging neonatal morbidity.Reliable prediction of the condition can improve management. Fetal pulmonary artery (PA) Doppler indices were suggested for prediction. However, the findings of different studies are conflicting. Aim of the work:The present study aimed to assess the value of PA indices in the prediction of neonatal RDS in term babies. Subjects and methods:This prospective study included 120 women with singleton term pregnancy. Assessed Doppler indices for the main pulmonary artery included pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV), and the At/Et ratio. Upon delivery, the newborn babies were examined for RDS signs (tachypnea, retractions, and/or nasal flaring).Results: Among the 120 delivered babies, there were 16 (13.3 %) with RDS. Comparison between neonates with RDS and neonates without showed significantly lower neonatal weight, higher pulmonary artery RI and PI, higher pulmonary artery PSV in neonates with RSD. Also, they had a significantly lower pulmonary artery at/et ratio when compared with normal babies. The pulmonary artery at/et ratio showed the best performance compared to other indices (sensitivity: 100.0 %, specificity: 50.0 %) at a cut-off (0.32). Conclusions:The present study documented reliable predictive value of PA hemodynamic parameters including RI, PI, PSV, and at/et ratio in predicting neonatal RDS in term babies.

Background and Objectives: Obstructive sleep apnea (OSA) is a sleep-related respiratory disorder that affects between 5% and 20% of the population. In obstructive sleep apnea, lingual tonsillar hypertrophy (LTH) has been suggested as a contributing factor to airway blockage. Objectives: The aim of this work is to demonstrate the polysomnographic indices and their values in OSA patients with LTH before and after the surgical intervention. Materials and Methods: The study was conducted on eighteen patients endoscopically diagnosed as having LTH, with the main complaints being snoring, sleep apnea, and/or sleep disturbance. Clinical examination, grading of LTH, body mass index (BMI), endoscopic assessment using Muller’s maneuver, and sleep endoscopy were recorded for all patients. The Epworth Sleepiness Scale (ESS) and overnight sleep polysomnography (PSG) were conducted before and after the surgical removal of LTH. All data were submitted for statistical analysis. Results: The mean ± SD of the AHI decreased from 33.89 ± 26.8 to 20.9 ± 19.14 postoperatively, and this decrease was of insignificant statistical value. The average SpO2 (%) mean ± SD was 91.14 ± 5.96, while the mean ± SD of the desaturation index was 34.64 ± 34.2. Following surgery, these indices changed to 96.5 ± 1.47 and 9.36 ± 7.58, respectively. The mean ± SD of the ESS was changed after the surgery, from 17.27 ± 6.48 to 7.16 ± 3.56. The mean ± SD of sleep efficacy was 71.2 ± 16.8 and the snoring index mean ± SD was 277.6 ± 192.37, and both improved postoperatively, to become 88.17 ± 9.1 and 62.167 ± 40.01, respectively. Conclusions: The AHI after lingual tonsillectomy showed no statistically significant change. The changes in the average SpO2 (%), desaturation index, sleep efficiency, snoring index, and Epworth Sleepiness Scale following the surgery were statistically significant.