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BACKGROUND Pneumonia, the commonest lower respiratory tract infection, can result in respiratory and non-respiratory complications. Few studies have reported on the prevalence of many complications. OBJECTIVES Identify the prevalence of 18 complications of pneumonia and compare complication rates by age group and type of pneumonia. Identify most prevalent comorbidities, the effect of the number of comorbidities on the presence of complications, and the association between specific comorbidities and specific complications. DESIGN Retrospective, cross-sectional prevalence study. SETTING Tertiary care center in Riyadh. PATIENTS AND METHODS The target population were patients aged 17 years and older, of different nationalities and both genders, diagnosed with pneumonia during the period of 2010 to 2017. Selection was by stratified sampling by year of admission. MAIN OUTCOME MEASURES Complications of pneumonia. SAMPLE SIZE 800. RESULTS Complications were observed in 427 patients (53.4%). The complications were respiratory in 258 patients (32%), sepsis and septic shock in 186 (23%), cardiac in 125 (16%), neurological in 5 (0.6%), and cholestatic jaundice in 2 (0.3%). Pleural effusion was the commonest complication, observed in 230 patients. There was a significant difference ( P <.001) between the complication rates in older patients compared to younger (60% as compared to 41%). For the type of pneumonia, there was a significant difference ( P <.001) between community-acquired pneumonia and hospital-acquired pneumonia in the presence of complications (OR=2.41, 95% CI for OR=1.66, 3.49). The number of comorbidities was significantly associated with the presence of complications ( P =.001) for those with multiple comorbidities (46% for patients with no comorbid illnesses versus 68% in patients with three or more comorbidities). CONCLUSION These results suggest that Saudi Arabia needs to establish better prevention and intervention programs, especially for the high-risk groups identified in this study: older patients, patients with hospital-acquired pneumonia and patients with two or more comorbidities. LIMITATIONS Retrospective design and single-centered.

BACKGROUND: Successful evaluation of a patient with stridor requires a thorough history and physical examination followed by a flexible fiberoptic laryngoscopy (FFL), which provides visualization of the upper airway. OBJECTIVES: Estimate the prevalence of causes of stridor in children who underwent FFL and compare different age groups. Find any significant associations between symptoms and laryngoscopic findings. Identify patients who needed further evaluation using direct laryngobronchoscopy (DLB). DESIGN: Retrospective, cross-sectional. SETTING: Tertiary care center in Riyadh. PATIENTS AND METHODS: We included all pediatric patients aged 1 month to 14 years who underwent fiberoptic laryngoscopy for stridor evaluation from January 2015 to January 2018 (37 months). Patients older than the age of 14 years, and patients with a workable diagnosis with adenotonsillar hypertrophy, choanal atresia, or laryngotracheo-bronchitis (croup) were excluded. MAIN OUTCOME MEASURES: Findings of FFL. SAMPLE SIZE: 217 pediatric patients. RESULTS: The median (interquartile range) age of the patients was 5 (8) months. Laryngomalacia was the most common diagnosis (n=149, 69%) followed by laryngopharyngeal reflux (n=42, 19%). Subglottic stenosis was the most common finding in patients who underwent DLB for further evaluation (n=19, 49%). Laryngomalacia was more frequent in children ≤12 months of age (83% vs 43% in children >12 months, P <.001). Vocal cord paralysis was more common in children >12 months of age (27% vs 9%, P <.001). FFL was effective in finding the diagnosis in 178 (82%) patients; only 39 (18%) patients needed further assessment using DLB. CONCLUSION: FFL is an effective and important tool for evaluating patients with stridor. LIMITATIONS: Retrospective design and single-centered. CONFLICTS OF INTEREST: None.

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Objective: This study was undertaken to screen the epidemiology of hepatitis B virus (HBV) in ethnically distinct, tribal dominated and of lower socioeconomic status area.Methods: Briefly, 3 ml blood was collected from 50 random liver disease cases with jaundice, receiving care at Central Hospital, N.F. Railway, Guwahati, and Guwahati Medical College, with informed consent. The patients detected with hepatitis A virus (HAV)-immunoglobulin M positive status were included and were stratified as acute viral hepatitis and fulminant hepatitis failure based on the clinical profile. HAV genotyping was studied by polymerase chain reaction-direct sequencing-phylogenetic analysis approach. Statistical analysis was performed using SPSS 13.0 software. Result:A total of 50 cases were HBV infected. HBV infection was predominant in the young and adult age group. HBV-RNA was detected in 19 cases. Conclusion:This study shows that HBV genotype D is most commonly found hepatitis in all tribes of Assam and poor sanitation and alcohol consumption are a common reason for its widespread.