 The prevalence of PPI use in the UK general population is high and still increasing. The majority of patients only use PPIs short term, with only 26% using them longterm. Clear attempts to step down long-term use were identified in two fifths of the patients, so there remain further opportunities for reducing the cost and side effects of PPI use through improving adherence to recommended withdrawal strategies.

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Objective To examine the risk of community acquired pneumonia before and after prescription of proton pump inhibitor (PPI) and assess whether unmeasured confounding explains this association.Design Cohort study and self controlled case series.Setting Clinical Practice Research Datalink (1990 to 2013) in UK.Participants Adult patients with a new prescription for a PPI individually matched with controls.Main outcome measures Association of community acquired pneumonia with PPI prescription estimated by three methods: a multivariable Cox model comparing risk in PPI exposed patients with controls, corrected for potential confounders; a self controlled case series; and a prior event rate ratio (PERR) analysis over the 12 month periods before and after the first PPI prescription.Results 160 000 new PPI users were examined. The adjusted Cox regression showed a risk of community acquired pneumonia 1.67 (95% confidence interval 1.55 to 1.79) times higher for patients exposed to PPI than for controls. In the self controlled case series, among 48 451 PPI exposed patients with a record of community acquired pneumonia, the incidence rate ratio was 1.19 (95% confidence interval 1.14 to 1.25) in the 30 days after PPI prescription but was higher in the 30 days before a PPI prescription (1.92, 1.84 to 2.00). The Cox regressions for prior event rate ratio similarly showed a greater increase in community acquired pneumonia in the year before than the year after PPI prescription, such that the analysis showed a reduced relative risk of pneumonia associated with PPI use (prior event rate ratio 0.91, 95% confidence interval 0.83 to 0.99).Conclusion The association between the use of PPIs and risk of community acquired pneumonia is likely to be due entirely to confounding factors.

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Background Several studies reported that Inter-professional Education (IPE) plays a major role in creating an effective collaborating environment in healthcare settings to achieve high-quality patient care. This study measured the College of Applied Medical Sciences (CAMS) students’ readiness for and perceptions of IPE. Methods A cross-sectional study was conducted with 232 undergraduate students in Riyadh, using a stratified random sampling method. All the undergraduate students of CAMS were included. Two previously validated questionnaires, the Interdisciplinary Education Perception Scale (IEPS) and the Readiness for Interprofessional Learning Scale (RIPLS) were used in the study. Results The mean score for the RIPLS was 86.8. The Tukey post-hoc test score was significantly higher comparing the Occupational Therapy and the Respiratory Therapy programs. There was no difference between the overall RIPLS and subscales between male and female students as well as senior and junior students. For the IEPS, the mean score was 77.7. The Tukey post-hoc test score was significantly higher in the Occupational Therapy and Respiratory Therapy programs. Conclusion The current study indicated that the Applied Medical Sciences’ students demonstrated readiness for IPE as an important element in creating collaborative teamwork in their programs. The early incorporation of IPE in the pre-professional years will enhance collaboration in management and patient care.

Objectives: To estimate the survival of adult and pediatric patients receiving mechanical ventilation and determine the associated risk factors Methods: A retrospective cohort study was carried out in the intensive care unit (ICU) at King Abdulaziz Medical City (KAMC) and King Abdullah Children’s Specialist Hospital (KACSH), Riyadh, Saudi Arabia. The analysis includes data from medical records of all patients admitted to ICUs who received mechanical ventilation between 2016-2018. For each patient, potential risk factors were collected. The main outcome of this study was the mortality during the stay in ICU after receiving mechanical ventilation Results: A total of 262 adults and 175 pediatric patients were admitted to ICUs and received mechanical ventilation during the study period. For adult patients, the overall mortality was 37%, with a median survival time of 11 days (interquartile range [IQR] 6-20 days). The main risk factors independently associated with the increased mortality rate were being aged 51-60 (odds ratio [OR] 2.6, 95% confidence interval [CI] 6.7-1.0) and factors related to ICU admission. For the pediatric population, the mortality rate was 17%, with a median survival time of 16 days (IQR 7-37 days). Prematurity with respiratory problems was the main recorded cause of initiation of mechanical ventilation (50% of patients). Neonates who had mechanical ventilation within one month of their birth and were born extremely preterm had a high mortality rate after the initiation of mechanical ventilation. Conclusion: Both patient age and the causes of the initiation of mechanical ventilation were influencing the survival of patients who required mechanical ventilation.

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Introduction: Road traffic accidents (RTAs) are the leading cause of mortality and disability nationally and globally. There is a need to identify the age and gender distribution of individuals involved in nonfatal RTAs. Methods: This was a cross-section study using electronic trauma registry data from King Abdulaziz Medical City. We included all trauma registry patients older than 14 years, who were involved in a nonfatal RTA from 2015 to 2017. The data collected included patient demographic information (age and gender), injury mechanism, injury type, and severity. Results: In total, 1314 patients were included in the analysis. The majority of the sample (88%) was male, with a median age of 25 (interquartile range: 21–35) years. A higher proportion of the male group had severe injury scores. Gender was equally distributed in terms of head-and-neck injuries. The majority (66%) of the sample was admitted in a ward. The female group had a higher proportion (17%) of chest injuries. In terms of age, the 65-year and older group had more severe injuries to the head, neck, and chest. Conclusions: The findings of this study provide updated evidence regarding the age group most frequently involved in nonfatal RTAs. The evidence from this study supports the urgent need for developing prevention programs such as early awareness and education for young drivers and passengers of both genders.