Several species of ants cause stings, but not all lead to allergic reactions. We present a series of cases of allergic reactions following insect bites or stings that presented to our emergency department and that were caused by the black samsum ant (Pachycondyla sennaarensis). Reactions ranged from mild allergic reactions to severe anaphylactic shock. Patients were treated with subcutaneous epinephrine 0.3 mg, intravenous methylprednisolone 125 mg, intravenous diphenhydramine HCl 50 mg, and intravenous normal saline as appropriate. These cases illustrate the range of clinical presentations to black ant stings, which can include severe reactions, indicating that ant stings are a significant public health hazard in Saudi Arabia. Physicians in the Middle East and Asia need to be aware of ant stings as a cause of severe allergic reactions.
The initial emergency department motor score showed the highest predictive validity among all of the other components. These results suggest its validity for blunt trauma triage when compared with the GCS or RTS.
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Patient satisfaction with the healthcare services is critical to addressing the barriers to accessing healthcare. Many combined factors are responsible for the poor accessibilities to primary healthcare centers. Less availability of prescription drugs and less thoroughness of care are most frequently associated with high rates of patient dissatisfaction. The low satisfaction rates of patients need to be investigated further to promote prevention programs and increase utilization of healthcare services by patients. The purpose of this book chapter is to analyse the critical dimensions that influence patient satisfaction with primary healthcare services in six gulf countries.
Background:
Discharge against medical advice (DAMA) occurs when the patient or their caretaker leaves the hospital against the recommendation of their treating physician. DAMA may expose the children to a high risk of inadequate treatment, which may result in readmission, prolonged morbidity, and mortality. The study aimed to identify the predictors of DAMA in the emergency department (ED) within the pediatric age group.
Methods:
This was a cross-sectional study. The study used the medical records of pediatric patients (
n
= 5609) that were admitted to the ED of King Abdullah Bin Abdulaziz University Hospital (KAAUH) in Riyadh, Saudi Arabia, during 2017 and 2018. Descriptive statistics, Chi-square, or Fisher's exact test were used. Unadjusted and adjusted odds ratios with their 95% CI were reported by performing logistic regression modeling.
Results:
A significant interaction between age and gender was observed in the multivariate analysis after adjusting for the other covariates. The odds of DAMA for a 5-year-old female child were 4.43 times higher than those of a 5-year-old male child (
P
< 0.1).
Conclusions:
The public should be educated about the consequences of DAMA. Continued health education and the promotion of child survival strategies at the community level, combined with an improvement in the socioeconomic conditions of the population, may further reduce DAMA and improve the chances of survival for children. Future studies should assess the socioeconomic status of the patients and estimate the cost that is incurred by the patients.
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