Background: Severe community-acquired pneumonia (SCAP) represents a frequent and potentially life-threatening condition. About 10% of all hospitalized patients with CAP require admission to the intensive care unit (ICU), and the mortality of these patients reaches 20-50%.Objective: To evaluate the clinical presentation, bacteriological profile and outcome of severe community-acquired pneumonia (SCAP).Patients and methods: 54 patients presented by symptoms and sign of severe community acquired pneumonia who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital from August 2015 to March 2016 were subjected to full clinical examination, chest X ray, complete blood picture, sputum and blood culture, PCR for suspected cases of Influenza H1N1 and MERS-COV, treatment, follow up, data collections and statistical analysis.Results: The present study included 54 patients 26 males and 28 females with SCAP who were admitted to respiratory care unit of Alhussein, Al-Azhar University Hospital. The most common comorbidities were diabetes mellitus and hypertension. The most common presentations were fever, cough, dyspnea and hypoxemia. Two patients developed renal failure and 4 patients developed septic shock. The most common isolated organism was Streptococcus pneumoniae, Influenza H1N1, and Staphylococcus aureus. Mortality was 24% and it was common in patients with comorbidity than in patients without comorbidities.Conclusion: SCAP occurs more frequently in those with comorbidities. The most frequent isolated causative organism of SCAP is S. pneumoniae, Influenza H1N1 and S. aureus. SCAP is associated with significant mortality, early recognition and prompt treatment may improve outcome.
Background: The accurate diagnosis of pleural effusion is challenging because even after thoracocentesis and/or closed pleural biopsy, 25-40% of pleural effusion remains undiagnosed. Thoracoscopy is now considered the approach of choice for diagnosis of certain kinds of pleural diseases such as pleural mass, malignant pleural effusion with negative pleural fluid cytology, and in the diagnosis of pleural tuberculosis.Aim of study: To evaluate the diagnostic utility and safety of medical thoracoscopy in patients with undiagnosed exudative pleural effusion and pulmonary parenchyma lesions.Methods: This study was conducted on 44 patients, 21 males and 23 females with age ranging between 32 and 74 years (mean age 57.59 ± 7.1 years). There were 38 patients with undiagnosed exudative pleural effusion, 3 patients with multiloculated pleural effusion, 1 patient with undiagnosed pulmonary nodules and 2 patients with undiagnosed pulmonary parenchyma ground glass appearance and reticulation. There were 21 patients with co morbidities and 23 patients without co morbidities.
This study aimed at evaluating the usefulness of a structured patient counseling program on clinical outcomes of asthma patients in Saudi Arabia. This cross sectional study enrolled 10 asthma patients and all were evaluated for their baseline knowledge on asthma, quality of life, compliance, patient satisfaction and drug related problems among randomly selected 5 (of the total 10) patients. The median (IQR) age of the patients was 46 (33.5-56.2) years. The baseline knowledge scores was 9 (8-11), the maximum possible scores to be 21. Cronbach alpha of the KQ was 0.65. The overall total median (IQR) compliance (Morisky) score was 4 (3-5), the maximum possible score was 5. The patient satisfaction median (IQR) score was 35.5 (32-46.25), the maximum possible score was 70. Of the total patients 3 (30%) had a history of allergy. There were total 18 allergens observed in these patients. There has been no drug-drug or drug-food interactions observed between among the prescribed drugs of the patients. Altogether 2 patients reported a total of 2 ADRs. The knowledge of the asthma patients was found to be poor. Missing the dose was the most commonly encountered drug taking behavior. The compliance was found to be good and the patient satisfaction was average.
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