Vaccination against SARS-COV-2 is considered an effective preventive strategy to halt COVID-19 pandemic. Reports of thromboembolic events in vaccine recipients has jolted some of the European countries to pause the vaccination process temporarily. It is still unclear whether the events are actually due to the vaccines or it is just a coincidence. The gravity of events particularly in young and previously normal patients merits further research to reach some conclusion. Here we present a similar case who sustained ischemic stroke shortly after receiving the first dose of his vaccine.
Purpose: The antimicrobial prescription in urinary tract infections (UTI) is driven by local data on its pathogenic spectrum and the resistance pattern exhibited by the disease-causing pathogens. We aimed to determine the bacteriological diversity of UTI causing pathogens and antimicrobial resistance in mostly gram-negative bacteria. Methods: This retrospective hospital-based cross-sectional study analyzed the culture and sensitivity reports of urine samples from a referral centre of Aljouf region of Saudi Arabia. All the antibiograms from January 1, 2020, to December 31st 2020 were included. The bacterial identification and antimicrobial testing were carried out by the BD Phoenix system (BD Diagnostics, Sparks, MD, USA). Antimicrobial testing was performed as per the Clinical and Laboratory Standard Institute recommendations. Frequencies of multidrug- and extensively drug-resistance were calculated. Results: Of the 1334 non-duplicate urine samples received, 422 (31.6%) bacterial growths were observed. Of these, 383 (90.8%) and 39 (9.2%) were gram-negative and gram-positive bacterial isolations, respectively. E. coli 161 (38.1%), K. pneumoniae 97 (23.0%), and E. faecalis 18 (4.3%) were frequent aetiologies of UTI. 309 (80.7%) of gram-negative bacteria were multidrug-resistant including 88 (23.0%) extensively drug-resistant. Overall, a resistance rate of > 55 % to 1st through 4th generation cephalosporins was observed except for cefoxitin (43.7%). A resistance rate of 37.6% was observed towards carbapenems with the lowest rate (34.0%) to meropenem. Conclusion: Multi-drug resistant gram-negative bacteria dominate the pathogenic spectrum of UTI in the region. A high resistance rate to cephalosporins and carbapenems exist in gram-negative organisms causing UTI.
Background Obesity is a risk factor that leads to many chronic diseases and, unfortunately, its prevalence in Saudi Arabia is on the rise. To successfully manage obesity and its complications, patient must be accurately diagnosed. This study aims to investigate the diagnostic accuracy of body mass index (BMI) when diagnosing obesity within the Saudi population using body fat percentage (BF%) as the gold standard. Materials and Methods This is a cross-sectional study that includes a calculated sample size of 942 subjects. Subjects were recruited from family medicine clinics that were linked to King Faisal Specialist Hospital and Research Centre (KFSH&RC) in Riyadh, Saudi Arabia from January 2005 to March 2016. BF% was estimated using DEXA scan. The diagnostic accuracy of BMI was assessed by using the WHO and the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) reference standard for obesity of BF% >25% in men and >35% for women. Results Findings indicate, out of the study population, 29% of men and 53% of women are obese using BMI-defined obesity cut-off point 30 kg/m 2 . The prevalence of obesity was 83.9% and 97.3% in men and women, respectively, using BF%-defined obesity, which corresponds to BMI cut-off of 24 kg/m 2 . Even when considering the highest acceptable BF% based on the mean age of our participants (33% for men and 43% for women), the BMI cut-off to diagnose obesity should not exceed 27 kg/m 2 among men and women in Saudi Arabia. Conclusion The accuracy of BMI 30 kg/m 2 to diagnose obesity among the Saudi population is limited. We have to lower the BMI cut-off point to improve its sensitivity as a screening tool for obesity. Our study suggests that the BMI cut-off point among Saudis and possibly the Arab population should not exceed 27 kg/m 2 for both sexes.
Introduction: Rheumatoid Arthritis (RA) is a chronic disease and a substantial proportion of patients continue to suffer from chronic pain and disability despite standard pharmacotherapy. A substantial proportion of patients with RA also develop anxiety and depressive symptoms. Positive Emotion Induction (PEI) has been shown to reduce pain symptoms. Aim: To know the effect of positive emotion induction as an adjunctive intervention on RA associated pain and disability. Materials and Methods: The longitudinal hospital based study was conducted at the Outpatient Department of Rheumatology and Psychiatry, Jagadguru Sri Shivarathreeshwara Hospital, Mysuru, Karnataka, India, from January 2018 to June 2019, included 85 consecutive participants with RA were recruited and assessed at baseline with Health Assessment Questionnaire scale {HAQ-DI and Visual Analog Scale (VAS)}, Hamilton Anxiety Scale (HAM-A), and Hamilton Depression Scale (HAM-D). Six session of PEI was done using recreating pleasant memory and the same was practiced at home daily by the patient. All participants were reassessed with the same parameter after three months. Paired sample t-test was done to know the change in the score pre and post test on the score of HAQ-DI and VAS, HAM-A, HAM-D. The value of statistical significance was p-value ≤0.05. Results: The majority of the participants belonged to 40-50 years of age, were married, females, studied to middle school, of low socio-economic status, had a nuclear family. The majority had duration of RA been two to four years, with severe illness and were on regular medication. Statistically significant difference was observed in pre and post test on the score of HAQ-VAS (t=8.23, p<0.05), HAM-A (t=11.40, p<0.05) and HAM-D (t=10.95, p<0.05). Conclusion: Brief psychological intervention (PEI) may be a useful adjunct intervention in patients with RA. Further study is needed to explore the clinical use of the PEI for intervention in RA.
Background: The patient’s understanding of the illness may mediate beliefs towards its treatment. There is a paucity of studies examining the relationships between these variables in depression. This study was conducted to know the relationships between explanatory models and attitude to medication in depression. Materials and Methods: 494 patients with depression in remission were assessed with sociodemographic proforma, Drug Attitude Inventory, and Mental Distress Explanatory Model Questionnaire. Results: A favorable attitude toward medication was observed in 57.49% of participants. Mean scores on MDEMQ subscales Stress, Western Physiology, Non-Western Physiology, and Supernatural were 32.96, 21.87, 10.06, and 47.55, respectively. Statistically significant associations were found between attitude towards medication and the patient’s marital status (more negative attitude with single status, χ2 = 11.72, df = 3, P = 0.008) and occupation (more negative attitude among unemployed patients, χ2 = 4.17, df = 1, P = 0.041). The scores of explanatory models did not differ based on positive or negative drug attitude. Conclusion: Though explanatory models are not linked to patient attitudes toward medication, patients who are single or unemployed have a negative attitude toward medications. Such negative attitude may impair compliance and worsen patient outcomes.
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