Objectives: To assess the correlation of different obstetrical factors with the hemoglobin level in multiparous pregnant females in Taif KSA. Anemia in pregnancy is a multifactorial phenomenon, among which obstetrical factors like parity, previous H/O abortions, inter pregnancy interval, mode of delivery etc are frequently associated. Study Design: Observational study. Setting: Outpatient department in King Faisal Hospital (KFH), Taif, Saudi Arabia. Period: 1st June 2018 and 31st August 2018. Material & Methods: Conducted in 200 pregnant women by random sampling technique. Hemoglobin value and all patient’s data was noted. All data was fed to SPSS version 23.0 and statistically analyzed using chi square test for qualitative and student’s t test for quantitative data. Results: The study was conducted in 200 patients that showed that there was no statistically significant association of increasing parity, inter pregnancy interval, mode of delivery (NVD or Cesarean section) & history of anemia and PPH in preceding pregnancy with the Hemoglobin level. While history of previous abortion is associated and a risk factor for anemia in pregnancy, 50% with history of 01 previous abortion had anemia while 100% of the cases with history of 02 previous abortions had moderate anemia. (Table-II). This association was observed statistically significant with p value of 0.001. Conclusion: This study concluded that anemia is a predictable as well as preventable entity. Obstetrical factors may be the contributory factors of anemia in pregnancy. Health education awareness programs, regular antenatal visits and iron supplements can be helpful to improve heath of pregnant women.

Objectives: To see the clinical characteristics and laboratory parameters of influenza A (H1N1) infection on hajj occasion 2018. Introduction: World Health Organization in 2009 declared H1N1 as pandemic, when about 70 countries documented approximately 30,000 cases of H1N1 infection. Saudi Arabia is representing a hot zone for influenza virus epidemics especially during Hajj gathering. Commonly H1N1 infection presents with flue like symptoms. Influenza infection is a major public health threat especially area like Makkah. Study Design: It was observational study. Setting: Done in Security Forces Hospital Makkah. Period: On hajj occasion from July to August 2018. Material and Methods: Total 50 admitted patients in isolation were included in study. Data was collected and analyzed using SPSS version 24. Results: In this study 08% patients had H1N1 +ve out of total patients included in study. Predominantly (75%) were < 14 years with 75% males. The most common presenting symptoms of these patients were Cough (100%), Fever (100%), breathlessness (75%), throat pain (50%), runny nose (75%), headache and lethargy (50%). Twenty five percent patients had hypoxia. Leukopenia was seen in 50% patients and thrombocytopenia was not documented in any patient. Liver Function Tests were deranged in 75% patients and Renal Function Tests were normal in all patients. Number of complications (pneumonia) was 25%. Conclusion: Clinical features and serological markers of influenza A +ve patients were same as reports globally and in KSA.

This study determined the predictors for neurological complications of bacterial meningitis in children versus adult patients. This is a prospective study that enrolled 155 Egyptian patients with suspected acute bacterial meningitis (80 children less than 16 years and 75 adults more than 16 years) , treated for bacterial meningitis in Shebin El-kom Fever Hospital. Nine relevant predictors were chosen to analyze their association with the incidence of neurological complications. P-value < 0.05 was considered statistically significant .Of 80 children, who were treated for bact-erial meningitis, 8 children developed neurological complications (10%) without children death (0%). The most important predictors for neurological complications in pediatric patients with bacterial meningitis were: age < 1 year (6.3%), seizures on admission (42.9%), CSF leucocytic count > 1000/mm3 (21%). Of 75 adults who were treated for bacterial meningitis, 10 developed neurological complications (13.3%) and seven patients died (9.3%). The most important predictors for neurological complications in adults with bacterial meningitis were seizures on admission (20%), the presence of co-morbidities (22.2%), CSF leucocytic count < 1000/mm3 (14.7%). The seizures on admission, the presence of co-morbidities, CSF leucocytic count < 1000/mm3 proved to be the strongest predictors for neurological complications of bacterial meningitis in adult patients, on the other hand, age < 1 year, seizures at admission ,CSF leucocytic count > 1000/mm3 proved to be the strongest predictors for neurological complica-tions of bacterial meningitis in children and valuable to select patients for more intensive therapy.

Background: To find out the causes of Acute Kidney Injury (AKI) in population.Methods: A total of 150 patients were enrolled from medical, surgical, gynecology and obstetrics units of Allied Hospital and Madinah Teaching Hospital, Faisalabad, Pakistan. History, physical examination and investigations were recorded on specially designed proforma. Patients were evaluated to find out the etiologies of AKI. All patients were subjected to urine analysis, complete blood count, blood biochemistry (urea, creatinine, electrolytes, uric acid, calcium and phosphorus) and ultrasound scan of the abdomen and pelvis. Renal biopsy, immunological assays, such as hepatitis B surface antigen, anti-hepatitis C virus antibody, complements level, antinuclear antibody, anti-double-stranded DNA, anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody were performed in selected cases.Results: Male (36%) and female (64%). Pre-renal AKI was most common and was reported in 80 patients (53.33%). Intrinsic Renal azotemia in 56 patients (37.33%). Post renal azotemia in 14 patients (9.33%). Among 80 patients of prerenal AKI, hemorrhage in 45(56.25%), gastroenteritis in 16(20%), sepsis in 8(10%), cardiac diseases in 4(5%), hepatorenal syndrome in 3 (3.75%), peritonitis in 2 (2.50%) and burns in 2(2.50%) were the main causes of Pre-renal AKI. Among 56 patients of intrinsic renal AKI, 40(71.4%) had acute tubular necrosis (ATN), 12(21.4%) with multifactorial causes and 4(7.14%) were found to have glomerulonephritis. Among 14 patients of post renal AKI, 6(42.9%) were having calculi, 6(42.9%) were to have enlarged prostate and 2(4.3%) were having stricture urethra. In this study, contribution of obstetrical, medical and surgical etiologies were recorded as 40%, 36% and 20% respectively.Conclusions: In contrast to study reported from neighbouring country, this study shows rather increase in pregnancy related AKI.

Introduction: Vascular access is lifeline for haemodialysis (HD) patients.Catheter related infections limit the duration of such devices and are important cause ofmorbidity in this population the main complication of catheter in hemodialysis is infection.Objectives: To determine frequency of haemodialysis Catheter Related Infections inhaemodialysis patients. Study Design: Prospective study. Place and Duration: This studywas conducted at Department of Nephrology, King Abdul Aziz Specialists Hospital, Taif, SaudiArabia in 1 year from Jan to Dec 2017. Methodology: This study included one hundred sixteenadults who underwent catheterization for Haemodialysis. These patients were evaluated todetermine the incidence of catheter related infections. At each dialysis session patients wereclinically examined and cultures taken from exit site and blood. Ten malfunctioning catheterswere changed over guide wire. At the time of catheter removal or change catheter tips weresent for culture. Results: Total of 116 catheters (50 femoral, 52 jugular, 14 subclavian) wereevaluated. Duration of catheterization varied from 2-70 days (average 21 days) for jugular andsubclavian whereas for femoral catheters it was 1-30 days (mean 8.4 days). Exit site cultureswere positive in 76 (66%) patients and common organism were Staphylococcus epidermis 32,Staphylococcus aureus 24, Gram negative rods in 12 and mix growth in 08 patients. Clinicalsepsis was observed in 27(23%) patients (fever with /without chills, purulent discharge aroundcatheter. One patient had endocarditis with big mass in right atrium). Organism isolated fromthese patients were (Staphylococcus aureus 11, Staphylococcus epidermis 8, gram negative5). Bacteremia alone was observed in 13 (11%) patients. Of 10 patients with soaked dressing7 (70%) patients subsequently became febrile. In all these patients catheters were removedand antibiotics instituted. Although clinical sepsis was more with jugular than femoral cathetersbut could be related to longer duration of jugular catheters. Catheters removed from febrilepatients had much higher rate of colonization and bacteremia. Catheter exchange over guidewire was not associated with higher infection rates. Conclusions: Catheter related infection stillremain high in dialysis population. Staphylococcus epidermis and Staphylococcus aureus werecommonly isolated organisms. Cather sepsis was an important cause of morbidity in thesepatients. Long duration of catheterization, soaked dressing and colonization were importantrisk factors.