CT of patients with Middle East respiratory syndrome coronavirus predominantly showed ground-glass opacities, with peripheral lower lobe preference. Pleural effusion and higher CT lung and chest radiographic scores correlate with poor prognosis and short-term mortality.

Background/Aims:The available studies on Helicobacter pylori (H. pylori) prevalence among healthy asymptomatic population across Saudi Arabia suffers from significant limitations. We conducted this large population-based study to estimate the H. pylori seropositivity rate among apparently healthy children in Saudi Arabia, using anti-H. pylori immunoglobulin A (IgA) and IgG serology tests, and to study the influence of H. pylori infection on growth.Materials and Methods:We conducted a cross-sectional study to screen apparently healthy school aged Saudi children (aged 6–15 years), attending primary and intermediate schools in Riyadh between 2014 and 2016, for H. pylori seropositivity by checking for the presence of anti-H. pylori IgG and IgA antibodies in serum specimens.Results:Out of 3551 serum specimens, 1413 cases tested seropositive for H. pylori organism (40%): 430 (12.2%) were both IgG and IgA positive, 212 (6%) and 771 (21.7%) cases showed isolated positivity for IgG or IgA, respectively. Male gender, older age, lower levels of socioeconomic status (SES), and family members >10 were significantly associated with H. pylori seropositivity. The proportion of participants with short stature was significantly more in the H. pylori seropositive group than the seronegative group (OR1.249, confidence interval [1.020–1.531], P = 0.033). There was no significant association between H. pylori seropositivity and gastrointestinal symptoms.Conclusion:The prevalence of H. pylori seropositivity among apparently healthy Saudi children (40%) is intermediate compared with that in developed and developing countries. The Saudi pediatric population shows a predominant IgA-type immunological response to H. pylori infection.

Objectives Few studies investigated the correlation between foreign body (FB) ingestion and occurrence of complications. The local literature is limited to case reports and small case series on esophageal FBs. We conducted this study to identify the high-risk factors predisposing to complications among Saudi children ingesting FBs. Methods The medical records of 436 children (boys, 59.6%; mean age, 4.4 ± 2.7 years) presenting to the emergency department (ED) between 2007 and 2016 were retrospectively reviewed. Relative risk analysis of clinical variables was performed between 2 groups: The first group constituted children without FB-related complications (n = 389), and the second group included those with major complications (n = 14). Major complication was defined as any event associated with significant morbidity such as esophageal stricture, esophageal perforation, esophageal fistula, and intestinal perforation or fistula formation. Results Most of the 436 cases presented between ages 2 and 4 years (35.1%). Coin was the most commonly ingested FB (22.9%) followed by button battery (19.5%). Most of the ingested FBs passed spontaneously without intervention (69%). Upper endoscopy was performed in 121 cases (27.7%). By multivariate analysis, the variables that were significantly associated with major complications included the following: very young age group (0–2 years; odds ratio [OR], 11.5), button battery (OR, 4), FB impacted at upper esophagus (OR, 8.7), and longer time duration to visit the ED (OR, 14.7). Conclusion Button battery impaction at upper esophagus in very young children and delayed presentation to the ED were the most significant risk factors of FB-related complications.

Obstructive urolithiasis is the retention of urine subsequent to the lodgement of calculi in the urinary tract from the kidney up to the urethral orifice. This report describes the post-mortem and chemical analysis findings of the calculi in an 18-month old Ouda-Yankasa cross ram presented at the Large Animal Clinic of the Veterinary Teaching Hospital, Usmanu Danfodiyo University, Sokoto. The patient was presented on 20th of March, 2013 with reports of anorexia, disinclination to drink water and anuria that developed four days before presentation at the clinic. On clinical examination, urethral blockage and mild ascites were observed. Cystocentesis was performed to relieve the patient and plain radiograph taken but was not diagnostic. The patient died before definitive diagnosis was made for rational treatment. The post-mortem findings include frothy exudate in the trachea and bronchial airways, congestion of the lungs, hydroperitoneum with recovered fluid measuring 2,350 ml, splenomegaly, hydronephrosis, distended urinary bladder, severe haemorrhagic cystitis, urinary calculi in the bladder and throughout the urethral length and urethral stricture. The urinary calculi recovered were white, friable and amorphous, ranging from small particles to 5mm in diameter. Histopathologic section of the kidney showed atrophied glomeruli. It can thus be concluded that the atrophied glomeruli in turn impaired glomerular filtration which invariably pre-disposed the patient to uraemia leading to its death. The chemical analysis of the calculi showed that the calculi was either oxalate, phosphate or silicate, or any of these mixtures.

Background: Falls are commonly reported among patients after total knee replacement. Previous literature and reviews have largely focused on the risk factors for fall among population undergoing total knee replacement. However, no systematic review has identified specific risk factors among female population undergoing the procedure regarding post discharge falls. Thus, the current review aimed to identify and provide summary of the key risk factors in women with total knee replacement about post discharge falls. Main Body: To identify the current evidence on risk factors among patients undergoing total knee replacement for after-discharge falls. Systematic review was conducted and data bases were searched including Cochrane, Medline, PEDro from 2000 to latest. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was performed using Nottawa Castle Scale for Case Control and Cohort studies and AXIS tool for cross sectional study. 10 articles finally met the inclusion criteria and were included in the review based on eligibility. There were 6 Cohort studies, 1 Cohort study protocol, 2 Case Control and 1 cross sectional, 3 randomized pilot studies and 1 prospective cohort study. Conclusion(s): Patients who underwent total knee replacement are at risk of post discharge falls. Advancing age, reduced proprioception, psychiatric disorders, living alone and operated knee pain were considered to be important risk factors for post discharge falls.