Saudi Med J
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To determine the ideal number of sputum acid-fast bacilli (AFB) smears and polymerase chain reaction (PCR) required for discontinuing TB isolation among patients with suspected pulmonary TB. Methods: This was a single-center, record-based retrospective study of all admitted patients diagnosed with culture-proven pulmonary TB between 2010 and 2018. The study was conducted at Prince Sultan Military Medical City (PSMMC) in Riyadh, Saudi Arabia, a large tertiary care center consisting of 1,200 beds. Data were obtained from our TB notification records. ⋯ Of 126 patients who were AFB smear positive, 98 (77.8%) were detected in the first specimen, 13 (10.3%) in the second specimen, and only 9 (7.1%) in the third specimen. Polymerase chain reaction for MTB was positive in 122 (96.8%) smear-positive patients. Four patients did not undergo a PCR test. Conclusion: A single Xpert MTB/resistance to rifampicin test detected all smear-positive patients, whereas the third smear did not significantly contribute to MTB isolation.
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To examine pediatric residents' perceptions of the 24-hour in-hospital shift and its impact on their well-being and education and patient safety. ⋯ A total of 314 residents participated in the survey (response rate, 30%). Of these, 168 (53.6%) were females. When asked about their preferences regarding the 24-hour on-call system, 286 residents (91.1%) preferred not to continue with this system. Residents ranked several indicators that they perceived as a negative impact due to the 24-hour on-call system. The first ranked indicator was missing academic activities and elective rotations post-call (mean 3.10 [standard deviation 1.25], RII 90.94%), and the second was decreased performance and decision-making skills during night duty (mean 3.51 [standard deviation 1.0], RII 88.11%). Conclusion: We found that the 24-hour on-call system negatively impacts residents' well-being and education and patient care. Pediatric residency training programs in Saudi Arabia should consider resident duty hour reform and evaluate new on-call models to improve resident well-being and training, as well as patient care.
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To provide a comprehensive summary of brucellosis incidence, prevalence, risk associated factors, and impact on the Saudi population. ⋯ Brucellosis poses a considerable impact on human and has a higher prevalence in developing countries as compared to developed countries. Our results revealed that brucellosis is a risk factor for adverse reproductive outcomes.
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To examined the safety of schools, availability of school personnel to help in diabetes management, glycemic control, absenteeism, and differences in diabetes care between public and private schools. Methods: This cross-sectional study used an online platform to circulate surveys to parents of children with type 1 diabetes mellitus (T1DM) attending school or kindergarten in all regions of Saudi Arabia from February to May 2019. Results: The 411 questionnaires received were completed mostly by mothers (80.8%). Limited trained staff were found to be responsible for management of diabetes at school, and parents had relatively poor perceptions regarding the care of children with diabetes at school. Glucagon availability, trained staff, possibility of contacting a treating physician during school hours, a written plan for diabetes, and parents' confidence in schools all scored low and were significantly related to school type. Hemoglobin A1c (HbA1c) level was significantly related to insulin regimen. ⋯ Parents had poor perceptions regarding diabetes care at school. There was no or very limited availability of glucagon kits and trained staff for management of children with T1DM. This study suggests a need to improve the management of diabetes at schools.
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The Precice nail is used to treat limb length discrepancies and has a low complication rate and a high patient satisfaction rate. While the Precice nail can be used for lengthening, unlike other lengthening nails, it can also be used for shortening. ⋯ The distal interlocking screws were then reattached to continue lengthening. This surgical technique can be used safely and satisfactorily in cases with more shortness as we can correct the extremity length discrepancy using only one nail.