Bradycardia Following Oral Corticosteroid Use: Case Report and Literature Review

Introduction: Corticosteroids are used in various clinical conditions that include many immune-mediated inflammatory diseases. Different side effects were described including cardiac arrhythmias. Most of those arrhythmias were in the form of bradycardia which usually occurs with high intravenous steroid doses. More significant arrhythmias and cardiac arrest were also described. In this report we describe a case of bradycardia that developed after the use of oral corticosteroids.Case report: We report a case of bradycardia that developed in a 14 year-old male after receiving oral prednisone. The patient had steroid- sensitive nephrotic syndrome and presented with anasarca that started to develop few days prior to hospitalization. He had no underlying heart disease. Vitals was normal. Investigations confirmed a new nephrotic relapse. Oral prednisone 80 mg / day divided into three doses was started. Albumin infusions were initially given with intravenous furosemide to control the edema. Seven days after hospitalization, he developed bradycardia with a pulse rate of 50-60 per minute, which was less than 50% of the baseline heart rate. He didn’t develop significant symptoms and he had no other apparent corticosteroids side effects. Cardiac evaluation and echocardiography were normal. Electrocardiogram revealed only sinus bradycardia.The bradycardia recovered after decreasing the dose of steroids to 60 mg PO every other day and he was discharged in stable condition a few days later.Conclusion: Cardiac arrhythmias may develop with all forms of steroids including oral prednisone. Bradyarrhythmias can occur even with standard doses of oral prednisone

The prevalence of physical activity and its socioeconomic correlates in Kingdom of Saudi Arabia: A cross-sectional population-based national survey

AbstractObjectivesTo determine the levels of physical activity in the Saudi population and to assess its socio-demographic correlates.MethodsThe data were part of a cross-sectional representative national survey of 4758 participants conducted in Kingdom of Saudi Arabia. A multistage stratified cluster random sampling design was used. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) version 2.0. Logistic regression analyses were used to identify the determinants and were adjusted in relation to various factors.ResultsOverall, physical inactivity was found to be 66.6% (95% C.I.: 65.3%–68%), 60.1% (95% C.I.: 58.1%–62.1%) for males and 72.9% (95% C.I.: 71.1%–74.7%) for females. Leisure time physical inactivity was found to be 87.9%, 85.6% for males and 90.2% for females. The northern and central regions reported the highest prevalence of no physical activity at work, leisure and transportation. Gender, geographical location and employment status exhibited a statistically significant correlation.ConclusionsThere is a high level of physical inactivity in various regions and population groups in the Kingdom of Saudi Arabia. Population interventions are greatly needed, especially those focusing on physical activity in their leisure time

Studying the impact of geosynthetic materials on the strain-stress state of soil structures applicable to the mechanics of granular media

In the modern construction industry, a solution being successfully proven is the use of geosynthetic materials, applied as semi-holders, to increase the reliability and stability of soil structures. In connection therewith, solving the issues of expanding the range of methods and approaches to predicting the behavior of such structures under the activity of surface loads is a relevant task, since this is a vital factor in evaluating the designing arrangements made, including the use of geosynthetic materials. The aim of the studies according to this paper is to expand the pertinence of the mechanics of granular media (MGM) in order to assess the reliability of decisions made in the design of soil structures from pitifully durable soils, supported with geosynthetic materials, by comparing the obtained values with the results of full-scale tests and the values obtained by the limited component strategy. For this purpose, the paper presents a comparative analysis for the results of determining vertical stresses under the bridge reinforced with geosynthetic materials and its displacement, obtained by the mechanics of granular media and the limited component strategy. The results of laboratory tests, performed in a soil tray, were taken as verification data. The actual values of vertical stresses were determined using soil pressure sensors, and the values of displacement were determined using the movement indicator of the clockwork installed on the deflection meter of a die unit. An approach to determining displacement of a reinforced bridge using the mechanics of granular media was presented for the first time. The newly presented approach to determining displacement of an bridge, reinforced at the base with geosynthetic materials, allows us to conclude on its reliability, which significantly expands the applicability of the MGM as an alternative to the use of the limited component strategy. The aftereffects of contrasting the upsides of vertical anxieties under the bridge reinforced with geosynthetic materials and its displacement, utilizing the Plaxis programming bundle and the MGM dependencies, counting when contrasted and the consequences of lab tests, are presented. Based on the results obtained, a general conclusion was made on the possibility to use the MGM dependencies in deciding the example of the pressure dispersion and the values of displacement of reinforced bridges under the action of surface loads. The paper also discloses the promising directions of research in this area of geotechnical engineering

Syringocystadenoma Papilliferum of the Upper Lip

Syringocystadenoma papilliferum (SCAP) is a rare skin tumour believed to arise from the apocrine or eccrine sweat glands. It appears predominantly in childhood, usually at birth. It is exceedingly rare for it to appear on the upper lip. We report a case of SCAP in a 10-year-old Omani girl who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in February 2012 with a non-tender, non-pruritic, solitary verrucous papule of 4 x 5 mm on the left side of the upper lip. It had been present since birth and had slowly been increasing in size over the years. It was occasionally associated with recurrent ulceration and bleeding and had previously been misdiagnosed and mismanaged. An excisional biopsy was performed and the whole lesion was removed. The surgical site was then sutured and the patient was discharged on the same day

Fine particulate matter pollution and risk of community-acquired sepsis

While air pollution has been associated with health complications, its effect on sepsis risk is unknown. We examined the association between fine particulate matter (PM2.5) air pollution and risk of sepsis hospitalization. We analyzed data from the 30,239 community-dwelling adults in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort linked with satellite-derived measures of PM2.5 data. We defined sepsis as a hospital admission for a serious infection with ≥2 systemic inflammatory response (SIRS) criteria. We performed incidence density sampling to match sepsis cases with 4 controls by age (±5 years), sex, and race. For each matched group we calculated mean daily PM2.5 exposures for short-term (30-day) and long-term (one-year) periods preceding the sepsis event. We used conditional logistic regression to evaluate the association between PM2.5 exposure and sepsis, adjusting for education, income, region, temperature, urbanicity, tobacco and alcohol use, and medical conditions. We matched 1386 sepsis cases with 5544 non-sepsis controls. Mean 30-day PM2.5 exposure levels (Cases 12.44 vs. Controls 12.34 µg/m3; p = 0.28) and mean one-year PM2.5 exposure levels (Cases 12.53 vs. Controls 12.50 µg/m3; p = 0.66) were similar between cases and controls. In adjusted models, there were no associations between 30-day PM2.5 exposure levels and sepsis (4th vs. 1st quartiles OR: 1.06, 95% CI: 0.85–1.32). Similarly, there were no associations between one-year PM2.5 exposure levels and sepsis risk (4th vs. 1st quartiles OR: 0.96, 95% CI: 0.78–1.18). In the REGARDS cohort, PM2.5 air pollution exposure was not associated with risk of sepsis

Characteristics, Risk Factors, and Treatment Practices of Known Adult Hypertensive Patients in Saudi Arabia

Objective. To determine the prevalence, risk factors, characteristics, and treatment practices of known adult hypertensives in Saudi Arabia. Methods. Cross-sectional community-based study using the WHO stepwise approach. Saudi adults were randomly chosen from Primary Health Care Centers catchment areas. Data was collected using a questionnaire which included sociodemographic data, history of hypertension, risk factors, treatment practices, biochemical and anthropometric measurements. Collected data was cheeked, computer fed, and analysed using SPSS V17. Results. Out of 4719 subjects (99.2% response), 542 (11.5%) subjects were known hypertensives or detected by health workers in the past 12 months. Hypertension was significantly associated with age, gender, geographical location, education, employment, diabetes, physical inactivity, excess body weight, and ever smoking. Multiple logistic analysis controlling for age showed that significant predictors of hypertension were diabetes mellitus, ever smoking, obesity, and hypercholesteremia. Several treatment modalities and practices were significantly associated with gender, age, education, and occupation. About 74% were under prescribed treatment by physicians, 62% on dietary modification, 37% attempted weight reduction, 27% performed physical exercise, and less than 7% used herbs, consulted traditional healers or quitted smoking. Income was not significantly associated with any treatment modality or patient practices. Conclusion. Hypertension (known and undetected) is a major chronic health problem among adults in Saudi Arabia. Many patients' practices need changes. A comprehensive approach is needed to prevent, early detect, and control the disease targeting, the risk factors, and predictors identified

Partially Synthesised Dataset to Improve Prediction Accuracy (Case Study: Prediction of Heart Diseases)

The real world data sources, such as statistical agencies, library data-banks and research institutes are the major data sources for researchers. Using this type of data involves several advantages including, the improvement of credibility and validity of the experiment and more importantly, it is related to a real world problems and typically unbiased. However, this type of data is most likely unavailable or inaccessible for everyone due to the following reasons. First, privacy and confidentiality concerns, since the data must to be protected on legal and ethical basis. Second, collecting real world data is costly and time consuming. Third, the data may be unavailable, particularly in the newly arises research subjects. Therefore, many studies have attributed the use of fully and/or partially synthesised data instead of real world data due to simplicity of creation, requires a relatively small amount of time and sufficient quantity can be generated to fit the requirements. In this context, this study introduces the use of partially synthesised data to improve the prediction of heart diseases from risk factors. We are proposing the generation of partially synthetic data from agreed principles using rule-based method, in which an extra risk factor will be added to the real-world data. In the conducted experiment, more than 85% of the data was derived from observed values (i.e., real-world data), while the remaining data has been synthetically generated using a rule-based method and in accordance with the World Health Organisation criteria. The analysis revealed an improvement of the variance in the data using the first two principal components of partially synthesised data. A further evaluation has been con-ducted using five popular supervised machine-learning classifiers. In which, partially synthesised data considerably improves the prediction of heart diseases. Where the majority of classifiers have approximately doubled their predictive performance using an extra risk factor