A baby diagnosed with epidermolysis bullosa associated with antral web

Encountering a neonate with epidermolysis bullosa and pyloric atresia is uncommon in clinical practice. To our knowlege, a complete prepyloric antral web in association with epidermolysis bullosa has not been reported before. The main issues in this case were the prognosis of the overall condition and weighing the risks and benefits of surgery. In other cases, surgical management has had good outcomes, although the risks could include leaks, wound complications, and recurrent obstruction. Uneventful postoperative courses have been reported in many cases. We used abdominal exploration and performedHeineke-Mikulicz antro-pyloroplasty, with an intraoperative finding of a complete antral web. The patient had a smooth recovery with no immediate complications. No major small-term complications occurred, and no further operations were required. One month after the surgery, the patient began full feedings. However, his skin condition worsened with multiple attacks of sepsis; then he developed uncontrollable upper and lower gastrointestinal bleeding. Unfortunately, the patient died at 5 weeks due to sepsis. We report this case to add to the literature, and discuss the management options when facing such a challenging case

The relationship between trust in primary healthcare providers among patients with diabetes and levels of depression and anxiety.

BackgroundTrust in healthcare providers has been shown to improve several clinical and patient-reported outcomes. However, its relationship with depression and anxiety has not been investigated among patients with chronic health conditions, such as diabetes. Therefore, the aim of this study was to examine whether trust in primary care physicians among patients with diabetes is associated with their levels of depression and/or anxiety.MethodAdult patients (≥18 years) with a diagnosis of diabetes, confirmed through their electronic health records, were recruited and interviewed from the primary care clinics of three public hospitals. Patient trust in primary care physicians was assessed using the Health Care Relationship (HCR) Trust scale. Depression and anxiety were assessed using the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7), respectively. Two multiple linear regression analyses were conducted to examine the association of HCR-Trust scores with PHQ-9 and GAD-7 scores controlling for age, sex, Charlson comorbidity index score, education, health literacy, annual income, nationality, duration of illness, and research site.ResultsThe number of patients who agreed to be interviewed was 367. Most of the participants were female (61.54%) and Saudi (92.86%). High HCR-Trust scores were negatively associated with PHQ-9 scores (β = -0.18; 95% CI: -0.23 --0.13; P = ConclusionsTrust in primary care physicians among patients with diabetes was associated with lower levels of depression and anxiety. Therefore, healthcare providers should adopt a patient-centered care approach that fosters trust in the relationship between their patients and themselves. Further research should explore whether interventions that foster shared decision-making and trust in healthcare providers might also improve the health outcomes of patients with diabetes

IMMUNIZATION COVERAGE AND HESITANCY IN SAUDI ARABIA

One of the greatest contributions to public health is vaccination. The majority of affluent nations have high rates of childhood vaccination, indicating that vaccination is still largely regarded as a public health policy in these nations. But there might be many individuals who are under-vaccinated. The rise of VPD outbreaks, such as measles, poliomyelitis, and pertussis, and under- or non-vaccinated communities have been linked in several nations. The World Health Organization (WHO) has identified vaccine hesitancy as one of the top 10 health hazards for 2019. Recently, there have been reports of vaccine reluctance in Saudi Arabia. Currently, the need for awareness campaigns about the benefits of vaccination is needed more than ever. In this review we will be looking at immunization hesitancy in Saudi Arabia, its definition, factors, and possible solutions