Patterns of pediatric trauma in Ramadan: an observational study

Introduction Motor vehicle crashes are a major cause of death among the Saudi population. In Ramadan, the working hours and the road traffic rush hours differ from other months of the year; the pattern of trauma may also differ. We compared trauma in the pediatric age group in Ramadan with non-Ramadan months in terms of frequency, patterns, and severity.Methods We conducted a retrospective study, which included all pediatric trauma cases, from 2001 to 2009, who were registered in King Abdulaziz Medical City Trauma Registry. Trauma patterns were divided into two groups according to the date of occurrence: victims in Ramadan versus victims in non-Ramadan.Results A total of 3766 patients were included. The average number of trauma per month was 39.2 versus 44 for non-Ramadan and Ramadan months, respectively (P = 0.79). The mean patient age in Ramadan was 8.04 years compared with 8.07 years in non-Ramadan months (P = 0.037). Blunt trauma was the most common type in both groups. The median of the Injury Severity Score was the same and equal to 4. In both groups, neurological and vascular injuries were more common in Ramadan: P = 0.02 and P = 0.03 respectively.Conclusion There were no significant differences between trauma in Ramadan and non-Ramadan months, except for the higher percentage of vascular and neurological injuries in Ramadan.Key words: children, head injury, motor vehicle accidents, Ramadan, Saudi, trauma, vascular injur

Unexpected differential metabolic responses of Campylobacter jejuni to the abundant presence of glutamate and fucose

Introduction: Campylobacter jejuni is the leading cause of foodborne bacterial enteritis in humans, and yet little is known in regard to how genetic diversity and metabolic capabilities among isolates affect their metabolic phenotype and pathogenicity. Objectives: For instance, the C. jejuni 11168 strain can utilize both l-fucose and l-glutamate as a carbon source, which provides the strain with a competitive advantage in some environments and in this study we set out to assess the metabolic response of C. jejuni 11168 to the presence of l-fucose and l-glutamate in the growth medium. Methods: To achieve this, untargeted hydrophilic liquid chromatography coupled to mass spectrometry was used to obtain metabolite profiles of supernatant extracts obtained at three different time points up to 24 h. Results: This study identified both the depletion and the production and subsequent release of a multitude of expected and unexpected metabolites during the growth of C. jejuni 11168 under three different conditions. A large set of standards allowed identification of a number of metabolites. Further mass spectrometry fragmentation analysis allowed the additional annotation of substrate-specific metabolites. The results show that C. jejuni 11168 upon l-fucose addition indeed produces degradation products of the fucose pathway. Furthermore, methionine was faster depleted from the medium, consistent with previously-observed methionine auxotrophy. Conclusions: Moreover, a multitude of not previously annotated metabolites in C. jejuni were found to be increased specifically upon l-fucose addition. These metabolites may well play a role in the pathogenicity of this C. jejuni strain.</p

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Knowledge of Parents Working in Healthcare Settings Toward Attention-Deficit Hyperactivity Disorder Among Children

Sawsan Abuhammad,1 Manar ALAzzam,2 Yasmine Alabbasi3 1Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al-Albayt University, Mafraq, 25113 Jordan; 3Department of Maternity and Pediatric Health Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, 11671 Saudi ArabiaCorrespondence: Yasmine Alabbasi, Email [email protected]: To examine the knowledge of parents who are working as healthcare workers about Attention-Deficit Hyperactivity Disorder (ADHD) and to determine the predictors of ADHD knowledge in children among parents.Methods: A cross-section study was conducted among parents who are working as HCWs. An online survey by google forms facilitated the creation of a 373 participant&rsquo;s sample.Results: The parents who are working as HCWs toward ADHD Knowledge 14.9 (SD = 7.9). The most questions were answered correctly. ADHD children are frequently distracted by extraneous stimuli 285 (76.8%). ADHD children often fidget or squirm in their seats 272 (73.7%) and HCWs training in managing an ADHD child are generally effective when combined with medication treatment 260 (70.5%).Conclusion: This study found that many parents who working as HCWs had poor knowledge regarding causes and general aspects of this disorder. The results had many implications that include increased efforts to improve the capabilities of parents who working as HCWs and prevent further complications for the children and increase awareness among parents and teachers.Keywords: ADHD, parents who working as HCWs, knowledge, Jorda

Career perspectives of senior dental students from different backgrounds at a single Middle Eastern institution

Abstract Background Differences between dental students in terms of social, economic and cultural backgrounds are likely to impact their professional career plans. The aim of this study was to explore the professional career plans among final year dental students from different backgrounds at a single Middle Eastern institution (Jordan university of Science and Technology-JUST). Methods Fifth year dental students at JUST were invited to fill out a paper based self-administered questionnaire. Data was collected on students` demographics, their future career plans and the impact of social and economic changes on such plans, their interest in postgraduate studies and the specialty of choice in addition to the influence of a group of factors on that choice. Data was also collected on the value of non-academic workshops, guidance regarding career plans, participants` preferred pattern of work (full-time versus part-time) and retirement plans. Students were categorized according to their nationalities. Pearson’s chi squared test, one way ANOVA and post hoc tests were used to measure statistical significance between measured variables and backgrounds of participants. The level of significance was set at P ≤ 0.05. Results A total of 227 students completed the survey (response rate = 84%). 47% of the participants were Jordanians, 27% were Malaysians, 11% were from Gulf States (Saudi Arabia, Bahrain, Kuwait and Qatar), 10% were from conflict zones in the Middle East (Syria, Iraq, Palestine and Yemen) and 5% comprised students from other nationalities. Significant differences were found between students from different backgrounds in their funding sources (Chi square = 132, P < 0.01), practice plans (Chi square = 43, P < 0.01), the impact of social and economic changes on their career choices (Chi square = 34, P < 0.01), planned work pattern within the first 10 years post-graduation (chi square = 18, P < 0.05) and 10–20 years after graduation (69%, Chi square = 22, P < 0.01) and retirement plans (Chi square = 25, P < 0.05). Students from different nationalities agreed on most factors affecting their choice of a specialty, except for the reputation of the specialty (P < 0.05). Conclusion Several differences in career plans were found between dental students from variable backgrounds studying a single institution. Many of these disparities could reflect variations in socioeconomic backgrounds

Histomolecular features of high-grade endometrial cancers

High-grade endometrial cancers (ECs) are an aggressive subset of ECs accounting for 70-80% of EC-related deaths. Currently, staging surgery, together with chemotherapy or radiotherapy, is the primary treatment strategy for these cancers. The widespread use of next-generation sequencing has led to a refined understanding of EC's genomics with important information for diagnosis and therapy for individual patients (precision medicine). However, advances in the genomics assessment of high-grade tumors have been slower due to their lower incidence than low-grade EC. This article will briefly introduce the current state of knowledge of the genomics of G3 endometrioid EC, serous uterine cancer, clear cell uterine carcinoma and uterine carcinosarcoma and discuss its implications for diagnosis and targeted therapy

The modified radical peri-partum caesarean hysterectomy (Soleymani-Alazzam-Collins (SAC) technique): a systematic, safe procedure for the management of severe placenta accreta spectrum (PAS)

OBJECTIVES: To describe a stepwise, systematic technique for radical caesarean hysterectomy for placenta accreta spectrum (PAS). To investigate outcomes for women with severe, invasive PAS, who were hysterectomised using this technique. STUDY DESIGN: A retrospective cohort study, undertaken at a large UK tertiary referral centre. Twenty-four cases of elective primary caesarean hysterectomy with a confirmed intrapartum diagnosis of severe percreta (FIGO grades 3b and c) were identified between 2011 and 2020. Sixteen had standard care (surgical technique dependant on surgeon's preference) and eight had the radical peri-partum hysterectomy using the SAC-technique as described. Non-parametric testing was used due to sample size. RESULTS: The SAC-technique resulted in significantly less blood loss (P=0.032), more transverse incisions (p=0.009) and less ICU admissions (p=0.046). There was no significant difference in theatre time. CONCLUSION: (s) The SAC-technique demonstrated a significant improvement in outcomes for women with severe PAS, without increasing surgical time