Drug compliance among hypertensive patients in a teaching hospital

Objective: To determine the compliance rate and associated factors among hypertensive patients in a teaching hospital. Study Design: A cross-sectional study. Materials and Methods: Ethical approval taken from the Institutional Ethics Committee (No. 00101/9/2013). One hundred adult hypertensive patients were interviewed using a pretested, structured, closed ended questionnaire. Inclusion criteria include all adult hypertensive patients attending outpatient clinic from 1st to 28th November 2013 at King Saud Medical City. Exclusion criteria include only if the patient refuse to participate in the study. Results: After calculating the compliance of each patient, we found that 63 of the patients had >80% compliance rate. The most common causes of noncompliance were felt good (reported by 59 patients out of 100), simply forgot (56%), had problems taking pills at specified time (55%), and felt asleep through dose time (52%). Conclusion: The compliance rate with medications was good, but there was a proportion of patients were noncompliant because maybe they need better education and family support

Extraoral Halitosis due to Exhaled Acetone in Patients Undergoing Sleeve Gastrectomy

Introduction: Bariatric surgery is widely used and considered as one of the most effective treatments for morbid obesity, but it can be associated with medical and dental adverse side-effects. It is frequently associated with major metabolic changes that may lead to extraoral halitosis. Aim: To assess the role of exhaled acetone produced as a result of weight loss in the production of extra-oral halitosis in patients undergoing bariatric surgery. Materials and Methods: A prospective longitudinal cohort study was designed from October 2018 to November 2019 and monitored for six months postsurgery. The subjects were patients undergoing sleeve gastrectomy surgery with a Body Mass Index (BMI) of 35-50 kg/m2 . Subjects were divided into two groups of low BMI loss (<5 Kg/m2 ) and high BMI loss (≥5 Kg/m2 ) postsurgery, Breath samples were collected with a portable breath ketone analyser for measurement of acetone concentrations, and blood samples were taken for measurement of 3-hydroxybutyrate levels. Breath and blood samples were taken at baseline then at one month, three months, and six months postsurgery. All statistical analysis were performed using the SPSS version 22.0 with a significance value of p-value set at p<0.05. Results: Out of 43 patients enrolled initially, eventually 39 patients completed the study. The mean level of breath acetone was 4.1, 3.4, and 3.8 ppm at one month, three months, and six months, respectively (p=0.018). There was a statistically significant increase in breath acetone at one month in patients with a high rate of BMI loss. At one month, the mean blood level of 3-hydroxybutyrate was higher in patients with a high rate of BMI loss than in those with a low rate of BMI loss (1.9 vs. 1.2 mmol/L; p=0.049). The levels of breath acetone and blood 3-hydroxybutyrate were significantly correlated at one month (r=0.6, p<0.05). Conclusion: Rapid weight loss one month after gastric sleeve surgery resulted in high acetone levels suggestive of increased extraoral halitosis in such patients. Increased Acetone levels in breath and 3-hydroxybutyrate in blood are suggestive of increased extraoral halitosis in patients undergoing gastric sleeve surgery particularly within a month after surger

Bariatric surgery in the Middle East and North Africa: narrative review with focus on culture-specific considerations

There is an increasing volume of bariatric surgeries in the Middle East and North Africa (MENA), but the context of bariatric surgery in the region is not fully understood. Incorporating culture-specific considerations in the provision of care to patients who undergo bariatric surgery may help to optimize outcomes after surgery. We conducted a narrative review of published research studies on bariatric surgery in the MENA region, highlighting cultural and contextual aspects relevant to the care of bariatric surgery patients who undergo surgery in this geographic area. The authors searched the following online databases: PubMed, CINAHL, Embase, and Academic Search Elite from 2010-2020 for studies conducted in 18 countries in the MENA region. This narrative review identifies cultural-specific considerations that may affect bariatric care and outcomes in 6 domains: knowledge of bariatric surgery; mental health, body image, and quality of life; influence of family; religion and lifestyle; preoperative practices; and healthcare access. Provision of culturally congruent care may help patients to achieve the best possible outcomes after bariatric surgery. Results may inform efforts to provide safe and culture-specific care in the MENA region, as well as those who migrate or seek care in other countries. More research is warranted on this heterogeneous population to optimize postsurgery weight trajectory and psychosocial adjustment

Appraising the outcome and complications of peritoneal dialysis patients in self-care peritoneal dialysis and assisted peritoneal dialysis: A 5-year review of a single Saudi center

Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1–83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23.5 (3–60) months. At the end of five years, 47 (42.34%) patients were continuing on PD, 12 (10.81%) had renal transplant, 33 (29.73%) patients were transferred to hemodialysis, and two (1.8%) patients were transferred to other centers. Seventeen patients died during this period giving a mortality rate of 7.13 deaths/100 patient-year during the five-year period. Six patients died due to cardiovascular causes, while five had sepsis. There was one death each due to prostate cancer, hyperoxaluria, and toxic epidermal necrolysis. Three patients died suddenly at home. Peritonitis rate was one episode/35.28 patient/month or one episode/2.94 patient/year. We compared the results for patients doing the dialysis themselves [56 (50.45%)] “self-care PD” to 55 (49.5%) patients assisted by a family member or other caregivers “assisted PD.” We found no significant difference in the incidence of complications, technical outcome, mortality, and peritonitis episodes. However, we found a high prevalence of diabetes mellitus and significant increase in exit site infection in assisted PD. Our study suggests that PD patients in Saudi Arabia have a good overall outcome. Furthermore, assisted PD showed good patient and technique outcome

Comparing T2 and T2-T3 ablation in thoracoscopic sympathectomy for palmar hyperhidrosis: A randomized control trial

10.1007/s00464-007-9241-9Surgical Endoscopy and Other Interventional Techniques21101768-177