Compliance and Association of Ventilator Associated Pneumonia Bundle Strategy With Ventilator Associated Pneumonia rate: A Saudi Experience

Objectives: To evaluate the effectiveness and compliance of Ventilator Associated Pneumonia(VAP) care bundle in local setting at Erfan & Bagedo General hospital, Jeddah, KSA. Materials and Methods: The study was a Quasi experimental before and after observation type of study, in which VAP care bundle was implemented to the ventilated patients without any control group. It was conducted from February 2010 to January 2011. Results: Out of a total of 3011 patient ventilator days, 18 patient developed VAP. Number of VAP care bundle implementation increased from 42 (17.36%) in February 2010 to 315 (91.8%) in October 2010. However the implementation rate was 100% during November, December 2010 and January 2011. VAP rate dropped from 8.85/1000 ventilator days in February 2010 to 3.15 in January 2011. Conclusion: There was a strong negative correlation between proportion of implementation of VAP care bundle and VAP rate (r= - 0.534 p value=0.037 for one tailed test). Adopting VAP care bundle approach may help in reducing the morbidity and mortality in the ventilated patients

The impact of economic development on water pollution: trends and policy actions in Malaysia

The paper examines the impact of development activities on water pollution in Malaysia. Hence, the main objective of this paper is not just to examine the trends of development-induced water pollution around the region of the country but to know where the problems are and the policy measures taken by the government. It evaluates the probable causative relationship between problems introduced due to technology employed in water pollution control and governmental policy measures. It examines the relationship between development indicators as sources of pollution and polluted rivers over a period of 12 years. The findings of the paper have shown that despite the policy enforcement actions against the identified sources of water pollution, all the three development indicators (chosen based on those identified sources) still accounted for high percentage of river pollution in Malaysia. The findings of the paper were used to identify the central fact of the location of the problem. Some crucial conclusions of where the problems likely to be, as reflected in the findings, are: (a) the issue of interactive-effects between pollutants that many policy-makers are not aware of. This is when policy measures concentrate only on one source of water pollution; (b) the enforcement strength and/or effectiveness of policy measures themselves; (c) financial constraints to invest in appropriate technology especially sewerage systems for controlling human source of water pollution in the country; as well as those confronting small polluting industries (d) finally, lack of cooperation between government and private business firms to comply with regulatory policies for water pollution control

Outbreak of Middle East Respiratory Syndrome at Tertiary Care Hospital, Jeddah, Saudi Arabia, 2014

During March–May 2014, a Middle East respiratory syndrome (MERS) outbreak occurred in Jeddah, Saudi Arabia, that included many persons who worked or received medical treatment at King Fahd General Hospital. We investigated 78 persons who had laboratory-confirmed MERS during March 2–May 10 and documented contact at this hospital. The 78 persons with MERS comprised 53 patients, 16 healthcare workers, and 9 visitors. Among the 53 patients, the most probable sites of acquisition were the emergency department (22 patients), inpatient areas (17), dialysis unit (11), and outpatient areas (3). Infection control deficiencies included limited separation of suspected MERS patients, patient crowding, and inconsistent use of infection control precautions; aggressive improvements in these deficiencies preceded a decline in cases. MERS coronavirus transmission probably was multifocal, occurring in multiple hospital settings. Continued vigilance and strict application of infection control precautions are necessary to prevent future MERS outbreaks

Obesity surgery and risk of colorectal and other obesity-related cancers: An English population-based cohort study

Background: The association between obesity surgery (OS) and cancer risk remains unclear. We investigated this association across the English National Health Service. A population-based Swedish study has previously suggested that OS may increase the risk of developing colorectal cancer (CRC). Methods: A retrospective observational study of individuals who underwent OS (surgery cohort) or diagnosed with obesity, but had no OS (no-surgery cohort) (1997–2013) were identified using Hospital Episode Statistics. Subsequent diagnosis of CRC, breast, endometrial, kidney and lung cancer, as well as time ‘at risk’, were determined by linkage to National Cancer Registration & Analysis Service and Office of National Statistics data, respectively. Standardised incidence ratios (SIR) in relation to OS were calculated. Results: 1 002 607 obese patients were identified, of whom 3.9% (n = 39 747) underwent OS. In the no-surgery obese population, 3 237 developed CRC (SIR 1.12 [95% CI 1.08–1.16]). In those who underwent OS, 43 developed CRC (SIR 1.26 [95% CI 0.92–1.71]). The OS cohort demonstrated decreased breast cancer risk (SIR 0.76 [95% CI 0.62–0.92]), unlike the no surgery cohort (SIR 1.08 [95% CI 1.04–1.11]). Increased risk of endometrial and kidney cancer was observed in surgery and no-surgery cohorts. Conclusions: CRC risk is increased in individuals diagnosed as obese. Prior obesity surgery was not associated with an increased CRC risk. However, the OS population was small, with limited follow-up. Risk of breast cancer after OS is reduced compared with the obese no-surgery population, while the risk of endometrial and kidney cancers remained elevated after OS

Rare adverse events associated with BNT162b2 mRNA vaccine (Pfizer-BioNTech): a review of large-scale, controlled surveillance studies

Given the increasing anti-vaccine movements erroneously touting vaccine danger, this review has investigated the rare adverse events potentially associated with BNT162b2 (Pfizer-BioNTech), an mRNA vaccine against the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Only real-world surveillance studies with at least 0.1 million BNT162b2-vaccinated participants and one unvaccinated control group were selected for review. A total of 21 studies examining the potential association of BNT162b2 with cardiovascular, herpetic, thrombotic or thrombocytopenic, neurological, mortality, and other miscellaneous rare adverse events were described in this review. Only myocarditis is consistently associated with BNT162b2. An unclear direction of association was seen with stroke (hemorrhagic and ischemic), herpes zoster, and paresthesia from BNT162b2, which may require more studies to resolve. Fortunately, most surveillance studies detected no increased risks of the remaining rare adverse events reviewed herein, further reassuring the safety of BNT162b2. In conclusion, this review has concisely summarized the current rare adverse events related and unrelated to BNT162b2, arguably for the first time in sufficient depth, to better communicate vaccine safety to the public