Multi National Survey of the Advice Given to Muslim Kidney Graft Recipients by Muslim Nephrologists about Lifestyle and Religious Rituals with Potential Medical Risk

Muslim renal transplant recipients often ask their physicians if performing certain lifestyles or religious obligations may be harmful to their health. Permissibility as advised by an expert Muslim physician is considered as being religiously accepted. A cross-sectional, survey-based study was conducted enquiring what nephrologists would advise their transplant recipients to do, about some lifestyles and religious duties. Fifty-eight nephrologists responded to the survey. Of these, 77% routinely follow-up post-transplant patients; 34% were from Saudi Arabia, 18% from the USA, and 20% from Pakistan. Fifty-four percent of the respondents would let patients with stable graft function fast during Ramadan, while 20% would not recommend fasting at any time following transplantation. This response did not change much if the patient was diabetic although in these patients, not recommending fasting at any time increased to 32%. For kidney donors, fasting would be allowed by 58% of the respondents once the kidney function stabilizes. About 50% would let their patients perform Omrah or obligatory Hajj any time after 12 months following transplantation, and only about 3% would not recommend that at any time after transplantation. For nonobligatory Hajj, 37% and 22%, respectively, would allow. Sixty-one percent would delay the pregnancy in nullipara with stable renal function, and none of the nephrologists would deny the opportunity to pregnancy at any time. In multiparous transplant recipients, the respective frequencies would be 45% and 20%. To our knowledge, this the first study exploring the consensus among Muslim nephrologists regarding the advice they would give on performance of potentially risky lifestyles and religious rituals by Muslim posttransplant patients

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Multi National Survey of the Advice Given to Muslim Kidney Graft Recipients by Muslim Nephrologists about Lifestyle and Religious Rituals with Potential Medical Risk

Muslim renal transplant recipients often ask their physicians if performing certain lifestyles or religious obligations may be harmful to their health. Permissibility as advised by an expert Muslim physician is considered as being religiously accepted. A cross-sectional, survey-based study was conducted enquiring what nephrologists would advise their transplant recipients to do, about some lifestyles and religious duties. Fifty-eight nephrologists responded to the survey. Of these, 77% routinely follow-up post-transplant patients; 34% were from Saudi Arabia, 18% from the USA, and 20% from Pakistan. Fifty-four percent of the respondents would let patients with stable graft function fast during Ramadan, while 20% would not recommend fasting at any time following transplantation. This response did not change much if the patient was diabetic although in these patients, not recommending fasting at any time increased to 32%. For kidney donors, fasting would be allowed by 58% of the respondents once the kidney function stabilizes. About 50% would let their patients perform Omrah or obligatory Hajj any time after 12 months following transplantation, and only about 3% would not recommend that at any time after transplantation. For nonobligatory Hajj, 37% and 22%, respectively, would allow. Sixty-one percent would delay the pregnancy in nullipara with stable renal function, and none of the nephrologists would deny the opportunity to pregnancy at any time. In multiparous transplant recipients, the respective frequencies would be 45% and 20%. To our knowledge, this the first study exploring the consensus among Muslim nephrologists regarding the advice they would give on performance of potentially risky lifestyles and religious rituals by Muslim posttransplant patients

Daily life satisfaction in Asia: a cross-national survey in twelve societies

Aside from political leaders' popularity rates and the stock exchange index of business firms, ordinary people are highly interested in aspects of daily life, such as housing, income, health, family, food, human relations and work. Cross-national opinion polls on daily-life satisfaction were carried out in Japan, South Korea, Thailand, Hong Kong, Macao, the Philippines, India, Myanmar, Taiwan, China, Malaysia and Pakistan in the fall of 2013 and winter 2014.. The percent difference index (PDI) is formulated as the sum of two positive responses (satisfied and somewhat satisfied) minus the sum of two negative responses (dissatisfied and somewhat dissatisfied). Percent difference indices are given according to society and daily-life aspects. For our analysis to go beneath national average and to go beyond national borders, two lines of analysis are carried out. First, the distance between the level of satisfaction of the top and bottom quartiles is given for each society and according to each of the daily-life aspects. Second, the regional sum of satisfaction of the top quartiles and bottom quartiles are shown crossed by daily-life aspects. In this article we confine ourselves to preliminary comparative description and analysis. More solid and deep comparisons will be carried out by local polling leaders of 12 Asian societies in the succeeding issue of the Asian Journal of Public Opinion Research. Nevertheless, two key threads stand out from these preliminary comparisons. First, social relations (family and human relations) stand out as most satisfied aspects of life in most of twelve societies. Second, the need to go beneath national averages and beyond national borders in analyzing cross-national surveys is confirmed. The comparability and validity of cross-national surveys with varying sampling method and survey mode are briefly discussed toward the end of the article

Daily Life Satisfaction in Asia: A Cross-National Survey in Twelve Societies

Aside from political leaders' popularity rates and the stock exchange index of business firms, ordinary people are highly interested in aspects of daily life, such as housing, income, health, family, food, human relations and work. Cross-national opinion polls on daily-life satisfaction were carried out in Japan, South Korea, Thailand, Hong Kong, Macao, the Philippines, India, Myanmar, Taiwan, China, Malaysia and Pakistan in the fall of 2013 and winter 2014. The percent difference index (PDI) is formulated as the sum of two positive responses (satisfied and somewhat satisfied) minus the sum of two negative responses (dissatisfied and somewhat dissatisfied). Percent difference indices are given according to society and daily-life aspects. For our analysis to go beneath national average and to go beyond national borders, two lines of analysis are carried out. First, the distance between the level of satisfaction of the top and bottom quartiles is given for each society and according to each of the daily-life aspects. Second, the regional sum of satisfaction of the top quartiles and bottom quartiles are shown crossed by daily-life aspects. In this article we confine ourselves to preliminary comparative description and analysis. More solid and deep comparisons will be carried out by local polling leaders of 12 Asian societies in the succeeding issue of the Asian Journal of Public Opinion Research. Nevertheless, two key threads stand out from this preliminary comparisons. First, social relations (family and human relations) stand out as most satisfied aspects of life in most of twelve societies. Second, the need to go beneath national averages and beyond national borders in analyzing cross-national surveys is confirmed. The comparability and validity of cross-national surveys with varying sampling method and survey mode are briefly discussed toward the end of the article