Incidence of hip fracture in Saudi Arabia and the development of a FRAX model

Summary A prospective hospital-based survey in representative regions of Saudi Arabia determined the incidence of fractures at the hip. The hip fracture rates were used to create a FRAX® model to facilitate fracture risk assessment in Saudi Arabia. Objective This paper describes the incidence of hip fracture in the Kingdom of Saudi Arabia that was used to characterize the current and future burden of hip fracture, to develop a country-specific FRAX® tool for fracture prediction and to compare fracture probabilities with neighbouring countries. Methods During a 2-year (2017/2018) prospective survey in 15 hospitals with a defined catchment population, hip fractures in Saudi citizens were prospectively identified from hospital registers. The number of hip fractures and future burden was determined from national demography. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Saudi Arabia. Fracture probabilities were compared with those from Kuwait and Abu Dhabi. Results The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 2,949 and is predicted to increase nearly sevenfold to 20,328 in 2050. Hip fracture rates were comparable with estimates from Abu Dhabi and Kuwait. By contrast, probabilities of a major osteoporotic fracture or hip fracture from the age of 70 years were much lower than those seen in Abu Dhabi and Kuwait due to higher mortality estimates for Saudi Arabia. Conclusion A country-specific FRAX tool for fracture prediction has been developed for Saudi Arabia which is expected to help guide decisions about treatment

Case report of Stomoxys calcitrans bites in residential area of Kashan, Iran

Stomoxys calcitrans has spread throughout the world and can be found anywhere food and weather conditions are desired. This is the first report of fly biting in Iran caused by Stomoxys calcitrans in Ravand, West of Kashan, central of Iran. Based on our survey, traditional home aviary in the garden courtyard was the development and breeding place of these flies. These flies can painfuly bit during the day. The larvaes and pupa were removed from birdhouse floor and transported to Entomology laboratory of Environmental Health Group, Kashan University of Medical Sciences. Laboratory tests determined that larvaes and pupa belonged to Stomoxys calcitrans species. By using insecticide spraying in the aviary floor by Sevin, bitings were stopped. The present study was the first report on the stable fly bites in Iran. Consumption remaining of vegetables as food in aviary house would attract reproduction of the Stomoxys calcitrans flies

Magnetospheric Science Objectives of the Juno Mission

In July 2016, NASA’s Juno mission becomes the first spacecraft to enter polar orbit of Jupiter and enture deep into unexplored polar territories of the magnetosphere. Focusing on these polar regions, we review current understanding of the structure and dynamics of the magnetosphere and summarize the outstanding issues. The Juno mission profile involves (a) a several-week approach from the dawn side of Jupiter’s magnetosphere, with an orbit-insertion maneuver on July 6, 2016; (b) a 107-day capture orbit, also on the dawn flank; and (c) a series of thirty 11-day science orbits with the spacecraft flying over Jupiter’s poles and ducking under the radiation belts. We show how Juno’s view of the magnetosphere evolves over the year of science orbits. The Juno spacecraft carries a range of instruments that take particles and fields measurements, remote sensing observations of auroral emissions at UV, visible, IR and radio wavelengths, and detect microwave emission from Jupiter’s radiation belts. We summarize how these Juno measurements address issues of auroral processes, microphysical plasma physics, ionosphere-magnetosphere and satellite-magnetosphere coupling, sources and sinks of plasma, the radiation belts, and the dynamics of the outer magnetosphere. To reach Jupiter, the Juno spacecraft passed close to the Earth on October 9, 2013, gaining the necessary energy to get to Jupiter. The Earth flyby provided an opportunity to test Juno’s instrumentation as well as take scientific data in the terrestrial magnetosphere, in conjunction with ground-based and Earth-orbiting assets

Surgical site infection after gastrointestinal surgery in children: An international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda