Clinical and biochemical characteristics of people experiencing post-coronavirus disease 2019-related symptoms: A prospective follow-up investigation

BackgroundPost-acute coronavirus disease 2019 (COVID-19) syndrome, also known as long COVID, is a prolonged illness after the acute phase of COVID-19. Hospitalized patients were known to have persisting symptoms of fatigue, headache, dyspnea, and anosmia. There is a need to describe the characteristics of individuals with post-COVID-19 symptoms in comparison to the baseline characteristics.PurposeTo investigate the clinical and biochemical characteristics of people who recovered from COVID-19 after 6 months of discharge from the hospital.MethodsThis was a prospective follow-up investigation of hospitalized and discharged COVID-19 patients. Adult patients admitted to King Saud University Medical City, Riyadh, Saudi Arabia, with laboratory-confirmed COVID-19 and discharged were recruited. The baseline demographic information, comorbidities, vital signs and symptoms, laboratory parameters, COVID-19 therapy, and outcomes were collected from the medical records. Blood samples were collected for cytokines estimation. A detailed interview about signs and symptoms was undertaken during the follow-up.ResultsHalf of the followed-up people reported experiencing at least one of the COVID-19-related symptoms. The mean blood pressure was found higher in follow-up. People with the symptoms were characterized by low lymphocyte count, lower serum calcium levels, and hyperglycemia compared to people without any post-COVID-19 symptoms. Cytokines IL-8, VEGF, and MCP-1 were higher in people with the most frequent symptoms.ConclusionPeople with post-COVID-19 symptoms were characterized by lower lymphocyte count, lower serum calcium levels, and hyperglycemia compared to people without symptoms. Individuals with the most frequent post-COVID-19 symptoms had higher baseline pro-inflammatory, chemotactic, and angiogenic cytokines

A comparative study between a single-dose and 24-hour multiple-dose antibiotic prophylaxis for elective hysterectomy

Introduction: Surgical site infections (SSIs) are a major health issue in surgical specialties in terms of health care costs and patients’ clinical outcomes. At the level of the patient, prolonged hospital stays or readmissions for SSIs, can affect the patient’s quality of life. At the level of the health care system, it exhausts the hospital’s resources and increases the burden on the medical staff due to the need for continuous wound care, microbiological cultures, laboratory tests and medications. In this study, we assessed the effectiveness of two antibiotic prophylaxis regimens for the prevention of SSIs in patients undergoing elective hysterectomy surgeries. Methodology: A retrospective cohort, analyzing 141 patients, was conducted between November 2016 and January 2019 at a university hospital. We compared the efficacy of a single dose vs. 24-hour multiple doses of Cefazolin in patients who underwent elective hysterectomy for benign or malignant indications. The secondary objective was to identify potential risk factors associated with SSIs. Results: There was no statistically significant difference between both groups (p = 0.872). Obesity and a laparotomy surgical approach are risk factors to the development of SSIs (p = 0.001 and 0.014, respectively). Other potential risk factors include the duration of hospital stay, the duration of the surgery and the amount of blood loss. Conclusions: Although the rate of SSIs is not significantly different between both groups, risk stratification can be done after screening patients and the prophylactic regimen must be tailored for each patient in a cost-effective manner and using a multidisciplinary approach

Glucagon-Like Peptide-1 (GLP-1) during Ramadan: Narrative Review of the Published Literature

Ramadan fasting, a religious practice observed by Muslims worldwide, involves abstaining from eating, drinking, smoking, and using oral medications from dawn to dusk during the ninth lunar month. Studies have demonstrated that fasting during Ramadan has been shown to increase HDL cholesterol, leptin, adiponectin, and insulin sensitivity, as well as lower several hemostatic risk factors for cardiovascular diseases. Additionally, it may result in a drop in blood sugar levels, especially in diabetics who are also on blood sugar-lowering medicine. Hypoglycemia, characterized by low blood sugar levels, could also result from fasting during Ramadan. The GLP-1 (glucagon-like peptide-1) hormone plays a significant role in regulating glucose metabolism and insulin secretion, and Ramadan fasting can affect its production and release in the gut. Research contributes to our understanding of the utilization of GL-1 medications during Ramadan among patients, broadening therapy alternatives and offering insightful information for well-informed decision-making. Therefore, this narrative review aims to explore the current evidence that studies the safety and efficacy of GLP-1 agonists during Ramadan for nondiabetic and diabetic patients to ensure healthy fasting during Ramadan

A comparative study between a single-dose and 24-hour multiple-dose antibiotic prophylaxis for elective hysterectomy

Introduction: Surgical site infections (SSIs) are a major health issue in surgical specialties in terms of health care costs and patients’ clinical outcomes. At the level of the patient, prolonged hospital stays or readmissions for SSIs, can affect the patient’s quality of life. At the level of the health care system, it exhausts the hospital’s resources and increases the burden on the medical staff due to the need for continuous wound care, microbiological cultures, laboratory tests and medications. In this study, we assessed the effectiveness of two antibiotic prophylaxis regimens for the prevention of SSIs in patients undergoing elective hysterectomy surgeries.&#x0D; Methodology: A retrospective cohort, analyzing 141 patients, was conducted between November 2016 and January 2019 at a university hospital. We compared the efficacy of a single dose vs. 24-hour multiple doses of Cefazolin in patients who underwent elective hysterectomy for benign or malignant indications. The secondary objective was to identify potential risk factors associated with SSIs.&#x0D; Results: There was no statistically significant difference between both groups (p = 0.872). Obesity and a laparotomy surgical approach are risk factors to the development of SSIs (p = 0.001 and 0.014, respectively). Other potential risk factors include the duration of hospital stay, the duration of the surgery and the amount of blood loss.&#x0D; Conclusions: Although the rate of SSIs is not significantly different between both groups, risk stratification can be done after screening patients and the prophylactic regimen must be tailored for each patient in a cost-effective manner and using a multidisciplinary approach.</jats:p

Goals of care discussions among critically Ill patients on vasopressor treatment.

BackgroundGoals of care (GOC) discussions are essential for aligning medical management with the values of critically ill patients, particularly those requiring vasopressors, such as dopamine. To evaluate GOC discussions in terms of prevalence, factors associated with documentation, and impact on survival among critically ill patients requiring vasopressors for hemodynamic support.MethodsWe conducted a retrospective cohort study at a tertiary healthcare facility in Riyadh, Saudi Arabia, focusing on patients admitted to intensive care units (ICUs) and internal medicine (IM) wards. The study included adult in patients who received dopamine during their hospital stay. Factors associated with GOC documentation were identified using logistic regression analysis. The 30-day and 1-year survival rates according to GOC discussions were analyzed using Kaplan-Meier survival curves, which were compared using the log-rank test.ResultsOf 301 patients, 56.8% were men and 64.8% were aged ≥60 years. GOC discussions were documented in 61.8% of patients and were more frequent among older patients (≥60 years) than among younger patients (73.1% vs. 51.3%, p ConclusionsGOCs were more prevalent among critically ill older patients. The study found significantly higher mortality rates at both 30 days and 1 year among patients who had documented GOC discussions. These findings highlight the need for institutional strategies to integrate GOC discussions into routine care and address their potential implications on patient outcomes

Epidemiological patterns of bacterial and fungal healthcare-associated infection outbreaks in Ministry of Health hospitals in Saudi Arabia, 2020-2021

Background: Healthcare-Associated Infections (HAI) outbreaks remain a huge challenge to the healthcare sectors worldwide. Their impact on morbidity and mortality, economic and healthcare burden remains a public health problem and a challenge to the HAI surveillance system, infection control, and HAI management strategies. Aim: This study aimed to investigate the epidemiological patterns, distribution, causative agents of HAI outbreaks and the influence of age, COVID-19 co-infection, medical invasive procedures, and hospital units on mortality among HAI outbreaks cases. Methods: This chart review study involved HAI outbreak cases recorded in Ministry of Health hospitals during 2020–2021 in Saudi Arabia. HAI outbreak notification and investigation forms were used for data collection. A binary logistic regression model was performed to determine the significant predictors of mortality. Univariate analyses were performed to determine the association between hospital units, organisms, and COVID-19 co-infection to the site of infection. Results: A total of 217 HAI outbreaks with 1003 cases were recorded in 2020–2021. Gram-negative bacteria were isolated from 73.8% of the cases. The overall specific case fatality rate was 47.5%. The significant predictors of mortality were age, invasive medical procedures, COVID-19 co-infection, and intensive care units’ admission. Moreover, ventilator-associated events were more associated with cases co-infected with COVID-19. Conclusion: HAI outbreaks were most prevalent in the Western and Central region and in intensive care units. Gram negative bacteria were responsible for most of cases while ventilator-associated events and central line-associated bloodstream infections were the most common infection sites. Implementing targeted and effective prevention and control strategies is recommended

Seroprevalence of Human Cytomegalovirus in Pregnant Women in the Asir Region, Kingdom of Saudi Arabia

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Human cytomegalovirus (HCMV) infection spreads easily by interpersonal contact. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; This study determined the prevalence of seropositivity of cytomegalovirus immunoglobulin G (IgG) in the Asir Region, Kingdom of Saudi Arabia. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The study evaluated the seropositivity for cytomegalovirus-specific IgG in 460 females. Collected samples were processed and tested using enzyme-linked immunosorbent assay and specific HCMV IgG. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The study showed that all the respondents aged 15–20 years were seropositive for the HCMV. HCMV seropositive status was recorded in 99.2% of the older patients (&amp;#x3e;40 years of age). In the remaining age groups, the rate of seropositivity ranged from 95.7 (age range 20–25 years) to 98.9% (age range 30 years). &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; In all age groups of females tested, the prevalence of seropositive for HCMV was high, i.e., in the range of 95.7–100%.</jats:p