21 research outputs found

    Systematic Review and Meta-Analysis of Randomized Clinical Trials in the Treatment of Human Brucellosis

    Get PDF
    BACKGROUND: Brucellosis is a persistent health problem in many developing countries throughout the world, and the search for simple and effective treatment continues to be of great importance. METHODS AND FINDINGS: A search was conducted in MEDLINE and in the Cochrane Central Register of Controlled Trials (CENTRAL). Clinical trials published from 1985 to present that assess different antimicrobial regimens in cases of documented acute uncomplicated human brucellosis were included. The primary outcomes were relapse, therapeutic failure, combined variable of relapse and therapeutic failure, and adverse effect rates. A meta-analysis with a fixed effect model was performed and odds ratio with 95% confidence intervals were calculated. A random effect model was used when significant heterogeneity between studies was verified. Comparison of combined doxycycline and rifampicin with a combination of doxycycline and streptomycin favors the latter regimen (OR = 3.17; CI95% = 2.05-4.91). There were no significant differences between combined doxycycline-streptomycin and combined doxycycline-gentamicin (OR = 1.89; CI95% = 0.81-4.39). Treatment with rifampicin and quinolones was similar to combined doxycycline-rifampicin (OR = 1.23; CI95% = 0.63-2.40). Only one study assessed triple therapy with aminoglycoside-doxycycline-rifampicin and only included patients with uncomplicated brucellosis. Thus this approach cannot be considered the therapy of choice until further studies have been performed. Combined doxycycline/co-trimoxazole or doxycycline monotherapy could represent a cost-effective alternative in certain patient groups, and further studies are needed in the future. CONCLUSIONS: Although the preferred treatment in uncomplicated human brucellosis is doxycycline-aminoglycoside combination, other treatments based on oral regimens or monotherapy should not be rejected until they are better studied. Triple therapy should not be considered the current treatment of choice

    Aggressive pulmonary destructive lesion caused by aggregatibacter actinomycetemcomitans: a pediatric case report in Saudi Arabia

    Get PDF
    BACKGROUND: This study aimed to describe invasive pneumonia with rib destruction caused by Aggregatibacter (Actinobacillus) actinomycetemcomitans that mimicked malignancy and tuberculosis of the chest on initial presentation. CASE PRESENTATION: We reported a case of A. actinomycetemcomitans pneumonia with rib destruction and reviewed similar published pediatric cases. It was noted in this case that Aggregatibacter (Actinobacillus) actinomycetemcomitans is a fastidious, slow-growing organism that caused pneumonia and rib destruction. It needed a long duration of therapy to eradicate the organism. CONCLUSIONS: Aggregatibacter (Actinobacillus) actinomycetemcomitans, a fastidious gram-negative bacillus that is part of the oral flora, is frequently found in human periodontal cultures and is an important pathogen causing various invasive infections. Pneumonia caused by A. actinomycetemcomitans is rare and treatment protocols are not well established

    Prevalence of Self-prescribing Propranolol Among Medical and Dental Students in Riyadh, Saudi Arabia: A Cross-sectional Study

    No full text
    Purpose: The life of students is full of stressors that might have an impact on their mood and academic performance. These stressors are exaggerated among medical and dental students, as they have to worry more about financial, social, and academic issues. The study aimed to estimate the prevalence and predictors of inappropriate self-prescribing of propranolol (Inderal®) among medical and dental students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) Riyadh, Saudi Arabia. Methods: A cross-sectional study using consecutive sampling was carried out among Saudi medical and dental students, who were enrolled in KSAU-HS during the study period. A validated newly developed English questionnaire was sent via E-mail to all eligible participants with response rate of 86.9%. Chi-square test was used to compare between groups, whereas multivariate logistic regression analysis was carried out, where the variables that were included in the model were the ones that showed statistical significance at the bivariate level. Results: Around 30% of the sample used propranolol (Inderal®) during their college years. Propranolol use predictors showed that females from both specialties were less likely to use propranolol (OR=0.11, 95% CI=0.06–0.24, P-value<.001), whereas medical students were more likely to be propranolol users (OR=12.38, 95% CI=4.89–31.35, P-value<.001). Notably, junior students were less likely to use the drug (OR=0.08, 95% CI=0.01–0.49, P-value= .006). Conclusions: The overall results showed a slightly high rate of propanol misuse among medical and dental students. The majority of users are aware of the risks and potential side effects of self-prescribing medications, however; the anxiety relieving effect of propranolol increased its use prior to oral exams and presentations. Educational activity targeting students must be implemented

    Assessment of Primary Care Physicians’ Expertise of Common Dermatological Conditions in the Jouf Region, Saudi Arabia: A Mixed Methods Study

    No full text
    Primary care physicians (PCPs) are the first line of defense for the management of common dermatological conditions (DCs). This study aimed to assess how dermatological diseases are identified, managed, and referred to in primary healthcare centers (PHCs). This was a mixed methods study comprising a cross-sectional survey and semi-structured interviews recruited through PHCs across the Jouf region of Saudi Arabia. Sixty-one PCPs completed the data, and eight participants were interviewed. A survey based on a sample of 22 photographs of common DCs in the Kingdom was administered to the participants to answer questions about the correct diagnosis, appropriate management, referral strategy, and encounter rate. In our sampled population, the mean overall knowledge level on a scale of 10 was 7.08 (±1.3). Among participants that had good to acceptable scores, 51 (83.6%) were in the overall knowledge parameter, 46 (75.4%) in the diagnosis parameter, and 49 (80.3%) in the management parameter. PCPs with five years or more of experience were found to have significantly higher overall knowledge and management scores. Most of our PCPs demonstrated sufficient knowledge of common DCs and had good to acceptable scores in all parameters. However, educational and regulatory aspects of PCPs’ clinical management were identified. Focused training, provision of workshops, and improving medical school curricula regarding common DCs are recommended
    corecore