A cause of circulatory collapse that should be considered following trauma

Management of poly-trauma patients presenting to the emergency room is usually a challenging and formidable task. Two of the common problems seen in those patients are shock and neurological dysfunction. A huge differential for post-traumatic circulatory collapse exist and timely identification of the etiology is of utmost importance to avoid complications. In this report we are describing 2 cases presenting with circulatory collapse following trauma. The first case was a 29 year old female who presented after a motor vehicle accident fully conscious with severe hypotension and bradycardia. The second case presented with severe hemodynamic instability after falling at home. Physical examination of both patients revealed weakness in all 4 limbs and CT cervical spine revealed complete anterior sublaxation of C5 over C6 cervical vertebrae in the first case and partial sublaxation of C5 over C6 cervical vertebrae in the second case confirming that spinal cord injury is the likely cause for these hemodynamic alterations. A high index of suspicion for spinal cord injuries is therefore mandatory when managing a trauma patient presenting with quadriparesis and hemodynamic instability that is otherwise unexplained especially when the ensuing hypotension is associated with bradycardia instead of reflex tachycardia. Awareness of this cause of circulatory collapse is particularly important in the unconscious patient where eliciting sensory and motor deficits looking for spinal cord injury is not always feasible. Both patients were transferred to the intensive care unit and were maintained on epinephrine till becoming hemodynamically stable. The report aims to sensitize readers to this cause of post-traumatic circulatory collapse

Self-Medication in University Students from the City of Mansoura, Egypt

Background. Self-medication is a common practice in developed and developing countries. Objectives. To explore the prevalence of self-medication practices among university students, probable reasons, symptoms requiring self-medication, and sources of advice. Methods. A descriptive cross-sectional study was carried out in Mansoura University, Egypt, and included 1st and last year students of both medical and nonmedical faculties. Results. Prevalence of self-medication was 62.9%. Younger age, female, medical, and ever-married students and those having home pharmacy tended to self-medicate more than their peers with significant difference between them. Being medical student, being from urban area, having good current health condition, being careless about health, and having drugs stored at home pharmacy were independently associated with the likelihood of self-medicating. Conclusion. Prevalence of self-medication among university students is high which constitutes a health problem that needs intervention

Saudi community care awareness food facts, nutrients, immune system and COVID-19 prevention in Taif City among different age categories

In December 2019, a new coronavirus was discovered in China, sparking a serious pandemic of human acute respiratory syndrome which spread worldwide at a fast rate. Public health knowledge and awareness is required on food facts, nutrients and immune system for coronavirus prevention. The study designed to investigate COVID-19 impact on dietary intake, knowledge, habits, activities and lifestyle among the people in Taif City. Data collection was conducted from the 4th to the 29th of June 2020. A total of 312 respondents, aged from ≤ 12 to ≥ 65 years were involved in the survey. About 81% of the respondents were with high education level (bachelor's degree or higher). Results show that the most frequent diseases in descending order of magnitude were obesity, dental problems, high blood pressure, diabetes, low immunity and colon problems. Data collected showed an increase in food intake frequency during the epidemic except for (4.44, 41.82,12.86, and 30.51 %), like fish, bread, pasta and fast food, respectively. Two hundred and eight (208) of the respondents preferred to use olive oil in their diet due to its several benefits. The majority of the respondents preferred star anise (124) followed by sagebrush (44) as herbal drinks in descending order, respectively. During the COVID-19 pandemic, the study population reported to eat more herbs such as garlic (169), ginger (152) and curcuma (103) to enhance the immune system. Multivitamin (66) and vitamin D intake were reported as the highest, while vitamin B Group and ascorbic acid recorded similar intakes values. Mineral supplement intake in descending order were reported as calcium (57), iron (37) zinc (29) and selenium (5). Around 119 of the respondents had no knowledge on the exact source of COVID-19, while 113 reported as an infection from a bat to humans. The respondents recognized the symptoms as fever (270) and shortness of breath (249). Observing social distance and hand washing were chosen by most respondents (301) as a way of preventing the infection. Two cases of smokers quit the smoking habit; a minor increase rate of training activity was reported; almost all of the respondents embraced the consumption of functional foods, oils, herbs, roots, colored fruits and vegetables and special supplements during COVID-19. Knowledge on COVID-19 had significant positive impact on the respondents’ healthy eating habits, physical exercise, water intake and reduced smoking. Findings recommended intensifying efforts in sensitizing the public to a better understanding of the COVID-19 pandemic and strengthening the immune system

Food consumption and lifestyle habits among university students in Saudi Arabia

Food consumption and lifestyle habits can have a positive or negative direct impact on an individual’s health. University students tend to have poor eating habits that are influenced mainly by sensory perceptions. This survey was done to evaluate the status of food consumption and lifestyle habits among Taif university students (males and females). A total of 600 students aged from 18 to 24 years participated in the survey and responded to questions on socio-demographic characteristics, lifestyle habits, eating habits, food consumption frequency, attitude, health and food awareness knowledge. The randomly selected students were from various levels in university representing wide categories and living conditions in Taif Region, Saudi Arabia. The examined students efficiently completed the survey with the help of the university staff. Weight and height were evaluated by a portable standing electronic scale and a portable stadiometer (Seca 879, Germany) to calculate the Body mass index (BMI) classes. Female students recorded 28% of underweight cases, which was higher than the male students (11%) with none significant at p>0.05. The rate of overweight in male students was 30% compared with the female students’ 26%. The study reported 49% and 64% for normal waist circumference for male and female students, respectively. A higher frequency of moderate physical exercise was reported among male students at 60% compared to that among female students (57%). The number of students who did physical exercise regularly was reported to be higher in females (15%) than males (8%). A percentage of 15% and 7% of the male and female students, respectively were smokers. Male students recorded higher sleeping hours than females. Male students reported high media consumption frequency of more than 3 hours a day 67%, followed by 21% between 3-6 hours a day for female students. About 46% and 55% of male and female students, respectively, reported fast-food consumption at least once a week and about 30% of males and 24% females took only 1 to 2 fast food meals in a month. The major meals skipped were breakfast, followed by lunch and dinner; however, this was not significant p>0.05. Meal skipping was high among female students (72%). It was noted that high percentage of male students (72%) reported low consumption levels of vegetables and fruits. The main reason for fast-food consumption was convenience (31%) for males, while females recorded 32% for choices. Female students had a higher score than males in nutrition knowledge. There is a need for awareness creation concerning better food choices, lifestyle habits and weight management that might create a helpful impact on the university student health

Stochastic Step-wise Feature Selection for Exponential Random Graph Models (ERGMs)

Statistical analysis of social networks provides valuable insights into complex network interactions across various scientific disciplines. However, accurate modeling of networks remains challenging due to the heavy computational burden and the need to account for observed network dependencies. Exponential Random Graph Models (ERGMs) have emerged as a promising technique used in social network modeling to capture network dependencies by incorporating endogenous variables. Nevertheless, using ERGMs poses multiple challenges, including the occurrence of ERGM degeneracy, which generates unrealistic and meaningless network structures. To address these challenges and enhance the modeling of collaboration networks, we propose and test a novel approach that focuses on endogenous variable selection within ERGMs. Our method aims to overcome the computational burden and improve the accommodation of observed network dependencies, thereby facilitating more accurate and meaningful interpretations of network phenomena in various scientific fields. We conduct empirical testing and rigorous analysis to contribute to the advancement of statistical techniques and offer practical insights for network analysis.Comment: 23 pages, 6 tables and 18 figure

Concomitant acute right ventricular infarction and ischemic cerebrovascular stroke; possible explanations

Concomitant acute myocardial infarction and ischemic cerebrovascular accidents has been rarely reported in the literature. In this report, we are describing a 48 year old male patient who presented with acute infero-posterior and right ventricular transmural myocardial infarction followed within one hour with massive cerebral infarction and deep coma. The patient succumbed to cardiogenic shock and fatal ventricular arrhythmias resistant to aggressive resuscitative efforts. This association can best be described as "cardio-cerebral infarction". The authors suggest that there exist a possible relationship between both pathologies rather than being just a mere coincidence. Explanations for this association are thoroughly explored and discussed. Early recognition of such cases is important and determines the patient's further management and prognosis. This report aims to sensitize readers to this rare and critical scenario and highlights the necessity of further research for the ideal management of this situation

Prevalence of thinness cases and dietary diversity among learners of various education stages in Taif Region, Saudi Arabia

Monitoring nutritional status during infancy, childhood, and adulthood is essential because good quality diet during growth is vital to cover the cognitive and physical demands, supply enough energy stores for illnesses and pregnancy and avoid adult nutrition-associated diseases. Thinness cases and lack of dietary diversity among learners in various education stages are common nutritional problems. A cross-sectional survey was carried out for the assessments of thinness cases and dietary diversity among the learners in various education stages in Taif Region, Saudi Arabia in August, 2020. A total of randomly selected 1602 respondents who fulfilled the exclusion and inclusion criteria (n=364 primary schools, n=410 middle schools, n=321 high schools, and n=507 university students) were examined and efficiently completed the survey. The survey comprised of socio-demographic characteristics, questions about health problems, adequate dietary diversity, habits, food item consumption, and nutritional knowledge test based on the student's theory and behaviors. The prevalence of thinness status among university students was very obvious (22%) and found to be mild followed by moderate (11%) and (0.4%) severely thin. The prevalence of severe thinness was the highest among primary school participants (28%). The prevalence of moderate thinness was reported slightly similar among middle and high school participants (29% and 32%, respectively). The highest prevalence of thinness cases was found in students from rural areas, while the lowest values were observed in those from urban areas. Students from large family size were more likely to be thin as compared to students from small size families. Students whose mothers were illiterate or had low formal education were more likely to be thin compared to those students whose mothers had completed university education or above. Further, 78% of primary school students reported meal skipping due to lack of appetite, while shape maintaining for the meal was accounted for 50% for middle school students as the main reason for the meal skipping. Snacking was also reported to be at a high rate among primary and high school students as 76% and 83% of the students mentioned having snacks, respectively. A higher frequency of light physical exercise was established for primary school pupils (81%), while university students reported (34%) as moderate. Almost all students had a low level of eating cereals, fruits and vegetables, while high schools and university students had a high-level consumption of fruits, animal-based foods and nutritional supplements. High school students had an excellent score 37% for nutrition knowledge. Education stage of learners was found to have direct influence on thinness, dietary diversity and food consumption frequency of the respondents. Consequently, nutritional education may positively affect the whole student's ability for good diet choices in the way to ensure a healthier status. The knowledge of nutrition education combined with physical exercise programmers may contribute to strengthening of the healthy eating messages at the various educationstages

The Pattern of Histologically-Proven Acute Post-infectious Glomerulonephritis in Tunisian Adults Seen in 1976 - 2004

Introduction: Acute post-infectious glomerulonephritis (APIGN) is uncommon in adults. It is widely recognized that the prognosis of APIGN is good in children. There is however little information about its long-term prognosis in adults.Methods: Between December 1976 and October 2004, 148 adult cases of APIGN were managed in our center. We retrospectively reviewed these patients’ records and evaluated their clinical course and outcome.Results: The mean age of studied patients was 36±15 years, and the male to female ratio was 2.3. The most common site of preceding infection was the respiratory tract (68.8%). At presentation, 89.2% had nephritic syndrome and 9.4% had rapidly progressive glomerulonephritis.Proteinuria was observed in 99.3%, hematuria in 95.3%, peripheral edema in 89.2% and hypertension in 81.8%. Most patients (60.7%) had acute kidney injury and four patients (2.7%) required dialysis. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis in 88.8% of patients, associated with extracapillary proliferation in 12%. After a median follow-up of 2.5 year, only two patients died and 16.12% of patients hadpersistent clinical and/or biological abnormality. Chronic kidney disease was noted in 10 patients (6.75%) including four patients (2.7%) who progressed to end-stage renal disease. Poor prognostic factors included nephrotic range proteinuria, extracapillary proliferation in renal biopsy,acute kidney injury and the need for dialysis.Conclusion: In this cohort of patients, APIGN progressed to chronic kidney disease in less than 10% of patients