Foreign body impacted in the Jejunum

We present a case with protracted vomiting which admitted to our hospital. After radiologic investigation, patients underwent laparotomy, were a foreign body was found impacted in the jejunum. Index Word: foreign body, jejunum, impaction, intestinal obstruction

A Study of Quality of Life and its Determinants among Hemodialysis Patients Using the KDQOL-SF Instrument in One Center in Saudi Arabia

Introduction: We aimed to assess quality of life (QOL) among Saudi hemodialysis (HD) patients and the impact on the QOL of a certain demographic and clinical factors. Methods: The QOL was assessed using an Arabic version of Kidney Disease Quality of Life Instrument Short Form (KDQOL-SF). Mean scores were compared for individual domain scores and for the three composite summary scores, namely the mental component score (MCS), the physical component score (PCS) and kidney-disease component score (KDCS). Results: The study included one hundred chronic HD patients from King Abdulaziz Medical City, Riyadh. The overall mean score was 60.4. Domains with very low scores were "cognitive function", "role-emotional", "role-physical" and "work status". Domains with high scores were "patient satisfaction", "dialysis staff encouragement" and "quality of social interaction". The mean scores for KDCS, MCS and PCS were 59.7, 54.2 and 52.7 respectively. KDC scores were higher among males and the married group. PCS scores were higher among males, patients aged < 40 years, and the higher income group. MCS scores were higher among males and the higher income groups. There was a positive correlation between KDCS and MCS (r = 0.62, P = 0.0001); and between KDCS and PCS (r = 0.65, P = 0.0001). Conclusion: We provided a detailed description of the QOL scores of a group of Saudi HD patients and the impact of certain factors on their QOL. Low scores were seen in the "work status", "cognitive function", "role-physical" and "role-emotional" while high scores were seen in "patient satisfaction", "dialysis staff encouragement" and "quality of social interaction" domains.Keywords: Hemodialysis; Kidney Disease; Quality of Life; Saudi Arabi

Salicylic acid improves salinity-alkalinity tolerance in pepper (Capsicum annuum L.)

Salinization and alkalization of soils are agricultural problems in arid and semiarid regions of the world such as Iran. In this experiment the effects of salicylic acid (SA) on resistance of pepper plants under salt stress (SS) and alkali stress (AS) were evaluated. Treatments include 0 and 150 mM of SS, 0, 50 and 100 mM of AS and 0, 0.75 and 1.5 mM SA. Results showed that SS and AS imposed negative effects on pepper plant growth and productivity. Reduction in growth and yield in SS was higher than AS and maximum reduction occurred in high mixed stresses. SA application improved growth parameters and increased yield, relative water content (RWC) and chlorophyll of plants subjected to SS and AS and provided significant protection against stress compared to non-SA-treated plants.  For most traits, 0.75 mM of SA was more effective than 1.5 mM concentration. SA ameliorated the injury caused by SS and AS by increasing chlorophyll and RWC and inhibiting proline accumulation and leaf electrolyte leakage (EL). In general, results indicate that salinity and alkalinity have negative effects on growth and yield of pepper plants and these negative effects can be ameliorated by application of SA

Factors Affecting Hemodialysis Patients' Satisfaction with Their Dialysis Therapy

Aim. To assess the degree of satisfaction among hemodialysis patients and the factors influencing this satisfaction. Methods. Patients were recruited from 3 Saudi dialysis centers. Demographic data was collected. Using 1 to 10 Likert scale, the patients were asked to rate the overall satisfaction with, and the overall impact of, their dialysis therapy on their lives and to rate the effect of the dialysis therapy on 15 qualities of life domains. Results. 322 patients were recruited (72.6% of the total eligible patients). The mean age was 51.7 years (±15.4); 58% have been on dialysis for >3 years. The mean Charlson Comorbidity Index was 3.2 (±2), and Kt/V was 1.3 (±0.44). The mean satisfaction score was (7.41 ± 2.75) and the mean score of the impact of the dialysis on the patients' lives was 5.32 ± 2.55. Male patients reported worse effect of dialysis on family life, social life, energy, and appetite. Longer period since the commencement of dialysis was associated with adverse effect on finances and energy. Lower level of education was associated with worse dialysis effect on stress, overall health, sexual life, hobbies, and exercise ability. Conclusion. The level of satisfaction is affected by gender, duration on dialysis, educational level, and standard of care given

Gastrointestinal manifestations and dynamics of liver enzymes in children and adolescents with COVID-19 infection: A systematic review and meta-analysis

Objectives: To improve the knowledge on Coronavirus Disease (COVID-19) infection, we aimed to study the prevalence of gastrointestinal symptoms and the dynamics of liver enzymes in children infected with COVID-19. Methods: We performed a systematic search of all the articles published up to May 2020 in the following databases: PubMed-MEDLINE, Scopus, and Cochrane. We chose the fixed-or random-effect model for analysis based on the I2 statistic. The included data were analyzed to identify the prevalence of gastrointestinal symptoms (diarrhea, vomiting or nausea) and to identify the dynamics of liver enzymes in children and adolescents diagnosed with COVID-19. Results: We detected an overall prevalence of all gastrointestinal symptoms of 26 (95 CI: 0.18-0.35). The pooled prevalence of diarrhea and nausea/vomiting was 12 (95 CI: 0.08-0.16) with no heterogeneity (P = 0.19; I2 = 23.53) and 11 (95 CI: 0.05-0.17), respectively. The pooled prevalence of elevated ALT and AST and LDH was 12 (95 CI: 0.07-0.17), 14 (95 CI: 0.10-0.18) and 33 (95 CI: 0.12-0.54), respectively among the included studies. Conclusions: According to our systematic review and meta-analysis, 26 of the children and adolescents diagnosed with COVID-19 present gastrointestinal symptoms. This paper has provided a comprehensive overview of the prevalence of digestive symptoms of COVID-19 and of the liver enzymes dynamics in children and adolescents. © 2020, Author(s)

Views on Bioethics Statements among Medical Students from Three Different Saudi Universities

Objective To investigate the level of agreement with ethics statements amongst medical students from different Saudi Universities that use traditional or problem based learning (PBL) methods. Methods The respondents enrolled were medical students from Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) which utilizes PBL methods, King Saud University in Riyadh (KSU), and King Abdulaziz University in Jeddah (KAU), both of which utilize traditional methods. As all KSAU-HS medical students are applied medical science graduates, a fourth group consisting of applied medical science graduates from KSU and KAU were included as controls. The respondents were asked to grade their degree of agreement with 19 statements on different bioethical issues by using a Likert type scale from 1 to 5 (1= I completely disagree, 5= I completely agree). The 19 statements were further divided into 5 summative ethical domains: –(a) goals of medicine (3 questions), (b) autonomy and informed consent (9 questions), (c) quality of life (1 question), (d)resource allocation (4 questions), and (e)withdrawal and withholding of treatment (2 questions). To avoid gender bias, only male students were sampled as KSAU-HS has only male students. Overall mean scores and mean scores for each statement and for each domain by each university were compared using unpaired two-tailed t test and Wilcoxon rank sum test. Results There were 43 students from KSAU-HS, 36 from KSU, 47 from KAU and 43 applied medical science graduates. There were significant differences between the overall mean scores by KSAU-HS on one hand (4.03 +/-0.69) and those by the other three groups on the other, being 3.75 +/- 0.66 (p=0.001) for KSU students, 3.76+/- 0.7 (p=0.015) for KAU students and 3,63 +/- 0.51 (p=0.0001) for the applied medical science graduates. The main differences between KSAU-HS students and the students from KSU and KAU were seen in the areas of objectives of medical care (p=0.05), autonomy (p=0.0001), patient centeredness (p=0.02), and informed consent (p=0.05). These differences could not be explained by the older age of KSAU-HS students or their being postgraduates as revealed by the different results seen with the applied medical science graduates. Conclusion The most paternalistic attitudes were held by the applied medical science graduates followed by KSU and KAU students. The least paternalistic were the students of KSAU-HS. We speculate that these differences are related to the different bioethics teaching and training methods used in the 3 universities

Insomnia in chronic renal patients on dialysis in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD). This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis.</p> <p>Methods</p> <p>This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data.</p> <p>Results</p> <p>Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 ± 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (<it><b>P-values: </b></it>0.05, 0.01, < 0.0001, < 0.0001, and < 0.0001, respectively). No significant association was found between insomnia and other variables, including BMI, smoking habits, underlying etiology of renal failure, dialysis duration, association with hemoglobin, ferritin, and phosphorus or dialysis adequacy as measured by the Kt/V index.</p> <p>Conclusion</p> <p>Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.</p