Secondary antiphospholipid syndrome on oral anticoagulant presented with subdural hematoma

A 50-year-old female known case of systemic lupus erythematosus with positive antiphospholipid antibody warfarin, presented to hospital complaining of severe headache and vomiting for four days. CT brain showed bilateral chronic subdural haemorrhage more on the left side. Her laboratory investigation showed normal Platelet and INR of 3.10. Warfarin reversed and the patient treated conservatively. Later on, admission, she became drowsy again CT brain repeated and showed extensions of hematoma and increased effacement of brain parenchyma. She underwent left sided burr hole to evacuate hematoma. More studies are needed to guide the management of APLS with bleeding

Vitamin D supplementation as a fall prevention method: A systematic review

BackgroundFalls are ‎common occurrences events leading to ‎remarkable morbidity and ‎mortality. Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials‎ conclude contradictory results.AimsThis review aimed to summarize the available RCTs that studied the effect of ‎vitamin ‎D administered on falls in older adults.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were systematically search for relevant articles. The terms ‎ vitamin D, falls, ergocalciferols, 25-hydroxy vitamin D, and ‎‎1, ‎‎25-dihydroxy vitamin D‎ were used. out of Three hundred and four, only ‎eleven fulfilled ‎the inclusion criteria.Results In the majority of the randomized control trial, vitamin D supplementation provides protection against falls among the elderly population.ConclusionThe majority of the studies concluded that vitamin D alone or ‎in ‎combination with calcium was a ‎successful fall ‎reduction method among the ‎elderly

Survey of awareness of diabetes mellitus among the Arar population, Northern Border Region of Saudi Arabia

Background: Diabetes Mellitus (DM) is one of the most widely prevalent diseases in Saudi Arabia. Health education is considered an essential component to improve knowledge and change behavior. People affected by diabetes often have inadequate knowledge about the nature of diabetes, its risk factors and associated complication. Objectives: The aim of this study was to assess the awareness of the Arar population with various aspects of diabetes mellitus. Methods: A cross-sectional study was carried out in Arar city, the capital of the Northern Province of Kingdom of Saudi Arabia (KSA). The study was carried out on Saudi nationals from different age groups that were selected by systematic random sampling. Data was collected by means of personal interview with the participants using a pre-designed questionnaire which was administered by the medical students for each diabetic patient. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. Results: A total of 702 participants were interviewed, among them 201 (28.6%) males and 501 (71.4%) females, and most of them (77.8%) had high educational level, 10.4% were diabetics, 78.9% did not have regular checkup visits to the doctor and 58.5% did not perform any regular exercises, including walking, 60% thought that DM was due to partial or total decrease in insulin secretion and 12.4% thought that it was due to excess sweet eating. Additionally, 48.7% of the respondents thought that lack of exercise and obesity were the major risk factors of DM, 33.2% thought that it was a genetic disease. The majority (86.3) of the participants believed that the treatment of DM was a combination of healthy diet, exercise and medication and more than half (63.1%) said that weight loss and modification of life style were the most important preventive measures of DM. Regarding participants’ knowledge about DM complications, 24.5% knew about retinopathy and loss of vision, 8.3% knew about retinopathy, loss of vision, low sensation and numbness in extremities, 24.9% said that symptoms of DM were thirst and frequent urination. Conclusion: This study recommends that health policy makers conduct more effective health education sessions to increase knowledge of diabetic patients and their caregivers about diabetes and the importance of compliance with its treatment

Primary Care Physicians’ Knowledge, Attitude, and Potential Referral Barriers towards Bariatric Surgery: A Northern Saudi Study

Introduction: Bariatric surgery is the most effective procedure for sustained weight loss and control of obesity-associated comorbidities among morbidly obese patients. Successful bariatric surgery depends on a multidisciplinary approach involving all healthcare workers, including the primary care physicians, from the referral of patients to long-term follow-up. The present study assessed the knowledge, attitude, and potential referral barriers of primary care physicians to bariatric surgery and associated sociodemographic factors. Materials and methods: The present analytical cross-sectional study was conducted among 280 randomly selected primary care physicians using a standard and validated data collection tool. We performed an independent t-test and one-way ANOVA to find the association between sociodemographic characteristics and knowledge, attitude, and referral barrier scores. Furthermore, multilinear regression analysis was executed to determine the association among knowledge, attitude, and barriers. Results: The current study found that 52.9%, 19.3%, and 59.3% had a low score in the knowledge, attitude, and barriers categories. The attitude scores were significantly associated with the education status (p = 0.005) and current position at primary health centers (p = 0.012), and the referral barriers score was significantly associated with the work experience duration (p = 0.004). We found a positive relationship between knowledge and attitude (regression coefficient (β) [95% CI]:0.389 [0.154 to 0.585], p = 0.001) and a negative relationship between knowledge and referral barriers (β [95% CI]: −0.291 [−0.127 to −0.058], p = 0.007). Conclusions: Our survey findings suggest that a lack of knowledge regarding bariatric surgery led to several concerns and referral barriers among the physicians. Therefore, the recommendation is to improve the primary care physicians’ knowledge through continuing medical education, symposium, and other suitable training methods with a special focus on obesity care in the curriculum. Furthermore, a mixed-method survey involving other provinces of the KSA is warranted to formulate the region-specific training needs