We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.

Ulcerative colitis and Crohn's disease have an approximately 2-3-fold increased risk of colorectal cancers. The risk factors most frequently associated with the risk of these cancers in inflammatory bowel disease are those indicative of chronic inflammation, primary sclerosing cholangitis, previous dysplasia, and a family history of colorectal cancers. The pace of CRC surveillance in this population will be determined by the presence of these risk factors, and the surveillance modality is based on colonoscopy with chromoendoscopy and targeted biopsies. In the absence of staining, systematic biopsies can be performed.

Background: Acute diarrhea poses a significant health threat to children globally, often leading to severe morbidity and mortality, particularly in developing countries. Electrolyte imbalances, including hyponatremia and hypokalemia, are common complications associated with acute diarrhea, further exacerbating the risk of adverse outcomes. Objective: This study aimed to evaluate the frequency of sodium and potassium abnormalities, specifically hyponatremia and hypokalemia, in children presenting with acute diarrhea. Methodology: A prospective cohort study was conducted at the Pediatric department of a tertiary hospital from July 2022 to June 2023. A total of 130 pediatric patients aged up to 5 years, presenting with acute diarrhea, were included in the study. Clinical examinations were conducted, and demographic data, including age, gender, residence, and socioeconomic status, were recorded. Serum sodium and potassium levels were determined from venous blood samples, and hyponatremia and hypokalemia were defined as sodium levels <130 mmol/l and potassium levels <3.5 mmol/l, respectively. Statistical analysis was performed using SPSS 24.0. Results: The mean age of the patients was 2.38 years, with a disease duration of 3.54 days. Male patients accounted for 60% of the cohort, and urban residency was predominant (55%). Clinical symptoms included loose motion (100%), abdominal pain (70%), fever (35%), vomiting (31%), and lethargy (27%). Hyponatremia was observed in 30% of patients, while hypokalemia was present in 40% of cases. Conclusion: Sodium and potassium imbalances are prevalent among children with acute diarrhea, highlighting the need for vigilant monitoring and appropriate management strategies to prevent adverse outcomes. The high incidence of hyponatremia and hypokalemia underscores the importance of early recognition and intervention in pediatric patients presenting with acute diarrhea.

Introduction: Cranial wounds encephalic penetrating by stab are rare and repesent 0.4% of Head trauma. They are often observed in an attempt at autolysis in mentally ill people, or in physical aggression. We report here a case of an adolescent victim of attack by the penetration of a knife into his brain. Patient and method: This is a patient aged 17 years old, with no known medical history, admitted to the Emergency Reception Department of the Gabriel TOURE University Hospital for open head trauma following a physical attack with the penetration of a knife inside his headrane. The entire blade of the weapon was lodged in his brain parenchyma. The entry point was the right parietal bone. The patient had a Glasgow score of 15/15, with good hemodynamic status. The cranial scanner encephalic which was carried out a few minutes after his admission high lighted the presence of the knife blade at the level of parietal and temporal lobe of her hemisphere right. Result: The patient was operated successfully with extraction of a knife whose blade measured 6 to 7cm. A good postoperative evolution followed. Conscious and without motor deficit, he received a follow-up CT scan on day 7. Then he was released from the hospital with out patient follow-up. Conclusion: Cranial wounds-encephalic by penetration of a bladed weapon are very rare. The CT scan in emergency is the key examination to clarify the location, the number of foreign bodies, as well as brain lesions. They require rapid surgical treatment after CT evaluation. Their prognosis remains reserved regarding the severity of the head trauma, endocranial vascular lesions and infections.

Introduction: Dengue fever is a mosquito-borne arboviral (arthropod-borne virus) disease which is of global concern. This fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, arthralgia, rash, leukopenia, and lymphadenopathy. Aim of the study: This study aimed to evaluate the clinical and laboratory profile of dengue fever in children less than 15 years old admitted to an urban hospital. Methods: This retrospective study was conducted in the Department of Paediatrics of Anwer Khan Modern Medical College Hospital (AKMMCH), Dhaka, Bangladesh during the period from 4 April 2019 to 9 September 2019. They have followed up on the symptoms, platelet count and management of the patients. Data were analysed by using MS-Excel-2016. Result: In total 98 patients from both groups completed the study. In our study, we found a maximum of 54.08% were male, more than half 53(54.08%) patients were below five years of age, about 95(96.94%) of the patients had a fever. Maximum patients, 81(82.65%), were managed by I/V fluid, more than 72(73.47%) of the patients were managed by paracetamol. Others by antibiotics 16(16.33%), platelet transfusion 14(14.29%) and blood transfusion 12(12.24%). Other management also includes plasma, & dopamine. Conclusion: These study children about 0-15 years of age more commonly suffer from dengue fever. As the vaccine is not available in Bangladesh, these patients need a timely diagnosis and critical monitoring during the disease course to prevent severity and mortality.

Background: A needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. Objectives: we aimed in this study to assess the prevalence of NSI among health care workers in King Saud Medical City and to assess their knowledge, attitude and practices regarding needle stick injuries. Methods: A cross-sectional study was conducted from 17th August 2022 until 30th November 2023. A structured questionnaire from Saudi Ministry of Health guidelines was used to collect the data. The content validity was evaluated by four academics from King Khalid University in Abha, and some minor changes were made. Results: As regard the prevalence of NSI, out of 220 participants, 132 individuals did not report any needle-stick injuries (NSI). While 92.3% of participants accurately defined NSI and acknowledged blood-borne disease transmission risks, only 39.1% followed preventive measures like recapping needles and proper disposal. There were knowledge gaps observed, with varying awareness levels on Hepatitis B and C prevention. Participants demonstrated awareness of post-exposure guidelines but lacked knowledge on immediate actions to take post-injury. Attitudes towards NSI varied, with a significant percentage 44.1% prioritizing patient care over healthcare worker safety. Interestingly, significant support was shown for immediate reporting of sharp injuries and the belief that NSIs are preventable. In terms of practice, adherence to safe needle practices varied, with the majority 90.9% using assigned disposal containers and being vaccinated against Hepatitis B, but not all receiving recent training on safe devices. Conclusion: This study revealed that NSIs remain a prevalent occupational health hazard among healthcare workers. Although a significant number of participants demonstrated adequate knowledge and awareness of NSIs and bloodborne disease transmission risks, there were noticeable gaps in their implementation of preventive measures and immediate post-injury actions. Attitudes towards NSIs varied, with some prioritizing patient care over healthcare worker safety. However, there was strong support for the immediate reporting of sharp injuries and belief in the preventability of NSIs.

This work was initiated with an objective that would screen for bioactive specifically antibacterial molecules secreted by actinomycetes growing in fresh water pond soil. Actinomycetes being treasure trove of thousands of bioactive molecules. It is recommended that either novel or present day bio molecule derivatives should be detected and pertinent drug development process be carried out with this background this study was proceeded to identify strains of Microbacterium barkeri (LMA4), Corynebacterium argetoratense (LMA5) and Streptomyces shenzhenensis (LMA6) form the local marshy pond soil. The actinomycetes was with Arial mycelia was gram positive with profuse branching. In a test considering MDR strain of Escherichia coli (BME4) and Staphylococcus aureus (BMS4) as test bacteria. The 16s rRNA sequences and the BLASTn analysis helped out to predict the sequence identification as the actinomycetes isolates.

Primary ciliary dyskinesia is a cause of bronchial dilatation, associated with rheumatoid lung is rare. This is why we report a case with the aim of discussing the clinical, diagnostic characteristics and therapeutic possibilities of ciliary pathology and showing the link between it and rheumatoid arthritis. Observation: This is a 40-year-old African patient, married without children, from a consanguineous couple, with a family history of a brother who died in adulthood in a picture of respiratory failure and productive cough. She presented with recurrent rhinorrhea since childhood and bronchorrhea in a picture of progressively worsening dyspnea and clubbing. During the evolution of the disease, inflammatory polyarthralgia was associated. The ultrastructural ciliary study by electron microscopy and the measurement of nasal nitrogen oxide are the confirmatory examinations of primary ciliary dyskinesia. They are not achievable in our practice. However, based on the history and clinical findings, the patient presented several elements in favor of this pathology. additional investigations, notably the rheumatoid factor and the chest CT scan, allowed us to suggest rheumatoid lung. Our therapeutic conduct was the administration of antibiotic therapy, oxygen therapy, immunosuppressant, anti-inflammatory and the practice of respiratory physiotherapy. Conclusion: Primary ciliary dyskinesia associated with pulmonary involvement in rheumatoid arthritis increases the risk of developing respiratory failure.

Introduction: Immunotherapy is a form of oncologic treatment directed towards enhancing the host immune system against cancer. Immunotherapeutic agents were significantly associated with a higher risk of developing adverse effects in cancer patients. Bevacizumab was significantly associated with higher risk of developing venous thromboembolism, GI perforation such as bleeding and leukopenia in cancer patients. Trastuzumab has led to a significant improvement in the treatment of both advanced and early breast cancer by over expressing HER-2 receptors. It was associated with an important adverse effect, cardiotoxicity. Cetuximab and Panitumumab are monoclonal antibodies targeting the endothelial growth factor receptors (EGFR) currently used for systemic treatment of metastatic colorectal cancer in combination or alone have been reported to be able to induce skin toxicities. Nausea, diarrhea and rash were the most common adverse effects in Pertuzumab alone and Pertuzumab – based therapies. Pertuzumab also increases the risk of clinical heart failure, but not asymptomatic/minimally symptomatic left ventricular systolic dysfunction, in HER2-positive cancer patients. Materials and Methods: An ambispective observational single center study was conducted by collecting details of patients prescribed with Trastuzumab, Bevacizumab Pertuzumab, cetuximab and panitumumab. Retrospective study period of 5 years (2017 November to 2022 November) and Prospective study period of 6 months were conducted (December 2022 to May 2023). Patients of all age groups prescribed with immunotherapeutic agents other than immune checkpoint inhibitors was included and patients who were discharged against medical advice and incomplete data was excluded. Results: Majority of patients in our study were in age groups of 56-65 years with 38.5%. Among 65 patients, 4 of them reported with trastuzumab induced cardiotoxicity and 3 of the patients taking trastuzumab along with pertuzumab also reported with cardiotoxicity. Among 30 patients who were taking bevacizumab, one patient was reported with pneumonitis. We conducted a correlation analysis using chi-square test between study considered drugs and the reported adverse reactions. All of the patients prescribed with Trastuzumab + Pertuzumab were having ADR. Also, majority of the patients prescribed with Bevacizumab were not having ADR. Since the p-value of chi-square test was found to be <0.001 so there exist a significant relation between drugs prescribed and ADR. Conclusion: We assessed the safety profile of immunotherapeutic agents other than immune check point inhibitors in cancer patients. We also correlated the study considered drugs and adverse drug reaction occurrence, there existed a significant correlation.

Background: Polypharmacy, the concurrent use of multiple medications by an individual, presents challenges in medication management, patient safety, and healthcare outcomes, particularly among older adults. In Saudi Arabia, the prevalence of polypharmacy is increasing due to the aging population and the burden of chronic diseases. Understanding healthcare providers' awareness and practices regarding medication switching is crucial for optimizing medication use and improving patient outcomes. Study Aim: This systematic review aims to synthesize and analyze existing literature on healthcare providers' awareness of medication switching for polypharmacy patients in Saudi Arabia. The study focuses on pharmacists and physicians, exploring their knowledge, attitudes, and practices related to medication management, deprescribing, pharmacovigilance, and Medication Therapy Management (MTM) services. Methodology: A systematic search was conducted across major databases, including PubMed, Scopus, and Google Scholar, using predefined search terms related to polypharmacy, medication switching, healthcare providers' awareness, and Saudi Arabia. Eligible studies were selected based on inclusion criteria, including study design, setting, participants, and relevance to the study aim. Data extraction and synthesis were performed to analyze key findings and themes related to healthcare providers' awareness of medication switching. Results: Six eligible studies were included in the systematic review, encompassing survey-based investigations, cross-sectional studies, and qualitative studies conducted in various healthcare settings across Saudi Arabia. The findings revealed gaps in pharmacists' and physicians' knowledge regarding Potentially Inappropriate Medications (PIMs), Drug-Drug Interactions (DDIs), pharmacovigilance practices, and deprescribing strategies. Recommendations for improving pharmacists' education, enhancing pharmacovigilance practices, and promoting collaborative care models were highlighted. Conclusion: Healthcare providers in Saudi Arabia demonstrate varying levels of awareness and practices regarding medication switching for polypharmacy patients. There is a need for targeted educational interventions, standardized pharmacovigilance practices, and collaborative efforts among healthcare providers to optimize medication use, reduce polypharmacy-related risks, and improve patient outcomes.

Background: The increasing consumption of fast food and junk food among adolescents is a growing public health concern, particularly in urban areas of developing countries like Bangladesh. This study aims to explore the relationship between knowledge of fast food and junk food consumption and sociodemographic characteristics among high school students in Bogura Town, Bangladesh. Methods: This cross-sectional descriptive study was conducted at the Department of Community Medicine, Rajshahi Medical College, from January 2023 to December 2023. A total of 384 high school students from various schools in Bogura were selected using purposive sampling. Data were collected using a pretested semi-structured questionnaire and analyzed using SPSS version 26. Descriptive statistics and chi-square tests were employed to assess associations between variables. Result: The majority of participants were aged 14-16 years (58.07%) and female (66.15%). Most students resided in urban areas (95.31%) and came from nuclear families (87.24%). Parental education levels were high, with 56.77% of fathers and 37.76% of mothers being graduates or having higher education. Despite this, only 23.70% of students had complete knowledge about the nutritional value of fast food and junk food. Significant associations were found between knowledge levels and gender, parental education, economic status, and BMI (p < 0.05). Fast food consumption was prevalent, with 74.48% consuming it at school and 78.13% consuming instant foods at home. Knowledge gaps were notable in areas such as the effects of saturated fats, metabolism, and chronic disease risks. Conclusion: The findings highlight significant gaps in nutritional knowledge among adolescents, despite high rates of fast food consumption. Sociodemographic factors play a crucial role in influencing nutritional knowledge. There is an urgent need for targeted educational programs to address these gaps and promote healthier eating habits among adolescents to improve long-term health outcomes.

This article provides an overview of Non-Invasive Prenatal Testing (NIPT), also known as noninvasive prenatal screening. It is a technique for estimating the likelihood that the fetus will have specific genetic defects at birth for pregnant women. The content is specifically tailored for pregnant women and ncompasses a detailed exploration of topics such as Genomics-based noninvasive prenatal tests, sample details for noninvasive prenatal testing, factors influencing test results, the interpretation of test results, limitations associated with the test, and the content included in the Declaration of Consent Form for Noninvasive Prenatal Testing.

Background: The management of chronic diabetic foot ulcers (DFU) poses a great challenge to the treating physician and surgeon. The aim of this study was to identify the risk factors, clinical presentation, and outcomes associated with chronic DFU. Objective: To determine the various risk factors for diabetic foot ulcers and study their associations. To study the grades of diabetic foot ulcers at presentation. Method: Purposive sampling. This study was done in the Surgery department of Shaheed Ziaur Rahman Medical College Hospital (SZMCH), Bogura for period of twelve (12) months. 100 cases were selected after informed consent. Study group (A) comprises of 50 cases of type 2 diabetes with diabetic foot ulcer and control group (B) comprises of 50 cases of age and gender matched type 2 diabetics without foot ulcers. Patients having serious systemic illness, type I diabetics and non-diabetic patients presenting with foot ulcer were excluded. Age, gender, duration of diabetes, duration of ulcer, glycemic control, presence of neuropathy and vascular disease were documented. Grading and Staging of ulcer was done according to New University of Texas Diabetic Wound Classification. Various risk factors were compared between the two groups. Data analyzed via SPSS version 17 with significant p-value < 0.05. Results: Among 100 cases (64 % males & 36 % females); mean age was 58.50 ± 9.8 (group A) versus 50.40 ± 10.5 (group B). Mean duration of diabetes was longer in group A (10.49 ± 7.06 years) vs. group B (8.34 ± 4.83 years) (p = 0.019). Glycemic control was poor in group A (72 %) vs. group B (56 %) (p = 0.045). There was significantly more peripheral vascular disease in group A (50 %) vs. group B (32 %) (p= 0.005). Sensory neuropathy was more in group A (90 %) vs. group B (38 %) (p < 0.0001). Grade-I ulcer was present in 16 % cases, Grade-II in 38 % and Grade-III in 46 %. Conclusion: Neuropathy carries highest risk for diabetic foot ulcer, followed by peripheral vascular disease and poor glycemic control. Therefore, diabetic patient must be educated about these risk factors, foot care and self-examination and to have regular screening by clinician. Appropriate glycemic control and timely medical and surgical intervention may reduce morbidity in diabetics.