Annals of Saudi Medicine最新文献

{"title":"Diabetic ketoacidosis in Saudi Arabia: factors precipitating initial admission and readmission","authors":"Raghad Alotaibi, M. Alsulami, Sumiah Hijji, Saad Alghamdi, Yasser A Alnahdi, Haifa Alnahdi, S. Samargandy","doi":"10.5144/0256-4947.2022.119","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.119","url":null,"abstract":"BACKGROUND: Diabetic ketoacidosis (DKA) is one of the complications of diabetes mellitus (DM), primarily type 1 DM. To our knowledge, only one study explored DKA readmission rates in Saudi Arabia. OBJECTIVES: Identify and analyze precipitating factors for DKA admission and readmission. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: We identified all patients aged 15 years and older admitted with DKA from 2018 to 2020. Descriptive factors and uni-and multivariate analyses are presented for associations with initial admission and readmission. MAIN OUTCOME MEASURES: Relationships between precipitating factors and initial admission and readmission. SAMPLE SIZE: 176 patients. RESULTS: Most of the patients had type 1 DM (n=157). The median (interquartile percentiles) for duration of DM was 6.0 (1.0-12.0) years. The mean (SD) HbA1C (%) was 11.8 (2.6). The factors that precipitated DKA were most commonly treatment nonadherence (55.1%), followed by infections (31.8%) and nonadherence to diet (25.6%). The most common symptoms were nausea and vomiting (87.5%), followed by abdominal pain (72.7%). During the study period, 32.4% of the sample were read-mitted with DKA. The median (interquartile range) duration between the first and second admission was 12 (4-25) weeks. In the multivariate analysis, increased odds of readmission for DKA were associated with type 1 DM and medication nonadherence (P=.038, P=.013, respectively). The severity of the initial DKA and the control of DM were not associated with the readmission rate. CONCLUSION: Treatment nonadherence is the leading precipitating factor of DKA in our region. Patient education and counseling play a major role in addressing this preventable complication and its medical and financial burden. We advocate more efforts dedicated toward patient education and logistic support. LIMITATIONS: Retrospective-single center. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"119 - 126"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47615339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of genetic variants of the vitamin D receptor gene with vitiligo in a tertiary care center in a Saudi population: a case-control study","authors":"G. B. Saif, I. Khan","doi":"10.5144/0256-4947.2022.96","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.96","url":null,"abstract":"BACKGROUND: Vitiligo is a common cutaneous disorder of the skin and hair caused by a systemic depigmentation disorder that affects 1% of the population or less due to its onset in early adulthood. Meta-analyses have documented a linkage between vitiligo and the vitamin D receptor (VDR) gene. OBJECTIVE: Investigate the relationship between the ApaI, BsmI, FokI and TaqI genetic variants in the VDR gene with vitiligo in a Saudi population. DESIGN: Case-control. SETTING: Single tertiary care center. PATIENT AND METHODS: The case-control study was carried out between January 2015-December 2015 in Saudi vitiligo patients and healthy controls. VDR genetic variants or polymorphisms (ApaI, BsmI, FokI and TaqI) were genotyped by polymerase chain reaction-restriction fragment length analysis followed by 3% agarose gel electrophoresis. Applicable statistical methods were used to assess relationships between vitiligo cases and controls. MAIN OUTCOM MEASURE: Effect of genotype distribution among four single nucleotide polymorphisms. SAMPLE SIZE: 152 vitiligo (median [IQR] 23 [19] years) patients and 159 healthy controls (45 [28.5] years). RESULTS: We found an association of vitiligo with ApaI and BsmI polymorphisms (P<.05). However, a decreased risk was noted in vitiligo patients with FokI and TaqI polymorphisms and in the diplotype and haplotype analysis within males and females. A positive association with vitiligo was observed in ACAC and AC (adjusted by gender) haplotypes (P<.05). The strongest linkage disequilibrium was observed between rs79785232 (ApaI) and rs731236 (TaqI) polymorphisms (r2=.83), followed by rs2228570 (FokI) and rs1544410 (BsmI) polymorphisms (r2=.53). CONCLUSIONS: Our results confirm an association of vitiligo with ApaI and BsmI polymorphisms and fail to show an association in TaqI and FokI polymorphism with vitiligo. Additional studies need to be carried out in different Arab populations to determine whether the polymorphisms are present. LIMITATIONS: Controls not age matched, small sample size, lack of biochemical parameters. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"96 - 106"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42516138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological outcomes in adult drowning patients in China","authors":"P. Zhou, Huaqing Xu, Bingccan Li, Chenbing Yang, Zhiliang Zhou, Jincun Shi, Zhangping Li","doi":"10.5144/0256-4947.2022.127","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.127","url":null,"abstract":"BACKGROUND: Drowning is the third leading cause of unintentional death worldwide. The epidemiological characteristics of adult drownings are rarely reported. OBJECTIVE: Investigate factors associated with neurological prognosis in adult drowning inpatients. DESIGN: Multicenter medical record review. SETTING: Tertiary health care institutions. PATIENTS AND METHODS: We collected demographic and clinical data on patients who drowned but survived between September 2006 and January 2020. Neurological prognosis was compared in patients with and without cardiac arrest. MAIN OUTCOME MEASURES: Neurological outcomes. SAMPLE SIZE AND CHARACTERISTICS: 142 patients with mean age of 50.6 (19.8) years, male/female ratio of 1.54:1. RESULT: Forty-five patients (31.7%) received CPR, 90 patients (63.4%) experienced unconsciousness, and 59 patients (41.5%) received endotracheal intubation and mechanical ventilation. Multivariate logistic regression analysis showed that the initial blood lactic acid level (OR: 7.67, 95%CI: 1.23-47.82, P=.029) was associated with a poor neurological prognosis in patients without cardiac arrest. The incidence of ICU admission (OR: 16.604, 95%CI: 1.15-239.49, P=.039) was associated with a poor neurologic prognosis in patients with cardiac arrest. CONCLUSIONS: For the drowning patients with cardiac arrest, ICU admission was associated with neurological function prognosis in these patients. Among the patients without cardiac arrest, the initial lactate value was associated with neurological function prognosis of these patients. LIMITATIONS: Retrospective. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"127 - 138"},"PeriodicalIF":1.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42673784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign nodules of the thyroid gland and 25-hydroxy-vitamin D levels in euthyroid patients.","authors":"Hacı Bolat, Aliriza Erdoğan","doi":"10.5144/0256-4947.2022.83","DOIUrl":"10.5144/0256-4947.2022.83","url":null,"abstract":"<p><strong>Background: </strong>The presence of nodules in the thyroid gland is common in iodine-deficient areas of the world. Recently, vitamin D levels were found to be lower than normal and sometimes deficient in malignant nodules of the thyroid.</p><p><strong>Objective: </strong>Evaluate the relationship between the serum vitamin D levels and benign thyroid nodules in euthyroid patients.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Tertiary care center in Turkey.</p><p><strong>Patients and methods: </strong>Patients referred to the general surgery outpatient clinic and diagnosed with thyroid nodules were the study group. The control group consisted of healthy individuals without thyroid nodules. Age, BMI, thyroid ultrasonography, serum 25-hydroxyvitamin D, free T3, free T4, thyroid stimulating hormone, calcium, magnesium, phosphorous, total protein, albumin, glucose, creatinine levels and glomerular filtration rate (GFR) were compared between groups.</p><p><strong>Main outcome measure: </strong>Serum 25-hydroxy-vitamin D levels and size of the thyroid nodules.</p><p><strong>Sample size and characteristics: </strong>Of 849 individuals, 453 were patients with thyroid nodules and 396 were healthy individuals.</p><p><strong>Results: </strong>The mean serum vitamin D levels of patients with thyroid nodules were significantly lower than controls (<i>P</i><.001). Serum vitamin D levels along with serum total protein levels and eGFR were independent variables associated with the presence of a thyroid nodule (<i>P</i><.001, p=.005 and <i>P</i>=.017, respectively).</p><p><strong>Conclusion: </strong>These findings suggest vitamin D deficiency might be one of the pathophysiologic factors in development of thyroid nodules.</p><p><strong>Limitation: </strong>Single-center and possible information bias.</p><p><strong>Conflicts of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"83-88"},"PeriodicalIF":1.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8982002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44433013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of post-operative infections in implantable cardiac devices in a cardiac tertiary care center.","authors":"Alamer Modi Atig, Yara Ibrahim Alhamad, Foz Salem Alanizi, Husam Ismail Ardah, Haitham Alanazi","doi":"10.5144/0256-4947.2022.58","DOIUrl":"10.5144/0256-4947.2022.58","url":null,"abstract":"<p><strong>Background: </strong>The rise in the incidence of implantation is one of the main causes behind the increased rate of CIED infection, which is considered as a serious life-threatening complication. The need of risk factor assessment has become a necessity to prevent further complications and provide prompt management.</p><p><strong>Objectives: </strong>Identify the risk factors of infection postoperatively among patients who have implantable cardiac devices.</p><p><strong>Design: </strong>A retrospective case-control study.</p><p><strong>Settings: </strong>Cardiac center for adults.</p><p><strong>Patients and methods: </strong>The study included all adult patients (≥14 years of age) of all nationalities who underwent cardiac electronic device implantation that was managed in the cardiac center between January 2012 to December 2018.</p><p><strong>Main outcome measures: </strong>Cardiac device infection and associated risk factors.</p><p><strong>Sample size: </strong>213, including 23 (10.8%) infected case patients and 190 (89.2%) non-infected controls.</p><p><strong>Results: </strong>The mean (SD) age of non-infected patients was 45.0 (12.7) years compared with 61.7 (13.7) for infected patients (P<.0001). Anticoagulant use, hypertension, dysplipdemia and age were the most common patient-related risk factors associated with infection. For procedural and post-procedural risk factors, the risk of infection increased as the number of leads and length of procedure increased. The device most often related to infection was the pacemaker. In the multivariate analysis, longer procedure, greater number of leads, older age, anticoagulant use, and implanted pacemaker device were independently associated with infection.</p><p><strong>Conclusion: </strong>We advise the prompt use of strict preoperative antiseptic prophylaxis measures and follow-up for post-implant patients along with patient education for early signs of infections, which will lead to improvement of both diagnosis and treatment quality for our patients in addition to reducing the economic impact on the health care system by minimizing infectious complications.</p><p><strong>Limitations: </strong>Single tertiary center study, small sample size.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"58-63"},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/c6/0256-4947.2022.58.PMC8812164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and health outcomes in patients with alcohol withdrawal syndrome: an observational study from Oman.","authors":"Juhaina Salim Al-Maqbali,&nbsp;Nasiba Al-Maqrashi,&nbsp;Aisha Al-Huraizi,&nbsp;Qasim Sultan Al-Mamari,&nbsp;Khalifa Al Alawa,&nbsp;Abdullah M Al Alawi","doi":"10.5144/0256-4947.2022.52","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.52","url":null,"abstract":"<p><strong>Background: </strong>Globally, alcohol withdrawal syndrome (AWS) is considered a serious medical diagnosis associated with increasing morbidity and mortality. Little information has been reported on the scope of the problem in Oman.</p><p><strong>Objective: </strong>Study clinical characteristics, management, quality of care, and health outcomes of patients managed for AWS.</p><p><strong>Design: </strong>Retrospective medical record review.</p><p><strong>Settings: </strong>University hospital.</p><p><strong>Patients and methods: </strong>The study included all patients with AWS admitted from 1 October 2019 to 30 September 2020. We collected demographic and clinical characteristics and did a univariate analysis of factors related to 90-day readmission.</p><p><strong>Main outcome measures: </strong>Length of hospital stay, 90-day read-mission, referral rate to alcohol rehabilitation center.</p><p><strong>Sample size and characteristics: </strong>150 male patients with median (IQR) age of 39.5 (32-48) years.</p><p><strong>Results: </strong>Most patients (70.7%, n=106) were smokers and 44 (29.3%) had a history of drug abuse. The average length of hospital stay was 2.3 (0.9-4.6) days. Approximately 9% of total hospital bed days were used to care for patients with AWS. Chronic liver disease (35.3%), diabetes mellitus (24.7%), and hypertension (24.0%) were common among AWS patients. The 90-day readmission rate (32.7%) was high, and there was low referral to alcohol rehabilitation (16.7%). Diabetes and epilepsy were associated with 90-day readmission.</p><p><strong>Conclusion: </strong>AWS is an important diagnosis that represents an important burden on acute medical services. Establishing a drug and alcohol service in our institution is an essential step to optimise care for patients with alcohol-related disorders.</p><p><strong>Limitations: </strong>Retrospective, so unable to collect data on manifestations of AWS such as delirium tremens, which is the most severe form of AWS. Also, the reason for the lack of referral to an outpatient alcohol rehabilitation program was not apparent.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"52-57"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/23/0256-4947.2022.52.PMC8812160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with mortality in younger and older (≥75 years) hospitalized patients with community-acquired pneumonia.","authors":"Mehtap Aydin,&nbsp;Bengü Şaylan,&nbsp;İnşa Gül Ekiz İşcanlı","doi":"10.5144/0256-4947.2022.45","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.45","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is among the most serious infections in the elderly. The evaluation of prognosis and predicting the outcome is essential in managing the treatment of patients with pneumonia.</p><p><strong>Objective: </strong>Evaluate factors that might affect the mortality of elderly patients hospitalized for community-acquired pneumonia (CAP) in two age groups.</p><p><strong>Design: </strong>Medical record review.</p><p><strong>Settings: </strong>Tertiary care hospital.</p><p><strong>Patients and methods: </strong>The study included CAP patients who were hospitalized during the period from January 2017 and December 2019. The CURB-65 scale was chosen to assess the severity of pneumonia on admission. Multivariate analyses were conducted separately for patients younger than 75 years and 75 years or older.</p><p><strong>Main outcome measures: </strong>30-day mortality, factors associated with mortality.</p><p><strong>Sample size and characteristics: </strong>1603 patients with a median age of 74, including 918 women (57%).</p><p><strong>Results: </strong>The 30-day mortality rate was 6.5%. Patients with carbapenem-resistant gram-negative bacteria had lower survival rates (<i>P</i><.0001). In the multivariate analysis, age, lung cancer, CURB-65, carbapenem resistance, and duration of hospital stay were associated with mortality in patients aged 75 years or older. Lung cancer, malignant disease, carbapenem resistance, duration of hospital stay and procalcitonin level were associated with mortality under the age of 75. Of 640 sputum cultures tested, <i>P aeruginosa</i> (42%) was the most common pathogen.</p><p><strong>Conclusion: </strong>The risk factors that affected mortality differed among patients aged 75 years or older versus younger patients. Our findings are important in determining factors associated with mortality in managing the treatment and follow up of hospitalized CAP patients younger or 75 years of age or older.</p><p><strong>Limitations: </strong>Single-center, retrospective.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"45-51"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/18/0256-4947.2022.45.PMC8812156.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39581339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common disease-associated gene variants in a Saudi Arabian population.","authors":"Mariam Aleissa,&nbsp;Taghrid Aloraini,&nbsp;Lamia Fahad Alsubaie,&nbsp;Madawi Hassoun,&nbsp;Ghada Abdulrahman,&nbsp;Abdulrahman Swaid,&nbsp;Wafa Al Eyaid,&nbsp;Fuad Al Mutairi,&nbsp;Faroug Ababneh,&nbsp;Majid Alfadhel,&nbsp;Ahmed Alfares","doi":"10.5144/0256-4947.2022.29","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.29","url":null,"abstract":"<p><strong>Background: </strong>Screening programs for the most prevalent conditions occurring in a country is an evidence-based prevention strategy. The burden of autosomal recessive disease variations in Saudi Arabia is high because of the highly consanguineous population. The optimal solution for estimating the carrier frequency of the most prevalent diseases is carrier screening.</p><p><strong>Objectives: </strong>Identify the most influential recessive alleles associated with disease in the Saudi population.</p><p><strong>Design: </strong>We used clinical whole-exome sequencing data from an in-house familial database to evaluate the most prevalent genetic variations associated with disease in a Saudi population.</p><p><strong>Settings: </strong>King Abdullah International Medical Research Center (KAIMRC) and King Abdulaziz Medical City.</p><p><strong>Methods: </strong>Whole exome sequencing data obtained from clinical studies of family members, a cohort of 1314 affected and unaffected individuals, were filtered using the in-house pipeline to extract the most prevalent variant in the dataset.</p><p><strong>Main outcome measures: </strong>Most prevalent genetic variations associated with disease in the Saudi population.</p><p><strong>Sample size: </strong>1314 affected and unaffected individuals.</p><p><strong>Results: </strong>We identified 37 autosomal recessive variants and two heterozygous X-linked variants in 35 genes associated with the most prevalent disorders, which included hematologic (32%), endocrine (21%), metabolic (11%) and immunological (10%) diseases.</p><p><strong>Conclusion: </strong>This study provides an update of the most frequently occurring alleles, which support future carrier screening programs.</p><p><strong>Limitations: </strong>Single center that might represent the different regions but may be biased. In addition, most of the families included in the database are part of the proband's genetic identification for specific phenotypes.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"29-35"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/e7/0256-4947.2022.29.PMC8812157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study.","authors":"Hadel Shahood,&nbsp;Annamaria Pakai,&nbsp;Kiss Rudolf,&nbsp;Eva Bory,&nbsp;Noemi Szilagyi,&nbsp;Adrienn Sandor,&nbsp;Verzar Zsofia","doi":"10.5144/0256-4947.2022.8","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications in patients who undergo open heart surgery are serious life-threatening conditions. Few studies have investigated the potentially beneficial effects of preoperative physiotherapy in patients undergoing cardiac surgery.</p><p><strong>Objectives: </strong>Assess the effects of preoperative chest physiotherapy on oxygenation and lung function in patients undergoing open heart surgery.</p><p><strong>Design: </strong>Randomized, controlled.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Patients and methods: </strong>Patients with planned open heart surgery were randomly allocated into an intervention group of patients who underwent a preoperative home chest physiotherapy program for one week in addition to the traditional postoperative program and a control group who underwent only the traditional postoperative program. Lung function was assessed daily from the day before surgery until the seventh postoperative day.</p><p><strong>Main outcome measures: </strong>Differences in measures of respiratory function and oxygen saturation. Length of postoperative hospital stay was a secondary outcome.</p><p><strong>Sample size: </strong>100 patients (46 in intervention group, 54 in control group).</p><p><strong>Results: </strong>Postoperative improvements in lung function and oxygen saturation in the intervention group were statistically significant compared with the control group. The intervention group also had a statistically significant shorter hospital stay (<i>P</i><.01).</p><p><strong>Conclusion: </strong>Preoperative chest physiotherapy is effective in improving respiratory function following open heart surgery.</p><p><strong>Limitations: </strong>Relatively small number of patients.</p><p><strong>Conflict of interest: </strong>None.</p><p><strong>Registration: </strong>ClinicalTrials.gov (NCT04665024).</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"8-16"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/3a/0256-4947.2022.8.PMC8812159.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Y-shape reconstructive biliary stenting in Klatskin cholangiocarcinoma through a single left-sided entry.","authors":"Ghazi Adlan Alshumrani,&nbsp;Abdullah Murhaf Al-Khani","doi":"10.5144/0256-4947.2022.64","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.64","url":null,"abstract":"<p><p>Percutaneous Y-shape reconstructive biliary stenting in the Klatskin tumor is typically performed through bilateral biliary access. Single access from a right-side biliary entry is the more commonly used side for biliary access in general. We present a successful Y-shaped biliary stent reconstruction through a single left-side biliary approach. Unilateral single access Y-shaped biliary stenting can be technically challenging; when performed through a left biliary approach, an additional technical challenge may arise due to the unusual combination of Y-shaped biliary stent reconstruction and the single left-side biliary approach. We concluded that percutaneous Y-shaped biliary reconstruction through a left-sided unilateral approach is a technically feasible, less invasive interventional approach in managing Klatskin tumor. SIMILAR CASES PUBLISHED: None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"64-67"},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/f5/0256-4947.2022.64.PMC8812163.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}