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Accidental ingestion of hairpin in an adolescent girl
(2019) Almarhabi, Ahmed
Ingestion of headscarf pin is a particular type of foreign body ingestion sometimes experienced by adolescent girls and even older women while putting on their headscarf. We report on a 13-year-old girl who presented at the emergency unit at our hospital within 48 hr after accidentally swallowing a headscarf pin. The pin was successfully retrieved from the ascending colon through colonoscopy. Headscarf pin ingestion is a serious problem among women who wear headscarves for various reasons. However, the retrieval of such pins from the colon through colonoscopy has been infrequently reported.
The association between waiting time and patient satisfaction in outpatient clinics: Findings from a tertiary care hospital in Saudi Arabia
(2019) Al-Harajin, Rasmah; Al-Subaie, Sara; Elzubair, Ahmed
BACKGROUND: Patient satisfaction is an important indicator for assessing the quality of health care because it affects the timely, efficient, and patient-centered delivery of quality health care, and patient satisfaction is associated with the clinical outcomes. This study aimed to examine the relationship between waiting time and patient satisfaction in a tertiary hospital in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted at family medicine and other specialized clinics. Data were collected through a structured, self-administered questionnaire distributed to patients seen at the outpatient clinics. Variables collected were sociodemographic information and patient satisfaction scores to evaluate the association between waiting time and satisfaction. RESULTS: A total of 406 patients participated in the study. Half of the patients reported being satisfied with the waiting time, while the remaining were dissatisfied (mean satisfaction score 38.4 ± 6.63). Family medicine clinic scored better in waiting time than other specialized clinics; between arrival and registration (P < 0.01), between registration and consultation (P < 0.01), consultation time (P < 0.01), and overall waiting time (P < 0.01). Patients treated at the family medicine clinic were more likely to be satisfied than those seen in other specialized clinics (61.2% vs. 40%, P < 0.01). CONCLUSION: Overall satisfaction was lower than shown in previous literature. Gender and clinic type were significantly associated with satisfaction score; those who attended the family medicine clinics were more satisfied than those attending other specialized clinics. Findings may be used to inform researchers, clinicians, and policy-makers' decisions on quality improvement programs.
Attitude of medical students at King Saud Bin Abdulaziz University for Health Sciences toward family medicine as a future specialty
(2019) Alshammari, Saad; Altulaihi, Bader; Alghamdi, Hazim; Alanazi, Abdullah; Alhazzaa, Saad; Alanazi, Rayan
BACKGROUND: Owing to the rising population of the Kingdom of Saudi Arabia, the need for family physicians is growing. The number of family physicians who would be available in the health service in future is dependent on the attitudes of medical students because their choice of specialty is a major factor in satisfying this demand. The aim of the study was to evaluate the attitudes of medical students to family medicine as a future career. MATERIALS AND METHODS: This cross-sectional study was conducted at King Saud Bin Abdulaziz University for Health Sciences. A total of 308 students were randomly selected from problem-based learning groups. Data were collected using a 25-item validated questionnaire, and Excel and SPSS were used for data entry and analysis. Mean and standard deviation were used to describe numerical data and frequencies and percentages to describe categorical data. P < 0.05 was considered statistically significant. RESULTS: A total of 308 medical students, 201 (65.3%) of whom were male, completed the questionnaire. Majority of the students (229 [74.3%]) agreed that family physicians make important contributions to medicine although family medicine was one of the least preferred specialties of the students. CONCLUSIONS: Most students were aware of the importance of family medicine; however, only a few of them chose this specialty. Further studies should be conducted to identify the factors that influence medical students' decisions in their choice of family medicine as a future career.
Author's reply
(2019) Khan, Zahid; Singh, Chanpreet; Khan, Tazeen
Abstract Not Available(Letter to Editor)
Battling pseudoscience in the era of medical misinformation – rising role of health advocacy
(2019) Kumar, Dinesh
Abstract Not Available( Letter to Editor)
Chest pain as a possible side effect of pitavastatin (Livalo)
(2019) AlZahrani, Nada; Yassin, Amna
Coronary heart disease is a serious complication of dyslipidemia. Pitavastatin is a more commonly prescribed medication for the treatment of dyslipidemia. Here, we report the case of a 37-year-old female, a known patient with well-controlled bronchial asthma. She was recently found to be dyslipidemic and started on pitavastatin calcium 4 mg once a day (OD). On the 10th day of treatment, she began to have crushing chest pain and was admitted to the hospital. All investigations for coronary heart disease came out negative. Her symptoms improved dramatically when pitavastatin was stopped. Pitavastatin is reported to cause myalgia and muscle spasm, especially at higher doses. There is evidence in literature that this medication might cause chest pain in old obese ladies if taken at high doses. We report this case as a possibility of chest pain even in younger females.
Community's compliance with measures for the prevention of respiratory infections in Riyadh, Saudi Arabia
(2019) Alhazmi, Ali; Alshammari, Sulaiman; Alenazi, Hanan; Shaik, Shaffi; AlZaid, Hala; Almahmoud, Nouf; Alshammari, Hotoon
BACKGROUND: Acute respiratory tract infections are the most common causes of both morbidity and mortality worldwid, and the management and prevention of acute respiratory infections is a global problem, especially in developing countries. This study sought to assess the community's compliance and practice of measures for the prevention of respiratory infections and discover their source of health information. MATERIALS AND METHODS: A cross-sectional study was carried out in the five biggest shopping malls in Riyadh city in July 2014. The required sample size was 980 persons aged 15 or older, with 196 from each of the five biggest shopping malls from each of the five geographic areas of Riyadh. Data was collected by face-to-face interview using standardised questionnaire, and analyzed using SPSS. RESULTS: Overall, 48.3% of the participants thought that they were susceptible to any of the respiratory infections of pandemic influenza; 59.7% always washed their hands with water and soap and 34.8% used antibacterial soap. About 29% reported avoiding touching their eyes, noses, and mouths directly with their hands; 63.5% covered their noses and mouths with tissue paper when sneezing or coughing. A substantial number said they “never” shared their personal stuff, including towels (70.5%) and utensils (49.0%) with others. Only 21.2% avoided crowded places or wore a mask (9.1%) in such a situation. A high proportion (62.8%) did not take the seasonal flu vaccine. The most common sources of health information included television/radio (47.9%), social media (29.4%), and friends/family (28.1%). CONCLUSIONS: Health authorities should seize every opportunity to prevent respiratory infections by adopting all evidence-based infection control measures to improve public awareness, attitude, and practice.
Consistency of child self-reports with parent proxy reports on the quality of life of children with attention-deficit/hyperactivity disorder in Riyadh, 2016
(2019) Al-Habib, Dina; Alhaidar, Fatima; Alzayed, Ibrahem; Youssef, Randa
BACKGROUND: The quality of life (QoL) of children with attention-deficit/hyperactivity disorder (ADHD) has not been addressed in Saudi Arabia despite the considerable attention it has on account of its prevalence, duration of illness, and sociopsychological effects. The aim of this study was to report on the QoL of children with ADHD and test the concord between children's and parents' reports. MATERIALS AND METHODS: Using the generic PedsQL™ (version 4.0) from both children's and parents' perspectives, a cross-sectional study of 112 children was conducted on children aged 5–18 years with an established diagnosis of ADHD attending child psychiatry clinics of three referral hospitals in Riyadh between December 2015 and May 2016. RESULTS: A total of 112 children with an established diagnosis of ADHD were recruited from the Child Psychiatry Clinic of Al Amal Mental Health Complex (41.1%), Prince Sultan Military Medical City (PSMMC), (33%), and King Khalid University Hospital (KKUH), (25.9%). The majority were boys (74.1%) and Saudi nationals (93.8%). The mean age of children with ADHD was 10.45 ± 3.06 years (Range 5 - 18 years). One-fourth of the mothers of children with ADHD had completed high school and 41.1% had a diploma, university, or postgraduate degree. One-third of the fathers of these children had completed high school (34%) and 38.4% had a diploma, university, or postgraduate degree. The intra-class correlation coefficients between the scores of children and parents were good for physical functioning, fair for social functioning, but moderate for school, emotional, and psychosocial functioning. Children rated themselves significantly better than their parents for emotional, social, school, and psychosocial functioning. The standardized response means indicated a small difference for social functioning and medium differences for the other three domains. The only significant discrepancy was observed in social functioning in relation to the child's age. CONCLUSION: Parents mirrored adequately the observable physical component of the QoL of their children. The QoL report of children with ADHD with respect to communications and intellectual abilities should be taken into account whenever possible and their parents' report also should be sought to provide a more comprehensive view of the child's status.
Correlates of physical disability in the elderly population of rural North India (Haryana)
(2019) Bashar, Md
Abstract Not Available(Letter to Editor)
Correlates of Psychotropic Polypharmacy in outpatient psychiatric clinics of two military tertiary hospitals in Saudi Arabia
(2019) Alharbi, Fares; Alharbi, Samar; Salih, Saleh; Al-Surimi, Khaled
BACKGROUND: Polypharmacy is meaningful and clinically justified under certain circumstances. However, the prescription of multiple psychiatric medicines is mostly based on practical experience rather than evidence. The aim of this study was to assess the current practice of and factors associated with the use of polypharmacy among patients attending outpatient psychiatric clinics. MATERIALS AND METHODS: A cross-sectional study was conducted among patients attending outpatient psychiatric clinics in two tertiary care hospitals in the kingdom of Saudi Arabia (KSA). Patients aged 18 years and above and who were taking any prescription or nonprescription medications were included. Data were collected by face-to-face interviews, followed by a review of electronic medical charts to determine the drugs being taken by patients, and track their current computerized drug prescriptions. Data were analyzed using SPSS statistical software version 21 (Chicago, IL, USA), applying both descriptive and inferential statistical analysis as appropriate. RESULTS: Of the 401 study participants, 53.6% were aged 25 years or older, and 63.6% were married and > 50% were unemployed. The overall prevalence of polypharmacy was 46.9%. The prevalence of polypharmacy was 67.3% in psychosis, 37.7% in depression, 27.1% in anxiety, 74.1% in bipolar disorders, and 53.6% for patients with two or more disorders, and 42.1% for patients diagnosed with “other” disorders. Overall, there was a significant association between polypharmacy and gender, marital status, and diagnosis of disorder. CONCLUSIONS: Psychotropic polypharmacy is common in outpatient practice. Patients with psychosis and bipolar disorders, especially those aged 25–45 years are exposed to high psychotropic polypharmacy. The concomitant use of large numbers of drugs should be periodically reviewed to improve the quality and safety of psychiatric care.
Dentists' awareness about the link between oral and systemic health
(2019) Nazir, Muhammad; Izhar, Faisal; Akhtar, Kamal; Almas, Khalid
BACKGROUND: Oral health is integral to systemic health. There is a growing body of evidence of an association between periodontal and systemic diseases. The aim of the study was to evaluate the awareness of dentists regarding link between oral and systemic health. MATERIALS AND METHODS: Data was collected using a self-administered pilot-tested questionnaire. Dentists awareness about link between oral and systemic link was assessed on five point likert scale. Data was entered and analysed using SPSS. RESULTS: Of the 588 dentists, 500 completed the questionnaire (response rate 85.03%). About 93% of the participants (mean age 25.82 ± 4.21 years) agreed that oral health was associated with systemic health. Most dentists were aware of a connection between periodontal disease and diabetes (84.4%) and heart disease (70.2%). Similarly, 85.6% believed in the negative impact of oral disease on the quality of life of patients. More female than male dentists were aware of the relationship between periodontal disease and adverse pregnancy outcomes, diabetes, and rheumatoid arthritis (P < 0.001). Most dentists (97%) believed that more patients would seek oral care if they were aware of the oral-systemic link. After adjustments, private dentists were 4.65 times more likely than public dentists to believe in improving access to oral care with increased patient awareness of the oral-systemic connection (P = 0.011). CONCLUSIONS: Most dentists were aware of the oral-systemic link. They believed that patients' access to oral care would improve if they were aware of a connection between oral and systemic health. Therefore, patients should be informed of the oral-systemic link to improve their oral health.
Determinants of energy drinks consumption among the students of a Saudi University
(2019) Alabbad, Mahmoud; AlMussalam, Mohammed; AlMusalmi, Ahmed; Alealiwi, Mohammad; Alresasy, Ali; Alyaseen, Haidar; Badar, Ahmed
BACKGROUND: Energy drinks contain stimulants mainly caffeine. The use of these drinks by university students is on the rise despite concerns about their safety. This study identified the determinants of the consumption of energy drinks in a cohort of Saudi university students. MATERIALS AND METHODS: This cross-sectional study was carried out at Imam Abdulrahman Bin Faisal University in Saudi Arabia. The students who volunteered to participate (n = 1255) were asked to complete a pretested questionnaire soliciting information on gender, marital status, class and college of study, pattern of energy drinks use, reasons for use, any benefits as well as any untoward effects experienced. Data was analysed using IBM-SPSS (version 21) to determine frequencies and compare various categories of the energy drink users. Logistic regression analysis were performed to identify determinants of energy drinks consumption. RESULTS: Out of 1255 participants, 245 reported using energy drinks. Out of a total 1255 students, 903 (72%) were from medical and 352 (28%) from nonmedical colleges of the university. There were 890 junior and 365 senior students. The female participants were significantly more among both senior and junior medical students. The age of the participants (mean ± SD) was 20.2 ± 1.9 years. The frequency of energy drinks users was higher in the male nonmedical students (both senior and junior) compared to the medical students. The most significant determinants identified were male gender (odds ratio [OR] 4.2, 95% confidence interval [CI] =3.34, 6.12), and being single (OR = 2.8, CI = 1.98, 4.24). In addition, being in non-medical field of study (OR = 1.3, 95% CI=0.61-2.13) was also found to have a reasonable association with energy drink consumption. CONCLUSION: We report male gender, unmarried status, and studying in nonmedical colleges of the university as the main determinants of the consumption of energy drinks by university students. Scrutiny of the patterns and reasons for the consumption of energy drinks might help in developing educational interventions to ensure the appropriate use of energy drinks by young adults.
Effect of maternal anemia on the status of iron stores in infants: A cohort study
(2019) Shukla, Arvind; Srivastava, Shitanshu; Verma, Garima
BACKGROUND: Iron deficiency anemia in pregnant women may affect the iron reserves of their infants and lead to anemia later. The objective of the study was to compare hemoglobin and iron store status of infants born to anemic and non-anemic mothers and to determine any correlation. MATERIALS AND METHODS: A cohort study was conducted in the Department of Pediatrics of a Teaching hospital after obtaining ethical approval and written informed consent from all participants. Total 180 mother-infant pairs were enrolled in the study were divided into two groups; Group I: 90 term infants born to anemic mothers (Hb <11 g/dl), Group II: 90 term infants born to non-anemic mothers (Hb >11 g/dl). Hemoglobin and ferritin levels were assessed in cord blood at birth and at 14 weeks after birth in the infants of both groups. Data was analyzed using SPSS 20.0; Chi-square test and t-test were applied to test for statistical significance. RESULTS: The final sample size was 85 for Group I and 78 for Group II. For Group I, mean hemoglobin and ferritin levels in the cord blood of infants at birth were 16.33 ± 1.19 and 135.40 ± 25.94, respectively. For Group II, Mean hemoglobin and ferritin levels in the cord blood of infants at birth were 17.62 ± 1.35 and 160.45 ± 28.50, respectively; differences were statistically significant. At 14 weeks, the mean Hb and ferritin was 11.24 ± 1.03 and 55.92 ± 10.44 in Group I and 13.18 ± 0.82 and 63.56 ± 10.15 in Group II; the differences were statistically significant. A significant correlation between maternal and infant hemoglobin and ferritin levels was observed at birth and 14 weeks after birth. CONCLUSION: Maternal iron deficiency may have an effect on the iron status of their infants. Thus, timely appropriate interventions are necessary.
Effect of Zamzam water on blood methemoglobin level in young rats
(2019) Badar, Ahmed; Bamosa, Abdullah; Salahuddin, Mohammed; Al Meheithif, Abdullah
BACKGROUND: Methemoglobin (MetHb) level in blood indicates exposure to nitrogenous compounds. Acquired methemoglobinemia as a result of exposure to nitrates in drinking water is primarily an issue for infants. The amount of nitrates in Zamzam water is said to be on the high side. This study was designed to determine the effect of prolonged use of Zamzam water on MetHb in rat pups. MATERIALS AND METHODS: Wistar rat pups (n = 52, 3 weeks old) were divided into four equal groups. All of them were given normal laboratory chow. The groups differed only in the exclusive source of water, that is ordinary bottled water, standardized mineral water, old Zamzam water (stored since 2008) or fresh Zamzam water. MetHb level was checked (using Avoximeter 4000) at the baseline, and then every week for 4 weeks from blood obtained from retro-orbital sinus. Other parameters tested were total haemoglobin, oxyhemoglobin and carboxyhemoglobin. ANOVA was used to compare the means between the groups. RESULTS: None of the rats in any of the four groups showed any sign of methemoglobinemia or toxicity. Both groups on Zamzam water showed higher increments in their total hemoglobin by the end of the study compared to their baseline (22%) than the ordinary water (9%) and the mineral water (5%) groups. None of the groups showed any significant difference in MetHb levels on intergroup comparison at any of the weekly readings and at the end of the study. CONCLUSION: Prolonged use of Zamzam water did not induce any significant difference in MetHb concentration in rat pups, which might indicate that it is safe for infants.
Factors affecting treatment compliance of patients on antihypertensive therapy at National Guard Health Affairs (NGHA) Dammam Primary Health Care Clinics (PHCC)
(2019) Abdelhalim, Hala; Zahrani, Adel; Shuaibi, Ahmed
BACKGROUND: Hypertension, a noteworthy hazard for stroke and coronary illness, is one of the most significant preventable causes of premature morbidity and mortality in developed and developing nations. Adherence to antihypertensive medications and lifestyle alterations can greatly affect the control of hypertension. This study investigated factors that impact on treatment compliance of patients on antihypertensive therapy at the National Guard-Health Affairs (NGHA) Primary Health-Care Clinics (PHCC), Dammam, Saudi Arabia, taking into account the Health Belief Model (HBM). MATERIALS AND METHODS: A cross-sectional study was conducted in the NGHA PHCC, Dammam. A total of 402 individuals were included in the study through convenience sampling method. Data were gathered by structured self-administered questionnaire. Data were entered into the computer and analyzed using SPSS software. The data were summarized using frequencies and percentages. The Chi-square test was used to compare ratios, and a Pearson's correlation analysis of HBM variables was carried out; all tests were performed at 0.05 significance level. RESULTS: The proportion of treatment-compliant participants in this study was 39.6%, and the participants' 'mean age was 54.09 (SD±10.703) years. About 59% females were compliant to the treatment regimen as against 19.7% of males. A total of 33.5% of the married participants were compliant, as against 16.7% of the single participants who were compliant. Unemployed patients (72.3%) were more compliant than the employed participants. CONCLUSIONS AND RECOMMENDATIONS: The study showed that the compliance of most hypertensive patients with antihypertensive therapy was poor. Based on the HBM, all predictors including perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and cues to action were statistically significant (P < 0.05). Therefore, the provision of health education by health-care providers to patients could have a substantial positive impact on patient compliance.
Forecasting Indian infant mortality rate: An application of autoregressive integrated moving average model
(2019) Mishra, Amit; Sahanaa, Chandar; Manikandan, Mani
BACKGROUND: The Infant Mortality Rate (IMR) reflects the socioeconomic development of a nation. The IMR was reduced by 28% between 2015 and 2016 (National Family Health Survey-4 [NFHS-4]) as compared to 2005–2006 (NFHS-3), from 57/1000 to 41/1000 live births. The target fixed by the Government of India for IMR in 2019 is 28/1000 live births (National Health Policy, 2017). One of the most common methods of forecasting this is the autoregressive integrated moving average (ARIMA) model. A forecast of IMR can help implementation of interventions to reduce the burden of infant mortality within the target range. MATERIALS AND METHODS: The objective of the study was to give a detailed explanation of ARIMA model to forecast the IMR (2017–2025). Secondary data analysis and forecast were done for the available year and IMR data extracted from “open government data platform India” website. RESULTS: The forecast of the sample period (1971–2016) showed accuracy by the selected ARIMA (2, 1, 1) model. The postsample forecast with ARIMA (2, 1, 1) showed a decreasing trend of IMR (2017–2025). The forecast IMR for 2025 is 15/1000 live births. CONCLUSION: In the current study, long-time series IMR data were used to forecast the IMR for 9 years. The data showed that IMR would decline from 33/1000 live births in 2017 to 15/1000 live births in 2025. When the actual data for another year (2017) are available, the model can be checked for validity and a more accurate forecast can be performed.
High blood pressure in children attending pediatric clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia
(2019) Ghamri, Ranya; Hegazy, Amal; Azizkhan, Anan; Alsalmi, Sultanah; Alharbi, Noha; Hemedy, Rawan; Alharbi, Amani
BACKGROUND: High blood pressure (BP) is an important health issue on a global level. It is one of the major factors for mortality in Saudi Arabia. Furthermore, high BP is considered a significant risk for heart disease responsible for 30% of all deaths all over the world. The aim of this research was to determine the prevalence of hypertension in children attending the pediatric clinics and determine the common risk factors associated with high BP. MATERIALS AND METHODS: It was a cross-sectional study conducted among 6-15 year aged children attending the pediatric clinic at King Abdulaziz University Hospital in Jeddah; children were selected using sytematic random sampling technique. Data was collected by interviewing the parents using a structured questionnaire. SPSS was used for data entry and analysis. Computed frequency and percentages for categorical variables, and mean and standard deviations for continuous variables. Chi-square test and correlation used to determine associations, and logistic regression performed to determine factors associated with blood pressure >= 95th percentile. RESULTS: The prevalence of hypertension and prehypertension was 14.4% and 6.5%, respectively, in males, whereas, in females, it was 16.3% and 5.2%, respectively. A high prevalence observed for the 6–10 years age group as compared with the 11–15 year age group, and the difference was statistically significant (P = 0.001). A high prevalence of hypertension and prehypertension in overweight and obese group was noticed. A significant positive correlation between systolic BP and weight, height, and BMI was demonstrated. The common risk factors for hypertension in this study were the age range of 6–10 years, (odds ratio OR = 2.44), overweight and obese children (OR = 2.44), children with family history of hypertension (OR = 1.39), and children with low birth weight (OR = 1.05). CONCLUSION: These factors are considered risk factors for such a chronic disease as cardiovascular disease. Consequently, continuous BP monitoring and early identification of high BP in children are some of the greatest strategies for the prevention of chronic diseases in adulthood.
Immune's-boosting agent: Immunomodulation potentials of propolis
(2019) Al-Hariri, Mohammed
With a concomitant increase in immune-related diseases such as allergic diseases, Type 1 diabetes mellitus, rheumatoid arthritis, multiple sclerosis, psoriasis, inflammatory bowel disease and other immune-related responses such as immunodeficiency, various infectious, diseases, vaccines, and malignancies, it has become very important to have a well-balanced and properly functioning immune system for the maintenance of human health. Recent scientific research has strongly suggested propolis as one of the most promising immunomodulation agents. This review describes recent findings with respect to propolis and its ingredients that show potential in this respect and evaluate their potential mechanisms. The author believes that propolis or/and its ingredients alone and in combination could be promising in manipulating the immune response and inducing immunomodulation. Further exploratory studies are needed to support large clinical trials toward further development of propolis.
The impact of using the term “Diabetic Ear” for the patients with skull base osteomyelitis
(2019) AlEnazi, Abdulaziz; Al Sharhan, Salma; Telmesani, Laila; Aljazan, Nasser; Al Qahtani, Bander; Lotfy, Mohamed
BACKGROUND: Diabetes and ear disease are some of the most widespread health concerns. The focus here is on the impact of using the term “Diabetic Ear” for patients with skull base osteomyelitis (SBM) in the context of malignant otitis externa (MOE). The aim of this study was to discover the awareness of general practitioners (GPs), residents, specialists, and consultants at Primary Health Care Centers about necrotizing otitis externa (NOE), also known previously as malignant external otitis (MOE), assess their deficiencies and provide solutions; also assist them for the early detection and possible prevention of diabetes- related ear diseases and their complications. MATERIALS AND METHODS: A cross-sectional study was conducted among a random sample of physicians (residents, specialists, and consultants) working at the Primary Health Care Centers in Al-Khobar and Dammam cities of the Eastern Province, Saudi Arabia. Data was collected using a standardized questionnaire. SPSS was used for data entry and analysis. RESULTS: The total number of medical practitioners was 84. Their mean age was 33.97 (±9.55). The proportion of females was higher than males, only 28.3% of the participants responded correctly when asked about MOE. Similarly, very few were aware of the risks of MOE (2.5%), complications associated with it (17.3%) and the necessary procedures for managing patients (24.2%). The awareness of doctors in the primary health clinics about MOE was significantly better than those in hospitals (P = 0.002). CONCLUSION: There was a significant deficiency in the knowledge of GPs on MOE. Therefore, health education and awareness programs on MOE are recommended. Furthermore, we recommend that it is necessary to encourage the use of the term “Diabetic EAR “to increase the level of awareness of physicians about MOE.
Imported Plasmodium vivax malaria complicated by reversible myocarditis
(2019) Khan, Fahmi
Myocarditis as a result of malaria infection is uncommon. However, we report a case of a Pakistani emigrant who presented with respiratory distress, fever, chills, and nausea at the emergency room. The patient had traveled to visit his relatives in Pakistan without receiving antimalarial chemoprophylaxis. (Travel clinic advises travelers to Pakistan to take antimalarial drugs as prophylaxis.) Cardiorespiratory examination revealed bilateral crepitation in all lung fields, as well as triple heart sounds. Examination of blood smear showed trophozoites and schizonts of Plasmodium vivax with low parasite density. Echocardiography showed diffuse hypokinesia with an ejection fraction of 22% consistent with acute myocarditis. The patient was given chloroquine phosphate, digoxin, perindopril arginine, furosemide, and spironolactone and gradually improved.

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