Australasian Medical Journal
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Effects of Hibiscus sabdariffa on high blood pressure, lipid profile and C- reactive protein among adult hypertensive patients
Get PDFBackgroundHypertension is a leading cause of mortality and morbidity worldwide. Hibiscus is a cheap readily available preparation.AimsWe aimed to assess the effect of Hibiscus sabdariffa on blood pressure, lipid profile, plasma sugar, and h-sensitive C-reactive protein.MethodsThis is a prospective cohort study conducted among 19 College staff members at the University of Tabuk, Saudi Arabia during January 2020. The participants signed written informed consent, then responded to a questionnaire to report their demographic data. At baseline, the blood pressure was measured, anthropometric measures collected, and, and a blood sample was taken to measure fasting plasma sugar, serum cholesterol, triglycerides, high-density lipoproteins, and high-sensitive C-reactive protein. Participants thereafter took Hibiscus sabdariffa for four weeks, then the above measurements were repeated. The compliance of the participants was also assessed.Results No significant effects of Hibiscus sabdariffa consumption were observed on systolic and diastolic blood pressure, fasting plasma glucose, lipid profile, and high-sensitive C-reactive protein, P-value< 0.05.ConclusionNo significant effects were observed among Hibiscus sabdariffa users on blood pressure, plasma sugar, lipid profile, and C-reactive protein. Further larger multicenter studies are recommended
The impact of childhood food allergy on quality of life of the paediatric population in Jeddah, Saudi Arabia
Get PDFBackgroundFood allergy is an allergic reaction to any type of food that differs in its severity and impact on the patient's life as well as on caregivers. AimsTo measure the quality of life in the paediatric population with food allergy at National Gourd Health Affairs Jeddah, Saudi Arabia.Methods The food allergy quality of life-parent form was used in this study. The sample size is 75 participants. An Arabic translated and validated version of both questionnaires, with minor modifications were used. Demographic profile, allergy profile, and symptoms profiles were described as frequencies. Cronbach’s alpha was calculated for each food allergy quality of life domain. Food allergy quality of life domains were described using the average scores of the summed corresponding variables. A two-way MANOVA was carried out.Results The total score for patients aged 0–3, 4–6, and 7–12 are 2.01, 2.56, 2.33, respectively. There was no significant interaction between the independent variables (p=0.123). Age group and gender had no effect on the combined score measuring the quality of life (p=0.061, and 0.465, respectively). The total score for parental concern about food safety is 3.56±1.15 (SD) and the total score for child's concern about food safety is 2.81±1.45 (SD). Total score for these domains general health perceptions, parental emotional impact, general mental health, and family and child's activities are 1.6±0.79, 2.84±1.36, 3.09±1.28, 2.39±1.27, respectively.ConclusionThere were no significant differences between age groups or gender in the overall score. Only minimal differences were observed in (emotional, social and dietary limitation). We highly recommend further studies in the same field to be able to generalize the results in the Saudi paediatric population
Cerebral venous sinus thrombosis; clinical characteristics, risk factors, diagnosis and outcome in a tertiary hospital
Get PDFBackgroundCerebral venous sinus thrombosis (CVT) is an uncommon form of stroke that has a highly variable clinical presentation. Data from Middle East and in particular Saudi Arabia are scarce. AimsIn this study, we evaluated clinical characteristics, risk factors, and outcomes of patients with CVT in a tertiary hospital, Saudi Arabia.MethodsA retrospective cross-sectional study was performed at a tertiary hospital in Saudi Arabia which included a total of 97 patients admitted with CVT diagnosis between January 2010 to December 2019. Demographic data, clinical information, radiological test, the in-hospital mortality recorded, and a three month outcome were retrieved from the health information system. ResultsMean age was 42 years with 83.5 per cent female predominance. Headache was the most frequent initial presentation in 79 per cent. During the course of the illness 41 per cent developed seizures and were significantly associated with the presence of intracerebral haemorrhage (p < 0.02). Oral contraceptive was a major risk factor in 21 per cent, no underlying risk factor or cause was found in 30 per cent of the patients. Non-contrast CT scan was reported normal in 30 per cent of the cases. In-hospital mortality was low, and prognosis at follow up was good. ConclusionFemale predominance and headache being the first manifestation were reconfirmed. A non-contrast CT scan can show some abnormalities but was normal in about 30 per cent of cases. Awareness about CVT clinical presentation and diagnostic tests are important to prevent misdiagnosis. These finding may be important to further characterize the condition in this area
The relationship between statins and diabetic retinopathy: A review of literature
Get PDFBackgroundTreatment with statins is a robust strategy in reducing cardiovascular complications among patients with diabetes mellitus and chronic kidney disease. There is an increasing awareness regarding the association of statins with diabetic retinopathy.AimsThe current review aimed to assess the relationship of statins therapy to diabetic retinopathy.Methods The literature in PubMed and Google Scholar was searched for relevant articles from the first available article up to present using the terms statins, simvastatin, atorvastatin, pravastatin, and diabetic retinopathy. Among the 169 articles retrieved, 26 full-texts were assessed for eligibility and only sixteen studies (four from the USA, another four from Europe, six from Asia, and one from Australia and Brazil each) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported.ResultsThe studies reviewed showed that statins reduce the development of diabetic retinopathy, retard the progression of hard exudates and micro-aneurisms, reduce retinopathy and macular oedema.ConclusionStatins prevent and reduce the progression of diabetic retinopathy and macular oedema
Better approach to optimize perioperative care for high risk older patients undergoing non cardiac surgeries
Get PDFBackgroundAs the population is aging, an associated rise in co-morbidities augment perioperative mortality and morbidity. Evidence is emerging to improve perioperative care for high-risk patients in view of better postoperative outcomes.AimsWhile there are number of international guidelines describing preoperative evaluation of such patients, a comprehensive review of a high-risk older patient’s journey through non-cardiac surgery is lacking in the literature. The aim of this review is to recapitulate current evidence for management approaches of high-risk patients undergoing non-cardiac surgeries.Methods In this review, literature search was conducted through East Metropolitan Health library service for studies and guidelines published on high risk older patients undergoing non cardiac surgeries. Priority was given to the evidence on preoperative risk stratification, investigation and management of chronic medical conditions and postoperative care.ConclusionThe available evidence should be used to optimize perioperative outcomes of high and intermediate risk older patients undergoing non-cardiac surgeries
Gastric Dieulafoy's lesion in an elderly man with comorbidities: A case report
Get PDFDieulafoy's lesion (DL) is an abnormal, enlarged (approximately 13mm) and tortious submucosal artery in the gastrointestinal tract wall. Herein, we report a case of recurrent bleeding from a gastric fundus DL in a 59-year-old man who presented with a history of melena associated with dizziness and palpitations. Esophagogastroduodenoscopy revealed a tortuous, dilated vessel in the gastric fundus. Computed tomography angiography revealed an aberrant vessel branching from the celiac artery. Surgery was performed, resulting in complete resolution of the patient’s symptoms. DL is a rare but life-threating cause of gastrointestinal haemorrhage and should be considered in the differential diagnosis
The association between linagliptin and acute pancreatitis: A review
Get PDFBackgroundLinagliptin is a Dipeptidyl Peptidase inhibitor (DPP-4i) with rare hypoglycaemic episodes and no need for renal adjustment. However, acute pancreatic is a major concern.AimsThe current review aimed to assess the relationship between linagliptin and acute pancreatitis.Methods A systematic electronic search was conducted in PubMed, MEDLINE, and the first hundred articles of Google Scholar for relevant articles. All human studies published during the period from 2006 to October 2019 were eligible. Studies on animals, experimental studies, and reviews were excluded. The search terms linagliptin, acute pancreatitis, chronic pancreatitis, and DPP-4i with protean AND or OR were used One hundred and thirty-two articles were retrieved and only six met the inclusion and exclusion criteria. The author's name, country of origin, date of publication, type of study, number of patients, and the duration were reported.Results There were 132 studies (thirty-two in Pub Med and MEDLINE and the first hundred articles in Google Scholar), out of fourteen full texts reviewed, only six studies were eligible. Three were meta-analyses (showed no association of linagliptin with acute pancreatitis, a pooled analysis of 22 randomized controlled trials supported the above observation, while a recent randomized controlled trial concluded acute pancreatitis in 0.3 per cent in linagliptin arm vs. 0.1 per cent placebo of which 2/9 were fatal. The last study was a case report at a high risk of acute pancreatitis due to multiple gallstones and diuretics use.ConclusionAcute pancreatitis was not higher among linagliptin users. Physicians need to take the benefits of this weight and cardiovascular risk-neutral drug with no need for renal adjustment
Chlorhexidine versus Povidone-Iodine for the prevention of Surgical Site Infections: A review.
Get PDFBackgroundSurgical Site Infections (SSIs) are the third most frequently reported health care-associated infection and it remain a major clinical problem despite improvements in prevention, as they are associated with significant mortality and morbidity. Prevention strategies for SSIs are based on reducing the risk of infection by bacteria, So many antiseptic agents are used, the most common one are Chlorhexidine and Povidone-Iodine.AimsTo discuss the findings of RCTs that compare Chlorhexidine versus Povidone-Iodine in the prevention of Surgical Site Infections (SSIs).Methods This systematic review was carried out, including PubMed, Google Scholar, and EBSCO that examining randomized trials of Chlorhexidine and Povidone-Iodine to summarize the major RCT that compare Chlorhexidine versus Povidone-Iodine in the prevention of Surgical Site Infections (SSIs).Results The review included six randomized studies that compare between Chlorhexidine and Povidone-Iodine for the prevention of SSIs. The findings showed that many studies prefer using Chlorhexidine over Povidine-Iodine to reduce SSIs, few studies prefer using PVI as antiseptic and other studies reported that there is no significant difference between both. ConclusionMajority of results prefer using Chlorhexidine than Povidone-Iodine as antiseptics but there were few findings prefer PVI and other studies reported that there was no significant difference between using them as antiseptics.
Challenges and barriers to start isotretinoin in acne patients
Get PDFBackgroundThe awareness of patients with acne about the side effects of isotretinoin is an important factor to reduce non-compliance with isotretinoin therapy, especially with long-term use.AimsThe objective was to assess gender-specific awareness and concerns of isotretinoin among patients with acne.Methods A cross-sectional survey study was conducted among acne patients of both genders attending dermatology outpatient clinics at a tertiary care hospital.Results A total 356 acne patients were included in the current analysis. The average age was 23.6±5.8 years. More than half of the patients (57.6 per cent) were females and the majority (79.5 per cent) were single. The majority of the patients were aware of isotretinoin (79.1 per cent) and its side effects (63.0 per cent). The most frequently recognized side effect was dryness (55.1 per cent), followed by teratogenicity (28.5 per cent), disturbance of lipid profile (9.3 per cent), and finally constipation (7.0 per cent). Compared to males, females were more likely to know and to be concerned about the teratogenic side effect of isotretinoin (p=0.022 and p < 0.001, respectively). The most important source of information about isotretinoin was physician (61.9 per cent), followed by patients (13.9 per cent), friends (8.8 per cent), and finally internet (8.1 per cent).ConclusionThe awareness of specific isotretinoin side effects among a group of young Saudi patients with acne was suboptimal. Females were more likely to be aware of and concerned about the teratogenic side effect isotretinoin. The majority of our patients prefer to receive isotretinoin information from trusted official sources. The findings highlight the dermatologist role in health education and counselling on acne and its treatments
Effect of microencapsulated granulas contained in the natural extracts on postsurgical wound healing
Get PDFBackgroundThe innovative complex technology of encapsulation of the natural extracts allows the products to be more efficient in surgical wound healing due to penetration of the microcapsules in the soft tissues.AimsThe aim of the randomized controlled trial was to evaluate the effectiveness of microencapsulated natural extracts contained in the gel on wound healing process after oral surgical procedures. Methods The study included 95 patients with indications for endodontic surgery: third molar surgical extraction or dental implants placement. The patients were randomly divided in two groups based on the postsurgical protocol on treating the wound after surgery: A/: Subgroup 1: GinGinat group used a gel composed of different natural products (GinGinat gel, LoB Foundation, Paris, France) for treating the surgical area; B/ Subgroup 2: Standard protocol used saline solution for treating the wound after surgery. At the seven day follow upallpatients were asked to rate their experience and satisfaction on the recovery process after surgery based on a questionnaire. They were observed and evaluated for satisfaction with the recovery process based on using Likert-type scale.Results The results showed a statistically significant difference in the postoperative recovery period between the GinGinat and standard group (p < 0.001) based on a therapist’s evaluation. The GinGinat group was rated with the higher clinical score compared to the standard group (p < 0.001). There was a statistically significant difference in the recovery postoperative period between the GinGinat and standard group as rated based on the results of a patient’s questionnaire (p < 0.001).ConclusionThe results showed clinical improvement and better postsurgical healing of the wounds as well as the stronger analgesic effect after the application of microencapsulated granulas which are contained in the natural extracts as opposed to the standard postsurgical protocol