Australasian Medical Journal
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The relationship between diet soda soft drinks, artificial sweeteners, and diabetic retinopathy
Get PDFBackgroundThe relationship between diabetic retinopathy and diet-drink (soft soda), non-nutritive sweeteners have not been fully determined. We here attempted to determine it.AimsThe study aimed to assess the association between soda soft drinks, non-nutritive sweeteners, and diabetic retinopathy.Methods A cross-sectional descriptive study was conducted at a diabetes center in Tabuk city, Saudi Arabia from September 2019 to April 2020: 174 patients with type 2 diabetes mellitus (DM) were interviewed using a structured questionnaire: demographic data, the DM duration, the lifestyles (exercise, smoking, and diet), and the medications. The weekly amount of diet soda and daily consumption of non-nutritive sweeteners were assessed. These were analysed with association with retinopathy.Results The glycated haemoglobin per cent was 8.50±1.60, the diet soda and artificial sweeteners consumptions were 1.18±1.57 cans/week and 0.89±1.26 sachets/day, respectively. No association was found between artificial sweeteners, diet soda, and diabetic retinopathy (Wald, 1.251, and 0.213, P-values, 0.263, and 0.644, 95 per cent CI, 0.583–7.204, and 0.190–2.793 respectively). Retinopathy incidence was associated with the DM duration (Wald, 8.095, P-value, 0.004, and 95 per cent CI, 0.766–0.952).ConclusionDiet soda and non-nutritive sweeteners were not associated with diabetic retinopathy, irrespective of gender or body mass index. Diabetic retinopathy was associated with the duration of DM after its first diagnosis
Differences in breast cancer treatment pathways for women participating in screening through BreastScreen New South Wales
Get PDFBackgroundPrevious studies have shown that mammographic screening is associated with earlier stage diagnosis of breast cancer and use of breast conserving surgery.AimsThe current study aimed to quantify and validate these associations in multivariate analysis and investigate surgery type, adjuvant radiotherapy and immediate breast reconstruction (IBR) for invasive breast cancer or ductal carcinoma in situ (DCIS) by participation in BreastScreen NSW mammographic screening.Methods A data linkage study of 10,931 women aged 40+ years surgically treated for breast cancers diagnosed in 2009-2011 using registry and routinely-collected data. Multivariable logistic regression was used to adjust treatment outcomes for patient and tumour characteristics.Results A third of women undergoing surgery had never screened, 46 per cent had screened recently (within 24 months) through BreastScreen NSW. Breast conserving surgery (BCS) and use of adjuvant radiotherapy following BCS were more common among recently screened compared with never screened women. Differences in treatment outcomes remained after adjusting for patient and tumour characteristics. There were no significant differences in use of IBR with mastectomy by screening participation, with 9 per cent and 33 per cent of women receiving IBR for invasive cancer and DCIS respectively.ConclusionTreatments received by women with invasive breast cancer and DCIS varied by mammographic screening history. This may be due to differences in treatment referral pathways or patient engagement in healthcare
The attitude and behaviour of family medicine residents toward qualitative researches, 2020
Get PDFBackgroundAlthough medical research consists of quantitative and qualitative research, the latter is less actively performed; this is also true in family medicine. In Saudi Arabia, the residency program requires family-medicine-residents to perform some research; however, many perform quantitative research. What prevents residents from performing qualitative research? The present study was an attempt to determine this.AimsTo evaluate the knowledge and barriers in conducting qualitative studies in the family medicine residency program at the Western Region of Saudi Arabia.Methods This cross-sectional observational study was conducted in Primary Health Care Centers at the National Guard Health Affairs, the Western Region of Saudi Arabia, including all Family Medicine residents in the third and fourth year who agree to participate. Twenty-one responses were collected from the residents via an electronic questionnaire. The data were analysed using SPSS (Statistical Package Social Sciences) version 24.0.Results The majority of participants (90.5 per cent) had research experience and agreed that qualitative research can lead to professional enhancement if supported by carrier advancement, the pursuit of personal interest, and further education. The majority of residents who were not currently involved in research stated that the lack of experience and release time were a great hindrance to performing qualitative research.ConclusionMany barriers including lack of training on qualitative study prevented residents from performing qualitative research. More emphasis should be paid on qualitative research in residency
Simulation based learning versus clinical rounds in hospitals as a method of teaching in obstetrics
Get PDFBackgroundIncreasing numbers of medical schools at Khartoum state with high numbers of medical students with limited teaching hospitals for training, associated with behavioural change of the patients towards accepting the training of medical student's makes simulation based education a best alternative to conventional clinical rounds with real patients.AimsTo compare the educational effectiveness between simulations based learning and clinical rounds in hospitals as a method of teaching in obstetrics.Methods This was a descriptive cross sectional institutional-based study done in obstetric department at Faculty of medicine of Alneelain University 2017, to study simulation based learning as effective methods compare to clinical rounds in hospitals as a method of teaching. The data collected using pre-constructed, validated questionnaire inquiring about simulation based education and clinical rounds, questions designed to evaluate the perception of medical students and then tested the same students marks in their final MBBS obstetric exam comparing their results in questions based on pure clinical rounds versus questions based on pure simulation based learning , the sampling includes 129 students in final years in semester 11, then the data analysed by statistical package for social sciences.Results In general more than halve 56.6 per cent of the student preferred the clinical round than simulation based learning as method of teaching. Concerning contribution of tutor in the teaching and clearly defined of course objectives in obstetric the student stated that it was more effective and defined in simulation based learning than in clinical round 51.9 per cent versus 41.1 per cent and 45.7 per cent versus 21.7 respectively. When assessing the exam results of both methods, the study verified that simulation based learning is better than clinical round as method of teaching because there is significant difference in means of exam remarks of those student (17.22 for simulation versus 11.12 for clinical round from total 20 marks ), P < 0.01.ConclusionThe study concluded that simulation based education is substitute and filling the gap in teaching obstetric curriculum in undergraduate medical students
A suggested approach to the diagnosis of urinary tract infection and empiric use of antibiotics among hospitalized older adults with acute confusion and or underlying cognitive and communication deficits
Get PDFBackgroundThe true incidence of urinary tract infection (UTI) among hospitalized older adults remains unknown.AimsWe aim to present an approach to improve correct identification of UTI diagnosis and empiric use of antibiotics among those who are unable to provide history.Methods A comprehensive review of the literature was undertaken.Results Our suggested approach appears safe and likely to enhance diagnostic accuracy and judicious use of antibiotics among hospitalized older adults.ConclusionOur suggested approach is based on best available literature evidence but requires validation in clinical studies
Assessment of the level of awareness about paediatric cataract among the general population of Jeddah
Get PDFBackgroundCataract is an extremely serious cause of visual impairment in paediatric patients worldwide, with untreated cataract being the leading cause of blindness in children.AimsThe aim of the present study was to assess the level of awareness and knowledge about paediatric cataract among the general population of Jeddah, Saudi Arabia.Methods This survey-based cross-sectional study was conducted between June and July 2018 and included a representative sample of the general population of Jeddah, Saudi Arabia. The questionnaire included a set of questions pertaining to paediatric cataract knowledge and awareness. The gathered data were analysed using Statistical Package for Social Sciences (SPSS) version 21, and the results were acquired by Pearson’s chi square tests and frequency calculations.Results In total, 678 individuals, including 51.6per cent women and 48.4per cent men, participated in the survey. Approximately 39.7per cent participants did not know whether cataract can affect the paediatric population or not. Although the majority could not recognize the risk factors and symptoms of the disease, 75.2per cent realized that it is treatable. Surgical intervention was identified as the main treatment modality by 46.9per cent participants.ConclusionOur findings suggest that the general population of Jeddah has limited knowledge about paediatric cataract. Thus, educational campaigns and programs are necessary to increase public awareness. In addition, further studies on awareness about this condition should be considered in order to prevent serious eye complications in children
Epidemiology of congenital heart disease among pediatric patients in Northwest, Saudi Arabia
Get PDFBackgroundCongenital heart defect (CHD) is considered one of the commonest major birth defects, causing children’s morbidity and mortality.AimsTo define the frequency and epidemiology of congenital heart disease among children in Tabuk, Saudi Arabia.Methods This was a retrospective observational study based on the medical hearts. The study population consisted of pediatric patients with confirmed CHD, who were referred to the pediatric cardiology clinic at the King Salman Armed Forces Hospital, Tabuk, Saudi Arabia between January 2015 and June 2019. Of patients with CHD, those with patent ducts arteriosus (PDA) and persistent foramen oval spontaneously resolved during the first four weeks of life were excluded.Results A total of 1,647 pediatric patients were referred to the pediatric cardiology clinic. Of these, 851 were confirmed to have CHD. The diagnosis was made most frequently during the neonatal period. The following three were most frequently observed (in the order of): Ventricular septal defect (VSD: 42 per cent), atrial septal defect (ASD: 32.6 per cent), PDA (16.2 per cent). Down syndrome (DS) was the most frequent underlying condition. Approximately two-thirds of cases were managed conservatively.ConclusionWe demonstrated the characteristics of children’s CHD in this referral center. The data may be important to further make health-policy-making in this area
Urine analysis sensitivity and specificity for paediatric urinary tract infections
Get PDFBackgroundPaediatric urinary tract infection (UTI) is one of the most common infections among children and a reliable method for diagnosis is critical for management. Few studies have discussed the relationship between the number of leukocytes in the microscopic urinalysis and urine culture.AimsOur aim was to determine the sensitivity and specificity of pyuria as a predictor of culture- proven UTI in the paediatric age group.MethodsThis retrospective study was conducted between 2015 and 2020 at King Abdulaziz University Hospital. Demographic data, history of congenital anomalies, and microscopic urine analysis of 315 participants (≤ 14 years old) was analysed. Pyuria was defined as > 5 WBC /HPF.ResultsUTI was diagnosed in 115 patients based on urine culture. The most common organism was Escherichia coli. Non-E. coli UTI are more common with vesicoureteral reflux patients. Pyuria was found to be positive in 134 (42.5 per cent) of the total sample; 80 of them had a confirmed UTI, with sensitivity of 70 per cent and specificity of 73 per cent. Nitrite has a high sensitivity (66 per cent) but a low specificity. The association between pyuria and positive urine culture was strongly and independently significant (P=0.001). Pyuria and nitrite positivity appear to be more sensitive to E. coli.ConclusionIn conclusion, pyuria is a strong predictor for urinary tract infection in the paediatric age group and is a wise initial test
Tolosa Hunt syndrome followed by facial nerve palsy
Get PDFTolosa Hunt syndrome (THS) is a rare neurological syndrome, manifesting as a unilateral headache with painful ophthalmoplegia. THS main symptoms are thought to be derived from the granulomatous inflammation of the cavernous sinus, superior orbital fissure or orbits. Although the facial nerve does not originate from the cavernous, few case reports have observed the involvement of facial nerve, proposing the idea of a diffuse systemic inflammation. We here describe a case of a typical THS in the form of initial presentation, imaging and response to treatment but has atypical features, in the form of extracavernous cranial nerve involvement
Role of adjuvant metformin therapy on HA1C in type 1 diabetes
Get PDFBackgroundAdequate glycaemic control is a protective strategy against diabetic complication that achieved manly with insulin therapy, studies have shown that type 1 diabetic patients had a reduced insulin sensitivity, on view of this fact, metformin as an insulin sensitizing agent was used in trials as an adjuvant medication to the insulin. AimsCurrent study aimed to summarize the benefit of adjuvant metformin on HA1C in type 1 diabetes on glycaemic control.Methods A systematic electronic search was conducted including the Pub Med, Google Scholar, and EBSCO using the following terms in different combinations: metformin, diabetes, HA1c, and C- peptide. Out of two hundred and four articles, only six were included.Results Six randomized control trials were identified, aimed to investigate the role of adjuvant metformin on glycaemic control in type 1 diabetes patients. Metformin in dose ranging between 1–2g per day were used for at least three months. Significant HA1c reduction was shown in two out of six trials.ConclusionAdministering adjunctive metformin therapy in type 1 diabetic patients associated with modest reduction in HA1c, improve insulin resistance as indicated by reduce daily insulin requirement.