Explore the vast range of titles available.

Drug resistance (DR) to antituberculosis drugs is a growing global problem that threatens the successful control of tuberculosis (TB) globally and within the Gulf Cooperation Council (GCC). In the GCC, TB remains a major public health issue. Understanding the prevalence and patterns of drug resistance to antituberculosis drugs is crucial for developing effective prevention and treatment strategies. Hence, the present systematic review is aimed at assessing the prevalence, pattern, and risk factors of drug-resistant TB (DR-TB) in GCC countries. We conducted this systematic review adhering to the guidelines outlined in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 Statement. Using the relevant keywords in the major databases, we included peer-reviewed articles that were published from 01 January 2014 and onwards in English language journals. The prevalence and patterns of DR-TB levels in different countries were different. Isoniazid monoresistance was the most commonly found type of resistance, with varying degrees of prevalence of multidrug-resistant tuberculosis (MDR-TB). Risk factors for DR-TB included diabetes mellitus, past TB treatment, younger age, female gender, and renal failure. There was a positive correlation between expatriate status and DR-TB. Collaborative actions by relevant stakeholders are essential to implement evidence-based interventions that reduce the DR-TB burden and improve overall community health. Ongoing research and surveillance activities are necessary for monitoring patterns, identifying new risk factors, and providing focused interventions to lessen the threat of DR-TB on public health in GCC countries.

Background Body mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. Methodology This cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using self-reported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. Results After controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m , 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. Conclusions Heart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

Child sexual abuse (CSA) has serious consequences that can affect the physical, social and mental health of a child. In the last two decades, concern about CSA has increased around the world including Saudi Arabia. Evaluate factors associated with parental perceptions and knowledge of CSA. Cross-sectional survey. Primary health care clinic. Simple random sampling was used to select participants. The main tool for data collection was a self-administered questionnaire. Factors associated with knowledge and perceptions of CSA. 400. Most respondents (69%) had good knowledge of the signs of sexual abuse in children. For perception scores, statistically significant variables were age (P=.004), educational level (P=.005), income (P less than .001), number of wives (P=.004), number of male children (P=.021), and number of female children (P=.027). For knowledge scores, statistically significant variables were income (P=.008), number of wives (P less than .005), number of male children (P=.003) and number of female chil.dren (P less than .003). Logistic regression showed that the older age group was significantly associated with a good perception score (P less than .046). Risk factors for parental lack of knowledge and poor perception associated with CSA are poverty and low education. Protective factors included the older parent age, size of the family and families with more than one wife. Education should be designed for parents and the community to increase the knowledge and perception of CSA. Single-center study and short study period. None.

Background and objectives Chronic kidney disease (CKD) is a global health issue affecting millions of people worldwide. The role of caregivers in the management of CKD patients on dialysis cannot be overstated. This study investigates the quality of life among caregivers of patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) for CKD at King Khalid University Hospital, Riyadh, Saudi Arabia. It aims to assess the quality of life and prevalence of depression among caregivers in each dialysis modality. By recognizing significant differences in caregiving experiences between HD and PD, this research seeks to enhance understanding of caregiver burdens and overall quality of life. Materials and methods A cross-sectional study was conducted at King Khalid University Hospital and included 80 Saudi adult caregivers of CKD patients on HD or PD receiving treatment at the dialysis center in February 2023. Caregivers were recruited through phone surveys. Participants were required to be over 15 years old, free from psychiatric illnesses, co-residing with the patient, and providing care for at least one month. Results Among the 80 caregivers, 49 (61.25%) were female. A statistically significant gender distribution was observed between groups, with a higher proportion of females among PD caregivers (31 (73.81%)) compared to HD caregivers (18 (47.37%); p=0.015). The mean age of caregivers was 41.41 years (SD=12.82). Regarding education, 55 (68.75%) caregivers had a university degree or higher, with a significantly greater proportion among PD caregivers (34 (80.95%)) than HD caregivers (21 (55.26%); p=0.047). Depression assessments showed that 54 (67.5%) caregivers experienced minimal depression, with no significant difference between groups. However, caregivers of PD patients reported lower levels of burden, with 25 (59.5%) experiencing no to mild burden compared to 14 (36.8%) of HD caregivers, showing a trend toward significance (p=0.053). Additionally, a larger proportion of PD caregivers (30 (71.43%)) were involved in long-term care (>24 months) compared to HD caregivers (17 (44.74%)), suggesting a potentially more sustainable caregiving role (p=0.057). Conclusion This study indicates that the quality of life for PD caregivers is generally better than that for HD caregivers, primarily due to the lower burden and higher educational level among PD caregivers. The in-center nature and frequent treatment schedule associated with HD may lead to higher levels of burden. Addressing the specific needs of caregivers based on dialysis modality can improve quality of life and enhance CKD management strategies, ultimately benefiting both patients and caregivers.

Background. Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness in humans. Fundamental questions about circulating viruses and transmission routes remain. Methods. We assessed routinely collected epidemiologie data for MERS-CoV cases reported in Saudi Arabia during 1 January—30 June 2015 and conducted a more detailed investigation of cases reported during February 2015. Available respiratory specimens were obtained for sequencing. Results. During the study period, 216 MERS-CoV cases were reported. Full genome (n = 17) or spike gene sequences (n = 82) were obtained from 99 individuals. Most sequences (72 of 99 [73%]) formed a discrete, novel recombinant subclade (NRC-2015), which was detected in 6 regions and became predominant by June 2015. No clinical differences were noted between dades. Among 87 cases reported during February 2015, 13 had no recognized risks for secondary acquisition; 12 of these 13 also denied camel contact. Most viruses (8 of 9) from these 13 individuals belonged to NRC-2015. Discussions. Our findings document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015. Our identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission.

Many studies have shown that open and laparoscopicsurgery for resection of colonic cancers produce similar short- and long-term results, but no data have been reported from Saudi Arabia. Compare 3-year disease-free and overall survival after laparoscopic versus open curative resection for potentially curable colon cancer. Multicenter retrospective cohort study. Tertiary academic hospital. We analyzed data of patients who underwent curative resection for potentially curable colon cancer using the laparoscopic or open approach at three tertiary care centers during the period 2000-2015. Overall and disease-free 3-year survival were the primary endpoints. Secondary endpoints included conversion rate, duration of surgery, length of hospital stay, rate of wound infection, resumption of bowel function, number of lymph nodes retrieved, adequacy of resection and rate of recurrence. Risk factors for recurrence, including complete mesocolic excision, were assessed. 721. Patient and tumor characteristics were similar in the two groups except for ASA class ( P<.01), weight ( P<.05) and tumor stage ( P<.05). Over a median follow-up of 46 months, the 3-year overall survival was 76.7% for open resection and 90.3% for laparoscopic colon resection ( P<.05). The 3-year disease-free survival was 55.3% for open colon resection and 64.9% for laparoscopic colon resection ( P=.0714). Overall and disease-free survival after the laparoscopic approach for curative resection of colon cancer is comparable to the open approach. Retrospective design and the possibility of selection bias. None.

Urinary tract infections are very prevalent among women. The majority of urinary tract infections are uncomplicated and can be managed empirically with no further investigations. However, imaging studies may be indicated in patients with severe or persistent symptoms. Complicated urinary tract infections typically develop in the setting of diabetes mellitus. We report a case of a 52-year-old woman who presented to the emergency department with severe lower abdominal pain for two days that was associated with nausea, vomiting, and fever. There was no history of change in urine or bowel habits. Besides the history of well-controlled asthma, the patient was not known to have any comorbid medical condition. Upon examination, the patient had tachycardia, low-grade fever, and a localized suprapubic tenderness with guarding. Laboratory investigation revealed leukocytosis, elevated erythrocyte sedimentation rate and C-reactive protein, and deranged renal functions. Further, urinalysis revealed numerous white blood cells, red blood cells, positive nitrite, and leukocyte esterase. A computed tomography scan demonstrated the presence of small locules of gas within the lumen and the wall of the bladder representing emphysematous cystitis. The patient was admitted to the intensive care unit. She received aggressive hydration therapy and a short course of opioid therapy for pain control. Broad-spectrum antibiotic therapy in the form of piperacillin-tazobactam was initiated. Over the following few days, the patient exhibited significant improvement in his symptoms and resolution of the laboratory parameters. Emphysematous cystitis is a rare infection of the lower urinary tract with gas formation. The case highlighted that such a condition may develop in the absence of diabetes mellitus or other risk factors. Prompt treatment is crucial as emphysematous cystitis can be life-threatening if the diagnosis is missed or delayed.

Background: Patient-centered care (PCC) plays a vital role in improving healthcare outcomes by addressing the individual needs and preferences of patients. Despite its significance, challenges to the implementation of PCC in nursing remain, impacting communication and the overall quality of care.Methods: This literature review examines empirical studies on nurse-patient interactions across various healthcare environments. Relevant articles published in English were sourced from databases such as CINAHL, PubMed, and Medline, with a focus on identifying barriers and facilitators of patient-centered communication. Key themes were extracted and used to develop a conceptual framework, the Patient-Centered Care and Communication Continuum (PC4) Model.Results: The review identified four primary categories of barriers: those related to institutional and healthcare systems, communication issues, environmental factors, and personal and behavioral obstacles. Common challenges include insufficient staffing, time limitations, lack of communication training, and cultural differences between nurses and patients. The findings emphasize the importance of effective communication in achieving successful PCC, noting that enhanced nurse-patient interactions promote patient engagement and satisfaction.Conclusion: Overcoming the identified barriers is essential to improving patient-centered care in nursing practice. The PC4 Model offers a useful framework for understanding and enhancing nurse-patient communication. By prioritizing effective communication and creating a supportive healthcare environment, nurses can better meet the needs of patients and families, leading to improved health outcomes.

Viruses have posed significant threats to human health throughout history, causing substantial disruptions and millions of deaths. Traditional viral detection methods, such as electron microscopy, cell culture, immunofluorescence assays, and reverse transcription polymerase chain reaction (RT-PCR), have limitations in terms of cost, time, and the need for skilled personnel. Paper-based diagnostic chips have emerged as a promising alternative, offering advantages such as affordability, portability, and user-friendliness. These devices are constructed from porous membranes coated with capture molecules that selectively bind to target pathogens. Recent advances in biosensor research have focused on developing faster, more affordable, and highly reliable diagnostic devices for viral detection. Paper-based diagnostic chips have demonstrated superior sensitivity, specificity, and selectivity compared to traditional methods in clinical contexts. Recent studies have yielded promising results for detecting various viruses, including hepatitis B, influenza, human papillomavirus, Ebola, herpes, HIV, hepatitis C, Zika, respiratory syncytial virus, and SARS-CoV-2. However, challenges such as sensitivity, selectivity, and signal stability must be addressed to achieve consistent and accurate pathogen detection. Despite these limitations, paper-based diagnostic chips represent a promising frontier in viral diagnostics, with ongoing research and technological advancements expected to deliver even more efficient, sensitive, and robust solutions in the future.