Electroencephalographic Grading of Neuronal Dysfunction in Various Etiologies of Encephalopathy

2020 ◽  
Vol 51 (6) ◽  
pp. 420-425
Author(s):  
Fahad Alkhamis ◽  
Saima Nazish
Keyword(s):  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
Neuronal Dysfunction ◽  
Septic Encephalopathy ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Continuous Eeg ◽  
Continuous Eeg Monitoring ◽  
Gcs Score ◽  
Ischemic Encephalopathy

Objective: The objective of this work was to study the electroencephalographic (EEG) grading of neuronal dysfunction in encephalopathy of various etiologies and assess their association with clinical outcomes. Subjects and Methods: This retrospective cross-sectional study was performed between June and November 2018 at the Neurology Department of King Fahd Hospital of University, Kingdom of Saudi Arabia (KSA) and involved a review and analysis of EEG and medical records pertaining to 222 patients in whom encephalopathy was diagnosed. Results: In patients suffering from encephalopathy, advanced age ( P = .01), low Glasgow Coma Scale (GCS) scores ( P = .00), and certain etiologies, namely hypoxic-ischemic encephalopathy (HIE) ( P = .00), septic encephalopathy ( P = .01), and other illnesses ( P = .00), were significantly associated with unfavorable clinical outcomes, whereas traumatic brain injury (TBI) ( P = .01) and GCS >7 ( P = .00) were associated with favorable outcomes. Among different etiologies, EEG grade I ( P = .02) and grade IV ( P = .04) neuronal dysfunction was significantly associated with TBI while grade III ( P = .05) and grade V ( P = .02) neuronal dysfunction was significantly associated with HIE. Grade I ( P = .03) neuronal dysfunction was mostly observed in septic encephalopathy cases, while patients suffering from other illnesses were also found to have grade I ( P = .04) and grade IV ( P = .05) neuronal dysfunction based on their EEG. Conclusion: EEG is being conducted routinely to determine the course and severity of various forms of encephalopathy. However, the clinical implications of EEG grading for neuronal dysfunction are largely dependent on underlying etiology and other clinical parameters, such as age and GCS score. Further larger prospective cohort studies involving other important prognostic parameters and continuous EEG monitoring are thus needed.

scholarly journals Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

2021 ◽  
Vol 8 (1) ◽  
pp. e000662
Author(s):  
Sen Yagi ◽  
Shinya Furukawa ◽  
Kana Shiraishi ◽  
Yu Hashimoto ◽  
Kazuhiro Tange ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Serum Albumin ◽  
Clinical Outcomes ◽  
Clinical Remission ◽  
Acute Inflammation ◽  
Japanese Patients ◽  
Cross Sectional Study ◽  
Mucosal Healing ◽  
High Serum ◽  
Cross Sectional

ObjectiveSerum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association.DesignThis cross-sectional study recruited consecutive patients with UC. Study subjects consisted of 273 Japanese patients with UC. Serum albumin was divided into tertiles based on its distribution in all study subjects. One endoscopy specialist was responsible for measuring partial MH and MH, which were defined as a Mayo endoscopic subscore of 0–1 and 0, respectively. The association between serum albumin and clinical outcomes was assessed by multivariate logistic regression.ResultsRates of clinical remission, partial MH and MH were 57.9%, 63% and 26%, respectively. Only high serum albumin (>4.4 mg/dL) was significantly positively associated with MH (OR 2.29 (95% CI: 1.03 to 5.29), p for trend=0.043). In patients with short UC duration (<7 years) only, high serum albumin was significantly positively associated with MH and clinical remission. In patients with long UC duration (≥7 years), in contrast, no association between serum albumin and clinical outcomes was found.ConclusionIn Japanese patients with UC, serum albumin was significantly positively associated with MH. In patients with short UC duration, serum albumin might be a useful complementary marker for MH.

scholarly journals Alcohol-related hospitalisations of trauma patients in Southern Taiwan: a cross-sectional study based on a trauma registry system

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005947 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Hang-Tsung Liu ◽  
Shiun-Yuan Hsu ◽  
Tzu-Yu Cho ◽  
Ching-Hua Hsieh
Keyword(s):  
Ct Scan ◽  
Injury Severity ◽  
Trauma Registry ◽  
Cross Sectional Study ◽  
Blood Alcohol ◽  
Cross Sectional ◽  
Brain Ct ◽  
Registry System ◽  
Gcs Score ◽  
Trauma Registry System

ObjectivesTo provide an overview of the demographic characteristics of patients with positive blood alcohol concentration (BAC) and to investigate the performance of brain CT scans in these patients.DesignCross-sectional study.SettingTaiwan.Participants2192 patients who had undergone a test for blood alcohol of 13 233 patients registered in the Trauma Registry System between 1 January 2009 and 31 December 2012. A BAC level of 50 mg/dL was defined as the cut-off value. Detailed information was retrieved from the patients with positive BAC (n=793) and was compared with information from those with a negative BAC (n=1399).Main outcome measuresGlasgow Coma Scale (GCS) and Injury Severity Score (ISS) as well as the performance and findings of obtained brain CT scans.ResultsPatients with positive BAC had a higher rate of face injury, but a lower GCS score, a lower rate of head and neck injury, a lower ISS and New Injury Severity Score. Alcohol use was associated with a shorter length of hospital stay (8.6 vs 11.4 days, p=0.000) in patients with an ISS of <16. Of 496 patients with positive BAC who underwent brain CT, 164 (33.1%) showed positive findings on CT scan. In contrast, of 891 patients with negative BAC who underwent brain CT, 389 (43.7%) had positive findings on CT scan. The lower percentage of positive CT scan findings in patients with positive BAC was particularly evident in patients with an ISS <16 (18.0% vs 28.8%, p=0.001).ConclusionsPatients who consumed alcohol tended to have a low GCS score and injuries that were less severe. However, given the significantly low percentage of positive findings, brain CT might be overused in these patients with less severe injuries.

Temporal Trends in the Severity and Mortality of Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Hypothermia

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cristina Vega-Del-Val ◽  
Juan Arnaez ◽  
Sonia Caserío ◽  
Elena Pilar Gutiérrez ◽  
Marta Benito ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Cross Sectional Study ◽  
Annual Incidence ◽  
Hypoxic Ischemic Encephalopathy ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Changes Over Time ◽  
Ischemic Encephalopathy ◽  
Annual Decline ◽  
Over Time

<b><i>Introduction:</i></b> There is a paucity of studies examining temporal trends in the incidence and mortality of moderate-to-severe hypoxic-ischemic encephalopathy (HIE) during the last decade of therapeutic hypothermia (TH). <b><i>Methods:</i></b> Multicenter cross-sectional study of all infants ≥35 weeks gestational age diagnosed with moderate-to-severe HIE within 6 h of birth in an extensive region of Spain between 2011 and 2019, in order to detect trend changes over time in the (1) annual incidence, (2) severity of neurological and systemic organ involvement, and (3) neonatal death from HIE. <b><i>Results:</i></b> Annual incidence rate of moderate-to-severe HIE was 0.84 (95% confidence interval [CI] 0.7–0.97) per 1,000 births, without trend changes over time (<i>p</i> = 0.8), although the proportion of severe HIE infants showed an average annual decline of 0.86 points (95% CI 0.75–0.98). There were 102 (70%) infants diagnosed with moderate HIE and 44 (30%) with severe HIE. TH was offered to 139/146 (95%) infants. Infants with clinical and/or electrical seizures showed a decreasing trend from 56 to 28% (<i>p</i> = 0.006). Mortality showed a nonstatistically significant decline (<i>p</i> = 0.4), and the severity of systemic damage showed no changes (<i>p</i> = 0.3). Obstetric characteristics remained unchanged, while higher perinatal pH values (<i>p</i> = 0.03) and Apgar scores (<i>p</i> = 0.05), and less need for resuscitation (<i>p</i> = 0.07), were found over time. <b><i>Conclusion:</i></b> The annual incidence of moderate-to-severe HIE has stabilized at around 1 per 1,000 births, with a temporal trend toward a decrease in severe HIE infants and a slight decline of mortality. No association was found between temporal trends and changes in perinatal/obstetric characteristics over time.

General Perception Regarding The Generic and Branded Medicines among the Visitors of the Turaif General Hospital

2021 ◽  
Vol 15 (12) ◽  
pp. 3516-3518
Author(s):  
Nawaf Alotaibi
Keyword(s):  
Saudi Arabia ◽  
General Hospital ◽  
Health Care Professionals ◽  
Generic Drugs ◽  
Generic Medicine ◽  
Cross Sectional Study ◽  
Generic Medicines ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Awareness Programs

Background: The utilization of generic drugs in Saudi Arabia is under development. Many studies concerning generic drugs and their utilization by the consumers and promotion by health care professionals have been conducted in Saudi Arabia. Most of these studies revealed general unawareness of generic medicines among the Saudi people. Objective: The objective of this study was to evaluate the general perception regarding the generic medicines and branded medicines among the visitors of the Turaif general hospital. Methods: This cross‑sectional study was carried out from December 29, 2019, to January 23, 2020, at Turaif General Hospital, Turaif, Kingdom of Saudi Arabia using a questionnaire. The questionnaire was shared with the visitors (N = 527) of the hospital after their agreement, and the data were collected. The obtained data were statistically analyzed by Statistical Product and Service Solutions (SPSS) version 16. Results: The results of this study revealed that more than 50% of the participants were unaware about generic medicines and branded medicines; preferred imported generic medicines over local generics; agreed that the imported generic medicines are of high quality, more effective, and expensive as well. However, almost 50% of the participants were not sure about the quality, efficacy, safety, price, and side effects of the branded medicine. Conclusion: It has been concluded that there is a need to provide awareness programs about branded medicine, imported generic medicine, and locally manufactured generic medicines. Keywords: Branded drugs, Generic drugs, Awareness, Turaif, Saudi Arabia.

#3119 Diagnosis and management of functional neurological symptoms: Saudi Arabia experience

2021 ◽  
Vol 92 (8) ◽  
pp. A13.1-A13
Author(s):  
Lujain Khoja ◽  
Abeer Khoja ◽  
Saeed Shabaan ◽  
Haythum Tayeb
Keyword(s):  
Saudi Arabia ◽  
Conversion Disorder ◽  
Cross Sectional Study ◽  
Neurological Symptoms ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Brain Functioning ◽  
Target Populations ◽  
Functional Neurological Symptoms ◽  
Dutch Experience

ObjectivesTo explore the opinion of todays neurologist and psychiatrist in the kingdom of Saudi Arabia regarding pathogenesis, diagnosis, treatment and outcome. It is a replication for Dutch experience with Functional Neurological symptoms Disorder (FND).MethodsA multi-centres Cross-sectional study was conducted in Saudi Arabia started from November 2019 and still ongoing. The target populations were a qualified psychiatrists or neurologists. Data were collected through an electronic questionnaire.ResultsThere were 70 respondents, 37.1% were female and 62.9% males. A 15.5% were Neurologists and 72.4% psychiatrists. Three questionnaires were taken out due to incompletion error. Most neurologists and psychiatrists believed that FND is a disorder of functioning of the nervous system together with psychogenic factors. However, 100% of psychiatrist believed that a prior psychological stress is a cause of the disorder (among other causes) while 86.84% of neurologists. Also found that, a 71% of patients who referred to neurologist were evaluated initially by a general practitioner, while 85% of the patients who referred to psychiatrist; were evaluated by neurologists. Eventually, most of the neurologists and the psychiatrists diagnosed patients by conversion disorder (13/38 of neurologist and 13/20 of psychiatrists).ConclusionOur preliminary conclusion is comparable for Dutch experience that is not considered purely a psychiatric disorder and counted disordered brain functioning together with psychogenic factors responsible for FNS. However, the majority of the psychiatrists in our study diagnose FND as conversion disorder.

DETERMINING MIGRAINE WITH AURA TRIGGER FACTORS TOWARD IMPROVING THE PRACTICE: A CROSS-SECTIONAL STUDY FROM SAUDI ARABIA

2021 ◽  
Vol 17 (37) ◽  
pp. 270-292
Author(s):  
Foziah Jabbar ALSHAMRANI ◽  
Noor Mohammad ALMOHISH ◽  
Mohammed Faisal ALMUAIGEL ◽  
Narjes Ali ALRAMADHAN ◽  
Maryam Mohammad ALJUMAH
Keyword(s):  
Saudi Arabia ◽  
Migraine With Aura ◽  
Cross Sectional Study ◽  
Computer Work ◽  
Sectional Study ◽  
Trigger Factors ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Background: Primary headache is one of the most common disorders treated in neurology clinics. Globally, it has been estimated that the current prevalence of headache disorder in adults symptomatic, at least once within the last year, is about 50%. According to the Global Burden of Disease Study 2015, migraine was ranked as the third most common cause of disability worldwide. One of the significant migraines is migraine with aura, a frequent headache that occurs after or with sensory disturbances. Aim: This study aimed to identify and compare triggers in previously diagnosed patients with migraine with aura (MwA) to those who have not been identified with migraine with aura before but diagnosed according to a questionnaire survey distributed in the Kingdom of Saudi Arabia (KSA). Methods: Adults aged 18–50 years were randomly selected in the Kingdom of Saudi Arabia to participate in this non-interventional, multicentre, cross-sectional study. The study data was collected via an online questionnaire using the diagnostic criteria of the International Classification of Headache Disorders 2018 and the Cleveland Clinic Canada headache questionnaire. Results and Discussion: Of the 4.140 potentially eligible individuals, 302 were not previously diagnosed with migraine with aura but were diagnosed with a questionnaire (Group A), while 71 participants were already diagnosed (MwA) (Group B). A significant relationship was found among MwA and stress and anxiety, sleep disturbance, noisy places, exposure to lots of lights, prolonged computer work, hunger, fasting, studying for exams, and menstruation in Group A. Group B experienced all of the previous triggers in addition to weather changes, certain odors, and the consumption of cheese, bananas, and hotdogs. Conclusions: The trigger factors are common in individuals with MwA. Awareness of these triggers is essential for preventing the severe complications of MwA, hence, enhance the quality of life of patients.

Influence of Occupational Factors on the Job Satisfaction Among Licensed Periodontist in Kingdom of Saudi Arabia: A Cross-Sectional Study

2020 ◽  
Vol 11 (1) ◽  
pp. 16-22
Author(s):  
Nouf Al-Shibani ◽  
Nawaf Labban ◽  
Fahad Ali Alshehri ◽  
Reem Al-Kattan ◽  
Hanan Al-Otaibi ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Saudi Arabia ◽  
Cross Sectional Study ◽  
Working Environment ◽  
Sectional Study ◽  
Kingdom Of Saudi Arabia ◽  
Extrinsic Factors ◽  
Cross Sectional ◽  
Intrinsic And Extrinsic Factors

Aim: To evaluate the overall job satisfaction among periodontists, highlighting the significance of intrinsic and extrinsic factors and their satisfaction level with patients, facilities, and workplace when working in the Kingdom of Saudi Arabia. Materials and Methods: An interview-type questionnaire-based cross-sectional study was formulated and consisted of total 38 questions in 8 domains. Contact details of registered periodontists were taken and a weblink containing details of the questionnaire using the tool SurveyMonkey was sent to periodontist from the office of Saudi Dental Society. A single investigator was done to minimize bias evaluated with all the responses. Statistical Package for the Social Sciences software version 21 (SPSS Inc., Chicago, IL, USA) was used for tabulation of descriptive analysis. Standard deviation, percentages and means were calculated. Results: Out of the total 75 emails sent to the periodontists, 65 (86%) responses were received. 63 (96.9%) of the respondents were Saudi nationals, whereas the rest 2 (3.1%) were non‑Saudis. 40 (61.5%) respondents were males, whereas 25 (38.5%) were females. Majority of the respondents were dentists 43 (66.2%). 32.3% reported better professional growth as the main reason for choosing periodontal profession. However, a vast majority of the respondents, 56.9% stated that working as a periodontist was their first choice. 49.3% of the respondents affirmed that they were pleased with the working environment as it was conductive and professional. Approximately, 73.9% of the periodontist were of the view that they had good relations with their patients. Conclusion: Job satisfaction among periodontists working in the Kingdom of Saudi Arabia was adequate as majority of them displayed a positive attitude toward working environment, their profession, peers, and intrinsic and extrinsic factors related to periodontal profession. Clinical Significance: Job satisfaction plays a vital role in delivering standard quality health care. Dissatisfaction in job may lead to stress, anxiety, and/or depression leading to compromised health care facilities and patient satisfaction.

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