Acute Neonatal Upper Limb Ischemia: Topical Vasodilation, Anticoagulation and Physical Therapy-A new option for complete reversal of ischemia

Acute upper limb ischemia in neonates is extremely rare and oftenassociated with disastrous outcomes including digital gangrene, chroniclimb ischemia, sepsis and limb loss. It is usually seen in the contextof intra-arterial catheters in the preterm neonates but it can be alsoseen in cases of difficult or traumatic deliveries as well as in infantswith coagulation deficits but can also be spontaneous with no obviousaetiology. Treatment options include topical vasodilators, systemicanticoagulation and in some instances, surgical intervention. We reportthree cases of acute limb ischemia in preterm neonates in which anew treatment option was introduced. The neonates responded to acombination of topical nitro-glycerine cream, systemic anticoagulationwith heparin and physical light massaging of the area just proximalto the site of reduced flow in the vessel assuming some degree ofvasospasm of the vessel occurs with or without thrombosis.Keywords: neonatal ischemia, management of neonatal ischemia, topicalvasodilators, systemic anticoagulation, massage therapy, surgicalintervention

Linezolid Induced Thrombocytopenia: A Case Report

Linezolid (LZD) is an antimicrobial agent with a broad spectrum of activity against virtually all clinically important Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCoNS) and vancomycin-resistant enterococci (VRE). Thrombocytopenia (TP) is a common adverse effect of Linezolid (LZD). Prolonged treatment duration, renal insufficiency, chronic liver disease, malignancy, previous vancomycin use, baseline platelet count, and lower body weight have been reported as possible risk factors for LZD-associated TP. Here, we illustrate a case of a 51-year-old male patient diagnosed with pancreatitis and urinary tract infection and was prescribed several antibiotics including Linezolid. In this case, platelets count which were initially normal started declining from day 7 of initiating Linezolid. Linezolid was withdrawn from treatment from day 9. Platelet count gradually came back to normal on day 16. This suggests reversible type of thrombocytopenia by Linezolid. This case illustrates need for careful observation of platelet count during the treatment with Linezolid. Keywords: Linezolid, Thrombocytopenia, Dechallenge

The Accuracy of Documented Nursing Care Plan among Registered Nurses

Background: Nursing documentation is a record of care planned and provided by qualified nurses under the guidance of a competent nurse for each patient as well as the clients. Objective: to provide published studies about accuracy of nursing documentation. Methods: Searches were conducted using the following electronic databases: PUBMED, MEDLIN, CINAHAL, SAUDI DIGETAL LIBRALY and GOOGLE SCOLAR as gray data base. Search was limited to English-Language publication. And include study over 10year period. Result: nursing documentations is inaccurate, lacking precision, and low in quality. Factors that influence nursing documentation differ but are also interrelated with each other. Shortage of employees, insufficient knowledge about the significance of documentation, patient load, lack of hospital education, and lack of support from nurse leaders are the reported challenges to documentation. Conclusion: Most of the lecture revel the necessary need of nursing documentation practice. Affected factor and with several recommendations for improvement noted. Keywords: ''nursing care plan," "nursing documentation,'' "accuracy of documentation" and ''nursing report.''

CONTRADICTION TO CLINICAL IMMUNOLOGY. SUPPRESSION AND STIMULATION OF IMMUNE REACTIVITY IN PATHOLOGICAL PROCESSES

The analysis of literature data and our published results of examination of patients with a wide range of pathological processes was carried out. It has been established that polar changes in reactivity provoke the development of immune-dependent ones, which include primary and secondary immunodeficiencies, auto-aggressive and immunocomplex diseases, or immunoassociated purulent-inflammatory, nonspecific inflammatory lung diseases, cerebrovascular diseases, in which suppression and stimulation of reactivity is a pathogenetic mechanism for normalizing homeostasis, depending on the links of the immune system, doses of antigens, the initial state of protective functions, phases of the immune response, etc. Keywords: Stimulation. Suppression. Immunodeficiency

Child and Adolescent Obesity in Saudi Arabia

Obesity is a critical universal well-being challenge. Obesity is influencing various chronic conditions like high blood pressure, diabetic illnesses, strokes, cardiovascular ailments, and different kinds of cancer. Treatment of obesity becomes subject to high healthcare costs and lifestyle modifications. However, the most worrying aspect in Saudi Arabia is the intensifying obese-related cases among kids and teenagers. Progression of the condition becomes complex to manage. Again, the vital or severity of health consequences of childhood obesity underscores the disorder as a community health issue in the country. Kids’ and teenagers’ obesity cases have adverse effects on life quality and expectancy and lead to substantial healthcare expenses. Evaluation of various research underscores a relation between obesity, socio-economic status, and lifestyle changes. According to Al-Hussaini et al. (2019), economic success and subsequent lifestyle shifts incorporating sedentary lifestyles and dietary mannerisms continue to influence child and adolescent obesity in Saudi. The evaluation of literature on obesity-related cases in the country offers a better comprehension of the link between child or adolescent obesity and lifestyle factors, which enables one to understand how to prevent and manage the condition effectively.

Relationship between Perceived Organizational Support and Quality of Nurses’ Work Life at King Fahad Hospital-Saudi Arabia

Background: Improving the quality of nurses’ working life is challenging for healthcareorganizations because of its effect on the staff, organizations, and customers. Thedevelopment of supportive environments will enhance the quality of nursing work lifein organizations. However, the association between perceived organizational supportand the quality of working life among nurses was limited information.Aim: This study aims to assess the relationship between perceived organizationalsupport and the quality of nurses’ work life at a King Fahad Hospital Jeddah, SaudiArabia.Methodology: This current study was conducted at King Fahad Hospital, Jeddah,Saudi Arabia. A descriptive correlational design was used. A convenience samplingtechnique was implemented to gather the needed data using a self-report questionnaire.Data was collected using the Survey of Perceived Organizational Support and Brook’Quality of Nursing Work Life Survey. In addition, a demographic questionnaire wasdeveloped by the researcher.Results: About 80.6% of staff nurses showed a moderate POS level, and 63.6% of staffnurses experienced an average level of QNWL. The Pearson correlation coefficientsshowed a statistically significant correlation between POS and overall QNWL (0.541).The correlations between POS and the sub-scales of QNWL came in the range (0.367– 0.521). Also, it found that non-Saudi nurses exhibited higher POS and QNWL levelscompared to Saudi nurses.Conclusion and Recommendation: The study found that perceived organizationalsupport is positively related to QNWL, which means that the higher nurses’ perceivedorganizational support will improve the nurses’ quality of working life. These findingsshould be used by nursing administrations and health policymakers to develop a seriesof organizational support that can improve the quality of working life amongnurses. Future research, further comparative research is needed to examine POS andits relation to QNWL among different healthcare organizations.Key words: Perceived Organizational Support–Quality of Nurses’ Work Life–Qualityof Nursing Work Life–Staff nurses

Knowledge of Breast Cancer Risk Factors and Practices of Breast Self-Examination among Women in Northern Ghana

Introduction: Breast cancer remains a major global health concern in both developed and developing countries. The current study aimed to assess the knowledge of risk factors of breast cancer (BC), and the practice of breast self-examination (BSE) among females in the Tamale Metropolis of Northern Ghana. Methods: This is a cross-sectional study involving 1122 participants; consisting of nurses 157 (14.1%), teachers 227 (20.2%), undergraduate university students 339 (30.5%), medical students 95 (8.5%) and market women 304 (27.3%). Using a convenience sampling method to select the participants, we distributed questionnaires to participants which were completed and returned. Results: Most of the participants, 498 (44.4%) were between age 19-25. The majority were enlightened about BC (93.1%), and BSE (87.6%), 723 (64%) had good knowledge about the risk factors of BC. A total of 857 (76.4%) had previously been taught BSE. However, only 417 (37.2%) were found to practice BSE regularly. Conclusion: The knowledge of BC risk factors and BSE was remarkable, but varied in the various occupational categories. However, only a few participants practiced BSE regularly. There is a need for widespread educational campaigns to educate further and encourage women to practice BSE regularly. The inclusion of men in these crusades is long overdue. Equipped with the knowledge and skills of BSE, men could assist and encourage their spouses to frequently examine themselves. Further research studies will be necessary to ascertain the role of men in championing BSE among their significant others. Keywords: awareness; breast cancer; breast self-examination; knowledge; practice; Ghana; Tamale

Nurses’ Organizational Citizenship Behavior and Its Association to their Job Satisfaction

Objective: To identify the level of organizational citizenship behavior and its relation tojob satisfaction in the nursing field.Methodology: One step search strategy includes an extended search in various databases:Cumulative Index Nursing and Allied Health Literature (CINAHL), MEDLINE, ProQuest,and google scholar. Twenty published studied between January 2015 and April 2020 wereincluded in the review.Results: Two themes emerged from the present review, which are nurses' organizationalcitizenship behavior level and effect of nurses’ job satisfaction on organizationalcitizenship behavior. In the theme of nurses' organizational citizenship behavior level;seven studies found most nurses had a high level of OCB, three studies found they hadhigher than average, five studies demonstrated that they had a moderate level while onlyone study found their OCB on a low level. Regarding the other theme, three studies did notfind a correlation between job satisfaction and OCB, whereas three studies displayed thatjob satisfaction had a positive effect on OCB.Conclusion: Most of the studies found that nurses had a high-level regard OCB.However, the result of studies regards the influence of job satisfaction on OCB wereambivalent.Keywords: organizational citizenship behavior, organizational behavior, job satisfaction,work satisfaction, nurses.

Preventing the spread of Coronavirus in ENT unit, our experience

SARS-CoV19 is spreading all over the world starting from China in the end of 2019. This important emergency involved every single aspect of ordinary life. Even hospitals have undergone changes with the aim of ensuring the best care and preventing the spread of the virus. This is a personal contribution to illustrate all the measures put in place to avoid contagion. Although in an ENT unit you have strictly to do with the airway, none of the staff so far has been positive. Keyword: SARS-CoV19, safety, prevention, ENT, contagion.

Nursing Practice Environment and Its Relation to Missed Nursing Care : A Scoping Review

Objective: To examine the association between the practice environment of nursing and themissed care of nursing in a systematic way in the related literature.Methodology: An extensive search was conducted in CINAHL, ProQuest, ERIC, MEDLINE,Web of Science, PubMed, and Science Direct databases. the included studies were publishedduring time period of 2015-2020 with full text.Results: A total of 110 studies were screened, out of which 19 studies were identified to beeligible as per fulfillment of inclusion/exclusion criteria. Degraded quality of nursing,inpatient complications, and mishaps, as well as negative patient outcomes, is examined asexamples for results of missed nursing care. The nurses missed the process and task ofproviding important patient care because of the increased workload, less communication andpoor working environment. Inadequate resources and staffing were the major factors thatwere linked with the events of missed nursing care.Conclusion: It is concluded that reducing and modifying the examined factors, such as poorworking environment, inadequate staffing, less resources, poor communication amongnurses or patients etc. may decrease the missed nursing care practice. In addition, the missednursing can also be managed through the practical implementation of motivating positivework environment and safety culture of patients. These improvements and practicalimplementation will help to provide quality patient care and decrease the missed nursingcare.Keywords: Practice environment, missed nursing care, Teamwork, communication,workload, resources.