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Background Refractory status epilepticus (RSE) is a common neurologic emergency with refractory cases leading to increased rates of morbidity and mortality in patients. The lack of previous studies on the incidence, causes, and management of refractory status epilepticus in the pediatric population from our region prompted us to investigate further in this study. Methods We included retrospective data of all patients admitted to the pediatric intensive care unit (PICU) with a provisional diagnosis of RSE at a tertiary care hospital in Karachi from February 2019 to February 2021. No personal identification data was used, and confidentiality of the data was maintained throughout the analysis. The Statistical Package for the Social Sciences (SPSS) software version 22.0 (IBM SPSS Statistics, Armonk, NY, USA) was used to pool data and perform a descriptive analysis. Results Among the 687 patients who presented to the PICU with seizures, 50 (7.27%) patients were eventually diagnosed with RSE during the two-year period. The majority of the patients were male and less than one year of age. Infectious causes predominated our data cohort, and a four-drug regimen consisting of phenytoin, levetiracetam, valproic acid, and midazolam was able to terminate RSE in the majority of the patients in our setting (70%). The mortality rate was noted to be 22% among patients with RSE. Conclusion Morbidity and mortality among pediatric RSE patients are high in our settings. Urgent emergency services and timely cause-directed intervention could improve outcomes.
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OBJECTIVE: To determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in a group of infertile couples attending a tertiary care facility in Saudi Arabia. METHODS: A retrospective cross-sectional observational study was performed by reviewing medical records of 500 couples referred to the Reproductive Endocrine and Infertility Medicine Department of the Women's Specialized Hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia between January 2006 and December 2008. All patients were screened for HBV markers (hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B core antibody, hepatitis Be antigen), anti-HCV, anti-HIV types I and II using enzyme linked immunoassay technique. RESULTS: The overall prevalence of HBV in the population studied was 1.8% (n=17). For females HBV prevalence was 1.5% (n=7), and for males it was 2.1% (n=10). Overall HCV prevalence in this group was 0.5%. All females were negative for HCV, while males had a prevalence of 1.1% (n=5). All males and females were negative for HIV. CONCLUSION: We found a high prevalence for HBV and HCV in a group of Saudi infertile population. The HIV prevalence was found to be 0%. Due to the risks of cross sectional and vertical transmission of these infections, and despite the low incidence of HIV infection and the cost implications, it is important to screen all Saudi infertile couples for these infections prior to embarking on fertility treatments.