The Emergency surgery score (ESS) accurately predicts outcomes of emergency surgical admissions at a Saudi academic health center.

BACKGROUND: The emergency surgery score (ESS) has emerged as a tool to predict outcomes in emergency surgery (EGS) patients. Our study examines the ability of ESS to predict outcomes in EGS admissions. METHODS: All EGS admissions to King Saud University Medical City (KSUMC) from January 2017 to October 2019 were included. ESS was calculated for each patient. Correlations between ESS and 30-day mortality and complications were evaluated. RESULTS: 1607 patients were included. 30-day mortality rate was 2.2% while complication rate was 18.7%. Mortality increased as ESS increased, from 0.3% for ESS≤2, to 30.1% for ESS >10, with a c-statistic of 0.88. Complication rates were 2.2%, 40%, and 100% at ESS of 0, 6, and 15, respectively, with a c-statistic of 0.82. CONCLUSIONS: ESS accurately predicted outcomes at our tertiary center. ESS could be useful in identifying high risk EGS admissions and in benchmarking quality of care across Saudi institutions.

The association between physical symptoms and depression among medical students in Bahrain.

OBJECTIVES: To examine the association between depression and physical symptoms among medical students in Bahrain. METHODS:   The present study employed a cross-sectional design.  A total of 160 students were recruited, 41.3% were male and 58.8% female, using a convenience sampling approach. Participants completed the validated Patients Health Questionnaires (PHQs) in which they provided information about demographics, physical symptoms, and depression. Results were considered significant if p <0.05. RESULTS: Nearly nineteen percent of the participants have moderate to severe depression, and 42.2% has moderate to severe physical symptoms.  Participants reported different physical symptoms, sleep problems, 40%; lethargy, 31.9%; and headaches, 23.8%. The results of the logistic regression showed that there was a significant association between age and gender (χ2(3) = 32.28, p < 0.001). Sleep and gastrointestinal symptoms were the most associated with depression, respectively (χ2(3)=49.77, p<0.001) and (χ2(3)=49.77, p< 0.05). CONCLUSIONS: The association between depression and physical symptoms are considerably high among medical students in Bahrain.  Medical educators should take such symptoms seriously among medical students as it may have serious consequences on the mental health of medical students. In practice, adequate awareness initiatives should be organized and provided for medical students to help them overcome their challenges they face. Additionally, incorporating screening self-screening strategies in the medical curriculum can be beneficial for early detections of mental health problems. The Implications and limitations of the study are discussed.

Control of Tetranychus urticae Koch by extracts of three essential oils of chamomile, marjoram and Eucalyptus.

OBJECTIVE: To evaluate the acaricidal activity of extracts of three essential oils of chamomile, marjoram and Eucalyptus against Tetranychus urticae (T. urticae) Koch. METHODS: Extracts of three essential oils of chamomile, marjoram and Eucalyptus with different concentrations (0.5%, 1.0%, 2.0%, 3.0% and 4.0%) were used to control T. urticae Koch. RESULTS: The results showed that chamomile (Chamomilla recutita) represented the most potent efficient acaricidal agent against Tetranychus followed by marjoram (Marjorana hortensis) and Eucalyptus. The LC50 values of chamomile, marjoram and Eucalyptus for adults were 0.65, 1.84 and 2.18, respectively and for eggs 1.17, 6.26 and 7.33, respectively. Activities of enzymes including glutathione-S-transferase, esterase (α-esterase and ß-esterase) and alkaline phosphatase in susceptible mites were determined and activities of enzymes involved in the resistance of acaricides were proved. Protease enzyme was significantly decreased at LC50 of both chamomile and marjoram compared with positive control. Gas chromatography-mass spectrometer (GC-MS) proved that the major compositions of Chamomilla recutita are α-bisabolol oxide A (35.251%), and trans-ß-farersene (7.758%), while the main components of Marjorana hortensis are terpinene-4-ol (23.860%), p-cymene (23.404%) and sabinene (10.904%). CONCLUSIONS: It can be concluded that extracts of three essential oils of chamomile, marjoram and Eucalyptus possess acaricidal activity against T. urticae.

Detection of genital colonization of group B streptococci during late pregnancy.

OBJECTIVE: To detect group B streptococcal carrier state of Saudi females during 3rd trimester of pregnancy and to assess type of specimens and the techniques used for the organism detection. METHODS: A total of 867 consecutive vaginal and rectal swabs were obtained from 217 pregnant women at > 28 weeks of gestation and their follow up testing from King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. Swab-specimens were cultured comparatively on Islam and Edwards blood agar plates, and into selective Lim broth. Enrichment Lim broth cultures (>12 hours) with and without positive modified coagglutination test were then subcultured on Islam and Edwards sheep blood agar plates. Presumptive colonies were then tested for group B streptococcus identity by convential biochemical reactions, serogrouping and serotyping. Collected neonatal swab-specimens (184) were also treated similarly. RESULTS: In comparison to Lim broth enrichment culture, the direct swab specimen culture on Edwards blood agar or Islam agar plates technique revealed 84% sensitivity and 100% specificity, whereas modified coagglutination test after selective Lim broth enrichment revealed 100% sensitivity and 96% specificity. Group B streptococcus was isolated in at least one of the specimens from the 217 patients in 66 cases. Of these 66 cases, group B streptococcus was isolated from both vaginal and rectal swabs in 33 (50%) cases and only from vaginal swabs in 22 (33%) and rectal swabs in 11 (17%) cases. Of the group B streptococcus positive cases, 10 (15%) cases had spontaneously lost their carriage, upon follow up testing, whereas out of the 151 negative cases, 4 (2.6%) cases became positive for group B streptococcus colonization upon follow up testing with an overall carriage rate of (60/217) 27.6%. Certain demographic factors were found to alter such rate of carriage. Additionally, 50% of group B streptococcal colonized mothers vertically transmitted the homologous serotypes of the organism to their newborns, but clinical infection was not recorded during the study period. CONCLUSION: Group B streptococci colonization rate among term Saudi pregnant women is relatively high (27.6%); and thereby constitutes a group of women whose infants are at great risk of early-onset invasive disease. The modified coagglutination test after growth amplification seems rapid and cost-effective to detect lightly or heavily group B streptococcal colonized women. Vaginal and rectal swab specimens at late pregnancy appeared necessary to accurately identify group B streptococcus maternal colonization.

[Craniofacial bone abnormalities in von Recklinghausen neurofibromatosis]. / Les anomalies osseuses cranio-faciales dans la neurofibromatose de Von Recklinghausen.

Cases of cranio-facial bone anomalies were observed in 40 cases of neurofibromatosis. The cranio-facial skeletal manifestations are numerous and varied. Radiographic investigation is important to confirm the diagnosis, when neurologic and cutaneous signs are absent. The diagnosis should be easily confirmed by a conventional radiographic study.