Intestinal Ischemia Due to Methamphetamine Abuse in a Confused Elderly Patient: A Case Report.

Bowel ischemia is a critical entity that mandates an early and proper diagnosis. Causes of bowel ischemia are numerous, yet, identifying and treating the exact cause is challenging. Methamphetamine-induced bowel ischemia is rare but of clinical significance due to its high disease burden. We describe a case of a 67-year-old man who presented with colicky abdominal pain shortly after methamphetamine intake. CT angiography was done and failed to show occlusive causes, which pointed to a non-occlusive cause of bowel ischemia. The patient was hemodynamically stable on admission. Diagnostic laparoscopy was converted to laparotomy; segmental gangrene of both the small and large bowels was found. Resection of the ischemic part was done. The patient improved and was hemodynamically stable postoperatively. In conclusion, a holistic approach to patient history and physical examination can grab attention to unusual pathologies that lead to early intervention and fastened life-saving measures. Questions about stimulant drug use are crucial not only in younger patients but in older patients as well. In this case, we highlight the surgical, medical, and mental aspects of methamphetamine abuse in the elderly population.

Hormonal Contraception Use and Depression Among Women in Saudi Arabia.

Purpose: To estimate the prevalence of depression amongst hormonal and non-hormonal contraception users, and the risk factors associated with depression in the sample. Patients and Methods: This is a community-based cross-sectional study conducted in the Kingdom of Saudi Arabia from October to November 2021, covering all regions of Saudi Arabia. All participants were women, living in Saudi Arabia, ≥21 years old and ≤45 years old, using a contraceptive method, and with no established history of depression. Results: A total of 4853 out of 18,596 met our criteria and were included in this study. Among all sample groups, 29% had moderate to severe depression. Rates of depression and association studies' results in women using hormonal were higher than those who use non-hormonal birth control methods. Psychiatric disorders, medical illnesses, substance use and depressogenic medication use were all associated with depression in both hormonal and non-hormonal contraception users. Conclusion: The current study shows high prevalence of depression amongst hormonal contraceptive users compared to non-hormonal contraceptive users.