Retraction: Celiac Artery Compression Syndrome: A Rare Cause of Abdominal Angina.

[This retracts the article DOI: 10.7759/cureus.20011.].

Compliance of Primary Healthcare Workers in Saudi Arabia With the National Surveillance System of Tropical and Non-tropical Dermatological Diseases.

BACKGROUND:  Control and prevention of infectious diseases has been a primary health mandate. The reporting system is a vital step in preventing and controlling of these diseases. Most important, healthcare workers who have a responsibility to report must be aware of this responsibility. The present study aimed to improve the compliance of primary healthcare workers against reportable tropical and non-tropical dermatological diseases. OBJECTIVE OF THE STUDY: The objective was to assess the knowledge, skills, and practice of primary healthcare workers in Saudi Arabia regarding the surveillance system of reportable tropical and non-tropical dermatological diseases using an assessment tool featuring closed-ended questions. As a secondary objective, this study assessed the satisfaction of primary healthcare workers with the surveillance system. SUBJECTS AND METHODS:  Through a cross-sectional design, the study used an electronic self-administered questionnaire targeting the primary healthcare workers who met the inclusion criteria through a non-probability sampling technique. RESULTS: By the end of the study period, data had been collected from 377 primary healthcare workers. Slightly more than half of them worked for the ministry of health facilities. In the last year, the vast majority (88%) of participants did not report any infectious diseases. Poor or low knowledge was reported by almost half of the participants concerning which dermatological diseases should be notified immediately on clinical suspicion or routinely on a weekly basis. Clinically and in response to the skills assessment, 57% of the participants had lower skills scores in detecting and identifying the skin ulcer of leishmania. Half of the participants were less satisfied with the feedback after their notification and considered the notification forms complicated and time-consuming, especially with the usual high workload in primary healthcare centers. Furthermore, the observed significant differences (p < 0.001) in knowledge and skill scores were demonstrated with female healthcare workers, older participants, employees from the Ministry of National Guard Health Affairs, and workers with more than ten years of experience. CONCLUSION: The present study has shown the limitations of public health surveillance due to underreporting and lack of timeliness. The dissatisfaction of study participants with feedback after the notification step is another finding that demonstrates the need for collaboration among public health authorities and healthcare workers. Fortunately, health departments can implement measures to improve practitioners' awareness through continuous medical education and providing frequent feedback to overcome these hurdles.

Septic Shock: Management and Outcomes.

The incidence rates of sepsis and septic shock as a complication have become more common over the past several decades. With this increase, sepsis remains the most common cause of intensive care unit (ICU) admissions and one of the most mortality factors, with a huge burden on healthcare facilities. Septic shock has devastating consequences on patients' lives, including organ failures and other long-term complications. Due to its dynamic clinical presentations, guidelines and tools have been established to improve the diagnosis and management effectively. However, there is still a need for evidence-based standardized procedures for the diagnosis, treatment, and follow-up of sepsis and septic shock patients due to the inconsistency of current guidelines and studies contrasting with each other. The standardization would help physicians better manage sepsis, minimize complications and reduce mortality. Septic shock is usually challenging to manage due to its variety of clinical characteristics and physiologic dynamics, affecting the outcomes. Therefore, this review presented the available data in the literature on septic shock diagnosis, management, and prognosis to have an overview of the updated best practice approach to septic shock.

Celiac Artery Compression Syndrome: A Rare Cause of Abdominal Angina.

Abdominal angina refers to an abdominal pain that develops shortly after food intake and gradually resolves after a few hours. It is related to insufficient mesenteric blood flow to meet the intestinal demand. In the majority of cases, this syndrome is caused by atherosclerotic narrowing of the mesenteric vessels. We report the case of a 61-year-old man, with a longstanding history of hypertension, diabetes mellitus, and dyslipidemia, who presented to the emergency department with acute abdominal pain that was aggravated by food intake. The patient reported similar but milder episodes of this pain for the last three years that led him to lose significant weight because of fear of eating. Despite this classic history of abdominal angina, his condition was misdiagnosed as indigestion, and was offered symptomatic treatment only. The basic laboratory findings were within the normal limits. The patient underwent a contrast-enhanced abdominal computed tomography scan in the arterial phase which demonstrated focal proximal stenosis of the celiac trunk due to thickened median arcuate ligament. Subsequently, the median arcuate ligament was resected laparoscopically to decompress the celiac artery. The surgical operation resulted in the complete resolution of the abdominal pain. Celiac artery compression syndrome is a rare etiology of abdominal angina. Computed tomography angiography is the imaging study of choice to make the diagnosis accurately. Laparoscopic resection of the median arcuate ligament is a safe and successful approach in the management.