Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak perceptions of risk and stress evaluation in nurses.

INTRODUCTION: Saudi Arabia was affected by an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV). We aimed to determine the perception of risk and level of stress among nurses. METHODOLOGY: A questionnaire survey was administered to determine the perceptions of risk of MERS-CoV infection. RESULTS: The majority of the participants were females (332; 86.0%), and there were 54 (14.0%) males. Of the 386 respondents, nurses constituted the majority of the respondents (293; 75.9%), and there were 34 doctors (8.8%). The percentage of exposure was found to be greater in those who were working in the intensive care unit (ICU) (89; 23%). There was a significant difference in the worry and fear scale of contracting the MERS-CoV infection between participants who worked in isolation areas, ICUs, and emergency rooms (mean: 3.01±1.1) compared to participants who worked in areas that are less likely to admit and have MERS-CoV suspected or positive cases (mean: 2.77±1.1; p = 0.031. Females were significantly more worried and fearful of contracting the virus compared to males (mean: 2.92±1.1 versus 2.61±1.0, respectively; p = 0.045). CONCLUSIONS: MERS-CoV caused a relatively significant level of distress among nurses. There was a difference in the worry and fear scale of contracting the MERS-CoV infection between participants who worked in areas likely to admit and have MERS-CoV suspected or positive cases. After the campaign, the level of confidence got higher and the participants were more adherent to the infection control precautions.

Pediatric pain management: More opportunities for better comfort.

Pediatric pain assessment is vital for optimal pediatric practice. After a year of implementation of pediatric pain assessment tools at a tertiary university hospital (King Saud University Medical City, Riyadh, Saudi Arabia), the physicians in the Department of Pediatrics were invited to participate in an interactive lecture about pediatric pain management to assess their awareness about using these tools. Their responses demonstrated that almost half of them were not using any pain scale in their daily practice. These findings highlight the need for a new strategy of implementation. The improvement of pain assessment and management necessitates extensive educational campaign for all health care providers and early audit in order to improve the physicians' awareness and compliance with these changes.

Hypertensive encephalopathy as the initial manifestation of Guillain-Barré syndrome in a 7-year-old girl.

We report a case involving a 7-year-old girl who initially presented with seizure and hypertensive encephalopathy, serious autonomic manifestations associated with Guillain-Barré syndrome, followed by subsequent bilateral ascending flaccid paralysis. Cerebrospinal fluid analysis showed cytoalbuminous dissociation. Nerve conduction velocity tests showed features of demyelinating polyradiculoneuropathy. An immunofluorescence test of her serum was positive for mycoplasma immunoglobulin M antibody. The present case highlights the importance of considering the initial autonomic manifestations of Guillain-Barré syndrome in the differential diagnosis of unexplained acute hypertensive crisis.