RESUMEN
Psoriasis, a chronic inflammatory skin condition, and metabolic disorders, such as obesity, diabetes, and dyslipidemia, have long been recognized as distinct clinical entities. However, emerging evidence suggests a complex bidirectional relationship between these seemingly unrelated conditions. Psoriasis is characterized by an accelerated skin cell turnover, resulting in the formation of erythematous plaques with silvery scales. Metabolic disorders, on the other hand, encompass a range of conditions associated with abnormal metabolic processes, including insulin resistance, dyslipidemia, and chronic low-grade inflammation. It is intriguing to note that psoriasis is commonly associated with several metabolic comorbidities, with a higher prevalence observed in individuals with obesity, type 2 diabetes, and metabolic syndrome. Mounting evidence suggests that chronic inflammation plays a pivotal role in both psoriasis and metabolic disorders. Shared inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP), have been implicated in the pathogenesis of both conditions. Moreover, adipose tissue-derived hormones, known as adipokines, including leptin and adiponectin, exert modulatory effects on immune responses and may contribute to the link between psoriasis and metabolic abnormalities. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search across databases identified 16 eligible studies (1975-2023), totaling 6,623,379 participants. Inclusion criteria encompassed peer-reviewed observational studies focusing on adults and specified outcomes. Data extraction, quality assessment (Newcastle-Ottawa scale (NOS)), meta-analyses, and heterogeneity evaluations were conducted using rigorous methods. Psoriasis displayed a significant association with diabetes mellitus (DM, 18% increased incidence), hypertension (HTN, 35%), hyperlipidemia (19%), and obesity (25%). Substantial heterogeneity was observed in meta-analyses, particularly for DM. The NOS indicated varied study quality, with some studies categorized as a high or moderate risk of bias.
RESUMEN
Nonaccidental injuries (NAI) in pediatric primary care in the Gulf Cooperation Council (GCC) region refer to intentional injuries inflicted on children, usually by a caregiver or a family member. The region has seen an increase in nonaccidental injuries in recent years, and healthcare providers have a crucial role in identifying and managing the cases. The aim of research on nonaccidental injuries in pediatric primary care in the GCC region is to identify objective assessment tools and evaluate trends in the region. PubMed, Google Scholar, and EMBASE databases were searched using search string keywords. The search was conducted on 7th February 2023. The keywords included in the search included the search terms: nonaccidental injuries, pediatric, and GCC. All the studies were published between 1990 and 2023. The articles that passed the eligibility criteria were read fully to examine whether they would be relevant to the current systematic literature review. An initial search identified 3059 studies (Google Scholar = 6, EMBASE =12, PubMed = 4732). After the deletion of similar articles, only 3613 articles were left for further screening. The abstracts and titles of the left articles were scanned and screened to decide whether they were included in this systematic review. After deletion, 16 papers were inspected and read fully based on predefined eligibility criteria. Eventually, 11 papers were recognized and identified that passed the eligibility criteria of this systematic review. The studies reviewed in this analysis highlight the significant problem of child abuse in the GCC region, particularly neglect as the most common form of abuse. The studies also suggest that parents are the most frequent perpetrators of abuse. The need for policies and interventions to prevent child abuse and support victims is paramount.
RESUMEN
Background: Because the emergency department (ED) is such an important element of health care, efficient usage must be taken into account while planning and creating the scope of service for emergency care. Our study's goal is to assess the participants' knowledge and attitude towards ED. Concerns among the general public over the use of emergency rooms (ER). Materials and Methods: A cross-sectional study was carried out among the sample of Saudi Arabia's population of Riyadh City in the year 2020. There were 440 people who responded. The information was gathered with a self-administered questionnaire. Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the data. Results: As a result of the findings, 22 symptoms were reported as the cause of ER visits, ranging from acute, urgent, and cold symptoms. Of these, 45.7% of those polled said they visited an ER if they get sick, then seek primary care, online consultation, and community pharmacy, which was 28.2%, 17.5%, and 8.6%, respectively. Around 14.32% of the visitors had a chronic condition, with asthma accounting for 41.3%, diabetes for 23.8%, and hypertension for 11.1%. In terms of the frequency of visits, 66.4% said they visit the emergency care once in every 3-6 months, and 47.7% said they visit once in a month. With a mean score of 16.16 ± 3.02/high in knowledge, the results revealed that the participants possessed a high degree of knowledge, with a significant difference among married group (F = 4.83, P < 0.05 = 0.003), and those from 24 to 29 years of age (F = 3.26, P < 0.05 = 0.012). Conclusions: Because there were characteristics connected to population knowledge, limited hours, and ED overutilization without necessity, the findings of our study could be valuable in understanding the reasons for ED overutilization without necessity. In Riyadh's primary health care centers (PHCCs), there are limited medical resources. Thus, we recommend that the primary health care (PHC) admission process should be improved putting in place a triage mechanism that determines the best location for patient care that is suited.
