Pathological features of early pregnancy disorders in women living at high altitude in KSA.

Objectives: Pregnancy at high altitudes is relatively challenging because of hypobaric hypoxia, which is associated with a smaller uterine artery diameter and diminished blood flow. Here, we investigated the histopathological characteristics of early pregnancy disorders among pregnant women living in a high-altitude region (approximately 2200 m above sea level). Methods: This cross-sectional study used retrospective data collection from a single tertiary hospital in a high-altitude region in KSA. Age and histopathology were analyzed in 495 women diagnosed with early pregnancy disorders (mainly miscarriage) in 2018-2020. Results: Approximately one-fifth of pregnancies in this high-altitude region were lost before 24 weeks' gestation, whereas 1150/6044 experienced miscarriage; 495 samples from those participants were sent for histopathological analysis. A total of 269 (54.34%) patients were younger than 35 years. Missed miscarriages accounted for 49.3% of miscarriages, followed by inevitable miscarriages (34.2%), which had a relatively higher frequency among mothers older than 35 years. The correlation between age and inevitable miscarriage was significant; ectopic pregnancy was diagnosed in 6.8%, molar pregnancy was detected in 6.26%, and blighted ovum was observed in 3.4%. Conclusion: The miscarriage rate in this high-altitude region was 19% of all pregnancies. Approximately half of the affected women were in their 30s. Missed miscarriage cases were relatively high in this region. The percentage of molar pregnancy was higher than those reported in prior studies, thus suggesting a need for monitoring and genetic workup practices. Furthermore, studies involving a larger population at high altitudes will be crucial for further risk assessment in addition to national studies on women living at sea level.

Histopathology laboratory paperwork as a potential risk of COVID-19 transmission among laboratory personnel.

BACKGROUND: Healthcare workers have a higher risk of acquiring coronavirus disease 2019 (COVID-19). The process of requesting pathological investigations is usually handled manually through paper-based forms. This study evaluated the potential for paper-based request forms to transmit severe acute respiratory virus coronavirus-2 (SARS-CoV-2) to laboratory staff in order to make recommendations for dealing with hospital paperwork in a post-COVID-19 world. METHODS: Paper-based forms were tracked from the time of test ordering until the release of the pathology report by calculating the time taken for the forms to reach the laboratory, and the exposure of each staff group to forms received from both high and moderate COVID-19 risk areas. RESULTS: Four hundred and thirty-two (83%) of 520 forms were received in the laboratory within 24 h. The remaining 88 (17%) forms took ≥24 h to be handled by laboratory personnel. The mean daily exposure time to the paperwork for various laboratory staff was as follows: receptionists, 2.7 min; technicians, 5.5 min; and pathologists, 54.6 min. CONCLUSION: More than 80% of the forms were handled by laboratory personnel within 24 h, carrying a high potential risk for viral transmission. It is recommended that paper-based request forms should be replaced by electronic requests that could be printed in the laboratory if required. Another option would be to sterilize received paperwork to ensure the safety of laboratory personnel. More studies are needed to detect the stability of SARS-CoV-2 on different surfaces and determine the potential risk of COVID-19 transmission via paper.

Enterobius vermicularis in appendectomy specimens; Clinicopathological assessment: Cross sectional study.

BACKGROUND: This study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute appendicitis. METHOD: ology: All the routinely examined appendectomy specimens received in the pathology laboratory of a referral hospital over a three year period of time were reviewed for the existence of E. v. These cases were evaluated for clinico-laboratory characterization. RESULTS: Out of 1150 appendectomies for clinical acute appendicitis picture, 31 (2.7%) cases revealed E. v infestation. The age ranged from 6 to 42 years old but more than 80% of the E. v infected cases were children. Twenty four cases (77.4%) did not show any other appendiceal pathology, six cases showed lymphoid hyperplasia and only one case showed concomitant histological acute inflammatory process. CONCLUSION: E. v infestation is an incidental finding during histopathology examination of appendectomy specimens for patients with clinical diagnosis of acute appendicitis, however there is no relation between the existence of E. v and occurrence of acute appendicitis which is the main indication for appendectomy, so further studies are recommended to reach out earlier diagnosis to eliminate the unnecessary surgical intervention. Also surgeons should consider E. v as a differential diagnosis when removing a normal looking appendix to take the necessary precautions for minimizing any chance of contamination and sending all the normal looking appendectomy specimens for histopathology examination.