Background and Objective: Constipation is a prevalent gastrointestinal condition that has a substantial impact on individuals and healthcare systems. This condition adversely affects health-related quality of life and leads to escalated healthcare expenses due to an increase in office visits, referrals to specialists, and hospital admission. This study aimed to evaluate the prevalence, recognition, risk factors, and course of constipation among hospitalized patients in medical wards. Materials and Methods: A prospective study was conducted, including all adult patients admitted to the General Medicine Unit between 1 February 2022 and 31 August 2022. Constipation was identified using the Constipation Assessment Scale (CAS), and relevant factors were extracted from the patients’ medical records. Results: Among the patients who met the inclusion criteria (n = 556), the prevalence of constipation was determined to be 55.6% (95% CI 52.8–58.4). Patients with constipation were found to be older (p < 0.01) and had higher frailty scores (p < 0.01). Logistic regression analysis revealed that heart failure (Odds ratio (OR) 2.1; 95% CI 1.2–3.7; p = 0.01), frailty score (OR 1.4; 95% CI 1.2–1.5; p < 0.01), and dihydropyridines calcium channel blockers (OR 1.8; 95% CI 1.2–2.8; p < 0.01) were independent risk factors for constipation. Furthermore, the medical team did not identify constipation in 217 patients (64.01%). Conclusions: Constipation is highly prevalent among medically hospitalized patients. To ensure timely recognition and treatment, it is essential to incorporate a daily constipation assessment scale into each patient’s medical records.

Background and Objectives: Constipation affects health-related quality of life and increases hospital visits. We conducted this prospective cohort study to assess laxative use, health outcomes of constipation in medically hospitalized patients, and related health outcomes. Materials and Methods: A prospective single-center study included all adult patients admitted under the General Internal Medicine Unit from 1 February 2022, to 31 August 2022. Constipation was defined using the Constipation Assessment Scale (CAS). Patients were assessed for 28 days during their hospital stay and up to 90 days post-discharge. Result: Among the included patients, 62.45% experienced constipation, which was associated with poor health outcomes including delirium (p = 0.048), intensive care admission (p < 0.01), cardiopulmonary arrest (p < 0.01), inpatient mortality (p < 0.01), longer hospital stay (p < 0.01), 90-day mortality (p < 0.01), and 90-day hospital readmission (p < 0.01). Laxative treatment was administered to only 33.93% of patients with constipation and was more commonly used among older patients (p < 0.01), those with high CAS scores (p < 0.01), longer hospital stays (p < 0.01), and critically ill patients (intensive care admission) (p = 0.01), as well as those who had cardiopulmonary arrest (p < 0.01) and high inpatient mortality (p < 0.01). Conclusions: This study identified several associations between constipation and poor health outcomes and highlighted the underutilization of laxatives in treating constipation. It is vital to interpret our results with caution. Therefore, we believe that a randomized controlled trial will help enhance our understanding of the interaction between constipation, laxative use, and poor health outcomes.

Background: Magnesium (Mg) is an essential mineral that plays a vital role in various physiological processes, including enzyme regulation, neuromuscular function, and cardiovascular health. Dysmagnesemia has been associated with arrhythmias, neuromuscular dysfunction, and poor outcomes in intensive care unit (ICU) settings, representing diagnostic and therapeutic challenges. However, the relationship between dysmagnesemia and health outcomes in the ICU remains inadequately defined. Aim/Objective: This study aimed to assess the prevalence of dysmagnesemia and evaluate the correlation between total (tMg) and ionized magnesium (iMg) levels in a cohort of ICU and high dependency unit (HDU) patients. It also sought to evaluate patient characteristics and relevant health outcomes by comparing both concentrations of iMg and tMg. Methods: This prospective study was conducted among adult patients admitted to the ICU and the high dependency unit (HDU). Results: Among the 134 included patients, the median age was 63.5 years (IQR: 52.0–77.0). The majority, 91.0%, required mechanical ventilation. Additionally, 50.0% were diagnosed with diabetes, 28.4% had chronic kidney disease, and proton pump inhibitors (PPIs) were administered to 67.2% of the patients. The prevalence of hypomagnesemia, as measured by iMg, was 6.7%, while hypermagnesemia was at 39.6%. When measured by tMg, hypomagnesemia and hypermagnesemia were observed at rates of 14.9% and 22.4%, respectively. The iMg measurements showed an association between the incidence of atrial fibrillation and hypomagnesemia (p = 0.015), whereas tMg measurements linked hypomagnesemia with longer hospital stays. Notably, only a few patients identified with iMg-measured hypomagnesemia received magnesium replacement during their ICU stay. Conclusions: Dysmagnesemia is prevalent among critically ill patients, with discordance between iMg and tMg measurements. iMg appears more sensitive in detecting arrhythmia risk, while tMg correlates with length of stay. These findings support the need for larger studies and suggest considering iMg in magnesium monitoring and replacement strategies.

Objectives: This study aimed to assess the mortality rate and related factors in dengue fever (DF) patients. Additionally, it will outline the clinical and biochemical characteristics and treatments administered to confirmed cases. Methods: This retrospective cross-sectional study included DF patients who presented to Sultan Qaboos University Hospital between January 2022 and July 2023. Data were extracted from the hospital's electronic system into a pre-designed Excel data collection sheet and analysed. Results: The study identified 319 confirmed DF cases with male predominance. The overall mortality rate was 3.8% (n = 12). Mortality was significantly higher among those with ischaemic heart disease (41.7%; n = 5), chronic kidney disease (25%; n = 3) and those on aspirin (25%; n = 3). Patients presenting with fever, headache, arthralgia and body aches, along with multi-organ involvement, exhibited confusion, lower platelet counts, abnormalities in haematocrit and haemoglobin levels, as well as deranged liver and renal function. Backward stepwise multivariate regression analysis showed that the use of antibiotics (odds ratio [OR] = 6.644, 95% confidence interval [CI]: 1.202--36.742; P = 0.030) and elevated bilirubin levels (OR = 1.058, 95% CI: 1.013--1.105; P = 0.011) were significant independent predictors of mortality. Conclusions: This study identified a mortality rate of 3.8% among patients with DF. Elevated bilirubin levels and antibiotic use during hospitalisation are independent predictors of mortality. Therefore, it is recommended that such patients be closely monitored for potential signs, symptoms and biochemical changes to reduce the risk of mortality.

BACKGROUND Inflammatory bowel disease is commonly associated with recurrent abdominal pain and bloody diarrhea, with or without systemic involvement. Here, we report a very rare presentation of inflammatory bowel disease with pneumomediastinum, which is important for healthcare workers to be aware of because pneumomediastinum can present with rapid symptoms onset. Previous reported cases were mainly noted after long-term steroids use or scope-induced perforation. CASE REPORT We present a case a 23-year-old woman with a 14-day history of constipation followed by diarrhea (sometimes bloody), with vomiting, abdominal pain, and fever. She was initially managed as having acute gastroenteritis, but due to persist unexplained tachycardia, a chest CT was done, which incidentally showed a pneumomediastinum along with pulmonary embolism. The patient deteriorated significantly on the same day of chest imaging and developed severe lactic acidosis with hypoglycemia and severe hepatic injury. After extensive assessment by imaging and scopes for biopsy, she was diagnosed with fulminant Crohn's disease, causing severe liver injury, colitis, and pneumomediastinum. She improved significantly with steroids and was discharged home. On follow-up, immunosuppressive agents were initiated. CONCLUSIONS Pneumomediastinum is a rare manifestation of inflammatory bowel disease, which could be reflective of severe colitis and should be considered in patients presenting with chest symptoms regardless of procedure, scope exposure, or long-term steroids use. Attention to early instability signs like tachycardia and tachypnea can help reveal early complications.