The EuroQOL five-dimension questionnaire (EQ-5D) is one of the most widely used tools to evaluate health-related quality of life (HRQOL). Studies on the psychometric features of the EQ-5D in the Gulf region of the Middle East are lacking. This study is aimed at evaluating the validity and reliability of the Arabic version of the EQ-5D in Saudi Arabia. The study was done utilizing a convenience sample of Arabic-speaking adult patients or visitors at the outpatient clinic at King Abdulaziz Medical City (KAMC) in Riyadh during October–December 2015. Participants were interviewed using translated into Arabic versions of the EQ-5D and the Short Form Health Survey (SF-36). Known-group construct validity of the EQ-5D and visual analog scale (EQ-VAS) was assessed through testing a number of hypotheses comparing responses to EQ-5D dimensions or EQ-VAS to SF-36 scores by dimension and external variables. Test-retest reliability was also assessed. Eighty subjects were included in the study. Mean ± standard deviartion age was 33.0 ± 11.6 years, with 51% of females. Responses to EQ-5D dimensions revealed that the proportion of respondents reporting problems ranged from 6% for problems with self-care to 48% for pain/discomfort. All of the five hypotheses linking EQ-5D responses to external variables were satisfied. Test-retest reliability was evaluated using Cohen’s κ, which ranged from 0.53 to 1.00. Validity and reliability of the Arabic EQ-5D were established for evaluating HRQOL in Saudi Arabia. Further studies are warranted to evaluate the validity and reliability of this standard tool in other Arabic-speaking countries with varying cultures.
Objectives: To evaluate the efficacy of a single injection of 0.3 mg intravitreal ranibizumab for the treatment of retinopathy of prematurity (ROP). Methods:We conducted this retrospective case series study at King Abdul Aziz Medical City, Riyadh, Saudi Arabia. Seventy-four eyes of 37 preterm infants with ROP stage III with plus disease in zone I, posterior zone II, and aggressive posterior ROP received a single injection of 0.3 mg intravitreal ranibizumab. The favorable outcome measure was complete regression of the disease with normal vascularization of the retina of those infants. Results: The gestational age of the 37 included cases was in the range of 23–28 weeks and their body weight at birth was between 510 and 1,235 g except for one case with 2,550 g under oxygen therapy <7days with severe hypoglycemia. All eyes showed a favorable response in terms of regression of plus disease from the first day after treatment, followed by regression of stage III retinopathy. All patients developed complete vascularization over variable periods of time. Conclusion: One injection of 0.3 mg intravitreal ranibizumab is effective in treating ROP stage III mainly in zones I and II.
Background and Purpose. Gentamicin (GEN) is a broad-spectrum antibiotic that cannot be prescribed freely because of its toxicity. Thymoquinone (THQ), a phytochemical, has antibacterial, antioxidant, and toxicity-reducing properties. However, its hydrophobicity and light sensitivity make it challenging to utilize. This incited the idea of co-encapsulating GEN and THQ in liposomes (Lipo-GEN-THQ). Method. Lipo-GEN-THQ were characterized using the zeta-potential, dynamic light scattering, Fourier transform infrared spectroscopy, and transmission electron microscope (TEM). The liposomes’ stability was evaluated under different storage and biological conditions. Lipo-GEN-THQ’s efficacy was investigated by the minimum inhibitory/bactericidal concentrations (MICs-MBCs), time–kill curves, and antibiofilm and antiadhesion assays. Bacterial interactions with the empty and GEN-THQ-loaded liposomes were evaluated using TEM. Results. The Lipo-GEN-THQ were spherical, monodispersed, and negatively charged. The Lipo-GEN-THQ were relatively stable and released GEN sustainably over 24 h. The liposomes exhibited significantly higher antibacterial activity than free GEN, as evidenced by the four-fold lower MIC and biofilm eradication in resistant E. coli strain (EC-219). TEM images display how the empty liposomes fused closely to the tested bacteria and how the loaded liposomes caused ultrastructure damage and intracellular component release. An antiadhesion assay showed that the Lipo-GEN-THQ and free GEN (0.125 mg/L) similarly inhibited Escherichia coli (EC-157) adhesion to the A549 cells (68% vs. 64%). Conclusions. The Lipo-THQ-GEN enhanced GEN by combining it with THQ within the liposomes, reducing the effective dose. The reduction in the GEN dose after adding THQ may indirectly reduce the toxicity and aid in developing an enhanced and safer form of GEN.
Medication errors (MEs) are a significant healthcare problem that can harm patients and increase healthcare expenses. Being immunocompromised, liver-transplant patients are at high risk for complications if MEs inflict harmful or damaging effects. The present study reviewed and analyzed all MEs reported in Liver Transplant Patients. All MEs in the Liver Transplant Patients admitted between January 2016 to August 2022 were retrieved through the computerized physician order entry system, which two expert pharmacists classified according to the type and severity risk index. A total of 314 records containing 407 MEs were committed by at least 71 physicians. Most of these errors involved drugs unrelated to managing liver-transplant-related issues. Antibiotic prescriptions had the highest mistake rate (17.0%), whereas immunosuppressants, routinely used in liver transplant patients, rank second with fewer than 14% of the identified MEs. The most often reported MEs (43.2%) are type-C errors, which, despite reaching patients, did not cause patient harm. Subgroup analysis revealed several factors associated with a statistically significant great incidence of MEs among physicians treating liver transplant patients. Although a substantial number of MEs occurred with liver transplant patients, the majority are not related to liver-transplant medications, which mainly belonged to type-C errors. This could be attributed to polypharmacy of transplant patients or the heavy workload on health care practitioners. Improving patient safety requires adopting regulations and strategies to promptly identify MEs and address potential errors.
Background: Acetaminophen is generally considered safe when used according to the recommended guidelines. Consumption in excessive doses can lead to severe liver damage and, in critical cases, may even result in death. To reduce the effects of acetaminophen overdose, N-acetylcysteine (NAC) has been established as the preferred intervention to prevent liver damage. Objectives: The purpose of this updated systematic review and meta-analysis is to evaluate the potential benefits of a two-bag N-acetylcysteine (NAC) dosing regimen compared to the traditional three-bag protocol in the treatment of acetaminophen-induced liver toxicity. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research team utilized the PubMed and Cochrane databases to perform a thorough and comprehensive search of the relevant literature from the inception of these databases up until January 2024. Results: Nine studies were included. The overall use of two-bag NAC was associated with lower anaphylactic reactions and gastrointestinal symptoms compared to the three-bag method. The rate of liver toxicity resolution was the same between the two treatment groups. Conclusions: The two-bag NAC regimen can be considered a safe and effective method for managing acetaminophen toxicity.
Introduction/Objectives: Although desmopressin is commonly used to reduce bleeding hazards in patients undergoing kidney biopsies, its effectiveness varies among individuals. This study aims to assess the impact of desmopressin on bleeding risk and hemodynamic stability in patients undergoing kidney biopsies while also identifying potential risk factors influencing these outcomes. Methods: A retrospective study was conducted at King Abdulaziz Medical City to evaluate adult patients who underwent either native or transplant kidney biopsies. The collected data included demographics, comorbidities, demographics, desmopressin usage, vital signs, lab results, and bleeding events. Bleeding was defined as a composite outcome encompassing both minor and major bleeding. Results: Data from 210 patients who received desmopressin during kidney biopsies were analyzed alongside 200 control patients. The distribution of gender and age was comparable between the two groups. However, the types of biopsies differed significantly, with a greater number of native kidney biopsies in the desmopressin group. Desmopressin was associated with a reduced incidence of major bleeding and shorter hospital stays. Longitudinal analyses revealed significant time-dependent changes in mean arterial pressure, hemoglobin, and hematocrit, although no treatment effect was observed. Logistic regression showed no significant impact of desmopressin on composite bleeding, hypotension, or hyponatremia, though comorbidities and transplant biopsies were associated with a reduced risk of hyponatremia. Conclusions: Desmopressin was associated with fewer episodes of major bleeding and shorter hospital stays but had no direct effect on hemodynamic parameters. Nevertheless, further research is necessary to explore its long-term clinical impact.