Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Prevalence of glucose-6-phosphate dehydrogenase deficiency and sickle cell trait among blood donors in Riyadh

<b>Background and Aims:</b> Blood donation from glucose-6-phosphate dehydrogenase (G6PD)-deficient and sickle cell trait (SCT) donors might alter the quality of the donated blood during processing, storage or in the recipient&#x2032;s circulatory system. The aim of this study was to determine the prevalence of G6PD deficiency and SCT among blood donors coming to King Khalid University Hospital (KKUH) in Riyadh. It was also reviewed the benefits and risks of transfusing blood from these blood donors. <b> Materials and Methods:</b> This cross-sectional study was conducted on 1150 blood samples obtained from blood donors that presented to KKUH blood bank during the period April 2006 to May 2006. All samples were tested for Hb-S by solubility test, alkaline gel electrophoresis; and for G6PD deficiency, by fluorescent spot test. <b> Results:</b> Out of the 1150 donors, 23 (2&#x0025;) were diagnosed for SCT, 9 (0.78&#x0025;) for G6PD deficiency and 4 (0.35&#x0025;) for both conditions. Our prevalence of SCT and G6PD deficiency is higher than that of the general population of Riyadh. <b> Conclusion:</b> We recommend to screen all units for G6PD deficiency and sickle cell trait and to defer donations from donors with either of these conditions, unless if needed for special blood group compatibility, platelet apheresis or if these are likely to affect the blood bank inventory. If such blood is to be used, special precautions need to be undertaken to avoid complications in high-risk recipients

Factors influencing the choice of pediatric resident: program directors perspective in Saudi Arabia: a cross-sectional study

Abstract Background Pediatrics is one of the most important medical specialties in the Kingdom of Saudi Arabia) KSA) since it serves a large population. Therefore, the pediatrics residency program is considered one of the most important and competitive programs. Obtaining acceptance in Saudi programs depends mainly on the Saudi Commission for Health Specialties (SCFHS) score, then the applicant enrolls to do the interviews with the training centers in the accepted region. This study aimed to evaluate the factors used by pediatric program directors (PD) in accepting applicants in their pediatric residency program in KSA. Methods In this cross-sectional study, an online questionnaire consisting of 49 items was distributed among 76 current and former pediatric PDs in KSA. Participants were selected via non-probability convenience sampling. Data were collected and analyzed using the Social Sciences Statistical Package (SPSS version 26). Results Of the sample of PD studied, males represented 77.6%, while females represented 22.4%. Most of the PDs were over 50 years old. Most of them were former pediatric PDs (71.1%). The current study found that the Saudi Medical Licensing Exam was the most important factor [3.87 (0.89)] followed by services and electives [3.86 (0.65)], research [3.84 (0.83)], interview [3.77 (0.89)], GPA [3.50 (0.62)], and letter of recommendation [3.39 (0.76)]. Conclusions For those interested in pediatrics residency programs in KSA, this study recommends that seeking a high Saudi Medical Licensing Exam (SMLE) score, taking pediatric elective rotations during internship, and acquiring excellent basic knowledge in research were the most important aspects of pediatrics residency selection from the pediatrics PD’s perspective

A multicolour flow cytometric assay for c-MYC protein in B-cell lymphoma

AimDevelop an objective assay to detect c-MYC protein expression using multiparametric flow cytometry (FCM) as an alternative to immunohistochemistry (IHC).Methods57 patient samples and 11 cell line samples were evaluated. Cell suspensions were obtained and c-MYC staining was performed in combination with CD45 and CD19 and, in some samples, CD10. The percentage of c-MYC+ cells by FCM was correlated with the percentage determined by IHC. The relationship between c-MYC protein expression and the presence of ac-MYCgene rearrangement in aggressive and high-grade lymphomas was also assessed.Resultsc-MYC expression by FCM and IHC demonstrated a high degree of correlation in a training set of 33 patient cases, r=0.92, 11 cell line samples, r=0.81 and in a validation set of 24 aggressive and high-grade B-cell lymphomas, r=0.85.c-MYCgene was rearranged by fluorescence in situ hybridisation in 6/9 samples with high c-MYC expression (&gt;40%) by FCM and 6/14 by IHC.ConclusionsWe have developed a reliable multicolour FCM assay to detect c-MYC expression suitable for clinical laboratories that should be helpful to accurately quantify c-MYC expression in B-cell lymphomas.</jats:sec

Assessment of the influence of gender and skin color on the preference of tooth shade in Saudi population

Aim: The aim of the study was to evaluate the influence of gender and skin color on the preference of different teeth shades in general population. Materials and methods: Two standardized frontal smile photographs of male and female subjects were manipulated using photoshop to represent 4 skin colors [(type II, III, IV, and V) (Fitzpatrick scale)]. The teeth shades under each skin color were digitally manipulated to represent one of 6 teeth shades (BL1, BL2, BL3, BL4, B1 and A1). A questionnaire assessed demographic characteristics (age, nationality, gender, education level, occupation, and income) along with the satisfaction of their smiles. Male and female set of pictures with combination of skin colors and teeth shades were presented and participants were asked to select the most esthetically pleasing teeth shade with regard to gender and skin color. Cross-tabulations and chi-squared tests were used to perform the statistical analyses (α = 0.05). Results: Three hundred and thirty-six (60.4% male; 39.6% female) individuals participated in the study. The difference in the preferred teeth shades was significant among the male and female photographs across all skin colors (p < 0.05). Lighter teeth shades were preferred among female subjects compared to male subjects with the same skin color. In addition, lighter teeth shades were preferred among subjects with a lighter skin color and vice versa (p < 0.05). Conclusion: Gender and skin color influences the perception of teeth shades among general population. Therefore, lighter tooth shades (BL1, BL2) for lighter skin color and comparatively darker tooth shades (BL4, B1, A1) for darker skin individuals should be prescribed as these are perceived as natural among Saudi population. Keywords: Skin color, Teeth shade, Color perception, Gender, Ag

Measurement of platelet function to determine the prevalence of aspirin non-responsiveness among Saudi type II diabetic patients

Introduction: Aspirin is widely used as either a primary or secondary preventive measure in of cardiovascular events however, platelets from diabetic patients are less responsive to aspirin and are unable to protect themselves from thrombotic events. Objective and Method: 180 diabetic patients were enrolled for measuring their platelet aggregation. The aim was to evaluate the prevalence of aspirin non-responsiveness among Saudi type II diabetic patients. Serum glucose level and other clinical data were collected to find out the possible determinant of reduced platelet sensitivity to aspirin. Results: The prevalence of aspirin non-responsiveness was 9.44%. A significant correlation between aspirin test and each of fasting blood sugar, HbA1c, cholesterol and platelet count was observed. In contrast, there was no correlation among aspirin non-response, body mass index, age or hypertension. Conclusion: The relationship between the levels of glucose in the blood and aspirin resistance relates the importance of controlling blood glucose in diabetic patients to guarantee better aspirin action. Regular examining of type II diabetic patients to determine the sensitivity of platelet to the antiplatelet therapy is necessary to protect them from the risks of cardiovascular complications