LEADING ARTICLE

Antimicrobial resistance in Saudi Arabia. An urgent call for an immediate action

Zowawi gives a brief overview on the current situation of antimicrobial resistance (AMR) in Saudi Arabia and the immediate actions needed to tackle the challenges that can stimulate the emergence and spread of multi-drug resistant bacteria in the country. He concludes that tackling these challenges need efforts from multiple sectors and should include active surveillance to monitor and successfully control the spread and emergence of AMR. Infection prevention and control precautions should also be optimized to limit further spread. Raising awareness is essential to limit inappropriate antibiotics use, and the antibiotic stewardship programs in hospital settings, outpatients, and community pharmacies should regulate the ongoing use of antimicrobials.

see page 935

SYSTEMATIC REVIEW

Non-therapeutic infant male circumcision. Evidence, ethics, and international law perspectives

Alkhenizan and Elabd discuss the significance of infant male circumcision in reducing the risk of urinary tract infections, human immunodeficiency virus transmission, and the transmission of human papilloma virus, in addition to significantly reducing penile cancer and foreskin inflammation. The authors believe that infant male circumcision is ethically justified and legally permissible based on international ethical principles and legal standards, as long as it is approved by both parents, and performed in facilities that can provide appropriate sterilization, wound care, and anesthesia, and that under these conditions the harms associated with infant male circumcision are rare, which makes it in the best interest of the children.

see page 941

ORIGINAL ARTICLES

The bacterial contamination rate of glucose meter test strips in the hospital setting

Al-Rubeaan et al’s prospective observational study was conducted by a team from the Strategic Center for Diabetes Research in 7 general hospitals in the Central region of Saudi Arabia during the period from August to September 2014. The authors aimed to investigate the rate of contamination and type of bacteria for both multi-use vials and single-use packed glucose strips in larger number of hospitals, in wider spectrum of hospital wards with a higher number of distributed strips in Riyadh, Kingdom of Saudi Arabia. Factors behind the high contamination rates were studied and the type of bacterial contamination was classified according to the National Institute of Health microorganism risk categories.

see page 985

Vitamin D deficiency and biochemical variations among urban Saudi adolescent girls according to season

In Sulimani et al’s prospective study, a total of 2000 Saudi females aged 12-18 years from different schools in Riyadh, Kingdom of Saudi Arabia participated and submitted a generalized questionnaire with clinical information. Fasting blood samples were obtained in 1618 subjects for the winter season (December to February) and only 499 subjects returned to submit fasting blood samples for the summer season (June-August). Circulating serum 25(OH)D, parathyroid hormone, and other biomarkers of bone remodeling were measured during both seasons. This study was undertaken to determine the prevalence of vitamin D deficiency among this age group and its biochemical and clinical characterization as influenced by season.

see page 1002

CASE REPORT

A modified technique for the laparoscopic management of large gastric bezoars

Ulukent et al describe a modified laproscopic technique in which an endobag is placed in the stomach instead of the peritoneal cavity. In the technique used, contamination is expected to be less, since the bezoar is put into the endobag placed in the stomach instead of the peritoneal cavity. The main disadvantage of this technique is the inapplicability for giant bezoars. Furthermore, it is difficult to use it in the removal of intestinal bezoars.

see page 1022

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Endobag opened in the stomach via the laparoscopically incized gastrotomy