REVIEW ARTICLE
Premarital hepatitis screening. Attitude towards screening and the risk factors for transmission
Alharbi & Aljarallah explore all research articles investigating hepatitis premarital screening programs (PSPs) worldwide, considering all different outcomes of such programs, including efficacy, possible limitations to screening, and participants’ knowledge and satisfaction regarding the program. The review included all full-length original articles related to premarital hepatitis screening in both indexed and non-indexed journals, but reviews, mini-reviews, and letters were excluded. Ultimately, 4 research papers were included. While conducting the search, the project was registered on PROSPERO database. Pre- and post-test counseling were provided to only a limited number of participants in each of the studies. This emphasizes the need for effective counseling sessions, which may help in decreasing the hepatitis burden in Saudi Arabia and worldwide. They conclude that the role of the practicing physician in any screening program is to provide effective pre and post-test counseling and correct any misinformation about the transmission of the hepatitis viruses.
see page 1179
ORIGINAL ARTICLES
Risk factors and molecular features of extended-spectrum beta-lactamase producing bacteria at southwest of Saudi Arabia
Al-Garni et al conclude that new epidemiological information about the prevalence of ESBL-producing organisms among patients in KAASH, Taif, Saudi Arabia. In addition, this study identified the clonal nature of isolated Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). The ESBL phenotype was detected in 351 of 1151 isolates (30.5%); E. coli (62.7%) and Klebsiella pneumoniae (K. pneumoniae) (23.6%) were the most prevalent. The highest proportion of ESBL specimens was found in urine (62%.5), and these organisms were mainly isolated from the female medical ward (20.2%). Based on the statistical analysis, lung diseases, renal diseases, diabetes and heart diseases contributed to the spread of ESBL infections. Amikacin, imipenem, meropenem and tigecycline were found to be effective in overcoming ESBL infections; however, these antibiotics may be inappropriate for new strains of K.pneumoniae. The distribution of the blaCTX-M gene was high (87%), compared with blaTEM (74.9%) and blaSHV (29.4%).
see page 1186
The extended-spectrum beta-lactamase (ESBL) genes distribution among Escherichia coli, and Klebsiella pneumoniae
Knowledge and practice in the management of asymptomatic hyperuricemia among primary health care physicians in Jeddah, Western Region of Saudi Arabia
Alqarni & Hassan et al conclude that there are inadequate levels of knowledge regarding asymptomatic hyperuricemia (AH) among Saudi primary health care (PHC) physicians increasing risk of malpractice including misprescription of urate-lowering therapy (ULT) and anti-inflammatory medications. Only 32.8% participating physicians had adequate knowledge about AH. Regarding practice, while majority (88.1%) correctly recommended a low-purine diet and lifestyle changes to patients, almost half misprescribed ULT and 10.9% misprescribed non-steroid anti-inflammatory drugs. Lack of knowledge and awareness about guidelines were the most frequently self-reported barriers to adequate practice.
see page 1218
The extended-spectrum beta-lactamase (ESBL) genes distribution among Escherichia coli, and Klebsiella pneumoniae
CASE REPORT
Emergent surgical treatment of lethal valve dysfunction during pregnancy in a last-trimester patient
Akbayrak et al present a 24-year-old female who was in her 38th week of pregnancy was admitted to the emergency room with aggravated dyspnea, tachypnea, and palpitation. She was referred to the hospital with a preliminary diagnosis of pulmonary embolism. She had 2 previous cardiac operations in her medical history. First, she had been operated on for a secundum type atrial septal defect at the age of 11. Then at the age of 13, she had received a prosthetic mitral valve replacement due to severe mitral regurgitation. They conclude that surgical approaches in pregnant patients who have MHVT should be preferred depending on the conditions of the mother and the baby. Earlier in gestation, when the fetus is most sensitive (before 30 weeks), emergent cardiac operations for stuck valves can be performed, but they carry a high risk of mortality for the baby. When emergency delivery of the baby is feasible, emergent surgical treatment should be utilized for patients who are in critical condition.
see page 1249
Intraoperative atrial view of severe pannus tissue and thrombi (arrow) on mechanical valve’s hinge area and sewing cuff
- Copyright: © Saudi Medical Journal
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