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Evaluation of modifi ed Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis

World Journal of Emergency Medicine 2017年第4期8卷 276-280页

作者： Abdullah Shuaib Ali Shuaib Zainab Fakhra bader marafi Khalid Alsharaf Abdullah Behbehani Department of Surgery Kuwait Mubarak Alkabeer Hospital Jabriya Kuwait Biomedical Engineering Unit Physiology Department Faculty of Medicine Kuwait University Kuwait City Kuwait MD in internship year Kuwait Institute of Medical Specialization Kuwait City Kuwait Department of Surgery Faculty of Medicine Kuwait University Kuwait City Kuwait

BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%–10%. The Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA) scoring system was established in 2008 specif ically for Asian populations. The aim of this study was to compare the modif ied Alvarado with the RIPASA scoring system in Kuwait ***: This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook(unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic(ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical ***: A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modif ied Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specif icity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specif icity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modif ied Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a signif icant difference(P<0.001) for both scoring ***: Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specif icity than the modif ied Alvarado scoring system in A

关键词： Acute appendicitis Modifi ed Alvarado score RIPASA score

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Diet in Renal Diseases: An Art of Science

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Open Journal of Nephrology 2024年第3期14卷 361-374页

作者： Kamel El-Reshaid Shaikha Al-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Jaber Hospital Ministry of Health Kuwait City Kuwait

Purpose of Review: Chronic kidney disease (CKD) is associated with a limited ability to excrete fluids, electrolytes, uremic toxins and other end-products of catabolism. Studies on adverse renal outcomes with dietary patterns are limited. Methods: Comprehensive search in PubMed of papers published until June 2024 describing prospective cohort studies on renal nutritional therapy (RNT) with at least 3 years of follow up. Results: RNT should include adequate yet limited amounts of calories, fluids, protein, lipids, sodium, potassium, and phosphorus. RNT is an adjuvant to specific drug-therapy in 1) certain complications viz. fluid overload, anemia and renal osteodystrophy, and 2) specific kidney diseases viz. glomerulopathies, tubulopathies, polycystic kidney disease, calcium oxalates urolithiasis and cystinuria, as well as 3) types of renal failure viz acute and chronic and its treatment viz. hemodialysis, peritoneal and transplantation. Conclusion: RNT is patient-specific and should be systematically planned to delay the progression of CKD as well as to prevent and treat its complications.

关键词： Calories Diet Disease Electrolytes Fluid Kidney Lipids Nutrition Protein Vitamins

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Prevalence and associated factors of clubfoot in the eastern province of Saudi Arabia: A hospital-based study

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World Journal of Orthopedics 2024年第7期15卷 635-641页

作者： Ammar K Alomran Bandar A Alzahrani bader S Alanazi Mohammed A Alharbi Loay M Bojubara Eman M Alyaseen Department of Orthopedic College of MedicineImam Abdulrahman bin Faisal UniversityDammam 34212Saudi Arabia College of Medicine Imam Abdulrahman bin Faisal UniversityDammam 34212Saudi Arabia College of Medicine Arabian Gulf UniversityManama 329Bahrain

BACKGROUND Clubfoot,or congenital talipes equinovarus,is a widely recognized cause of disability and congenital deformity worldwide,which significantly impacts the quality of *** management of clubfoot requires long-term,multidiscip-linary *** is important to understand how common this condition is in order to assess its impact on the ***,few studies have investigated the prevalence of clubfoot in Saudi *** To determine the prevalence of clubfoot in Saudi Arabia via the patient population at King Fahad University Hospital(KFUH).METHODS This was a retrospective study conducted at one of the largest hospitals in the country and located in one of the most densely populated of the administrative *** Of the 7792 births between 2015 to 2023 that were included in the analysis,42 patients were diagnosed with clubfoot,resulting in a prevalence of 5.3 per 1000 live births at *** The observed prevalence of clubfoot was significantly higher than both global and local estimates,indicating a substantial burden in the study population.

关键词： Clubfoot Talipes equinovarus Congenital talipes equinovarus Prevalence Saudi Arabia

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Hydroxychloroquine: A Safe, Effective and Inexpensive Maintenance Therapy for Chronic Spontaneous Urticaria

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International Journal of Clinical Medicine 2024年第6期15卷 225-232页

作者： Kamel El-Reshaid Shaima Al-bader Abdulla Al-Refaee Department of Medicine Faculty of Medicine Kuwait University Kuwait Kuwait Asad Al-Hamad Dermatology Center Ministry of Health Kuwait Kuwait

Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.

关键词： Autoimmune Disease Chronic Spontaneous Urticaria Corticosteroids Hydroxychloroquine Omalizumab

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Systemic Amyloidosis Secondary to Psoriasis: A Rare, Autoimmune and Genetically-Determined Disorder That Is Amenable to Treatment with Cyclosporin A—Cyclosporin A for Psoriasis-Induced Amyloidosis

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Open Journal of Nephrology 2024年第2期14卷 226-232页

作者： Kamel El-Reshaid Shaima Al-bader John Patrick Madda Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Asad Al-Hamad Dermatology Center Kuwait City Kuwait Department of Pathology Amiri Hospital Kuwait City Kuwait

Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.

关键词： Amyloidosis Psoriasis Nephrotic Syndrome Cyclosporin A

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Occult Adrenal Insufficiency in Patients with Chronic Renal Disease

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International Journal of Clinical Medicine 2024年第8期15卷 375-381页

作者： Kamel El-Reshaid Abdulmohsen Al-bader Hossameldin Tawfik Sallam Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Otolaryngology Farwania Hospital Ministry of Health Kuwait City Kuwait Department of Medicine Al-Amiri Renal Center Ministry of Health Kuwait City Kuwait

Background: Addison’s disease is a rare disorder of the adrenal cortex that leads to inadequate production of cortisol initially followed by aldosterone and androgens. Its manifestations are usually slow and non-specific with potential for life-threatening adrenal crisis following hypermetabolic demands (infection, trauma, surgery). Patients: Over the past 10 years, 19 CRD-patients were diagnosed with occult PAI in our center. Results: Unprovoked hypotension was the most common manifestations of occult PAI and was the unmasking event in 11 (58%). It was without significant cardiac and/or severe systemic sepsis and was refractory to isotonic saline infusions. Equal number of the remaining patients (n = 2) presented with persistent and inexplicable electrolytes abnormalities viz. 1) hyponatremia despite restricted oral fluid intake, lack of dehydration and massive fluid overload, as well as 2) hyperkalemia despite potassium-restricted diet, hyperkalemic drugs and adequate therapy with Furosemide and low-potassium dialysis-baths. On the other hand, similar proportions presented with unprovoked 3) progressive weight loss, decrease appetite and cachexia as well as 4) frequent hypoglycemic attacks. All patients were treated and were medically stable after 29 (2 - 60) months of follow up. Autoantibodies to 21-hydroxylase enzyme were positive in 16 (90%). At diagnosis, and subsequent follow up, only 7 patients (37%) had multi-endocrine dysfunction of whom 2 with type 1 and 5 with type 2. Conclusion: High index of suspicion should be exerted in diagnosis of PAI in patients with CRD, since its clinical picture is similar to CRD manifestations and complications. In those patients, confirmatory tests and specific management can save their lives. .

关键词： Addison’s Disease Autoimmune Adrenalitis Chronic Renal Disease Multiple Endocrine Dysfunctions Primary Adrenal Insufficiency

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Investigating the therapeutic efficacy of psilocybin in advanced cancer patients: A comprehensive review and meta-analysis

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World Journal of Clinical Oncology 2024年第7期15卷 908-919页

作者： Husam bader Husam Farraj Joud Maghnam Yazan Abu Omar Department of Internal Medicine University of MichiganAnn ArborMI 48109United States Department of Internal Medicine University of New MexicoAlbuquerqueNM 87106United States Faculty of Medicine AL-Balqa Applied UniversityAl-Salt 19110Jordan

BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and *** has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced *** systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced *** To investigate the therapeutic effect of psilocybin in patients with advanced *** A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February *** reference lists of the included studies were also searched to retrieve possible additional *** A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 *** results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety *** effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin *** The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.

关键词： Quality of life Advanced cancer Psilocybin Systemic review Meta analysis

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Pleomorphic leiomyosarcoma of the maxilla with metastasis to the colon:A case report

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 361-367页

作者： Asma Alnajjar Abdulrahman Alfadda Abdullah Mohammad Alqaraawi bader Alajlan Jean Paul Atallah Hussah Fahad AlHussaini Section of Gastroenterology Department of MedicineKing Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia Department of Oncology King Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia Department of Pathology King Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia

BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all *** behave aggressively and often have poor *** can affect the gastrointestinal tract and *** date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine *** SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and *** most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending *** polyp was removed using hot snare polypectomy technique and retrieved with *** examination of the polyp showed a metastatic pleomorphic *** Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.

关键词： Pleomorphic leiomyosarcoma Colon polyp Hot snare polypectomy Maxillary Spindle cell tumor Case report

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Mental health status among COVID-19 patients survivors of critical illness in Saudi Arabia:A 6-month follow-up questionnaire study

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World Journal of Clinical Cases 2024年第15期12卷 2560-2567页

作者： Abdullah M Alhammad Namareq F Aldardeer Abdulaziz Alqahtani Mohammad H Aljawadi Bushra Alnefaie Raghad Alonazi Mansour Almuqbil Abdulrahman Alsaadon Rakan M Alqahtani Rashid Alballaa bader Alshehri Mohammed I Alarifi Fahad D Alosaimi Department of Clinical Pharmacy College of PharmacyKing Saud UniversityRiyadh 12372Saudi Arabia Department of Pharmacy Services King Faisal Specialist Hospital and Research CentreJeddah 21499Saudi Arabia Corporate Department of Pharmacy Services King Saud University Medical CityRiyadh 12372Saudi Arabia College of Pharmacy King Saud UniversityRiyadh 12372Saudi Arabia Department of Critical Care Medicine College of MedicineKing Saud UniversityRiyadh 12372Saudi Arabia Department of Psychiatry College of MedicineKing Saud UniversityRiyadh 12372Saudi Arabia

BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological ***,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had *** To evaluate anxiety and depression among patients who had severe *** This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for *** patients were contacted via *** patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS *** secondary outcomes were risk factors of anxiety and/or *** Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the *** mean age was 56.3±17.2 *** patients(62.5%)were *** main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)*** mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),*** from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and *** compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.

关键词： COVID-19 Critically ill Anxiety Depression HADS Saudi Arabia

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Impact Assessment of Plug-in Electric Vehicle Charging Locations on Power Systems with Integrated Wind Farms Incorporating Dynamic Thermal Limits

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Journal of Modern Power Systems and Clean Energy 2022年第3期10卷 710-718页

作者： bader Alharbi Dilan Jayaweera Department of Electronic Electrical and Systems EngineeringUniversity of BirminghamBirminghamUK Department of Electrical Engineering College of Engineering in Majmaah UniversityAl-Majmaah 11952Saudi Arabia

The increased presence of electric vehicle charging locations in a power system with high penetration of intermittent wind power potentially leads to operation complexities resulting in abnormal *** paper proposes an innovative framework for assessing the impact of plug-in electric vehicle(PEV)charging locations on a power system with integrated wind farms,incorporating dynamic thermal limits(DTLs).The framework comprises Monte Carlo simulation,which is embedded with stochastic modeling of various uncertainties under the key operating *** part of the modeling framework,the transmission lines are ranked in accordance with the lowest level of expected energy not *** PEV charging demand is then modeled by incorporating DTLs and applied to the least stressed transmission lines,following the IEEE 738-2006 *** new assessment framework is investigated using an IEEE 24-bus test *** results demonstrate that applying DTLs on the least stressed transmission lines in conjunction with the integration of decentralized wind farms and strategic charging location of PEVs significantly improves the security of the energy supply and considerably reduces interruption costs,as opposed to not having such a framework.

关键词： Dynamic thermal limit impact assessment Monte Carlo simulation plug-in electric vehicle wind farm

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