Yousef Qari

Percutaneous gastrostomy and gastrojejunostomy: radiological and endoscopic approach.

BACKGROUND The aim of the study was to report our experience, comparing and evaluating the effectiveness, safety, indications, and obstacles of percutaneous placement of gastrostomy and gastrojejunostomy catheters by fluoroscopic (percutaneous fluoroscopic gastrostomy--PFG) and endoscopic (percutaneous endoscopic gastrostomy--PEG) techniques. PATIENTS AND METHODS In this retrospective comparative study over a five-year period, 52 patients were referred for gastrostomy or transgastric jejunostomy procedure for various reasons. Of these, 19 patients (36.5%) were referred for PEG and 33 patients (63.5%) were referred for PFG. The mean age was 65 years for PEG; 14 patients were male and 5 were female. The mean age for PFG was 51 years; 16 patients were male and 17 were female. The medical files and follow-up records of these patients were studied thoroughly. RESULTS Success rate for catheter placement was high for both approaches (PFG and PEG), with a higher rate for PFG (100% vs. 89%). Major complications were 0% for PFG and 5.3% for PEG (P>0.05), whereas minor complications were 29% for PEG and 27% for PFG (P>0.05). Thirty-day procedure-related mortality was 0% for both techniques. CONCLUSION Both PEG and PEG are successful, safe, and effective techniques for the installment of catheters in the stomach or jejunum. PEG technique appears to have no major complications, and is capable of overcoming some of the obstacles that may render PEG unsuccessful.

Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia.

Introduction This survey evaluates knowledge, attitudes and practices of medical students towards use of antibiotics for upper respiratory infections (URTIs). Methodology Cross-sectional questionnaire study among 1042 randomly selected medical students in Saudi Arabia. Results Respondents were mostly Saudis (97.5%), had previous knowledge of antibiotics (99.7%) and their usage (98.3%) against bacterial infections (93.7%). 18.1% thought that they could be used for viral infections. Nearly all students (97.2%) used antibiotics themselves during the previous year and self-medication without a prescription was high at 49% of cases. Most antibiotics were taken for URTI symptoms (61.8%). Female medical students had better knowledge on antibiotic effectiveness against bacteria and viruses, and overall knowledge increased with study year. Health seeking behaviour rates for symptoms of RTI and associated estimated necessity for antibiotics varied but were highest for cough with yellow/green phlegm. Conclusions The depth of knowledge that healthcare professionals have in relation to the proper use of antibiotics is essential in spreading the right message within communities. This is the first large study among medical students in Saudi Arabia, shedding important light on areas for improvement in the medical curriculum as well as antibiotic practices of medical students themselves.

Antimicrobial effect of different types of honey on Staphylococcus aureus

Honey exhibits antimicrobial activities against a wide range of bacteria in different milieu. This study aims to compare the effects of five types of honey (both imported and local Saudi honey) against Staphylococcus aureus. The five types of honey (Manuka Honey UMF +20, Manuka Honey UMF +16, Active +10 Manuka Honey, Sidr honey and Nigella sativa honey) were evaluated for their bactericidal/bacteriostatic activities against both methicillin resistant and sensitive S. aureus. The inhibitory effect of honey on bacterial growth was evident at concentrations of 20% and 10% (v/v). Manuka Honey showed the best results. Manuka Honey UMF +20 had a bactericidal effect on both methicillin resistant and sensitive S. aureus. However, Sidr and N. sativa honey exerted only a bacteriostatic effect. The efficacy of different types of honey against S. aureus was dependent on the type of honey and the concentration at which it was administered. Manuka Honey had the best bactericidal activity. Future experiments should be conducted to evaluate the effects of honey on bacterial resistance.

Prevalence and molecular characterization of hepatitis D virus in Saudi Arabia: A single-center study

Background/Aims: Hepatitis D virus (HDV) is a defective RNA virus that is dependent on hepatitis B surface antigen (HBsAg) for transmission and replication. HDV significance arises from the possibility of poor prognosis of hepatitis B virus (HBV) infection. In Saudi Arabia, HDV prevalence varied from 8 to 32% before the HBV vaccination program and ranged from 0 to 14.7% after the vaccination program was started. The last study, performed in 2004, showed a prevalence of 8.6% in hospital-based HBV cases and 3.3% in healthy donors. The aim of this study was to investigate the prevalence and molecular characterization of HDV in chronic hepatitis B (CHB) patients at the King Abdulaziz University Hospital in Jeddah, Saudi Arabia by molecular and serological techniques. To the best of our knowledge, this is the first study to detect HDV at the molecular level in Saudi Arabia. Patients and Methods: The study included samples from 182 CHB patients from Jeddah; 13 samples with HBsAg negative were excluded. Samples were tested for HDV-Ab, viral RNA by reverse transcriptase–polymerase chain reaction (RT-PCR) in the HDV L-Ag region and sequence analysis. Results: The mean age of the participants was 44.36 years; 75.1% of the participants were Saudi nationals, 58% were males. Nine samples were positive for HDV-Ab and four were borderline; all were subjected to RT-PCR amplification. Three of the positive HDV-Ab cases and 1 borderline case were positive by RT-PCR. All the positive cases had HBV genotype D, and the positive RT-PCR cases were positive for HBV DNA. One of the HDV viremic samples was of genotype 1 by sequencing. The prevalence of HDV in the study was 7.7%, which was lower in Saudis (6.3%) than in non-Saudis (11.9%). Conclusion: HDV coinfection does not seem to have an effect on the clinical status of the recruited CHB cases in this study. More studies are needed to investigate the genetic diversity in other areas such as the southern parts of the Kingdom.