Articles

<b>Background: </b>Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. <b>Aims and objectives: </b>This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. <b>Case report:</b> We report the case of a 54-year-old housewife who presented with transient loss of consciousness and right sided hemiparesis following electrocution, while at home. <b>Results: </b>The patient met clinical critera for partial Brown- Sequard syndrome, which to our knowledge, has not been previously reported. She showed significant improvement over a month and is currently under monitoring. <b>Conclusions:</b> Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.

Antenatal and postpartum major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) is defined as either daily sustained sad mood or lack of enjoyment or desire for a minimum two weeks plus four associated manifestations (only three if the two major symptoms are present) that start throughout pregnancy or during the first 4 weeks postpartum respectively: 1) Unintentional notable slimming up or down; 2) Sleepiness or sleeplessness; 3) Tiredness sensation; 4) Guilty or futility sensation; 5) Declined concentration capacity; 6) Frequent suicidal thoughts; 7) Psychomotor excitation or delay. Perinatal depression carries vital and adverse consequences on mother’s psychosocial aspects of life, pregnancy and delivery outcomes, her interrelations specifically with the new born with poorer overall health and influences negatively on offspring from the intrauterine life passing by complicated delivery experiencing hard unstable childhood reaching unhealthy adolescence and adulthood. These negative consequences necessitate a great attention for prevention, screening and prompt treatment for antenatal and postnatal depression to prevent such disastrous effects.

Baloxavir marboxil (BXM) is a novel anti-influenza agent that developed in Japan and inhibit the cap endonuclease specifically, and suggested the more clinical effectiveness in influenza. BXM reduces viral shedding more than do neuraminidase inhibitors (NAIs), and its clinical efficacy is equivalent to that of NAIs but is superior to that of NAIs in the case of type B influenza. BXM does not demonstrate any issues with safety, and treatment with BXM reduces the incidences of complicating sinusitis and bronchitis. Prophylactic administration of BXM inhibits intrafamilial transmission of influenza although low susceptible viruses with a PA/I38X substitution are isolated with a certain frequency following administration of BXM. Finally, In influenza treatment for patients aged 12−19 years and for adult outpatients, BXM can be used with the same recommendation level as oseltamivir.

The pulmonary characteristics of <i>Staphylococcus </i><i>aure</i><i>u</i><i>s</i> (<i>S</i><i>.</i><i> </i><i>aureus</i>) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear.<b> </b><b>Case series</b>: Two patients with methicillin-susceptible <i>S</i><i>.</i><i> </i><i>aureus</i><i> </i>(MSSA) infection in the lungs co-infected with either SARS-CoV-2 or influenza virus are reported. Case 1 was a 66-year-old woman who was admitted with SARS-CoV-2 infection. Her chest X-ray and computed tomography (CT) showed multiple cavity formations with infiltration shadows, and MSSA was detected from her sputum and blood, suggesting COVID-19-related bacterial pneumonia and pulmonary embolism. No catheters had been used, but she had skin eruptions and a history of SARS-CoV-2 vaccination. Ampicillin/sulbactam (ABPC/SBT) was administered, and she finally improved. Case 2 was an 87-year-old man with a history of atopic dermatitis who was admitted with moderate pneumonia, and influenza virus co-infection was found. He showed multiple cavitary shadows, and MSSA was isolated from both his sputum and blood. He was diagnosed with influenza-related bacterial pulmonary embolism. No catheters had been used, but he had a history of influenza vaccination. He was also treated by ABPC/SBT and finally improved. <b>Conclusions:</b> These cases suggest that MSSA showed affinity to the lungs when co-infected with either SARS-CoV-2 or influenza virus, and it presented as septic emboli without catheter use. We should consider MSSA infection when patients have SARS-CoV-2 or influenza virus co-infection, and multiple cavity formation and skin disorders are seen, even though they were vaccinated and no catheters were used.

Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care maternity set-up in Riyadh City. Data for this cross-sectional study were obtained using a structured questionnaire from eligible pregnant women admitted to King Saud Medical City (KSMC) between August 2020 and March 2021. Data were analyzed using descriptive and inferential statistics. Out of a minimum estimated sample size of 170, researchers recruited 362 participants. As observed, only 92 people, or 25.4%, had enough knowledge about various educational levels. The majority (91.2%) lived in villages, had no history of chronic disease (74.0%), and said that it took them at least 30 minutes to commute from their home to the hospital (69.3%). Two hundred two (55.7%) lacked appropriate knowledge, although most women (76.2%) had one to four pregnancies. Poor psychological health resulted from 37 people's (10.2%) inadequate Awareness. Even though 139 (38.4%) had spent more than 15 minutes receiving education from medical staff and 200 (61.5%) had attended the prenatal care clinic more than four times, most lacked adequate knowledge. The variables education level (P=0.000), working status (P=0.022), and place of residence (P=0.044) showed a statistically significant association with the knowledge level, also only education level statistically significantly affected the likelihood of knowledge gaps. In conclusion, early identification of obstetric warning signs and associated risk factors of pregnancy complications is integral to prevention.

Artificial intelligence systems have been previously used to predict post-operative complications in small studies and single institutions. Here we developed a robust artificial intelligence model that predicts the risk of having cardiac, pulmonary, thromboembolic, or septic complications after elective, non-cardiac, non-ambulatory surgery. We combined structured and unstructured electronic health record data from 3.5 million surgical encounters from 25 medical centers between 2009 and 2017. Our neural network model predicted postoperative comorbidities 15 to 80 times faster than classical models. As such, our model can be used to assess the risk of having a specific complication postoperatively in a fraction of a second. With our model, we believe clinicians will be able to identify high-risk surgical patients and use their good judgment to mitigate upcoming risks, ultimately improving patient outcomes [1].

Caesarean section is the most common surgical procedure in obstetrics, but also in pregnant women with dystocia. The purpose of this study is to identify factors that contribute to post-caesarean complications in emergency of gynecology-obstetrics service of Saint Joseph Hospital in Kinshasa. This is a descriptive cross-sectional study and was conducted at Saint Joseph Hospital in Kinshasa city for a month (1^st and 30^th July 2021). A questionnaire was used to collect different data namely socio-demographic characteristics and different variables important for the study. Independent variables were factors related to the parturient and the current pregnancy, the surgical procedure and the operational room. While the dependent variable was post-caesarean complications in gynecology-obstetrics service.<b> </b>Descriptive statistical analyses namely frequency and percentage were done to describe the sample profile. To measure the strength of association between different variables were estimated using Pearson's Chi-Square (X²) test and the p-value was 0.05. Data analysis was performed using SPSS version 20 software. The majority of participants are over 33 years of age, have secondary school skills, married and have 3 to 4 children. It was observed that 88.2% of participants have acute respiratory distress prior to caesarean section, 76.6% have a personal history of thromboembolic disease prior to caesarean section. All the participants who underwent caesarean section were victims of external ventilation through the windows of the operating room, which remained open before, during and after the surgery and benefited from antibiotic treatment without any para-clinical analysis before the caesarean section. Furthermore, 82.4% of participants had benefited from the caesarean section with sterilized care materials 48 hours before and after the intervention. While 47.1% of participants had caesarean sections with defective equipment for the operation (use of dry heat sterilization etc.). A better identification of these risk factors can reduce significantly rate of complications and can consequently improve the maternal-infantile prognosis. The obstacles to effective management are related to the provision of quality services.