Pregnant women’s use and attitude toward herbal,vitamin, and mineral supplements in an academic tertiary care center,Riyadh, Saudi Arabia

Background

Herbal medicine has been widely utilized by pregnant women despite the limited available evidence regarding the safety and efficacy of that practice. The current available studies, from different countries, estimated that the use of herbal medicine during pregnancy range from 7% up to 96%. The aim of this study is to determine the prevalence, attitude, source of information, and reasoning behind the use of herbal medicine among pregnant women in Saudia Arabia.

Myelographic study of the spinal cord ascent during fetal development

To assess the length of the spinal cord relative to the vertebral column during fetal development, we performed translumbar myelograms on 340 spontaneously aborted fetuses. Of these, 146 were selected for study. There were 76 males and 70 females, with fetal age ranging from 7 to 33 weeks. Significant variation in the level of spinal cord termination was found in fetuses between 12 and 25 weeks gestational age. In fetuses between 25 and 33 weeks gestational age, the cord ended at or above the third lumbar vertebra.     

Twenty years’ experience of laparoscopic 1-anastomosis gastric bypass: surgical risk and long-term results

BackgroundLaparoscopic 1- (single-) anastomosis gastric bypass (OAGB) was developed as a simplified technique of Roux-en-Y gastric bypass (RYGB), but super long-term data are lacking.ObjectivesTo evaluate the risks and long-term results of OAGB over a period of 20 years.SettingTertiary teaching hospital.MethodsA total of 2223 patients underwent OAGB from 2001 to 2020; the mean age was 35.3 ± 11.4 years (range, 14–71 yr), 70.2% were female, and the mean body mass index was 40.2 ± 11.9 kg/m². All data were kept in a prospective bariatric database. Patients were divided into 4 groups, based on the 5-year period in which their surgery was performed, and a retrospective analysis was conducted.ResultsThe means for operating time, intraoperative blood loss, and length of hospital stay after OAGB were 131.9 ± 40.1 minutes, 38.5 ± 30.7 mL, and 4.5 ± 4.0 days, respectively. There were 27 patients (1.2%) with 30-day postoperative major complications overall, but the group rate decreased to .4% in the last 5-year period. At postoperative years 5, 10, and 15, the percentages of total weight loss were 31.9%, 29.6%, and 29.5%, respectively, and the percentages of excess weight loss were 77.2%, 68.4%, and 65.5%, respectively. Among 739 patients (33.2%) with type 2 diabetes (T2D), the rates of complete remission (glycated hemoglobin < 60%) at 5, 10, and 15 years were 67.3%, 73.8%, and 66.7%, respectively. The weight loss and antimetabolic effects were similar in each 5-year period, but a significant malnutrition effect was observed. A total of 113 (5.1%) patients needed revision surgery at follow-up, due to malnutrition (n = 51), weight regain (n = 24), acid or bile reflux (n = 22), marginal ulcer (n = 8), ileus (n = 3), and other causes (n = 5). At 15 years, the overall revision rate was 11.9% (27/226), and 80% of the patients were very satisfied with their procedures.ConclusionOur results showed that OAGB is a safe and durable primary bariatric procedure, with sustained weight loss and a high resolution of T2D up to 20 years post surgery in Taiwan, although malnutrition is a major side effect.     

Etiology and management of transverse lie

Sixty-two cases of transverse lie were studied, with an average incidence of 1:250. The different etiologic factors predisposing to transverse lie are discussed, and the medical literature is reviewed. Antenatal management and management at term are also discussed.     

Factors that facilitate reporting of adverse drug reactions by pharmacists in Saudi Arabia

Objectives: Adverse drug reactions (ADRs) are a pervasive global problem, and its management is integral to patient safety and healthcare quality. Pharmacists play a pivotal role in monitoring and reporting ADRs, which has a direct impact on patient care. The aim of this study was to identify potential factors that facilitate pharmacists in community and hospital settings to report ADRs.

Methods: A cross-sectional, online survey using a validated questionnaire was administered to pharmacists working in community and hospital pharmacies in Saudi Arabia.

Results: 1,717 community and 153 hospital pharmacists participated in this study. Only 10.2% and 26.8% of community and hospital pharmacists, respectively, admitted ever reporting an ADR. The most reported factors that may facilitate ADRs reporting have included ongoing improvements in therapeutic knowledge about ADRs, attending educational programs with continuous medical education credits, the seriousness of the experienced ADRs and accessibility to patients’ medical profile. The impact of peers by seeing colleagues reporting ADRs and ADRs due to herbal or traditional medicine were the least important factors reported by pharmacists.

Conclusion: The study identified factors that can effectively address the under-reporting of ADRs by pharmacists. A multi-stakeholder, multi-pronged approach of ADR reporting is needed to develop greater awareness of this issue among pharmacists.     

Size and Number of Food Boluses in the Stomach after Eating Different Meals: Magnetic Resonance Imaging Insights in Healthy Humans

Oral processing of food results in the formation of food boluses, which are then swallowed and reach the stomach for further digestion. The number, size and surface properties of the boluses will affect their processing and emptying from the stomach. Knowledge of these parameters, however, is incomplete due to limitations of the techniques used. In this work, non-invasive magnetic resonance imaging (MRI) was used for the first time to measure boluses in the stomach a few minutes after swallowing. Three groups of nine healthy participants were fed three different meals: chicken and roasted vegetables (Meal 1), bread and jam (Meal 2) and cheese and yogurt (Meal 3), and then, their stomach content was imaged. The median number of boluses within the stomach was 282, 106 and 9 for Meal 1, Meal 2 and Meal 3 (p < 0.0001) with an average volume of 0.47 mL, 2.4 mL and 13.6 mL, respectively (p < 0.0001). The cohesiveness as well as the meal composition seem to play a key role in the resulting boluses. These new in vivo data from undisturbed organ imaging can improve knowledge of the digestion process, which will, in turn, inform in vitro and in silico modelling of digestion, thus improving their in vitro/in vivo relevance.     

Development of New Lead-Free Composite Materials as Potential Radiation Shields

Utilizing a polymer-based radiation shield offers lightweight, low cost, non-toxic compared to lead and solution for eliminating generated secondary neutrons. Incorporating silicon (i.e., one of the most abundant elements) in new applications, such as shielding, would have an impact on the economy and industry. In this study, seven potential shielding materials, composed of silicon, silicon carbide, and boron carbide embedded ethylene vinyl acetate (EVA) copolymers, are proposed. The shielding performance of these composite materials, including the attenuation coefficients (µ), the mass attenuation coefficients (µ_m), the half value layer (HVL), the mean free path (MFP), and the radiation protection efficiency (RPE) were examined using photon beams. Measured µ_m were verified against the calculated values. The averaged agreement was within ±7.4% between the experimental measurements and the theoretical calculation results. The HVL and MFP measured values for the polymer composites were lower than that for the pure EVA polymer, indicating the fillers in the polymers enhanced the shielding performance. The EVA + SiC (30%) and EVA + Si (15%) + B₄C (15%) composites required the lowest thickness to stop 50% of the incident photons. The evaluation of experimental results of the RPE revealed that the polymer composites containing SiC (30%), Si (15%) + B₄C (15%), or SiC (15%) + B₄C (15%) succeeded in blocking 90–91% of X-rays at nearly 80 keV. However, a thicker shield of the proposed composite materials or combined layers with other high-Z materials could be used for higher energies.