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Glipizide is an antidiabetic drug that belongs to a class of medication known as sulfonylureas. It is considered one of the highly prescribed antidiabetic drugs for the treatment of type II diabetes in patients following a kidney transplant. It lowers blood glucose levels by causing the release of insulin from β-cells in the pancreas. Its main metabolizing pathway is through the liver. It has several adverse effects, which range from an upset stomach to glipizide-induced haemolytic anaemia and hypoglycaemia. These adverse effects may be spontaneous, or they could have a genetic cause. The present study aimed to assess and document the incidence of glipizide-induced adverse reactions among patients prescribed the drug. The present retrospective case-control study used the electronic medical records of patients prescribed glipizide for the past 3 years. These records were reviewed to extract and document cases and/or signs of glipizide-induced adverse reactions. The results revealed that the incidence of adverse effects was higher among female patients (odds ratio, 2.40, P<0.001). Moreover, the results revealed that the likelihood of developing adverse drug reactions among patients <40 years of age was higher than in older patients (P>0.05). The outcomes of the present study are expected to prompt future studies to take sex and age into consideration, in an aim to improve treatment outcomes, reduce adverse events and decrease the burden of unnecessary costs for healthcare systems. Recommendations also include genetic screening prior to administering the medication, educating the patients and caregivers on the possibility of adverse drug reactions, and routine follow-up. This issue is of utmost importance to achieve the optimal outcomes with the minimal detrimental effects. [ABSTRACT FROM AUTHOR]

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Objectives: Phlebitis caused by peripherally infused potassium chloride (KCl) is well documented in the literature. This study focuses on documenting the rate, grade, and timing of this complication, and explores the cause and effect of added lidocaine on pain and phlebitis rate. Methods: A retrospective chart review was conducted for patients receiving KCl peripheral infusion with or without added lidocaine. Descriptive statistical analysis was performed. The prevalence of infusion phlebitis was evaluated using the appropriate X2 test, t-test/Mann-Whitney U test. A multivariate Cox proportional hazards regression model was used to assess the independent effect of age and sex on the rate of catheter-related complications. Statistical significance was considered at P < 0.05. Results: There were 85 infusions of 10 and 20 mEq KCl, of which 67% (N = 57) had added lidocaine. Overall, phlebitis rate was 19%. There was less phlebitis with lidocaine-added infusions (13% vs 19%; P = 0.65), and infusions lasted more than those without added lidocaine. Animal and human data support the occurrence of a KCl-mediated vasoconstriction causing pain. Our data anecdotally support such observations. Besides the low pH and high osmolarity of KCl infusions, vasoconstriction seems to add insult to the patient veins. The role of lidocaine in alleviating pain and in delaying phlebitis may go beyond being a local anesthetic once its vasodilatory and anti-inflammatory effects are considered. Conclusions: The cause of pain and phlebitis of KCl infusions may be more related to vasoconstriction than just low pH and high osmolarity. The addition of lidocaine to KCl infusions appears to be safe, and potentially delays or alleviates KCl infusion pain through its speculative vasodilatory and anti-inflammatory effects. [ABSTRACT FROM AUTHOR]

Background. Vancomycin and piperacillin-tazobactam (PTZ) are commonly used as empirical therapy for patients with health care associated infections. Vancomycin has been recognized as a nephrotoxic agent and in a few cases in the literature PTZ has been associated with interstitial nephritis nevertheless; the combination of these agents has routinely been used for many years. However, there have been some observational studies that showed high rates of acute kidney injury (AKI) in patients receiving vancomycin and PTZ concomitant treatment compared to patients receiving vancomycin alone. The incidence of AKI in adult patients receiving vancomycin and PTZ concomitant treatment was reported in these studies to be relatively high. Similar studies in pediatric patients are lacking. Method. We conducted a single center retrospective chart review of 248 pediatric patients receiving one of the following treatments: vancomycin alone 36 patients, vancomycin/PTZ 62 patients, vancomycin/ceftazidime 99 patients, and vancomycin/ceftriaxone 51 patients. Result. Our results showed a low incidence of AKI in patients on vancomycin/PTZ concomitant treatment where overall incidence was only (4.8%) three cases and only one of them (2.0%) in a patient receiving the vancomycin/ceftriaxone concomitant treatment. No cases of AKI present in patients receiving vancomycin with ceftazidime or vancomycin alone. There were no statistically significant differences between the four treatment groups in terms of AKI incidence, vancomycin trough, and use of nephrotoxins. Conclusion. Overall, the incidence of AKI was low in our study sample with no statistically significant increased risk when PTZ was used in combination with vancomycin in a pediatric population. However, further investigation with an equal larger sample size is needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to understand the attitude of medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU‑HS) toward anesthesia as a specialty and to determine common factors influencing their career choice options. Study Design: This was a cross‑sectional study. Methods: The study was conducted between March 25, and April 20, 2017, at KSAU‑HS. The survey was distributed among 5th and 6th years medical students. Data were collected through a validated hardcopy questionnaire of 16 multiple choice questions. The questionnaire included demographic characteristics, specialty preferences, what factors attract Saudi medical students to choose their preferred specialty and how they view the option of choosing anesthesiology as a career. Results: A total of 236 students completed the questionnaire. The majority of respondents were in their 5th year of medical school representing (62%). The distribution of medical field interest ranged from (38%) surgery to (1%) anesthesiology. approximately, (60%) thought that controllable lifestyle was an important factor to consider in choosing a residency program. Only (45%) of respondents thought that prestige of specialty is a major factor that would influence their choice for a specialty. Conclusion: Based on the outcome of the study, it is recommended that medical undergraduate students exposure to anesthesia specialty should be magnified. Greater efforts have to be made to increase the number of medical students preferring anesthesia through emphasizing on the positive aspects of the specialty. [ABSTRACT FROM AUTHOR]

Objectives: Chronic heart failure (CHF) is a global health issue with notable morbidity and mortality. Currently, red cell distribution width (RDW) has appeared to be potential prognostic marker in patients with CHF.This study aims to assess the prognostic value of RDW in Saudi population with CHF. Methods: This study was a retrospective cohort study that included 233 CHF patients treated with standard antifailure drugs. RDW were ascertained at baseline with 2-D echocardiographic assessments of left ventricular mass and function. The follow up period was 24 months. Primary endpoint was the relationship between RDW and allcause mortality (ACM). Secondary endpoints included the potential association with major adverse cardiovascular events (classical 3-point MACE). Results: The mean age of patients was 60.15 ± 12.24 years, and 64.8% were males. Baseline RDW was 14.40 (13.50, 15.80) % (median, and interquartile ranges); 43 deaths occurred during the follow-up period. RDW was found to be the most significant and independent predictor of ACM, with a hazard ratio (HR) of 1.238 (95% CI; 1.090, 1.407) (P=0.001). While RDW change over 12 months had similar predictive value for ACM with HR 1.226 (95% CI; 1.117, 1.346) (P<0.0001). RDW was also found to be a significant and independent predictor for secondary endpoints. Conclusion: Our study supports the usefulness of RDW as an independent prognostic indicator for ACM and other CV outcomes in Saudi population with CHF. [ABSTRACT FROM AUTHOR]