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Background Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by the presence of obsessions and compulsions that interfere with the patient’s life. It has been shown that patients with OCD have increased rates of neurological soft signs (NSS) when compared with healthy controls. NSS are minor abnormalities like poor motor coordination, sensory and perceptual difficulties, and difficulties in sequencing of complex motor tasks. It has been suggested that OCD patients with poor insight are at the most severe end of this spectrum. Aim of the work The aim of this study was to determine the frequency pattern of symptoms (obsessions and compulsions) in OCD patients, to examine NSS in patients compared with healthy individuals, and find any correlation between NSS scores and the severity of OCDs [total Yale Brown Obsessive Compulsive Scale (YBOCS) score] and the degree of insight. Participants and methods The study included two groups: 30 OCD patients and 30 healthy individuals as controls. Both groups were subjected to psychiatric and neurological examination using the Cambridge Neurological Inventory (Part 2), the YBOCS checklist to detect types of obsessions and compulsions, and the Overvalued Ideas Scale to assess the degree of insight in OCD patients. Results The most common types of obsessions and compulsions among the patients were religious (70%), contamination (77%), and cleaning compulsions (77%). OCD patients recorded significantly higher total scores of NSS and domain scores (motor coordination, sensory integration, and primitive reflexes) compared with the control group (P Conclusion We conclude that OCD patients have higher scores for NSS compared with controls, particularly for motor coordination signs. NSS positively correlated with the severity of disease. There was a positive correlation between NSS scores and OVIS scores, which measures the degree of insight.

The aim of this study was to assess the use of neutrophil distribution width (NDW) and to compare it to C-reactive protein (CRP) and procalcitonin (PCT), in the detection of early sepsis in the intensive care unit.Subjects (N = 166) were divided into 4 groups: healthy, acute inflammatory non-infectious (AINI), localized infection, and systemic infection, according to clinical history and cultures. NDW, CRP, and PCT were compared among the different groups using multivariate analysis of variance (MANOVA). Diagnostic efficacy was assessed using receiver operating characteristic curves and areas under the curves (AUC).The lowest mean(NDW) was found in the healthy group (n = 41), followed by the AINI (n = 20), localized infection (n = 55), and systemic infection (n = 50) groups. AUC(NDW) was 0.877 for infected (localized + systemic) vs non-infected (healthy + AINI) groups, and 0.965 for systemic infection vs non-infected groups. A cut-off of 21.9 resulted in 90% sensitivity, 92% specificity, 90% positive predictive value, and 92% negative predictive value (AUC(NDW) = 0.965, 95% confidence interval 0.935-0.995). According to MANOVA, only NDW was able to differentiate an acute inflammatory process from early infection in postoperative patients, but not healthy from AINI subjects.NDW had the highest diagnostic accuracy and is available with the complete blood count with differential (CBC). It may be a promising parameter to aid in the diagnosis of acute infection in adults, provided the possibility of haematological disorders is first ruled out.

Background Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem. Methods This is a cross-sectional study of a cohort of 62,681 patients aged ≥ 25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors. Results The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%-3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%-2.16%), 0.19% (0.16%-0.22%), and 1.06% (0.98%-1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥ 10 years, insulin use, retinopathy, nephropathy, age ≥ 45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16-99.62), 14.47 (8.99-23.31), 12.06 (10.54-13.80), 7.22 (6.10-8.55), 4.69 (4.28-5.14), 4.45 (4.05-4.89), 2.88 (2.43-3.40), 2.81 (2.31-3.43), 2.24 (1.98-2.45), 2.02 (1.84-2.22), 1.54 (1.29-1.83), and 1.51 (1.38-1.65), respectively. Conclusions Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.

Objectives The aim of the study was to determine the prevalence and risk factors of metabolic syndrome among drug-naive psychotic patients. Patients and methods The sample consisted of two groups: group I had 65 drug-naive patients recruited from psychiatric outpatient clinics of Zagazig University Hospitals and group II had 65 participants selected randomly from among Zagazig University Hospital visitors. Patients were subjected to a semistructured psychiatric interview, using the DSM-IV criteria for diagnosis. Severity of symptoms was rated using the Positive and Negative Syndrome Scale. Detection of metabolic syndrome was based on the criteria of the International Diabetes Federation. Results The results of the study show that the prevalence of metabolic syndrome among drug-naive psychotic patients was 12% (eight patients). There was also significant correlation between sex and marital status and all metabolic syndrome criteria, between education and triglycerides level, and between age and waist circumference, blood pressure, triglycerides, and high-density lipoprotein levels. Conclusion The current study concluded that prevalence of metabolic syndrome is higher in drug-naive psychotic patients and psychosis is a risk factor for developing metabolic syndrome among drug-naive psychotic patients.

BackgroundWorldwide, eHealth is a rapidly growing technology. It provides good quality health services at lower cost and increased availability. Diabetes has reached an epidemic stage in Saudi Arabia and has a medical and economic impact at a countrywide level. Data are greatly needed to better understand and plan to prevent and manage this medical problem. ObjectiveThe Saudi National Diabetes Registry (SNDR) is an electronic medical file supported by clinical, investigational, and management data. It functions as a monitoring tool for medical, social, and cultural bases for primary and secondary prevention programs. Economic impact, in the form of direct or indirect cost, is part of the registry’s scope. The registry’s geographic information system (GIS) produces a variety of maps for diabetes and associated diseases. In addition to availability and distribution of health facilities in the Kingdom, GIS data provide health planners with the necessary information to make informed decisions. The electronic data bank serves as a research tool to help researchers for both prospective and retrospective studies. MethodsA Web-based interactive GIS system was designed to serve as an electronic medical file for diabetic patients retrieving data from medical files by trained registrars. Data was audited and cleaned before it was archived in the electronic filing system. It was then used to produce epidemiologic, economic, and geographic reports. A total of 84,942 patients were registered from 2000 to 2012, growing by 10% annually. ResultsThe SNDR reporting system for epidemiology data gives better understanding of the disease pattern, types, and gender characteristics. Part of the reporting system is to assess quality of health care using different parameters, such as HbA1c, that gives an impression of good diabetes control for each institute. Economic reports give accurate cost estimation of different services given to diabetic patients, such as the annual insulin cost per patient for type 1, type 2, and gestational diabetes, which are 1155 SR (US $308), 1406 SR (US $375), and 1002 SR (US $267), respectively. Of this, 72.02% of the total insulin cost is spent on type 2 patients and 55.39% is in the form of premixed insulin. The SNDR can provide an accurate assessment of the services provided for research purposes. For example, only 27.00% of registered patients had an ophthalmic examination and only 71.10% of patients with proliferative retinopathy had laser therapy. ConclusionsThe SNDR is an effective electronic medical file that can provide epidemiologic, economic, and geographic reports that can be used for disease management and health care planning. It is a useful tool for research and disease health care quality monitoring.