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Introduction: The last few decades have increased our understanding of autoimmune encephalitis (AE). In both the pediatric and adult populations, it proves to be a disease of dramatic acute onset of heterogeneous clinical manifestations, notably encephalopathy with neuropsychiatric symptoms, seizures, and extrapyramidal symptoms. More often, it is triggered by a viral infection in the pediatric age groups, as suggested by the preceding febrile symptoms in over half of cases, and more ostensibly, NMDAR encephalitis post herpes encephalitis. An underlying neoplasm may be present in certain types (i.e., NMDAR encephalitis). The rising rate of antibody detection and subsequent confirmation has been boosted by improved live cellular assay detection methods. The corresponding clinical phenotypes, common underlying malignancies, and histopathological findings have helped improve our management regarding intervention and choice of immunotherapy. New assessment tools such as the Clinical Assessment Scale in Autoimmune Encephalitis (CASE score) have helped improve the objective assessment of impact on cognitive functions (1). Early intervention with immunotherapy (and tumor removal in proven underlying neoplasms) has improved overall outcomes in most presenting patients. But nearly 40% of cases fail to respond to the first tier of treatment (2). The complex interplay between pathogenic autoantibodies, T-cells, B-cells, and cytokines has led to the emergence of additional immunotherapy agents (i.e., tocilizumab and bortezomib). Methods: In this retrospective observational study of pediatric AE conducted at two tertiary care centers, we observed the clinical characteristics, autoantibody yield, treatment modalities used, and disability scores during presentation and follow-up. Our secondary aim was to delineate prognostic factors for poor outcomes. Results: Neuropsychiatric symptoms, encephalopathy, and seizures were the predominant manifestations in most of our patients. Younger age groups, refractory seizures, profound encephalopathy, and refractory disease harbored higher disability scores. The group that received combined immunotherapy has shown mitigation of disability score from severe to mild during long-term follow-up, signifying the role of multifaceted immunotherapy in pediatric refractory AE. Conclusion: Early implementation of combined immunotherapy in refractory cases significantly improved longterm disability scores, in spite of lingering residual effects on neurologic functions, notably cognition, behavior, and speech. [ABSTRACT FROM AUTHOR]

Background: Millions of Muslims gather annually in Makkah, Saudi Arabia, for pilgrimage (the Hajj). Some medical conditions need specialized care involving transfer outside the hospital. However, providing health care to emergency cases in such unparalleled mass gatherings is challenging. This study aimed to describe the medical conditions of patients transferred by the medical convoy team in well-equipped ambulances to Arafah in Makkah during the Hajj season in 2019. Methods: Patients' data were extracted via a standardized electronic evaluation form. The treating physicians made the primary diagnoses in the admitting secondary or tertiary healthcare facilities. Results: Of the 274 transferred patients, 36.1% were older adults (>60 years), 55.8% were men, 59.9% were Asian, and 36.4% were African. The primary diagnoses were cardiovascular diseases (26.7%), fractures (16.1%), respiratory diseases (15.3%), gastrointestinal diseases (12.8%), skin infections (10.3%), metabolic diseases (4.7%), neurological or psychiatric diseases (4.7%), and urogenital diseases (3.6%). Older adults comprised 50.0% of those with respiratory diseases, 46.2% of those with metabolic diseases, 37.1% of those with gastrointestinal diseases, 34.1% of those with fractures, 32.9% of those with cardiovascular diseases, and 30% of those with urogenital diseases. Conclusions: Cardiovascular, respiratory, metabolic, and gastrointestinal diseases, as well as fractures, contributed to most of the transferred medical conditions transported in the medical convoy in Makkah during the 2019 Hajj season. Older adults were more than a third of the transferred patients. [ABSTRACT FROM AUTHOR]

Objectives under Saudi Vision 2030. [ABSTRACT FROM AUTHOR]

Introduction: Heat-related illnesses (HRIs) are defined as elevated body core temperatures when exposed to an intense high temperature. HRIs include but are not limited to heat exhaustion (HE) and heat stroke (HS). HE and HS are among the leading causes of morbidity and mortality among pilgrims when the Hajj season occurs during the hot cycle of the year in Makkah. Method: A retrospective cross-sectional data analysis was conducted on HRI cases during Hajj 2022/1443 Hijri. The data were extracted from the Hajj electronic health records system software immediately at the end of the Hajj period. Result: A total of 200 patients presented with HRI symptoms during the study period. Over half of the HRI patients were male (n = 116, 58%). The mean age was 44 ± 14.6 years. One hundred forty-three patients (71.5%) were diagnosed with HE, while 57 (28.5%) were diagnosed with HS. A statistically significant association between age and HRIs was observed. Conclusion: More HRIs are expected due to the gradual elevation of ambient temperature and the global warming phenomenon. This study emphasizes the importance of education and awareness regarding preventive measures in the general population, especially among the most vulnerable subpopulations. [ABSTRACT FROM AUTHOR]

Byline: Yasir. Almuzaini, Fahad. Alsohime, Sarah. Subaie, Mohamad. Temsah, Yousef. Alsofayan, Fahad. Alamri, Ahmed. Alahmari, Hadil. Alahdal, Hana. Sonbol, Rana. Almaghrabi, Mahmoud. Nahhas, Anas. Khan CONTEXT: Exploring clinical characteristics of [...]

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects young children in social relatedness and communication besides other characteristics. A community's awareness and early intervention services in diagnosing and treating autistic children are essential for preventing the expected complications, eg language delay, social interaction, and intellectual ability. Aim: To assess the parent's knowledge and perceptions regarding autism and its associated clinical features and effects. Methodology: A cross-sectional study was conducted targeting all available parents aged 18 years or more living in Aseer region. Data were collected using a self-reported questionnaire from randomly selected parents who attended outpatient clinics at Abha Maternity and Children Hospital and Aseer Central Hospital. Parents' knowledge regarding autism was assessed covering general knowledge, clinical features, social effects, consequences, and curability. Results: A total of 477 parents participated. Parents' ages ranged from 18 to 85 years. 261 (54.7%) parents were male and 216 (45.3%) were females. Nearly 65.6% of parents were university graduates and 28.3% had a secondary level of education. About 50.9% of the parents know that genetics play a major role in causing autism, 69.6% think that most children with autism have special talents or abilities, 64.2% know that delayed language development is one of the main symptoms of autism, 61.2% also know that repetitive movements of the hands and head are a common symptom of autism. About 36.9% of parents think that diagnosing a child with autism will lead to discrimination against the child, 33.3% of parents think that autism is a rare condition in this country compared to the West. Conclusion: The study showed that parents had poor knowledge levels regarding autism and its related clinical features, especially male parents with low levels of education. On the other hand, their perception of the disease and its frequency in the study area was satisfactory. [ABSTRACT FROM AUTHOR]

Health security has become an integral part of global health after many epidemics, the latest of which was the COVID-19 pandemic, from which the world is still suffering. The term "health security" was first used in the mid-twentieth century. Now that a globalized transportation industry has allowed for the mass movement of travelers and public health emergencies, such as global warming, affect everyone, "health security" has become a top priority of countries around the world. This article breaks down the stages in the development of health security as a concept and discusses them. To that end, it reviews the most prominent international and regional initiatives in the field of global health security, including the efforts of the World Health Organization (WHO). This review will help to anticipate the future development of global health security and offer some suggestions for further research. The article thus concludes with a call for countries to work together to develop a shared method of measuring health security. Whether such initiative is taken by the WHO or by low- and middle-income countries, greater collaboration is needed to discuss shared concerns and develop new strategies, particularly in the field of digital health. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess the knowledge and awareness, and to identify the practice reflection of knowledge concerning Middle East Respiratory Syndrome (MERS) on hospital visitor's daily life. Methods: A cross-sectional study, conducted in 2 tertiary referral hospitals in Riyadh Saudi Arabia, from February 2015 to February 2016. A total random sample of 305 hospital visitors consented to participate. Data were collected through a self-administered questionnaire consisting of questions regarding awareness and practice of measures to prevent the spread of infection. Results: Study showed that participants have a fair knowledge regarding the cause of MERS (N = 228; 74.8%). Nearly half of them (47%) stated that camels are the source of the spread of MERS. Approximately 70% of the participants preferred both sanitization and wearing facemasks as preventive measures for MERS. However, only 3.95% practiced not eating camel products, such as milk and meat. Conclusions: Although hospital visitors showed some knowledge and positive awareness in several aspects of MERS awareness, there are weak areas where knowledge and awareness were not up to recommended guidelines. Continued educational programs are needed to improve awareness and knowledge of all the public toward MERS-coronavirus infection. This study may assist in the development of future strategies on preventive measures of the disease. [ABSTRACT FROM AUTHOR]