Search

The current study aimed to determine the pregnancy outcomes complications in patients with SLE and its association with clinical, laboratory variables, disease activity, and medication use in the Saudi population, as well as pregnancy effect on disease activity. Methods: A multicenter study included pregnant female patients with Systemic Lupus Erythematosus (SLE) from three tertiary centers in Saudi Arabia. The demographics, clinical, and laboratory variables, SLE disease activity index (SLEDAI), medication before, during, and after pregnancy, planned pregnancy, pregnancy-related outcomes, and complications in comparison to age-matched healthy female controls were noted. Results: A total of 66 pregnant patients with SLE and 93 healthy age-matched pregnant controls were included in the study. A total of 77.3% had SLEDAI-2K ≤ 4 before conception, and 84.85% of pregnancies were planned. Age of conception, cesarean section, miscarriage, and low birth weight were statistically significant (p < 0.05) higher in SLE patients than in healthy controls. Among all clinical and laboratory variables, SLEDAI-2K > 4 and active lupus nephritis during pregnancy were statistically associated with adverse outcomes (p < 0.05), history of lupus nephritis was not associated with statistically adverse pregnancy outcomes. Higher SLEDAI-2K > 4 was an independent risk at least 4.87 times higher association with adverse pregnancy outcomes. (p < 0.05). Conclusion: SLE is intricately connected with unfavorable pregnancy outcomes. The preconception of high disease activity stands as a pivotal risk factor for adverse outcomes. Despite the disease remission and meticulous planning, SLE patients frequently grapple with disease exacerbations during pregnancy, culminating in unexpected and unfavorable pregnancy-related outcomes. This underscores the intricate and multifaceted nature of managing SLE during gestation. [ABSTRACT FROM AUTHOR]

Background: Currently, there are no guidelines for the treatment of rheumatoid arthritis (RA) tailored to the context of the Kingdom of Saudi Arabia (KSA). Adaptation of guidelines accounts for contextual factors and becomes more efficient than de novo guideline development when relevant, good quality, and up-to-date guidelines are available. The objective of this study is to describe the methodology used for the adolopment of the 2021 American College of Rheumatology (ACR) guidelines for the treatment of RA in the KSA. Methods: We followed the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE)-ADOLOPMENT methodology. The adolopment KSA panel included relevant stakeholders and leading contributors to the original guidelines. We developed a list of five adaptation-relevant prioritization criteria that the panelists applied to the original recommendations. We updated the original evidence profiles with newly published studies identified by the panelists. We constructed Evidence to Decision (EtD) tables including contextual information from the KSA setting. We used the PanelVoice function of GRADEPro Guideline Development Tool (GDT) to obtain the panel's judgments on the EtD criteria ahead of the panel meeting. Following the meeting, we used the PANELVIEW instrument to obtain the panel's evaluation of the process. Results: The KSA panel prioritized five recommendations, for which one evidence profile required updating. Out of five adoloped recommendations, two were modified in terms of direction, and one was modified in terms of certainty of the evidence. Criteria driving the modifications in direction were valuation of outcomes, balance of effects, cost, and acceptability. The mean score on the 7-point scale items of the PANELVIEW instrument had an average of 6.47 (SD = 0.18) across all items. Conclusion: The GRADE-ADOLOPMENT methodology proved to be efficient. The panel assessed the process and outcome positively. Engagement of stakeholders proved to be important for the success of this project. [ABSTRACT FROM AUTHOR]

Background: Infectious complications in children with chronic renal disease (CKD) are a major cause of increased morbidity and mortality rates among these children. This study aimed to determine the diagnostic value of Procalcitonin (PCT) and Pancreatic Stone Protein (PSP) as markers of infection in children with chronic renal failure and to decrease morbidity and mortality rates in these children. Methods: This case control study was conducted on 36 patients diagnosed with Chronic Renal Failure and admitted at Nephrology Pediatric Unit, Children's Hospital, Zagazig University during the period from October 2018 to February 2019. They were divided into 2 groups, the first group (case group) included 18 children with CKD diagnosed with infectious complications, the second group included (control group) 18 children with CKD who didn't develop any infectious complications. The serum expression of PCT and PSP was measured. Pearson correlation analysis was conducted to correlate PCT & PSP with each other and with CRP, temperature, HR, pus cells and blood culture. ROC analysis was used to test the value of PCT, PSP and CRP in early diagnosis of infection in Children with chronic renal failure. Results: The serum levels of PCT and PSP in case group were higher than in control group (P<0.01). Serum PCT concentrations showed a significantly positive correlation with PSP levels (P<0.001). ROC analysis showed that the area under curve (AUC) values of PCT, PSP and CRP were 0.944 (95% CI, 866-1.000), 0.870 (95% CI, 0.757-0.984) and 0.931 (95% CI, 0.729 -0.859) respectively and suggested cutoff levels were >0.62 ng/ml for PCT, >22.8 ng/ml for PSP and >6.5mg/L for CRP with sensitivity 88.9%, 81.8% and 83.3% respectively and specificity 95.6%, 72.2% and 94.4% respectively. Conclusion: Serum levels of PCT and PSP are promising biomarkers of early detection of infectious complications in Children with Chronic renal failure. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is associated with adverse pregnancy outcomes and postpartum complications, especially with severe disease activity. Objective: The current study aimed to compare the pregnancy outcomes in patients with RA and healthy controls as well as to assess the impact of disease-related variables, medications and disease activity on pregnancy and neonatal-related outcomes in the Saudi population. Methods: This prospective multicenter study included pregnant female patients with RA from three tertiary centers in Saudi Arabia. The demographics, disease activity scoring (DAS28-CRP), medication before and during pregnancy, pregnancy-related outcomes, and complications in comparison to age-matched healthy female controls were noted. Results: A total of 77 pregnant patients with RA and 250 healthy age-matched pregnant controls were included in the study. A total of 67.53% were in remission before conception (DAS28CRP ≤ 2.6), and 81.8% of pregnancies were planned. Age of conception, preterm labor, neonatal intensive care unit (NICU) admission and low birth weight were statistically significant (p < 0.05) and higher in RA patients than in healthy controls. Longer disease duration (p < 0.001), and high C-reactive protein and erythrocyte sedimentation rate levels before conception (p ≤ 0.001) were statistically associated with preterm NICU admission. There was statistically significant association between mild (p = 0.015) or moderate to severe DAS28-CRP (p = 0.001) and RA patients regarding pregnancy outcomes. The classification table obtained from the logistic model showed patients with mild and moderate-severe DAS28-CRP have significantly high chances of having an adverse pregnancy outcome. Conclusion: RA has a negative impact on pregnancy-related outcomes. Higher disease activity is considered a major risk; thus, tight disease control should be aimed. Planned pregnancy follow-up is associated with better pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Background: Ocular manifestations of inflammatory bowel disease (IBD) considered being the most common extraintestinal complication. Eventually, early detection and management improve the patient's quality of life as well as prevent potentially visually threatening complications. Objectives: To assess the prevalence and pattern of ocular manifestations among patients with inflammatory bowel disease during the COVID-19 pandemic. Materials and Methods: Cross-sectional study was performed using anonymous online surveys were administered which included the participant's demographics, prevalence and pattern of IBD intestinal and ocular manifestations, precipitating factors, and quality of life. Data were analyzed using (SPSS) version 20 (Armonk, NY: IBM Corp.). Chi-squared test Mann–Whitney and Kruskal–Wallis tests were applied. A P < 0.05 was considered statistically significant. Informed consent and ethical approval were obtained. Results: A total of 216 participants responded to the survey with 50.50% of females and 49.50% were male. About 90.3% of the participants had their GIT symptoms start before their eye symptoms. Almost two-thirds of the participants, (68.5%) suffered from frequent severe bowel symptoms that prevented them from carrying out work and/or perform the normal daily activity. Furthermore, one-third of the participants (31.6%) are unemployed and described a positive family history (32.8%). More than 75% of participants described eye symptoms associated with the intestinal disease activity which range from mild self-limiting to more severe ones that required hospital visits (50%). Although, majority of participants (90.00%) did not routinely receive official referral to ophthalmologist. The non-significant difference was found between the presence of eye symptoms and participant's gender, marital status, educational level, stress, and smoking habits. Conclusion: Most of the IBD patients suffered from significant ocular manifestations with frequent hospital visits. Misdiagnosis and/or inadequate management negatively affect the quality of life of IBD patients during the COVID-19 pandemic. Risk-based Ophthalmic screening strategy may reduce the impact of IBD. [ABSTRACT FROM AUTHOR]

The most blooming and successful software among them are: Linux Operating System, Mozilla, Apache web server and Openoffice.org [1]. The FOSS is being viewed by many as its being good in terms of their usage, reliability, performance and market share. The major focus of open source software developer is on functionality and the features which are useful, easy to use by the users. The major advantages of FOSS and its importance is the usability of open source applications which are embedded in most Linux OS and how it can be measured by assessing user performance such as, satisfaction, effectiveness and acceptability. Linux is a freely available Operating System in different flavours and with different languages. The Linux feature set is similar to the feature set of Microsoft Windows. [ABSTRACT FROM AUTHOR]