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Nov 2025 DOI 10.14302/issn.2694-2283.jsem-25-5730
Objective The goal of this systematic review is to identify common themes amongst acute spinal cord injuries (SCI) in equestrian athletes. Design A systematic review was performed using PubMed, CINAHL Plus with Full Text (EBSCO), Cochrane Library, and Scopus with pre-determined MESH terms. The initial search returned 354 studies. Following PRISMA guidelines, 13 articles were included. Exclusion criteria included injuries to the horse only, non-English language, cauda equina, and case reports. Data extraction was completed, and common findings were evaluated narratively due to heterogeneity of data. Results Seven manuscripts listed specific horse-related activities that caused SCI, with fall from horse as the highest percentage of injury. Nine articles identified the injury region, with large variations and no clear dominant area of injury. Five articles identified the length of hospital stay with ranges from 1 to 82 days. Four articles looked at the association of professional vs non-professional riders. Only two articles evaluated helmet use at time of injury, with one article showing 81% of those with SCI used helmets, and the other showing only 35.6% utilized this safety measure. Conclusion SCI in equestrian athletes can have a wide presentation, with large variation on location of injury, length of stay, and other factors. However, non-professional riders are at greater risk of SCI and individuals are more likely to sustain injury from a fall from a horse rather than a kick or another modality of injury. Future study can elicit presenting symptoms, types of surgical intervention used, and long-term outcomes and recovery.
Jul 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5616
Objectives Blood transfusions in cardiac surgery are associated with increased morbidity and mortality. The purpose of this study is to identify potential benefits of ANH in high-risk cardiac surgery. Design This was a prospective, randomized, controlled study. Setting The study was performed at a tertiary care university hospital. Participants 61 patients who underwent complex cardiac surgery with cardiopulmonary bypass (CPB) were enrolled in the study. Measurements and Main Results After randomization, 32 patients were assigned to the ANH arm, and 29 patients were assigned to the control group. ANH was associated with a lower incidence of total perioperative pRBC transfusion (0.6 ± 1.2 units vs 2.7 ± 6.8 units; p = 0.030/0.049). Total perioperative transfusion of all other fractionated blood products, including platelets (0.8 ± units vs 1.9 ± 2.4 units; p=0.010), cryoprecipitate (0.5 ± 0.7 vs 1.3 ± 2.0; p=0.016) and FFP (0.5 ± 1.0 vs 2.3 ± 6.2 units; p=0.013), was significantly lower in the ANH group compared to controls. Participants in the ANH group received significantly fewer intraoperative transfusions of pRBC (0.4 ± 1.2 vs 2.6± 7.0 units; p=0.037), platelets (0.8 ± 1.2 units vs 1.9 ± 2.4 units; p=0.013, logtrans), FFP (0.4 ± 0.9 vs 2.5 ± 6.4 units; p=0.003) and cryoprecipitate (0.5 ± 0.7 vs 1.3 ± 2.1 units; p=0.012, logtrans). With respect to secondary clinical outcomes, ANH participants had statistically shorter ICU (3.7 ± 1.9 vs 5.4 ± 3.6 days; p=0.020) and hospital (6.7 ± 2.1 vs 9.5 ± 7.7 days; p = 0.048) length of stays Conclusions ANH in complex cardiac surgical patients is safe and may be effective in reducing the allogenic blood product transfusion of PRBCs, FFP, platelets and cryoprecipitate in the perioperative period.
May 2022 DOI 10.14302/issn.2379-7835.ijn-22-4190
Background Nutrition support during the acute phase post allogeneic haematopoietic stem cell transplantation (HSCT) is required to optimise short- and long-term outcomes for children. An algorithm was developed and evaluated to assist clinicians to make objective and consistent enteral feeding decisions. Methods The algorithm was evaluated on all patients who underwent allogeneic HSCT treatment between November 2017 - February 2019. Results Of the 48 patients, 43 had a nasogastric tube (NGT) inserted, of which 36 patients received a hydrolysed peptide-based formula, 5 patients received a whole protein formula only and 2 patients were fed an amino acid-based formula. Parenteral nutrition (PN) was used in 41 of the patients. Eleven did not have an NGT in-situ at the commencement of HSCT. Of the remaining 37 patients, 26 followed the algorithm and 11 patients did not comply. The group of patients who did not follow the algorithm had the longest median length of stay (LOS) of 49 days. Patients receiving only EN had the lowest median LOS of 30 days. The two groups that reported better weight outcomes were those who followed the algorithm and those who were fully EN fed. Conclusions Effective use of the HSCT feeding algorithm indicated improved patient outcomes for children undergoing HSCT, with better weight outcomes and reduced LOS. Recommendations to improve the efficacy and compliance of the algorithm include regular education/input to the oncology medical teams to better understand objective thresholds for EN and PN commencement.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3652
Background The use of hydroxychloroquine in coronavirus disease (COVID-19) pandemic raised significant concerns as regards safety and efficacy in hospitalized patients. The objective was to examine the effect of hydroxychloroquine on clinical improvement and mortality among hospitalized patients with COVID-19. Methods A prospective cohort study was conducted at four general hospitals in the Western region, Saudi Arabia. Patients who had absolute or relative contraindication for using hydroxychloroquine were excluded. Patients concomitantly receiving other medications including azithromycin, antivirals, and supportive treatment were not excluded. Results A total 267 patients were included in the current analysis; 185 (69.3%) on hydroxychloroquine and 82 (30.7%) on non-hydroxychloroquine treatments. The average age was 46.0±13.3 years and 78.3% of the patients were males. Approximately 95.9% of the patients were symptomatic with mild (50.6%), moderate (32.6%), severe (8.2%), or ARDS symptoms (4.5%). Compared with no hydroxychloroquine, those on hydroxychloroquine had significantly longer length of stay (11.5±7.1 versus 7.8±4.3 days, p<0.001), more ICU admission (22.7% versus 9.8%, p=0.012), and more intubation (12.4% versus 3.7%, p=0.026). Improvement of symptoms (84.3% versus 81.7%, p=0.595) and hospitalization death (7.0% versus 1.2%, p=0.071) were not significantly different between groups. With exception of length of stay, the association of hydroxychloroquine with the above negative outcomes disappeared after adjustment for several factors including disease severity and concomitant use of azithromycin. Conclusions Hydroxychloroquine is not associated with better improvement of symptoms compared with other treatments. Moreover, it is associated with longer length of stay but not mortality or ICU admission in adjusted analysis.
Feb 2019 DOI 10.14302/issn.2690-4837.ijip-18-2515
Surgical site infections (SSI) have a high incidence, accounting for 20% of all hospital-acquired in-fections. Surgical site infections are linked to a increased length of stay and the risk of mortality. Although most patients recover from an SSI, 77% of mortality can be attributed to the infection it-self 14. The incidence of SSI is 2% to 5% undergoing inpatient surgery 1. Estimated annual in-cidence varies, but may range from 160,000 to 300,000 in the US 14. These estimates might be understated, given the surveillance failure after discharge
Aug 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1200
Objective: To assess mortality, medical complications, and care indicators among stroke patients admitted to general medical units at King Abdulaziz Medical City-Jeddah-Saudi Arabia. Methods: This retrospective cohort study included all adult patients (>16 years) admitted to KAMC-Jeddah between January 1, 2014, and June 30, 2015, with acute stroke. Data regarding in-hospital stroke mortality and medical complications (pressure ulcer, pneumonia, venous thromboembolism dysphagia, and wheelchair dependency) and stroke care indicators (time-to-CT, carotid imaging, lipid profile, physical therapy, swallowing assessment, nutritional assessment, and length of stay) were collected. Results: Patients included were 208. Acute stroke mortality was 19%, while wheelchair dependency, and dysphagia on discharge were 39% and 56% respectively in general medical units. The incidence of pressure ulcers, pneumonia, and venous thromboembolism was 17%, 14%, and 3%, respectively. Pneumonia (odds ratio OR, 5.5; P = 0.002; 95% confidence interval CI, 1.9–16), abnormal troponin level (OR, 4.4; P = 0.002; 95% CI, 1.7–11),hemorrhagic stroke (OR, 3.9; P = 0.015; 95% CI, 1.3–12), and pressure ulcers (OR, 3.0; P = 0.036; 95% CI, 1.1–8.0) were significantly associated with increased mortality. Median time to CT scan was 117 minutes. Carotid imaging was performed for 67% of ischemic stroke patients, and 65% underwent fasting lipid profile assessment. Assessment by nutritionist, physiotherapist, and swallowing therapist was done for 90%, 76%, and 53% of stroke patients respectively. The median length of stay was 12 days. Conclusion: Acute stroke mortality was 19 %, while wheelchair dependency, and dysphagia on discharge were 39% and 56% respectively in general medical units at KAMC Jeddah. Pneumonia, abnormal troponin, hemorrhagic stroke, and pressure ulcers are associated with increased mortality. Future research is needed to compare outcomes of stroke care between general units and specialized stroke units nationally.