Issue 1 (August)

Background

We conducted a meta-analysis to assess the eosinophil counts in the small intestine and colon of children without obvious gastrointestinal disease.

There are now a variety of viewpoints on eosinophil counts in the small intestine and colon of children without obvious gastrointestinal disease, and there are not many thorough assessments that are pertinent.

Methods

A systematic literature search up to July 2022 was performed and 2378 related studies were evaluated. The chosen studies comprised 1800 children without obvious gastrointestinal disease participated in the selected studies' baseline trials; 607 of them were colonic eosinophilia, while 1193 were normal. Odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the eosinophil counts in the small intestine and colon of children without obvious gastrointestinal disease by the dichotomous, and contentious methods with a random or fixed effect model.

Results

The colonic eosinophilia resulted in significantly higher cell counts in the duodenum and terminal ileum (MD, 9.66; 95% CI, 6.50-12.81, p<0.001) compared to the normal for children without obvious gastrointestinal disease.

However, no significant difference was found between colonic eosinophilia and normal for children without obvious gastrointestinal disease in cell counts in the large intestine and the rectum (MD, 13.25; 95% CI, 0.17-26.33, p=0.05).

Conclusions

The colonic eosinophilia resulted-in-significantly-higher-cell-counts-in-the-duodenum-and-terminal-ileum,-however,-no-significant-difference-was-found-in-cell-counts-in-the-large-intestine-and-the rectum compared to the normal for children without obvious gastrointestinal disease. The small sample size of 8 studies out of 15 and the small number of studies in certain comparisons calls for care when analyzing the results.

The COVID-19 pandemic showed us that the world should have a proper protocol for the handling of such pandemics. A similar severe coronavirus pandemic occurs in 1918 (The spinach flu pandemic) and took two years to finish. Both pandemics took a lot of lives.

The 1918 Spanish flu pandemic was prevented with lower healthcare facilities. The main prevention method was social distancing. The effect of this social distancing was obvious when it was broken in Denver, the USA with its double-humped mortality curve of the Spanish flu pandemic in 1918. Even though this pandemic is also a coronavirus pandemic but some differences were observed in COVID-19. This commentary was to discuss the situation that occurs in COVID-19 and compare it to the Spanish flu pandemic in 1918 to reach a protocol for handling any possible upcoming coronavirus pandemics.

Background: The aim is to present an electronic CPR calculator combined with CDSS (clinical decision support system) as a safer and faster method for CPR calculation than manual calculation.

Methods: A group of 70 nurses were randomly selected to calculate a CPR card and then enter the patient data into the CPR calculator. The time needed to complete the calculations and the time needed to enter patient information into the CPR calculator were measured. In addition, the number of medication calculation errors were recorded.

Result: The time to finish the CPR card manually was 00:08:31 minutes and the time to generate the CPR card electronically was 00:01:15. The number of nurses who made errors in manual calculation was 23, the total number of errors was 101. There were no errors with the calculator.

Conclusion: The CPR calculator has provided an accurate (with no errors) and faster way to generate CPR cards compared to the manual method.

Background: Measurement of educated people knowledge about COVID-19 is important to enhance health measures to reduce the rate of infection. Also, knowing the most usable source of data for the public is important point for enhancing the public awareness about the disease. Hence, this study aimed to evaluate the awareness and the practices related to COVID-19 among educated people.

Methods: 360 participant received a questionnaire that was divided into several parts aimed at collecting data about participant awareness regarding COVID-19. Data collected using a designed questionnaire; to evaluate the knowledge related to COVID-19. The questionnaire was classified into 6 parts covering all aspects of COVID-19 awareness data. The first part was to evaluate the respondent’s general knowledge [6 items]; the second was to evaluate symptoms knowledge [1 item]; the third was to evaluate transmission knowledge [2 items]; the fourth was to evaluate preventive knowledge [4 items]; the fifth was to evaluate treatment knowledge [2 items] and the sixth was indicted the main source of gathering information about the disease [1 item].

Results: A total of 360 participants participated, 91% of them know the main clinical symptoms of COVID-19. 86% believed that following preventive measures (the etiquette of sneezing, coughing, personal hygiene or wearing a mask) reduce infection transmission. More than 90 % of participants used the social media for gathering information about the disease, while highly educated (Master and PhD holders) used the published articles as a source for their knowledge, however they represent a few percent of the participant.

Conclusion: Overall, the study participants had good knowledge about COVID-19, however, more efforts are needed to maximize the awareness of the public. Further clinical study is required to evaluate the effect of such good knowledge on decreasing the infection rate.

Background: The objective of this study was to compare the cost of outpatient ferric carboxymaltose (FCM; Ferinject®) versus Iron sucrose complex (ISC; Ferosac®), two prevalent intravenous iron therapy used in the treatment of iron-deficiency anemia (IDA) in the Kingdom of Saudi Arabia (KSA) from a tertiary care hospital perspective.

Methods: A retrospective study was performed for all patients who were administered FCM in the outpatient clinical setting at Prince Sultan Military Medical City from January 1, 2019, until December 31, 2019. The descriptive data was analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA). The total cost of treatment reflected the cost of drugs, the cost of disposables for each infusion, drug monitoring costs during infusion, the cost of productivity loss, and patient traveling cost.

Result: Overall, 993 patients with IDA, treated with FCM in 1,688 outpatient visits were recruited in the study. In the outpatient setting, the per annum cost of treatment was SAR 1,434,092.50 with FCM treatment and SAR 1,715,299.70 with ISC treatment, with a corresponding saving of 16.4% (SAR 281,207.20) with FCM. The cost savings with FCM treatment can be attributed to the reduced frequency of patient visits and corresponding reduction in drug monitoring costs (SAR 266,995.20;77.3%), loss of productivity per year (SAR 163,550.20; 77.3%), and cost of transportation per year (SAR 573,920.00; 77.3%).

Conclusion: The use of FCM, as opposed to ISC resulted in a reduced number of iron infusions (4.4 visits for ISC as compared to one visit for FCM), accompanied by a reduction in the total cost. FCM may represent a cost-saving option compared with the existing alternative therapy used for the management of IDA in KSA.