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Objectives To evaluate the prevalence of back pain among staff who regularly use lead aprons, correlating this to their use, and improve the knowledge and understanding of lead apron use among staff. Methods A questionnaire study was undertaken from November 2018 to February 2019 on staff in departments using lead aprons on a routine basis (n = 59) defined as the study group (SG), and staff who did not wear lead aprons (n = 62) defined as the control group (CG). Additionally, a separate questionnaire (n = 43) was distributed to lead apron users regarding education and knowledge, following which an education session was set up and the staff was re-evaluated. Results The prevalence of back pain was higher in the SG; 63% (SG) versus 32% (CG). The proportion of staff that felt lead aprons (SG) or work (CG) was the cause of this back pain was also higher in the SG than the CG 83% versus 37%. A significant proportion of staff was unaware of the lead equivalence, material, and types of lead aprons available, after education this improved; 92% of staff now think more carefully when choosing a lead apron. Discussion Back pain is prevalent among staff using lead aprons and a lack of education regarding their use is evident. This could result in time off work and lead to unsafe practices around ionizing radiation. Education improved the knowledge and understanding of lead apron use. This could lead to increased comfort and less strain on the back, potentially lowering the prevalence of back pain.

This study sought to evaluate the main causes of hospitalization of patients with systemic lupus erythematosus (SLE) in a tertiary health center in Saudi Arabia.

A retrospective observational study was performed for all the SLE patients admitted to King Saud Medical City between 2016 and 2019. The primary reason for hospitalization was determined by the primary physician caring for the patient at the time of admission.

Of the 98 hospitalizations for SLE, 49% of patients were admitted from the emergency department (ED) and 51% from the rheumatology clinic. The most common reason for hospitalization was lupus flare (68.4%) followed by infection (20.4%). The lupus flare patients commonly presented with

(MSK)symptoms (34.6%), renal manifestations (25.5%), and skin rash (24.5%), whereas patients admitted with infection were commonly diagnosed with community-acquired pneumonia (12.2%). Other hospitalization causes were obstetric complications, adverse drug reactions, and thrombosis. Intensive care unit (IC. Other hospitalization causes were obstetric complications, adverse drug reactions, and thrombosis. Intensive care unit (ICU) admission was necessary for 7% of patients due to acute respiratory distress syndrome (ARDS) and pulmonary hemorrhage (28.6%) or other reasons (14.1%), such as pleural effusion, cardiac tamponade, and thrombotic thrombocytopenic purpura (TTP). Conclusions The two most common reasons for SLE hospitalization were lupus flare and infection. Lupus flare was mainly due to MSK, renal, and dermatologic manifestations. The most common infection leading to hospitalization was community-acquired pneumonia, and ICU admission was mainly due to ARDS and pulmonary hemorrhage.Atrial fibrillation is a commonly encountered clinical entity with various cardiovascular consequences. Common risk factors include alcohol abuse, hyperthyroidism, mitral stenosis, hypertension, diabetes mellitus, and coronary artery disease. Another risk factor, yet under scientific scrutiny, is hiatal hernia. This anatomical abnormality, due to its proximity to the heart and high prevalence in atrial fibrillation patients, has merited scientific investigation to determine if an association truly exists between this gastrointestinal pathology and atrial fibrillation. The case herein is of an 81-year-old hospitalized female with a hiatal hernia who was recorded to have recurrent episodes of atrial fibrillation in the absence of traditional risk factors for arrhythmogenesis.Linea arcuate herniae (LAH) are rare and usually asymptomatic but can present with generalized abdominal pain in the absence of bulging and are impalpable. Diagnosis is dependent on cross-sectional imaging, and operative approach to their management is debatable. Here, we report the case of a 56-year-old female with abdominal pain diagnosed with a linea arcuate hernia by computed tomography (CT) scan. She went on to have laparoscopic primary suture closure of the hernial defect with reinforcing underlay mesh. LAH are effectively elucidated with CT. Although there are concerns regarding mesh-related complications, we advocate a laparoscopic approach and repair with prosthetic mesh reinforcement, fixated with sutures. Long-term follow-up of these patients is still required.Background and objective Menstrual irregularities and sociodemographic factors such as increasing age, Hispanic race, low socioeconomic strata, and low income status are known risk factors for cervical cancer. This study aimed to examine the prevalence of cervical cancer and its association with menstrual irregularities and other known risk factors based on a large nationwide inpatient sample database. Methods We used the Nationwide Inpatient Sample (NIS) database for the year 2017 and identified cases where cervical cancer and menstrual irregularities are the primary and co-occurring diagnoses using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Pearson's chi-square test, independent-sample t-test, and multiple logistic regression were used to generate the analysis. Results A total of 15,800 (0.19%) female weighted admissions between the age group of 18-55 years reported a diagnosis of cervical cancer. Patients with a diagnosis of menstrual irregularity had a statistically significant higher odds of association [odds ratio (OR) 1.582] for being diagnosed with cervical cancer. The odds of association were also high for the Hispanic race [OR 1.280, 95% confidence interval (CI) 1.128-1.453]. MI503 The odds of a diagnosis of cervical cancer increased with age, with the highest odds being reported for the age group of 46-55 years (95% CI 12.107-21.171) and the population with lower median household income, with the highest odds being observed for the lowest interquartile range (95% CI 1.418-1.892). Conclusion Based on our findings, a diagnosis of menstrual irregularity, the Hispanic race, increasing age, and lower household income are factors that significantly increased the odds of being diagnosed with cervical cancer.Over the years, medical education delivery has seen a change from teacher-centric to student-centric teaching-learning methods. Educators are constantly looking to develop interactive and innovative teaching-learning tools. One such supplementary tool is the use of the quiz for medical education. The Quiz has been used traditionally as a feedback assessment tool, but lately, it has found its way into the medical curriculum, mostly informally. The few available documented studies on the Quiz as a teaching and learning tool illustrate its acceptance and impact on the stakeholders. It could be one of the solutions to the endless search for a student-centric and engaging tool to deliver the medical curriculum. Commonly, the format for medical quiz is either on a case-based or image-based approach. Such an approach helps bridge the gap between traditional classroom teaching and clinical application. The Quiz is a readily acceptable tool that complements didactic lectures and improves students' learning and comprehension. Being an interactive student-centric tool, it enhances active student participation and encourages regular feedback mechanisms. It promotes healthy competition and peer-assisted learning by encouraging active discussion among students, hence improving student performance in standard examination techniques, along with teacher satisfaction. This literature review aims to enumerate the various formats of the Quiz, their role in improving the understanding and retention of knowledge among the students and assess their acceptability among the stakeholders.Dapsone overdose is a well-known potent cause of methemoglobinemia and hemolytic anemia. We discuss a case of a two-year-old male who developed severe persistent methemoglobinemia treated with multiple doses of methylene blue (MB), multidose activated charcoal, and vitamin C. Methylene blue infusion (rather than bolus dosing) aided in controlling this patient's methemoglobin (MetHb) levels and symptoms and may reduce the total needed dose.

Our goal was to assess the demographics, risk factors, and hospital admission and length of stay (LOS) among patients with acute COVID-19 and to identify whether age, smoking status, race, risk factors, and sex significantly affect the severity of illness according to hospitalization or admission to the intensive care unit (ICU). Severity was defined as admission to the hospital or ICU.

This retrospective cohort chart review included patients who received care from March 13 to August 17, 2020, at a single academic medical center. Age, COVID-19 risk factors, sex, race, smoking history, and hospital LOS were analyzed with hospital admission and ICU admission. Categorical variables were summarized.

The chart review assessed 1,697 adult patients with various degrees of severity of COVID-19 illness 23 patients had been admitted to the hospital, and 7 had been admitted to the ICU. Older age and more COVID-19 risk factors, as defined by the Centers for Disease Control and Prevention, were significantly associated with hospital admissions, and longer LOS was statistically associated with ICU admission.

Severe COVID-19 infection was associated with older age and more risk factors. Current smoking status, sex, and race were not significantly different between hospitalized patients with severe COVID-19 infection who were admitted to the ICU and those who were not admitted to the ICU.

Severe COVID-19 infection was associated with older age and more risk factors. Current smoking status, sex, and race were not significantly different between hospitalized patients with severe COVID-19 infection who were admitted to the ICU and those who were not admitted to the ICU.Background Although evidence has emerged indicating that patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia present a high risk of venous thromboembolism (VTE), its real incidence and best diagnosis course remain unclear. In this study, we aimed to determine the incidence of pulmonary embolism in these patients and the role of D-dimer serum level as a predictive factor of a new VTE event. Methodology This was a single-center retrospective observational cohort study conducted in a tertiary hospital. All patients admitted to the infectious diseases ward with SARS-CoV-2 pneumonia with clinical or laboratory criteria for suspected VTE events were eligible for inclusion in the study. The t-test or Mann-Whitney U test was used to analyze the differences between the with-VTE group and the without-VTE group. Results Overall, VTE incidence was registered to be 30%. Chest computed tomography angiography data revealed thrombus mainly in segmental (five patients, 71%) and subsegmental pulmonary artery branches (four patients, 57%).