Endotracheal Oxygen Insufflation Associated with Life-Threatening Barotrauma during Apnea Testing.

Apnea testing is a standard method when diagnosing brain or more specifically brainstem death; however, it is imperative to acknowledge the potential for lung injury during this procedure and follow clinical practice guideline recommendations that may reduce the risk of complications. Two cases of barotrauma leading to pneumothorax occurred during apnea tests that used higher-than-recommended oxygen flow rates. Additional data are necessary to clarify the mechanism and incidence of this life-threatening complication.

Beyond borders: Exploring the mental, emotional, and spiritual significance of Hajj.

For Muslims all across the world, the desire to participate in the religious rites of the Hajj (pilgrimage to Mecca) which stands as one of the five pillars of Islam is a heartfelt longing. It stands for the pinnacle of devotion and spiritual gratification, luring followers to the most sacred city in Islam for a life-changing journey of faith, comradery, and submission to Allah. Muslims hold Mecca in the highest regard; it is a source of endless inspiration and devotion throughout their lives, as seen by their desire to undertake the Hajj and Umrah.

Microbial surveillance of Hajj tents: Bioaerosol sampling coupled with real-time multiplex PCR.

Background: Respiratory tract infections are common among pilgrims attending annual Hajj in Mecca, Saudi Arabia. Pilgrims typically spend most of the Hajj period inside ventilated tents, where microorganisms may be transmitted through bioaerosols and droplets.

Objective: To perform microorganism surveillance inside Hajj tents and assess the similarities between microorganisms isolated from tent bioaerosol samples and nasopharyngeal swabs (NP) of tent occupants.

Assessment of anti-factor Xa activity in critically ill COVID-19 patients receiving three different anticoagulation regimens.

Introduction: Critically ill COVID-19 patients are at increased risk of thrombosis with an enhanced risk of bleeding. We aimed to explore the role of anti-factor Xa levels in optimizing the high-intensity anticoagulation's safety and efficacy and finding possible associations between D-dimer levels, cytokine storm markers, and COVID-19-induced coagulopathy or thrombophilia.

Methods: Retrospective cohort study conducted on 69 critically ill COVID-19 patients who received three regimens of higher intensity anticoagulation.

Nephroprotective effect of pigmented violacein isolated from in wistar rats.

The present study aimed to analyze the nephroprotective property of violacein obtained from the bacterium, . The nephrotoxicity in the animal model was induced by gentamicin, potassium dichromate, mercuric chloride, and cadmium chloride-induced nephrotoxicity in the Wistar rats was analyzed by measuring the serum creatinine, uric acid, and urea level. The present investigation revealed the nephroprotective property on convoluted proximal tubule (S1 and S2 segments) and the straight proximal tubule (S3 segment).

Removal of nitrogen from wastewater of date processing industries using a Saudi Arabian mesophilic bacterium, Stenotrophomonas maltophilia Al-Dhabi-17 in sequencing batch reactor.

The main aim of the present study was to assess the technical feasibility of nutrients removal from the wastewater from the date processing industries in sequencing batch reactor. Heterotrophic nitrifying and aerobic denitrifying bacteria were isolated from the soil sediment samples. The bacterial strain Al-Dhabi-17 effectively removed nutrients than other isolates from the wastewater and characterized as Stenotrophomonas maltophilia Al-Dhabi-17.

Theoretical analysis of evaporative cooling of classic heat stroke patients.

Heat stroke is a serious health concern globally, which is associated with high mortality. Newer treatments must be designed to improve outcomes. The aim of this study is to evaluate the effect of variations in ambient temperature and wind speed on the rate of cooling in a simulated heat stroke subject using the dynamic model of Wissler.

Unusual case of central alveolar hypoventilation.

Central alveolar hypoventilation is rarely encountered. This case report describes a young woman who was recently diagnosed with hypertension and ischemic heart disease. She presented to the emergency room with hypercapnic respiratory failure, for which she was mechanically ventilated.

Assessment of antigen presenting cell infiltration in lung tissues of patients with bronchiectasis.

Background: Bronchiectasis is a chronic disease characterized by permanent dilatation of the conducting airways accompanied by sustained inflammation.

Aims: To assess whether chronic inflammation of lungs in bronchiectasis is associated with alterations in the numbers of infiltrating antigen presenting cell (APC).

Setting And Design: Lobectomy specimens from 12 nonsmoker, nonasthmatic patients with acquired (noncongenital) bronchiectasis and six control patients were included in the study.

Can computed tomography and carbon monoxide transfer coefficient diagnose an asthma-like phenotype in COPD?

Background And Objective: Post-mortem and computed tomography (CT) studies indicated that emphysema is a feature of COPD even in the 'blue bloater/chronic bronchitis' type. We aim to test the hypothesis that the non-emphysematous patients are distinct from the main body of COPD and are more akin to asthmatic patients.

Methods: We studied 54 patients with COPD.

The Levels of Tissue Factor Pathway Inhibitor in Sepsis Patients Receiving Prophylactic Enoxaparin.

Objective: Sepsis syndrome is usually accompanied by activation of blood coagulation mechanisms. Earlier studies found deficiencies of the 3 main natural anticoagulants, antithrombin, protein C, and protein S. However, none of these inhibitors block tissue factor, the prime trigger of coagulation during sepsis that is controlled specifically by the tissue factor pathway inhibitor (TFPI).

A case of near fatal asthma: The role of ECMO as rescue therapy.

We report a case of an adolescent with near fatal asthma (NFA). He presented with severe hypoxemia and lifethreatening acidemia, who failed to respond to conventional therapy. His hospital course was complicated by barotrauma and hemodynamic instability.

Descending necrotizing mediastinitis.

Descending necrotizing mediastinitis (DNM) is a rare but severe life threatening complication of oropharyngeal infections. We report a young lady who had severe pharyngitis complicated by anterior neck infection that descended to the mediastinum causing necrotizing mediastinitis. The course of her illness was complicated with septic shock, acute kidney injury, tracheo-esophageal fistula, and critical illness polyneuropathy.

Bronchoscopy as a rescue therapy in patients with status asthmaticus: Two case reports and review of literature.

Management of status asthmaticus requires more than guidelines-guided therapy. Occasionally, uncommon therapeutic interventions and procedures may provide significant benefits. The role of bronchoscopy in fatal asthma is still not clearly defined.

Protocolized eye care prevents corneal complications in ventilated patients in a medical intensive care unit.

Background: Eye care is an essential component in the management of critically ill patients. Standardized eye care can prevent corneal complications in ventilated patients.

Objective: This study was designed to compare old and new practices of corneal care for reduction in corneal complications in ventilated patients.

Venous thromboembolism in a medical intensive care unit. The effect of implementing clinical practice guidelines.

Objective: To determine the incidence of VTE in medical patients admitted to the intensive care unit (ICU) following the implementation of a standard deep venous thrombosis (DVT) prophylaxis protocol using unfractionated heparin (UFH), and to identify risk factors for DVT in these patients.

Methods: We prospectively studied 123 consecutive patients admitted to the Medical ICU of King Khalid University Hospital, Riyadh, Saudi Arabia. We excluded patients on anticoagulation or with contraindications for heparin.

Prediction of pulmonary hypertension in patients with or without interstitial lung disease: reliability of CT findings.

Purpose: To study the reliability of pulmonary vascular measurements based on computed tomography (CT) in the prediction of pulmonary hypertension (PH) in patients with advanced interstitial lung disease (ILD) compared with those without ILD.

Materials And Methods: The study was approved by the Institutional Review Board. All patients gave written informed consent.

Respiratory tract infection during Hajj.

Respiratory tract infection during Hajj (pilgrimage to Mecca) is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M.

Yield and complications of flexible fiberoptic bronchoscopy in a teaching hospital.

Objective: To assess the diagnostic yield and safety of flexible fiberoptic bronchoscopy (FFB).

Methods: A retrospective review of bronchoscopy reports and corresponding patients charts over 3 years from January 2004 - December 2006 in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. Indication for procedure, suspected diagnosis, final diagnosis, and complications were reported.

Right and left ventricular function and pulmonary artery pressure in patients with bronchiectasis.

Background: Bronchiectasis may have deleterious effects on cardiac function secondary to pulmonary hypertension (PH). This study was designed to assess cardiac function and determine the prevalence of PH in patients with cystic and cylindrical bronchiectasis.

Methods: A cross-sectional study of patients with bronchiectasis diagnosed by CT scan was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between December 2005 and January 2007.

Survival of bronchiectatic patients with respiratory failure in ICU.

Background: The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. This study aims to identify the in-hospital and long-term outcome of patients with bronchiectasis and respiratory failure (RF) in ICU.

Outcome of patients with severe asthma in the intensive care unit.

Background: Because little has been reported about the outcome of severe asthma outside the US and western Europe, we performed a retrospective case analysis of patients treated in the medical intensive care unit (MICU) of a university hospital in Riyadh, Saudi Arabia, to determine the management, complications and outcome of severe asthma requiring ICU admission.

Methods: The records of patients with severe asthma admitted to the MICU between the periods of January 1996 to December 2003 were reviewed. Sixty-one episodes from 54 patients were studied, of which 27 (44%) were male.

Recent advances in the diagnosis and treatment of deep vein thrombosis: a regional consensus.

Considerable progress has been made in the understanding of the risk factors for venous thromboembolism (VTE). The clinical applications of molecular techniques have allowed identification of important inherited, yet not uncommon, risk factors for VTE, such as mutations that cause Factor V Leiden and prothrombin G20210A. However, advances in our understanding have raised several questions regarding the need for, and duration of anticoagulation.