Knowledge, perception and acceptability of breastfeeding and bottle feeding among Saudi population

Despite the enormous benefits of breastfeeding (BF), its prevalence is suboptimal, with exclusive BF ranging between 7.3 % and 51% in the Saudi community. The aim of this study was to assess the Saudi community's knowledge regarding BF, exposure to BF promotional messages and formula milk advertisements and acceptability of BF in public places. It was a cross-sectional study that included Saudis aged 20-55 years old between December 2019 and June 2020. It utilised a self-administered questionnaire, which asked about background information, knowledge of BF, exposure to BF-promoting messages and exposure to formula milk advertisements and acceptability of BF versus bottle feeding in public. Data were analysed using the Statistical Package for the Social Sciences (SPSS v. 22). For the analysis, a p-value <0.05 was considered significant. The sample included for analysis was 914. The mean age of participants was 33.8 ± 9 years. The majority of participants were female 823 (90%); males 87 (10%). The vast majority (94%) agreed that breast milk is more beneficial than formula milk. Nearly two-thirds (61%) were continuously exposed to messages advertising formula feeding, compared to only 35% who were exposed to messages promoting BF. The study found that 67.2% accept BF in public places. Among male participants, only 49% accepted BF in public places compared to 79% of female participants who accepted it; p-value <0.001. Acceptability of BF in public places was significantly higher among participants who had family members who breastfed (68%), compared to those who did not (50%), (p-value 0.01).

Neurological complications in children with infective endocarditis: Incidence, risk factors, and outcome: A 10-year single-center experience

BACKGROUND AND OBJECTIVE

Despite improvement in medical management, infective endocarditis (IE) remains a serious disease that may affect children with and without preexisting cardiac conditions with significant morbidity and mortality. Neurological complications of IE represent the worst with guarded prognosis. The aim of this study is to describe the incidence, etiology, characteristics, risk factors, and outcome of children with neurological complications associated with IE.

MATERIAL AND METHODS

A retrospective cohort study was conducted from 2009 to 2019 where all pediatric patients who fulfilled the modified Duke criteria for IE were included. We divided the cases into 2 groups: IE with neurological complications and IE without neurological complications control group. We compared the two groups statistically and analyzed the results.

RESULTS

We identified 31 (17 male, 14 female) patients with IE. Neurological complications occurred in 7/31 (23%) patients, mainly in the form of a stroke. Gram-positive microbes were the main causative agents for IE (52%) followed by gram-negative (14%), then fungal organisms (3%). Univariate analysis identified the following risk factors for neurological complications: lower body weight, higher C- reactive protein (CRP) level, and left-sided valvular lesions with P values of (0.0003, 0.0001, and 0.04), respectively.Although mortality was higher in the neurological complications group, it was 43% in comparison to 21% in the control group and it did not reach statistical significance (P = .49). Large vegetation size (more than 10 mm) was seen in 57% of patients with neurological complications as compared to 16% in the control group (P = .052).

CONCLUSION

Neurological complications occurred in almost a quarter of children with IE. Possible risk factors include lower body weight, left-sided valvular lesion, and higher levels of inflammatory markers (CRP). Stroke was the most common neurological complication encountered with possible increased risk of mortality.

Effect of Fasting the Whole Month of Ramadan on Renal Function Among Muslim Patients With Kidney Transplant: A Meta-Analysis

OBJECTIVES

Muslim renal transplant patients often ask whether fasting during Ramadan would be harmful to their kidneys. We performed a meta-analysis on relevant studies to answer this question.

MATERIALS AND METHODS

We searched 4 databases using comprehensive search terms with predefined eligibility criteria. Two reviewers (FH and RA) independently assessed the relevance of studies obtained during the search. If disagreement occurred, a consensus would be sought; if disagreement persisted, the arbitration would be left to a third author (AAS).

RESULTS

Eight studies (549 patients) were identified as eligible; these studies measured renal function before and after Ramadan with patients acting as their own controls in 5 studies. Our pooled analyses showed no significant changes after fasting with regard to estimated glomerular filtration rate (70.1 ± 9.1 vs 68.5 ± 7.5 mL/min, respectively; P = .6) or in serum creatinine levels (105.3 ± 8.8 and 106.1 ± 6.0 μmol/L, respectively; P = .47). In 4 self-controlled studies (148 patients) that had analyzed changes in systolic and diastolic blood pressure before versus after fasting, no significant differences were shown. However, in 3 studies that assessed changes in glomerular filtration rate in fasting (n = 358) versus nonfasting patients (n = 355), there was a significant difference in change in glomerular filtration rate following Ramadan fasting (-0.13 ± 1.2 mL/min in those who fasted versus 4.2 ± 4.6 mL/min in those who did not fast; P = .039); however, these results were associated with significant publication bias (systematic heterogeneity).

CONCLUSIONS

Fasting during Ramadan did not result in significant changes in kidney function or blood pressure in posttransplant patients with good baseline kidney function when patients acted as their own controls.