Browsing by Author "Khan, Amjad"

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    A 20-year retrospective clinical analysis of Candida infections in tertiary centre: Single-center experience
    (Elsevier, 2022) Muzaheed; Alshehri, Bashayer A.; Rabaan, Ali A.; El-Masry, Omar S.; Acharya, Sadananda; Alzahrani, Faisal M.; Al Mutair, Abbas; Alhumaid, Saad; Al-Tawfiq, Jaffar A.; Muhammad, Javed; Khan, Amjad; Dhama, Kuldeep; Al-Omari, Awad; Medicine, School of Medicine
    Introduction: Fungal infections have risen exponentially in the last decade. In fact, candidiasis has become the most frequent type of hospital acquired infection especially in patients receiving treatment for chronic and terminal illnesses in a hospital. A retrospective analysis for a period of twenty year was undertaken to analyze the incidence rate of candidiasis, especially of Candida species, patients treated in a tertiary care center. Materials and methods: Clinical data was collected from samples of patients who were receiving tertiary care were presenting with clinically suspected fungal infections. Direct microscopy with 10% potassium hydroxide was done to visualize the presence of fungal elements, and Gram staining was done for any suspected yeast infection. The samples were inoculated on Sabouraud's Dextrose Agar and kept at 22 °C. Results: A total of 1256 samples with presumed fungal etiology were included in the study. The maximum number of fungal infections were present in elderly (70-79 years age). Females (53.8%) were more affected (45.5%). 21% isolates were identified as yeast but belonged to non-Candida fungi. Among Candida species, Candida albicans was the most dominant species (58.3%) followed by Candida glabrata (6.4%). The year-round data of fungal cases showed that the highest incident of Candida albicans infection were in January with a mean value of 3.80, while the lowest infections were reported in June, with prevalence of 2.32 of C. albicans. The twenty-year data analysis showed that the years 2001 and 2000 showed the highest incidents of C. albicans, with a mean prevalence of 7.50 and 6.83, respectively. Specimen vs fungal prevalence data showed that 38% of the C. albicans were isolated from body aspirate specimens, followed by 26% from swab specimens. Conclusion: The high prevalence of Candida spp. in the present study suggests increased susceptibility of patients with critical or chronic illnesses to fungal infections.
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    Extracorporeal membrane oxygenation support for SARS-CoV-2: a multi-centered, prospective, observational study in critically ill 92 patients in Saudi Arabia
    (BMC, 2021-12-09) Alhumaid, Saad; Al Mutair, Abbas; Alghazal, Header A.; Alhaddad, Ali J.; Al‑Helal, Hassan; Al Salman, Sadiq A.; Alali, Jalal; Almahmoud, Sana; Alhejy, Zulfa M.; Albagshi, Ahmad A.; Muhammad, Javed; Khan, Amjad; Sulaiman, Tarek; Al‑Mozaini, Maha; Dhama, Kuldeep; Al‑Tawfiq, Jaffar A.; Rabaan, Ali A.; Medicine, School of Medicine
    Background: Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives: To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods: A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient's medical records prospectively. Results: ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion: Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations.
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    New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review
    (BMC, 2022-10-13) Alhumaid, Saad; Al Mutair, Abbas; Rabaan, Ali A.; ALShakhs, Fatemah M.; Choudhary, Om Prakash; Yong, Shin Jie; Nainu, Firzan; Khan, Amjad; Muhammad, Javed; Alhelal, Fadil; Al Khamees, Mohammed Hussain; Alsouaib, Hussain Ahmed; Al Majhad, Ahmed Salman; Al-Tarfi, Hassan Redha; ALyasin, Ali Hussain; Alatiyyah, Yaqoub Yousef; Alsultan, Ali Ahmed; Alessa, Mohammed Essa; Alessa, Mustafa Essa; Alissa, Mohammed Ahmed; Alsayegh, Emad Hassan; Alshakhs, Hassan N.; Al Samaeel, Haidar Abdullah; AlShayeb, Rugayah Ahmed; Alnami, Dalal Ahmed; Alhassan, Hussain Ali; Alabdullah, Abdulaziz Abdullah; Alhmed, Ayat Hussain; AlDera, Faisal Hussain; Hajissa, Khalid; Al-Tawfiq, Jaffar A.; Al-Omari, Awad; Medicine, School of Medicine
    Background: Liver diseases post-COVID-19 vaccination is extremely rare but can occur. A growing body of evidence has indicated that portal vein thrombosis, autoimmune hepatitis, raised liver enzymes and liver injuries, etc., may be potential consequence of COVID-19 vaccines. Objectives: To describe the results of a systematic review for new-onset and relapsed liver disease following COVID-19 vaccination. Methods: For this systematic review, we searched Proquest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA guideline for studies on the incidence of new onset or relapsed liver diseases post-COVID-19 vaccination, published from December 1, 2020 to July 31, 2022, with English language restriction. Results: Two hundred seventy-five cases from one hundred and eighteen articles were included in the qualitative synthesis of this systematic review. Autoimmune hepatitis (138 cases) was the most frequent pathology observed post-COVID-19 vaccination, followed by portal vein thrombosis (52 cases), raised liver enzymes (26 cases) and liver injury (21 cases). Other cases include splanchnic vein thrombosis, acute cellular rejection of the liver, jaundice, hepatomegaly, acute hepatic failure and hepatic porphyria. Mortality was reported in any of the included cases for acute hepatic failure (n = 4, 50%), portal vein thrombosis (n = 25, 48.1%), splanchnic vein thrombosis (n = 6, 42.8%), jaundice (n = 1, 12.5%), raised liver enzymes (n = 2, 7.7%), and autoimmune hepatitis (n = 3, 2.2%). Most patients were easily treated without any serious complications, recovered and did not require long-term hepatic therapy. Conclusion: Reported evidence of liver diseases post-COIVD-19 vaccination should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively very small in relation to the hundreds of millions of vaccinations that have occurred and the protective benefits offered by COVID-19 vaccination far outweigh the risks.