International Research Journal of Medicine and Medical Sciences

75-83

Authors: Maha Al Turki, Sarah Al Shloi, Alhanouf Al Harbi, Alanoud Al Agil and Fatmah Othman

Breakfast is considered the most important meal of the day, especially for schoolchildren. To address the need for data to develop public health policies and programs for children in Saudi Arabia, we aimed to investigate the association between breakfast consumption habits and cognitive/academic performances among primary schoolchildren in Riyadh. A cross-sectional study was conducted among schoolchildren (aged 6 to 12 years), randomly selected from 8 primary schools. Anthropometric measurements were obtained to determine the body mass index (BMI)-for-age percentile. A self-reported questionnaire was used to collect information on their breakfast consumption habits. Cognitive functioning was assessed using the Raven Progressive Matrices test. The academic performance was determined using their scores in three subjects. Statistical analyses were performed using STATA 15 (Stata Corp., College Station, Texas). A total of 384 students were included in this study. The mean (± SD) age of the subjects was 9.1 ± 1.7 years. Sixty percent of the schoolchildren reported consuming breakfast more than 4 times per week. Breakfast consumption was significantly associated with cognitive test scores. Children who consumed breakfast regularly were found to be twice more likely to achieve higher cognitive scores compared to those who were not regular breakfast consumers. A greater percentage of schoolchildren who consumed breakfast regularly achieved excellent scores in mathematics (78%), science (87%), and Arabic language (98%). However, the difference in the academic performances of regular breakfast consumers and skippers did not achieve statistical significance. In conclusion, the findings of the present study support the hypothesis that regular consumption of breakfast has a short-term positive impact on the cognitive function and performance among young children. Nevertheless, the long-term beneficial effects of having regular breakfast on the academic performances of schoolchildren were not confirmed. School breakfast programs should, therefore, be developed and implemented to promote healthy eating habits among school-age children.

91-98

Authors: Samaneh Shariatmaghani, Somayeh Sadat Shariatmaghani, Alireza Sedaghat, Mona Najaf Najafi and Ahmad Bagheri Moghaddam

Colistin is a valuable antibiotic for controlling gram-negative pathogens, but the associated nephrotoxicity is an important side effect which limits its use. This study aimed to evaluate the incidence of colistin-associated nephrotoxicity and the role of other confounding factors in the incidence of acute kidney injury (AKI) in critically ill patients. In this prospective cohort study, all patients over 18 years with a positive culture for Acinetobacter baumannii who admitted to ICUs from March 2017 to February 2019 were enrolled. They were divided into two groups; the study group received colistin but the control group consisted of patients who were positive for Acinetobacter culture but due to unavailability of the drug, colistin was not prescribed. Demographic data and clinical characteristics were recorded in a designed questionnaire. The primary outcome was the occurrence of renal failure based on the KDIGO criteria. In total 115 patients were studied, 75 (65.2%) cases and 40 (39.8%) controls. The incidence rate of AKI in the colistin and control groups was 48 and 17.5%, respectively indicating a statistically significant difference (P=0.033). AKI was established on average in the first 6 days of colistin administration. There is no significant difference between the daily and total dose of colistin consumption in patients with AKI and without AKI in the colistin group. After adjusting the confounding variables such as the age of patients, use of simultaneous and potentially nephrotoxic drugs and hypotensive episodes we get an Odds Ratio of 2.48 with a 95% Confidence interval of 0.97 to 6.36 and a P-value of 0.059. Colistin is an antibiotic with potential capability for AKI development in ICU patients; however, its incidence in critically ill patients is associated with factors other than colistin as well.

105-110

Authors: Yanitama Putri, Dewi Sutriani Mahalini and I Gusti Ngurah Made Suwarba

Epilepsy is the most common neurological diseases with a high prevalence in the world. Valproic acid as the first line therapy has some adverse effects on hematology field. However, the data about hematological effects from the use of valproic acid as therapy in children with epilepsy is currently still limited. This is a cross sectional study to describe the hematology profile of children with epilepsy treated by valproic acid at Sanglah Hospital. Data collection was done during February to May 2018. We report 58 subjects of children with epilepsy treated with valproic acid at Sanglah Hospital. The mean age is 4.47 years, 60% are male. About 79.3% were generalized seizure, and 89% from them were tonic clonic type. Fifty percent of partial seizure were partial complex epilepsy. Forty-six EEG results (79.3%) were abnormal. We found 4 cases (0.07%) of thrombocytopenia at dose of 30 mg/kg/day and the others at 25 mg/kg/day. The thrombocyte level recovered after the valproic acid discontinued. We found 29 cases of anemia, 86.2% with mild anemia and others 13.2% with moderate anemia. Most of the anemia cases were found after 12 months of treatment. In conclusion, the use of valproic acid as a therapy indicates the role of drug dose and time-related spectrum of hematology disorders that ranges from thrombocytopenia to anemia. Routine laboratory evaluation is necessary, especially after 12 months of treatment with valproic acid and at a dose of valproic acid 25 mg/kg/day or more.