Cardiopulmonary resuscitation induced consciousness is a very rare phenomenon where patients who are in cardiac arrest and undergoing cardio-pulmonary resuscitation (CPR) express signs of consciousness such as talking, making purposeful limb movements, and opening eyes. This phenomenon leads to frequent CPR interruptions and put the CPR team under psychological pressure, impacting the quality of the resuscitation proceedings. We report presents the case of a 49-year-old man who presented with ischemic chest pain, and then had a witnessed in-hospital cardiac arrest. During the CPR, he gave intermittent signs of consciousness despite the absence of return of spontaneous circulation. The CPR team had to restrain, sedate, and intubate the patient to facilitate the resuscitation process.

Social media plays a major role in the revolution of medical learning. Many training centers have incorporated it into their teaching curriculum. The aim of this research is to evaluate the current utilization of social media by residents and its effect on their learn-ing process during their residency training.We performed a quantitative cross-sectional survey based study. A 20-questions survey was constructed and distributed to residents from all specialties and training levels registered under the national specialty board in training period 2014/2015. 132 (69%) of the resident use social media as a platform for asking medical questions and half of them use it to consult experts in the field and to discuss cases. The most popular media for learning was YouTube 104 (55%) and free chat 49%. (71%) did not receive any course or guidance on how to use social media for educational purposes and 83.2% believe that a course or a formal lecture is needed.In line of these results medical educators should pay attention to these sites and incorporate appropriate strategies to guide residents on effective use of social media.

Objectives: To study the epidemiology of drowning among children cases reported at Sultan Qaboos University Hospital in Oman. Methods: We conducted a retrospective study of the patients who were presented at emergency department with the history of drowning over a period of 10 years from January 2008 to December 2017. Patients with age 1 to 18 years were included in the study. The data including demographics, timing and location of drowning, season, adult supervision, swimming ability, medical risk factors, duration of submersion, on spot resuscitation, emergency medicine department assessment, hospital management and outcome were collected from electronic hospital information system using a preformed proforma. Outcome was categorized into either full recovery, severe neurological injury or brain death based on the pediatric cerebral performance category (PCPC). A good outcome represents to a score of 1-3 points and PCPC 2 of 4-6 points corresponds to poor outcome. We calculated correlation for all variables with the outcome by using chi square and fisher exact tests. P value of <0.05 is taken as significant value. Results: A total of 74 patients were included in the study. Of them, 54 (73%) were male, children of less than six years of age were 47 (63.5%). More than 50% of drownings happened in outside swimming pool, 21 (28.4%) of patients were unsupervised during incident and 39 (52.7%) required cardiopulmonary resuscitation. Out of all studied subjects, 3 (4%) were brain dead and 2 (2.7%) developed severe neurological injury. On univariate analysis, the following variables were statistically significant (p<0.05) predicting the poor outcome like lack of adult supervision, duration of submersion >10 minutes, asystole, Glasgow Coma Scale <8, temperature <35c, PH <7, anion gap >20, blood glucose >10 mmol/L, abnormal chest x-ary findings, rewarming, cardiopulmonary resuscitation, intubation, inotrope support and pediatric intensive care unit admission. Conclusion: This study suggests that children especially male below 6 years of age without swimming ability need strict supervision next to body of water. Furthermore; preventive measures might include raising community awareness about the risk factors of drowning, commencing public CPR lessons and strict pool safety regulation by related authorities.

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Background and Aim: Bronchiolitis is an acute viral lower respiratory tract infection. It is a common disease among children below 2 years old, resulting in frequent presentation to the emergency department and occasionally admission1 . For proper management of such patients, studying the disease spectrum and the risk factors is important2 . The aim of this study was to investigate the demographics and risk factors for severe bronchiolitis in children (0–2 years old), in the emergency department (ED) at Sultan Qaboos University Hospital (SQUH). Methods: We conducted a retrospective cohort study, including children ( < 2 years old), who came to the ED with a presentation suggestive of bronchiolitis. We reviewed the charts for a two-year period (January 2015–December 2016). Demographic and baseline characteristics were gathered from electronic medical records and then analyzed. We categorized patients into severe and non-severe bronchiolitis according to the guidelines set by the New South Wales (NSW) Ministry of Health in Australia in 2012 for the “Acute Management of Bronchiolitis in Infants and Children”3 . Therefore, in our study children who were considered to have severe bronchiolitis had one of the following: unwell appearance, apneas, severe tachypnea (>70 breaths/min), bradypnea ( < 30 breaths/min), moderate to severe grunting, cyanosis, pallor, oxygen saturation < 90% in air (or < 92% in O2), tachycardia (>180 beats/min) and difficulty in feeding (taking less than 50% of normal feed).We investigated the following risk factors to predict severe bronchiolitis: maternal age, birth weight, prematurity ( < 37 weeks of gestational age), age < 12 weeks, congenital heart defects, congenital respiratory diseases, immunodeficiency, and global developmental delay. We described the cohort using descriptive statistics and performed a logistic regression analysis to determine the risk factors for severe bronchiolitis. Results: Of the 235 children with bronchiolitis, 133 had severe bronchiolitis while 102 had the non-severe form of the disease, with a greater percentage of males than females in both groups. The majority of children with severe bronchiolitis were in the age < 3 months group (32%), while the least was in the ≥ 12 months age group (10%). There was a trend toward statistically significant results for the following factors: chronological age < 12 weeks (OR = 2.67, 95% CI = 0.89–2.67), congenital cardiac diseases (OR = 2.12, 95% CI = 0.85–5.30) and congenital respiratory diseases (OR = 1.86, 95% CI = 0.80–4.27).The following factors were associated with severe bronchiolitis using stepwise logistic regression: increased heart rate (OR = 1.046, 95% CI = 1.026 – 1.066), decreased SpO2 (OR = 0.890, 95% CI = 0.827 - 0.957), male gender (OR = 2.248, 95% CI = 1.105 – 4.573), irritability (OR = 2.209, 95% CI = 1.024 – 4.769) and global developmental delay (OR = 3.5, 95% CI = 1.0 – 12.537). Conclusion: Multiple factors were associated with severe bronchiolitis and three were trending toward significant association inc...