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Background Delirium is a common neuropsychiatric syndrome encountered in all hospital settings and is usually associated with many deleterious effects. Patients with delirium tend to require longer hospital stays and have higher mortality rates, even when the severity of their underlying illness is accounted for (1,2). Hospitalized patients with delirium are known to exhibit different symptoms ranging from lethargy and inattentiveness to restlessness, watchful, and combative behavior (3, 4). Based on systematic clinical observation of hospitalized patients, the spectrum of psychomotor behavior seen in delirious patients can be classified as hyperactive, hypoactive or mixed-type (4, 5). It has been suggested that each delirium subtype can result from a different pathophysiological mechanism,

Aim: Studies have reported that the knowledge of medical doctors about dental conditions is not satisfactory. Medical and dental students need to have and reflect good oral health knowledge as they will be major providers of health services in future. This study was conducted to assess and compare the level of oral health knowledge of medical and dental students. Materials and Methods: Using a self-administered structured questionnaire, cross-sectional study was conducted at King Faisal University University, Saudi Arabia. The survey tool consisting of 25 items assessed knowledge about oral health problems, etiology and importance in relation to general health. Descriptive statistics were performed using SPSS version 20. Results: Medical students exhibited a good level of oral health knowledge on 16 (64%) items, whereas dental students demonstrated on 18 items (72%) (p=0.02). In both streams, male students displayed a good level of knowledge on 17 items, while female displayed on 11 items. Mean score of male students to all the questions was 80.68% and that of females was 66.96% (p=0.001). Dental students scored marginally better than medical students for 14 out of 25 items, and mean scores was insignificant between medical and dental students (p=0.21). Students of years 2, 3 and 4 displayed better knowledge compared to those from years 1 and 5 (p=0.001). Students from any particular year did not seem to be having consistently better knowledge than the other years across all the items. Conclusion: This study showed a moderate to good level of knowledge about oral health. Dental students and men displayed somewhat better knowledge levels compared to medical students and women, respectively. Clinical Significance: This study highlights the importance of scientific oral health knowledge for the future health care professionals. Objective is to draw attention towards incorporation of preventive oral health sciences in medical curriculum at undergraduate level.

BackgroundSurvival of systemic lupus erythematosus (SLE) patients has improved dramatically due to improved treatment, and the morbidity pattern has shifted towards long-term complications as osteoporosis. SLE occurs in women during child-bearing years and the disease often persists to the postmenopausal period1. Assessment of fracture risk in SLE patients is important as fractures may occur while bone mineral density (BMD) is above the osteoporotic threshold or at the normal range2. Osteocalcin measurement helps to assess fracture risk and select patients for treatment.ObjectivesTo assess the fracture risk in a cohort of Egyptian female SLE patients by using BMD and osteocalcin level with correlation to disease activity, damage index and drugs in use.Methods70 females with SLE ≥40 years old satisfying the SLICC classification criteria were enrolled with detailed history taking including disease duration, drugs in use, traditional risk factors, regular exercise, history of previous fractures and menstrual history. Assessment of disease activity using Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease damage using the Systemic Lupus International Collaborative Clinics/ American College of Rheumatology Damage Index (SLICC/ACR DI). Serum calcium, phosphorus and alkaline phosphatise were measured. BMD measured by dual energy X-ray absorpiometry (DEXA) scans at lumbar spine (LS) (L2-L4) and femoral neck (FN), serum osteocalcin level and World Health Organization fracture risk assessment tool (FRAX®).Results14//70 (20%) patients had LS osteoporosis, 25//70 (35.7%) had LS osteopenia and 6/70 (8.6%) had FN osteoporosis, 30/70 (42.9%) had FN osteopenia. FRAX-Major ≥20% was observed in 10% of patients, FRAX-HIP ≥3% was seen in 27.1% of patients. Serum osteocalcin level was significantly decreased in SLE patients with lower BMD than those with normal BMD, and significantly decreased in patients with osteoporosis than those with osteopenia. A significant negative correlation was found between osteocalcin level and age of patients, disease duration, SLEDAI and SLICC scores, current, IV pulse and cumulative steroids, immunosuppressants, anticoagulants, but there was a positive correlation with antimalarials and calcium supplements.ConclusionsSLE patients are at greater risk for developing osteoporosis and osteopenia. Ten-year risk of major and hip fractures was high in SLE patients. Increasing age, disease duration, high anti-DNA titres, SLEDAI and SLICC were associated with a higher 10-year probability of major osteoporotic fracture. FRAX predicted incident hip and major osteoporotic fractures among SLE patients with normal and low bone mass not just those with frank osteoporosis. Physicians should be alerted to the higher risk of future fractures in SLE patients for periodic monitoring.References Furukawa M, Kiyohara C, Horiuchi T, Tsukamoto H, Mitoma H, Kimoto Y et al. Prevalence and risk factors of vertebral fracture in female Japanese patients with systemic lupus erythematosus. Mod Rheumatol, 2013; 4:...

Background: Sepsis is defined as an inflammatory body response to infection, with severe sepsis and septic shock being its more severe forms. 1 Despite advances in the management of septic patients, sepsis is still the second leading cause of death among patients in non-coronary intensive care units (ICU). 2 The number of elderly admitted to ICU is increasing in recent years due to increase survival. 3 Routinely, the macronutrient contribution is thoroughly studied when a patient is admitted to ICU. However, it must be kept in mind that along with macronutrients, micronutrients are also significant, and these must be taken into account. Previous studies tackled trace elements in relation to surgery complications 4 , and total parenteral nutrition. 5 Concerning sepsis, some studies were conducted to evaluate if trace elements are related to inflammation 6 , critical illness 7 and if supplementation would affect the outcome. 8 We aimed to evaluate baseline trace elements as s predictor of septic shock in Egyptian elderly patients within intensive care setting. Methods Prospective observational single central cohort study included all patients ≥ 60 years old, admitted to geriatric ICU during a 6 months period. Patients admitted for brief postoperative monitoring were excluded. The subjects were further subdivided into two groups. First group includes patients who developed septic shock. The second group included patients who did not develop septic shock.