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Objective: Drug-resistant tuberculosis is a major health problem worldwide. In Saudi Arabia, 16.4% of tuberculosis cases were found to be resistant to at least one first-line drug. This study aims to assess and determine patterns of tuberculosis drug resistance among patients with culture-positive tuberculosis in order to develop an appropriate treatment strategy. Methods: Data for 51 patients with culture-proven drug-resistant tuberculosis from January 2006 to January 2017 seeking treatment at the King Abdulaziz University Hospital were retrospectively analyzed. World Health Organization criteria were used to classify cases according to type of resistance: monoresistant, polyresistant, and multidrug resistant. Results: Of the 299 tuberculosis positive cases there were 51 cases of drug-resistant tuberculosis, of which 60.8% were monoresistant (isoniazid, 17.6%; rifampin, 5.88%; pyrazinamide, 11.76%; ethambutol, 3.92%; streptomycin, 21.57%), 25.49% were multidrug-resistant tuberculosis, and 13.73% were polyresistant. Moreover, 18% involved children, 37% adolescents, 17.6% early adults, 17.6% late adults, and 11.76% elderly. Two-thirds of the patients were non-Saudi (76.46%). We found that 5.8% of the patients were HIV positive and 50% of these patients demonstrated monoresistant tuberculosis. Moreover, 47.05% of patients had type 2 diabetes. A total of 45 (88%) patients had primary resistance and 6 had secondary resistance. Radiologically, 60.78% of the patients had cavitary tuberculosis and 64% had bilateral pulmonary disease. Conclusions: Our results show that the pattern of tuberculosis drug resistance observed within King Abdulaziz University Hospital is similar to that observed globally.

Introduction: Appendicitis is the most common abdominal emergency worldwide. Many standard laboratory tests are used to diagnose appendicitis, but there are no specific indicators. Some studies suggested that hyperbilirubinaemia correlates with appendiceal perforation. The objective of this study is to review the bilirubin level in patients with acute appendicitis (non-perforated appendix) and in those with a perforated appendix, to assess the efficacy of using the bilirubin level to predict if patients will have a perforated appendix. Patients and Methods: This is a retrospective study of 269 patients who had undergone appendectomy from June 2008 to September 2016 in King Abdul Aziz University Hospital. These cases were classified histologically as acute non-perforated appendicitis and perforated or gangrenous appendicitis. The bilirubin levels of the two groups were compared in terms of the mean, sensitivity, and specificity.

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This work was carried out in collaboration between all authors. Authors AM, MMA, MAA, NTA and AKD wrote the protocol, wrote the first draft of the manuscript, managed the analyses of the study and managed the literature searches. Authors MMA, MAA, NTA and AKD did the data collection, designed the study and performed the statistical analysis. All authors read and approved the final manuscript.