السياسة اللغوية ومظاهرها في مدونة قرارات اللغة العربية في المملكة العربية السعودية

هدفت الدراسة للوقوف على الوضع اللغوي في المملكة العربية السعودية والتعرف على القرارات الرسمية وخطاباتها التواصلية في تدبير مشكلات اللغة. ولتحقيق هدف الدراسة فقد استخدم الباحث المنهج الوصفي، وتوصل الباحث إلى مجموعة من النتائج أهمها أنَّ القرارات الخاصة باللغة العربية غطَّت جميع نواحي الحياة الخاصة بالمجتمع السعودي تقريبًا؛ وذلك لأنها اللغة الأم لهذه المنطقة ولأن تفشي غيرها من اللغات يؤثر سلبًا على هذه اللغة وعلى عادات وتقاليد أهل هذه البقعة الفاضلة من هذه الأرض.

Diagnostic Utility of Who Defined Sepsis Syndromic Criteria With Procalcitonin in Identification of Sepsis in Children With Suspected Infections

Title: Diagnostic Utility of WHO Defined Sepsis syndromic Criteria with Procalcitonin in Identification of Sepsis in Children with Suspected Infections Background: Bacterial infections are a major cause of morbidity and mortality in children but accurate and timely diagnosis remains a challenge to the frontline clinicians. Cultures of sterile bodily specimens are considered the gold standard but are insensitive and results are delayed. Procalcitonin (PCT) has recently emerged as a biomarker with high sensitivity and specificity making it superior to culture based techniques performed in non-ideal circumstances which prevail in resource poor settings. This study investigated the diagnostic utility World Health Organization (WHO) defined criteria for sepsis in diagnosis of bacterial sepsis using procalcitonin (PCT) as the “gold standard”. Methods: This was a prospective survey conducted between July to October 2014 whose primary objective was to determine the sensitivity, specificity, and predictive values of WHO definitions of sepsis syndromes using procalcitonin as the ‘gold standard’ in children with suspected infections. Our secondary objective was to investigate association between PCT elevation and severity of disease and other markers of sepsis. The study was conducted at the paediatrics casualty of the Aga Khan University Hospital, Nairobi (AKUHN) and enrolled children aged >30 days and ≤15 years with suspected infection. This was defined as presence of systemic inflammatory response syndrome (SIRS) (abnormal temperature (>38.5°C or12hours. Children with obvious causes of SIRS such as mechanical/surgical trauma, severe burns, cancer, and without parental/guardian consent were excluded. A standard clinical proforma that allowed classification into various WHO clinical sepsis syndromes for enrolled patients was fulfilled by attending clinician. Blood sample of 0.5ml was collected and PCT test done. Sensitivity (Sp), specificity (Sn), negative and positive predictive values (NPV, PPV), and positive and negative likelihood ratios (LR+, LR-) were calculated for the WHO syndromic definitions. The gold standard for bacterial sepsis was defined as PCT level ≥0.5μg/l. Logistic regression was done and odds ratios calculated to test for association between procalcitonin and disease severity/clinical signs. Kaplan Meier survival analysis was done to compare duration of hospitalisation in various sub-groups. Results: A total of 231 children were enrolled and 22% (51 children) fulfilled criteria for WHO sepsis syndrome. WHO sepsis syndromes definitions had low Sn, 56.9% (95% CI; 50.5%, 63.3%) and Sp, 66.7% (95% CI; 60.6%, 72.8%) for diagnosis of sepsis. PPV was 32.6% (95% CI; 26.5%, 38.6%) and NPV was 84.5% (95% CI; 79.8% 89.2%). Presence of WHO