23[CI2.18-2.27], P less then 0.001), Asians (aOR 1.16[CI1.12-1.20]. P less then 0.001), in rural areas (aOR 1.44[ 95%CI1.41-1.48], P less then 0.001) and those in the lowest household income quartile (aOR 1.03[CI1.01-1.05], P less then 0.001). The average length of stay (LOS) was shorter for the uninsured (4.79±8.26 vs 4.96±7.55 days, P less then 0.001). Conclusions The findings suggest that lack of health insurance is correlated with hospital mortality in patients hospitalized with disease and disorders of nervous system, with an increased disparity in vulnerable populations.Background Obesity in Saudi Arabia is on the rise, especially among females who are more likely to suffer from obesity in the reproductive age group than males in the adult age group. Biologically, pregnancy can increase women's weight and put them at greater risk for adverse obstetric outcomes. Objectives To find the prevalence of obesity among pregnant women and their obstetric outcomes. Methods This retrospective study was conducted on pregnant women who delivered between January 2013 and May 2018 at the obstetrics clinic of King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. A datasheet was formed to collect data from the medical records of these pregnant women. The analysis was done using the Statistical Package for Social Sciences (SPSS), version 26 (IBM SPSS Statistics, Armonk, NY). A p-value of less then 0.05 was used to calculate statistical significance. Results A total of 9,095 pregnant women delivered during that period. Of those women, a total of 2,235 were found to be obese, and 1,842 were included in the study. A total of 1,130 women were categorized under Class I obesity, 458 were categorized under Class II obesity, and 254 were categorized under Class III obesity. The majority of the sample were Saudis (72.3%) and young adults (90.8%) with 1,672 cases. The average age was 31.7 (standard deviation (SD) 5.9). Twenty percent of the sample had preterm newborns, while the majority (62.4%) ended up with cesarean delivery. Advanced age, multipara, and cesarean delivery were statistically significant with adverse pregnancy outcomes (p less then 0.05). Conclusion As demonstrated in this study, obesity among females in Saudi Arabia has increased over the past decade. Hence, this puts them at higher risk of developing adverse pregnancy outcomes, as pregnancy physiologically results in additional weight gain. Proper antenatal counseling, health education, and a comprehensive plan prior to conception are highly recommended.Multiple myeloma is a plasma cell neoplasm characterized by clonal proliferation of immunoglobulin producing terminally differentiated B cells. Classically patients are described to present with bone pain, hypercalcemia, anemia, and/or renal impairment. A less described clinical manifestation related to the myeloma is acquired coagulation abnormalities including paraprotein interfering with the coagulation cascade or exhibiting specific antibody activity.  https://www.selleckchem.com/products/VX-809.html  Factor X deficiency is reported in patients with secondary amyloidosis. We describe a patient who presented with bleeding tendency and an abnormal prothrombin and activated partial thromboplastin times (PT/PTT) due to factor X deficiency. A thorough workup revealed the diagnosis of multiple myeloma with the presence of monoclonal lambda light chain restricted plasma cells with qualifying end-organ damage without evidence of amyloidosis. Prior to the ultimate diagnosis, the patient succumbed to septic shock and acute respiratory distress syndrome due to Streptococcus Pneumonia infection.The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov2), is the causative pathogen of coronavirus disease 2019 (COVID-19), which is primarily described as a respiratory illness. However, a wide array of cardiovascular complications has also been described in the setting of COVID-19. Wellens' syndrome, also regarded as a left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending (LAD) artery stenosis. It is characterized by deeply inverted T-waves or biphasic T-waves in the anterior precordial chest leads in a patient with unstable angina. Patients typically present with symptoms consistent with acute coronary syndrome. To our knowledge, we present the first case of Wellens' syndrome in a patient with a COVID-19 infection. Furthermore, this case describes stenosis of the left circumflex artery, a variant of the unusual angiographic findings associated with Wellens', as it is usually associated with occlusion of the proximal LAD. The pathophysiology of cardiovascular complications associated with COVID-19 is not well-understood; nevertheless, it was reported that mortality from coronary artery disease (CAD) complications is significantly higher in these patient populations. Healthcare providers should also be aware of identifying Wellens' syndrome, as urgent coronary angiography is superior to stress testing.Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) non-contrast sequence that can indicate tissue ischemia or infarction. Adrenal infarct may present similarly to biliary or gallbladder pathologies, and the differential diagnosis during emergency work-up can be narrowed utilizing DWI sequences. In this paper, we describe the usefulness of DWI for urgent diagnosis in a case of non-hemorrhagic adrenal infarct of a pregnant female presenting with right upper quadrant pain. Although uncommon, adrenal infarct may occur in patients with hypercoagulability and localizing pain that is unexplained by other imaging modalities. We outline the imaging features of DWI in evaluating adrenal infarct as a safe and time effective application for patients with contraindications to imaging with ionizing radiation.Actinotignum schaalii, a Gram-positive rod residing in the urinary tract, is responsible for urinary tract infections and their complications including but not limited to bacteremia and sepsis. A. schaalii is increasingly being detected in body fluid specimens owing to advancements in PCR techniques. This report describes an interesting case of an adult diabetic patient managed for Fournier's gangrene. A. schaalii was detected in the PCR of his wound cultures. To the best of our knowledge, this is the second case of A. schaalii as the causative agent for Fournier's gangrene.