Conjunctival vessel morphology in patients with type 2 diabetes mellitus: findings of a case-control study.

OBJECTIVE: Diabetic retinopathy is a serious complication of diabetes mellitus that may lead to vision loss. Retinal problems are more likely to occur as the illness advances. Micro- and macro-vascular angiopathy is both linked to diabetes mellitus. Examining the impact of diabetes on blood vessels is one approach to understanding the disease's outward symptoms. The purpose of this research is to evaluate the morphology and breadth of conjunctival vessels in people with type 2 diabetes mellitus and to establish a correlation between these alterations and clinical retinal changes. PATIENTS AND METHODS: A case-control study was conducted in the Department of Ophthalmology, KIMS, Koppal, Karnataka. The study included diabetic patients who voluntarily participated and were assessed at the Ophthalmology Outpatient Department (OPD). The general and ophthalmic history was taken for both cases and control. The best corrected visual acuity was estimated. Each subject, including cases and controls, had a general and ophthalmic history recorded. The anterior segment was evaluated with a slit lamp. After completing the clinical examination, the subjects underwent a conjunctival vessel imaging study using the slit lamp. The imaging included the study of conjunctival vessel morphology using ImageNet. RESULTS: Both the test and control groups are comparable in terms of age and gender. The severity of diabetic retinopathy was shown to correlate with the conjunctival width range. Mild diabetic retinopathy is characterized by a conjunctival width of 30-34 microns (mean: 34.9), moderate diabetic retinopathy by 35-39 microns (mean: 37.3), severe diabetic retinopathy by 40-44 microns (mean: 42.4), and proliferative diabetic retinopathy by 50-54 microns (mean: 45.6). CONCLUSIONS: Diabetes mellitus patients have larger conjunctival arteries as the disease becomes more severe. Dilated and tortuous conjunctival arteries are visible indicators that correlate with worsening diabetic retinopathy. This could be used for screening to ensure timely referral.

A nationwide survey to assess COVID-19's impact on health and lifestyle in Saudi Arabia.

OBJECTIVE: Since COVID-19 outbreak, there is a lack of extensive literature on the impact of the COVID-19 pandemic on health and lifestyle. The aim of the study was (1) to assess the COVID-19 related knowledge and its socio-demographic correlates in individuals from different parts of Saudi Arabia, (2) to evaluate the health-related impact and lifestyle changes in the Saudi population because of the COVID-19 pandemic, and (3) to determine the perceived importance of future preparedness among residents. MATERIALS AND METHODS: A cross-sectional study was conducted in different regions of Saudi Arabia from  December 2020 to February 2022. Individuals aged 18 years and above were surveyed from different parts of the county. The questionnaires were made available online, and the participants filled them in. The questionnaires included COVID-19 related knowledge, the assessment of the health impact of COVID-19, perceived importance of future preparation for the pandemic, lifestyles, and demographics. Likert plot, univariate and multivariate logistic regression analyses were done. RESULTS: A total of 616 respondents were included in the study. The majority of the repondents were female (58.6%).  36% of the respondents considered their knowledge level on the novel coronavirus as very good. 43.5% said their knowledge level on preventing the spread of the novel coronavirus is excellent. Retired people were 84% (aOR 0.16, 95% CI 0.03-0.78) less likely of higher physical activity as compared to working (≥40 hrs/week) professionals. Separated/divorced/widowed and singles were 3.65 times (aOR 3.65, 95% CI 1.34-9.94) and 2.23 times (aOR 2.23, 95% CI 1.28-3.89) more likely of higher screen time as compared to those who were married/cohabitation/common-law. CONCLUSIONS: Lifestyle in Saudi Arabia has changed significantly due to the COVID-19 pandemic. Healthy habits such as eating at home and cooking at home have increased, while unhealthy habits such as reduced physical activity, screen time have increased.

Assessment of hand or foot eczema and contact dermatitis among car mechanics.

OBJECTIVE: Exposure to mineral oil and petroleum derivatives is common among motor vehicle repair workers, leading to occupation-related dermatological conditions. OBJECTIVE: We aimed to determine the prevalence of contact dermatitis among workers of car garages in the unorganized sector and to explore their personal safety measures. SUBJECTS AND METHODS: This prospective community-based study was conducted among 200 workers aged 18 years and above employed at 70 car garages in Majmaah City, Saudi Arabia. Data were collected by a trained medical student using a standardized questionnaire on age, nationality, type of work, working hours, past history of dermatitis, clinical examination, personal safety equipment, and treatment-seeking behavior of workers. Descriptive analysis and chi-square test of significance were done using SPSSv25.0. RESULTS: The self-reported prevalence of eczema/contact dermatitis within the past year was 14.5% (n=29), with hand lesions being the commonest (63%). Participants aged 18-30 years, working as car mechanics, and working for more than 10 hours had a statistically significant higher prevalence of contact dermatitis as compared to their counterparts. Most of them wore some or the other safety wares like safety shoes (20.9%), gloves (20.3%), Face masks (20%), earmuffs (10%), and helmets (2.8%). However, only 30% of cases sought treatment for the condition, reflecting poor healthcare-seeking behavior. CONCLUSIONS: The prevalence of contact dermatitis among workers of car garages was found to be lower than in other countries in KSA, probably due to stringent implementation of Occupation and Health Safety laws. However, workers had poor treatment-seeking behavior for this condition, which needs to be improved by taking appropriate public health measures.

Prevalence of micro and macro vascular complications and their risk factors in type 2 diabetes in Saudi Arabian population: an analysis from SHIS.

OBJECTIVE: Diabetes mellitus is a non-communicable disease (NCD) with metabolic dysfunction that has attained epidemic proportions worldwide. Vascular complications account for the mortality and morbidity associated with diabetes. Hence, the study aimed to estimate the prevalence and risk factors for vascular complications in patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: A cross-sectional national multistage survey, the Saudi Health Interview Survey (SHIS), was used in this study, which surveyed individuals aged 15 years or older. After inclusion and exclusion criteria, 1240 diabetic patients' data were analyzed for sociodemographic data, risk factors, and prevalence of micro and macrovascular complications. Binary logistic regression with stepwise backward elimination was performed to build the optimal model to assess the determinants of macrovascular complications in diabetic patients. The strength of the associations was examined by estimating adjusted odds ratios (aOR) with their 95% CI. p-value < 0.05 was considered statistically significant. R Studio Version 1.2.1093 was used for statistical analysis RESULTS: Prevalence of micro and macrovascular complications in the diabetic patients was 6.05%, in which 3.5% had myocardial infarction, 1.2% had stroke and 1.9% had renal failure. The optimal model showed that for each year increase in age (aOR=1.05, 95%CI 1.02-1.07; p-value=0.000), smoking history (aOR=4.02, 95%CI 2.23-7.26; p-value=0.000), hypertensive patients (aOR=2.71, 95%CI 1.47-4.99; p-value=0.001), patients with low physical activity (aOR=4.32, 95%CI 1.26-14.82; p-value=0.001) were more likely to develop macro and microvascular complications in diabetic patients. CONCLUSIONS: The high prevalence of microvascular and macrovascular complications in diabetic patients poses a serious threat to public health in Saudi Arabia. A multisectoral approach needs to be undertaken to properly control and modify common risk factors at the community level.

Neurological manifestation with special reference to HIV-associated neurocognitive disorder (HAND) among people on anti-retroviral treatment in India.

OBJECTIVE: The neurological manifestations and their severity in patients on antiretroviral treatment (ART) are currently unexplained. We aimed at studying the prevalence of HIV Associated Neurological Disorders (HAND) among people on antiretroviral treatment, using the International HIV Dementia Scale (IHDS). PATIENTS AND METHODS: A predesigned and pretested proforma including the International HIV Dementia Scale (IHDS) was administered to 100 HIV patients attending to ART center of KIMS teaching Hospital (Koppal, Karnataka) from January 2020 to March 2020. The data was analyzed SPSS version 15 software. Descriptive statistics were used for demographic characteristics. The Student's t-test and chi-square test methods were applied to determine the relationship between qualitative characteristics. RESULTS: The prevalence was found to be 59%. Out of 100, 57 HIV patients scored less than 10 whereas 43 HIV patients scored ≥10 on the IHDS scale. The mean age of the study population was 39.14 ±13.01 years; the total IHDS score was 9.96±1.53 and the CD4 count was 427.91±226.0. This study demonstrated that the patients with CD4 count more than 350 (i.e., 63.60%) had a better IHDS score. CONCLUSIONS: Neurocognitive disorder was found to be more common than anticipated. All ICTC Centers need to consider assessing HIV-associated neurocognitive disability (HAND), and the International HIV Dementia Scale (IHDS) as one instrument for such assessment.

Association of indoor air pollution on cognitive dysfunction among elderly.

OBJECTIVE: Cognitive dysfunction among the elderly is a devastating condition preceded by accumulation of neuropathology leading to accelerated cognitive decline. Many epidemiologic studies have reported the relation between indoor air pollution exposure and cognitive impairment. To clarify the nature of the association, a comprehensive systematic review and meta-analysis were performed. MATERIALS AND METHODS: The analysis included all observational studies, including cross-sectional studies, prospective and retrospective cohort studies. Experimental studies, randomized controlled trials (RCTs), and controlled clinical trials were excluded. Studies on the relationships of indoor air pollution and cognition published before 30 April 2021 which are peer-reviewed scientific publications available in English were included after performing a structured literature search through electronic databases, including PubMed, Embase, Cochrane Library, and clinical trial.gov. A total of 146 articles were collected, and after screening thoroughly only, 9 studies were selected. Meta-analysis for the final set of selected studies was performed using the R software. RESULTS: The quality of all the studies was adequate as almost all reported an association between at least one pollutant and cognitive dysfunction. However, relatively few studies considered outcomes that provide the most substantial evidence for a causal effect. In total, 5 studies have reported on cognitive function. The pooled mean of cognitive function was 12.16 (95% CI: 10.73 to 13.58). However, the heterogeneity was very high (I2=100%; chi-square test for heterogeneity = p<0.001). We used a modified JBI structured risk of the bias assessment tool, and it was minimal among the included studies as most of the studies have followed a random sampling method and explicitly mention it in their methods. CONCLUSIONS: Exposure to indoor air pollution through fuels used for cooking and heating was significantly associated with cognitive dysfunction among elderly women. Given the limitations, a more extensive meta-analysis and longitudinal studies are recommended to investigate the biological mechanism behind the impact of indoor air pollution on cognitive health.

"LONG COVID": an insight.

We aimed this systematic review to analyze and review the currently available published literature related to long COVID, understanding its pattern, and predicting the long-term effects on survivors. We thoroughly searched the databases for relevant articles till May 2021. The research articles that met our inclusion and exclusion criteria were assessed and reviewed by two independent researchers. After preliminary screening of the identified articles through title and abstract, 249 were selected. Consequently, 167 full-text articles were assessed and reviewed based on our inclusion criteria and thus 20 articles were regarded as eligible and analyzed in the present analysis. All the studies included adult population aged between 18 and above 60 years. The median length of hospital stay of the COVID-19 patients during the acute infection phase ranged from 8 days to 17 days. The most common prevalent long-term symptoms in COVID-19 patients included persistent fatigue and dyspnea in almost all of the studies. Other reported common symptoms included: shortness of breath, cough, joint pain, chest pain or tightness, headache, loss of smell/taste, sore throat, diarrhea, loss of memory, depression, anxiety. Associated cardiovascular events included arrhythmias, palpitations and hypotension, increased HR, venous thromboembolic diseases, myocarditis, and acute/decompensated heart failure as well. Among neurological manifestations headache, peripheral neuropathy symptoms, memory issues, concentration, and sleep disorders were most commonly observed with varying frequencies. Mental health issues affecting mental abilities, mood fluctuations namely anxiety and depression, and sleep disorders were commonly seen. Further, diarrhea, vomiting, digestive disorders, and Loss of appetite or weight loss are common gastrointestinal manifestations. Therefore, appropriate clinical evaluation is required in long COVID cases which in turn may help us to identify the risk factors, etiology, and to my help, we treat them early with appropriate management strategies.

Prevalence, patterns and contributing factors for tobacco usage amongst Saudi population - analysis from SHIS 2013.

OBJECTIVE: The present study aimed to determine the prevalence, patterns and contributing factors for tobacco usage amongst Saudi population. MATERIALS AND METHODS: Between April and June 2013, a cross-sectional study was organized among 10735 individuals aged 15 years or older. The survey consisted of face-face interview for collecting data on socio-demographics, tobacco usage, diet, physical activity and comorbidities. Univariate and multivariate binary logistic regression was applied to check for the association of prevalence (both smoked and smokeless) with socio-demographic factors. The strength of association was examined by approximating odds ratios (OR) with their 95% CI using SPSS software and p-value set at < 0.05. RESULTS: A total of 10195 respondents aged from 15 to 101 were considered. Overall prevalence of current smoking was 12.8%. Daily smoking was reported by 12% of the population. Sex, age group, education, married and occupation were strong predictors of tobacco use in both univariate and multivariable model. From multivariable model, men were 14.54 times more likely to smoke tobacco (aOR 14.54, 95% CI 11.07-19.11) when compared with women. Respondents between 15 to 30 years, 31 to 45 years, were 3.36 times (aOR 3.36, 95% CI 2.29-4.93) and 3.51 times (aOR 3.51, 95% CI 2.47-4.98) more likely to smoke tobacco when compared to >60 years. CONCLUSIONS: The results of present study indicate a significant, but differing purpose of sex, age group, education, marital status and work status on tobacco usage in the country.