Long-term incompatibility of nutritional status and early childhood caries-A call to revamp perinatal and early childhood dietary care and follow-up.

Background and aim: Dietary pattern and diet quality can influence the incidence of dental caries and can be indicated by decay missing filled (Dmf) scores in the primary dentition. This study aims to find the relationship of nutritional status and oral hygiene practices on Dmf scores of preschool children. Materials and methods: Semi-structured and self-administered questionnaires, distributed among 60 preschoolers' parents, were used to assess the demographic and diet related data. Anthropometric measurements of the preschoolers were taken following universally accepted protocols. The relationship between dietary supplement consumption and the presence of dental caries was evaluated by chi-square test employing SPSS 22. Results: The anthropometric measurements among 4-year-old children were on par with the standard values and that of 5-year-olds were below the reference range. All the measurements except head to chest circumference were higher than normal range among 3-year-old subjects. Regular and periodic dental check-ups significantly influenced dental caries prevention (p = 0.030). Statistically, there was no significant association between Dmf scores and thumb-sucking habits (p = 0.568), brushing teeth and usage of tooth floss (p = 0.96), consumption of nutrient supplements (p = 0.744), and BMI (p = 0.564) of the subjects. Furthermore, the correlation between z scores and Dmf scores was found insignificant. Conclusion: Long-term as well as short-term malnutrition initiated 2 years after the start of the pre-schooling. With severity of undernutrition there was a trend to have high Dmf scores.

The Prevalence and Awareness of Dietary Supplement Use Among Saudi Women Visiting Fitness Centers in Riyadh, Saudi Arabia.

Background Dietary supplements are used for a variety of reasons, some of which are for medical conditions, to compensate for dietary insufficiency, to improve physical performance, and to boost immunity. Generally, individuals who visit sports facilities seek different benefits; it could be for health and well-being, to achieve the desired body shape, for enjoyment purposes, or as a way to socialize. To help achieve some of these goals, dietary supplements can be taken. Aims This study is designed to assess the prevalence and awareness of dietary supplement use among Saudi women who frequent fitness centers in Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted in November 2021 among Saudi women who visited gyms in Riyadh, Saudi Arabia. The sample consisted of 355 participants, all of whom were women from Saudi Arabia. The statistical analysis was done using IBM Statistical Package for Social Sciences (SPSS), Version 21.0 (Armonk, NY: IBM Corp.). Necessary statistical tests such as the chi-square, the t-test, and other appropriate tests were used. A p-value of less than 0.05 has been adopted for statistical significance. Results The majority of the 355 female participants consumed dietary supplements (68.7%). The most commonly used supplements were vitamins (82.8%), amino acids and proteins (30.3%), minerals (22.1%), and fatty acids (3.3%). In the study group, 53.3% of those who were using or used supplements had previous knowledge; 13.1% were up-to-date; and 33.6% weren't. No relationship was found between supplement use and educational level, weight, body mass index (BMI), or marital status. Conclusion Dietary supplement use is common among women who visited gyms in Saudi Arabia. Vitamins were the most commonly used supplements, which suggests that users were more concerned about general health and diet deficiencies than anything else. The participants use dietary supplements cautiously; the majority consume dietary supplements under a doctor's prescription and after reading the leaflets.

Knowledge on added sugar content in food labels among adult out-patient clinic visitors at a tertiary care teaching hospital, Riyadh, KSA.

Consumption of added sugars is reported as an etiological factor for high prevalence of diet-related diseases. Food labels of food products indicate the presence of added sugars. Knowing the different terms used to describe added sugars helps people to avoid food products rich in added sugars. Therefore, it is of interest to assess consumer knowledge about the added sugar terms on food labels. A study was conducted among 215 visitors of a tertiary care hospital outpatient clinic during July-September 2020. The data for this prospective cross-sectional study was collected by using online Google form. Adult visitors of both genders were selected using a non-probability convenient sampling technique. Demography and knowledge of the added sugars were collected. SPSS version 22 was used for data analysis. Mean (± SD), median, and Inter quartile Range (IQR), and Pearson Chi-square test were used. A "p" value of < 0.05 was considered statistically significant. The majority (96.7%) of the study participants was Saudi nationals with a median (IQR) age of 28 (23, 38). Most (68.37%) of the respondents were undergraduates. Physical inactivity (37.21%) and incidence of obesity (25.58%), and lifestyle diseases (15.40%) were reported. The chi-square test indicated a significant relationship between gender and knowledge of added sugars (χ2 = 69.85; p<0.05). Females (69.41%) have more knowledge about added sugars than males. These findings support the notion that there is a lack of knowledge about added sugar terms on the nutrition labels, which might contribute to the prevalence of obesity and other non-communicable chronic illnesses.

Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale.

BACKGROUND: Emergency care continues to be a challenge, since patients' arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. METHOD: This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient's symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). RESULT: A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). CONCLUSION: The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.

Characteristics of Nonaccidental Fractures in Abused Children in Riyadh, Saudi Arabia.

BACKGROUND: Child abuse is a major problem globally. Nonaccidental fractures are the second most common injury among physically abused children; however, there is a lack of studies describing the characteristics of nonaccidental fractures in Saudi Arabia. OBJECTIVES: The objective of this study was to determine the characteristics of nonaccidental fractures among abused children in Riyadh, Saudi Arabia, using radiography. MATERIALS AND METHODS: This retrospective study analyzed the data and radiographs of all nonaccidental fracture cases in children (aged ≤14 years) registered in the National Family Safety Program Registry at King Abdulaziz Medical City, Riyadh, between 2009 and 2015. RESULTS: A total of 1512 cases of child abuse were found in the National Family Safety Program Registry database from Riyadh city. From these, 103 fractures were identified; however, radiographs were available for only 70 fractures from 56 children. Of these, 33 (59%) were boys, and 25 (45%) were aged 1-5 years. In terms of the type of abuse, neglect was more common than physical abuse (52% vs. 45%). History of injury was identified in 75% (42) of the cases, of which fall accounted for about 55% (23). Nearly 79% of children presented with a single bone fracture, while 21% had multiple bone fractures. The most common sites of fractures were skull (40%), upper limbs (31%) and lower limbs (29%). The most common fracture pattern was transverse fractures (48%), and it was mainly diagnosed in skull fractures (51%). CONCLUSIONS: This study found that in Riyadh, Saudi Arabia, neglect is the most common cause of nonaccidental fractures, abusive head trauma is the most commonly associated injury and transverse fracture is the primary pattern of fracture in abused children. Notably, as most children experienced a single-bone fracture, the authors recommend clinicians to lower their threshold of considering abuse even in cases with an isolated fracture.

Diagnosis and treatment of developmental dysplasia of the hip: A current practice of paediatric orthopaedic surgeons.

BACKGROUND: Developmental dysplasia of the hip (DDH) is one of the prevalent musculoskeletal conditions in young adults and is a leading cause of hip osteoarthrosis in this age group. The optimum age for surgical intervention when needed is not well established in the literature and the lack of management guidelines and standard practice of DDH leads to different practices worldwide. This study aims to investigate the current practice of paediatric orthopaedic surgeons in diagnosing and treating DDH worldwide and identify points of agreement and disagreement. METHODS: A cross-sectional study utilizing an online questionnaire was designed to examine the different points of view and current practice of paediatric orthopaedic surgeons worldwide regarding DDH diagnosis and treatment. RESULTS: Ninety-one surgeons responded, with an overall response of 45.5%. The vast majority of respondents use ultrasonography in children less than 3 months of age and pelvic radiography in over 3 months to diagnose DDH. Pavlik harness is the most popular DDH treatment for children younger than 6 months. For older children, closed reduction with hip spica cast is the most preferable treatment. The maximum duration of first-line treatment has a broad range. The treatment of bilateral DDH varies widely among surgeons. CONCLUSION: This study shows clearly that paediatric orthopaedic surgeons do not agree on the diagnosis and treatment protocol of DDH, hence different approaches to this common disease are practised. The lack of an international guideline should motivate paediatric orthopaedic surgeons to discuss and formulate a uniform and evidence-based protocol for the diagnosis and treatment of DDH.