Mobile teledermatology--patient satisfaction, diagnostic and management concordance, and factors affecting patient refusal to participate in Saudi Arabia.

We evaluated the use of a 4G smart phone for mobile teledermatology. A dermatologist took pictures of skin images with a mobile phone (8 Mpixel camera resolution) and made a face-to-face diagnosis. The images were transmitted to a second dermatologist who viewed them on a similar mobile phone and made an independent diagnosis for comparison. Images were taken and transmitted only after receiving informed consent from the patients. A total of 166 consecutive patients were included in the study (97 male and 69 female). A questionnaire to assess patient satisfaction was administered to each patient. Most of the responders were highly satisfied with teledermatology. However, 23 patients (14%) refused photography of the skin lesions (21 female and 2 males). The main reasons for refusal to be photographed were stated as social or religious. The broad categorical diagnostic and management concordance (i.e. when considering at least one of the diagnoses to be similar) was 95%. Specific diagnostic concordance varied according to the disease. The average kappa coefficient was 0.66 for diagnostic concordance and 0.82 for management concordance. Refusal to be photographed--a problem not limited to teledermatology--needs to be considered when designing teledermatology protocols for larger scale implementation in areas like the Middle East.

Maternal obesity predict isolated birth defects in live births in Eastern Province of Saudi Arabia.

OBJECTIVE: There is no research on the predictors of birth defects in Al Ahsa Governorate in the Eastern Province of Saudi Arabia. The aim of this research was to detect the predictors of isolated structural birth defects in live births. METHODS: We conducted this study from April 2006 to 2010. Live births with isolated birth defects represented our sample for this retrospective case control study. Univariate analysis was done for all possible risk factors. Logistic regression analysis was done for all predictors in relation to different birth defects. RESULTS: Out of 37168 live births, isolated structural birth defects were found in 318 cases. Obesity ( body mass index > 30) was a significant predictor for increased nervous system anomalies ( odds ratio (OR): 7.83, CI: 3.9-15.4), facial defects (OR: 5.92, CI: 2.8-12.4), genitourinary anomalies (OR: 4.6 CI: 1.9-11.1), and cardiac malformations (OR: 2.7 CI: 1.3-5.7). Consanguinity increased the risk for cardiac malformations (OR: 3.32, CI: 1.54-7.17). Low socio-economic status increased the risk for nervous system anomalies (OR: 2.09, CI: 1.18-3.7), facial defects (OR: 2.33, CI: 1.25-4.33) and musculoskeletal anomalies (OR: 2.3, CI: 1.29-4.09). CONCLUSION: Maternal obesity represented the most common predictor for certain categories of isolated structural birth defects including nervous system, facial, genitourinary and cardiac.