Clinical Effects of Dental Caries on the Quality of Life of Paediatric Patients Aged 8-10 Years: Utilisation of the PUFA Index.

PURPOSE: Saudi children have poor oral health; however, little data are available on the effects of dental caries and its clinical complications on the oral health-related quality of life (OHRQoL) in school-aged children. This study evaluated the impact of caries and its clinical effects on the OHRQoL of a sample of 8- to 10-year-old children attending King Abdulaziz University Hospital. MATERIALS AND METHODS: The following variables were assessed for each child: sociodemographic data, OHRQoL using an Arabic-validated Child Perception Questionnaire for 8- to 10-year-old children (CPQ8-10), and two global health rating questions. Caries and its clinical effects on oral health were also assessed using the decayed-missing-filled teeth (dmft/DMFT) and pulpal involvement, ulceration, fistula, and abscess (pufa/PUFA) indices. Descriptive statistics of the sociodemographic variables and responses to the CPQ8-10 questions are presented as absolute values and percentages. The CPQ8-10 scores between children with different dmft/DMFT and pufa/PUFA scores were compared. RESULTS: In total, 169 children participated in this study. The means ± SD of dmft and DMFT were 5.03 ± 2.5 and 2.35 ± 1.7, respectively. However, the pufa and PUFA scores were 1.03 ± 1.6 and 0.05 ± 0.2, respectively. The most common oral health complaint affecting OHRQoL was food stuck to the teeth. Participants with higher dmft and pufa/PUFA scores had statistically significantly higher CPQ8-10 scores than did their counterparts. CONCLUSION: High dmft and pufa/PUFA scores have a statistically signifcantly negative effect on the OHRQoL among healthy 8- to 10-year-old children. Worse global health ratings correlate with lower OHRQoL.

A comparison of three thromboprophylaxis regimens in critically ill COVID-19 patients: An analysis of real-world data.

Introduction: Thrombotic complications of coronavirus disease 2019 (COVID-19) have received considerable attention. Although numerous conflicting findings have compared escalated thromboprophylaxis doses with a standard dose to prevent thrombosis, there is a paucity of literature comparing clinical outcomes in three different anticoagulation dosing regimens. Thus, we investigated the effectiveness and safety profiles of standard, intermediate, and high-anti-coagulation dosing strategies in COVID-19 critically ill patients. Methodology: This retrospective multicenter cohort study of intensive care unit (ICU) patients from the period of April 2020 to August 2021 in four Saudi Arabian centers. Inclusion criteria were age ≥ 18 years, diagnosis with severe or critical COVID-19 infection, and receiving prophylactic anticoagulant dose within 24-48 h of ICU admission. The primary endpoint was a composite of thrombotic events, with mortality rate and minor or major bleeding serving as secondary endpoints. We applied survival analyses with a matching weights procedure to control for confounding variables in the three arms. Results: A total of 811 patient records were reviewed, with 551 (standard-dose = 192, intermediate-dose = 180, and high-dose = 179) included in the analysis. After using weights matching, we found that the standard-dose group was not associated with an increase in the composite thrombotic events endpoint when compared to the intermediate-dose group {19.8 vs. 25%; adjusted hazard ratio (aHR) =1.46, [95% confidence of interval (CI), 0.94-2.26]} or when compared to high-dose group [19.8 vs. 24%; aHR = 1.22 (95% CI, 0.88-1.72)]. Also, there were no statistically significant differences in overall in-hospital mortality between the standard-dose and the intermediate-dose group [51 vs. 53.4%; aHR = 1.4 (95% CI, 0.88-2.33)] or standard-dose and high-dose group [51 vs. 61.1%; aHR = 1.3 (95% CI, 0.83-2.20)]. Moreover, the risk of major bleeding was comparable in all three groups [standard vs. intermediate: 4.8 vs. 2.8%; aHR = 0.8 (95% CI, 0.23-2.74); standard vs. high: 4.8 vs. 9%; aHR = 2.1 (95% CI, 0.79-5.80)]. However, intermediate-dose and high-dose were both associated with an increase in minor bleeding incidence with aHR = 2.9 (95% CI, 1.26-6.80) and aHR = 3.9 (95% CI, 1.73-8.76), respectively. Conclusion: Among COVID-19 patients admitted to the ICU, the three dosing regimens did not significantly affect the composite of thrombotic events and mortality. Compared with the standard-dose regimen, intermediate and high-dosing thromboprophylaxis were associated with a higher risk of minor but not major bleeding. Thus, these data recommend a standard dose as the preferred regimen.

Combined Oral Contraceptives and Vascular Thrombosis: A Single-Center Experience.

Background Combined oral contraceptives (COCs) are frequently prescribed for contraception, to regulate ovulation and treat endometriosis, and to control menopausal symptoms. A major risk of hormonal contraceptives is vascular thrombosis. Methods A retrospective chart review of female patients with deep vein thrombosis (DVT), pulmonary embolism (PE), or other sites of thrombosis or emboli seen in the thrombosis clinic of the department of internal medicine at a tertiary care hospital in Saudi Arabia between March 2010 and February 2015 was performed to identify and characterize which women were taking COCs. Results Of 1,008 patients treated for DVT, PE, or other sites of thrombosis or emboli, 100 (9.9%) were taking COCs. Venous (98%) and arterial (2%) thromboses were seen. Overall, 62% of the patients experienced a DVT and 26% pulmonary emboli, and 20% of the patients experienced unusual sites of thrombosis. Furthermore, 53% were obese or morbidly obese. The incidence of venous thrombosis was the highest during the first year of COC use (73%). Of the patients, 8% had thrombophilia. Conclusion This study characterizes Saudi women with thrombotic events taking COCs and identifies risk factors, including unusual sites of thrombosis. Most patients experienced the vascular event during the first year of taking COCs. Age of 40-50 years, obesity, and thrombophilia were the commonly observed risk factors.

Compliance With Tobacco Control Policy and Visibility of Cigarette Retailers Around Educational Facilities in Riyadh, Saudi Arabia.

Background: In Saudi Arabia, cardiovascular diseases are among the top causes of death and disability, and smoking is one of the leading risk factors, particularly among males. Objective: Our study aims to evaluate the compliance with the anti-smoking law among cigarette retailers and examine the visibility of cigarette retailers around educational facilities in Riyadh city, Saudi Arabia. Methods: We conducted a mapping survey and geospatial analysis of cigarette retailers around educational facilities from February to March 2020 (before the COVID-19 restriction) in Al-Olaya municipality in Riyadh city as a pilot study. We found 249 retailers, of which 152 sold cigarettes. Data analyses in ArcMap 10.6 compared the visibility within 250 and 500 meters from educational facilities. Results: We found many retailers were not compliant with the tobacco control regulation: 57.1% of minimarkets sell cigarettes, 15.8% of cigarette retailers display the products openly, and 12.5% of cigarette retailers sold cigarettes by the stick. Moreover, 71% of the total cigarette retailers were within 500 m from schools, and 62% of all schools had at least one cigarette retailer within 500 m buffer (5-min walking or 2-3-min driving distance). Conclusion: There is non-compliance with the anti-smoking law among cigarette retailers and high visibility of cigarette retailers around educational facilities in Saudi Arabia. Monitoring is needed for the effective implementation of tobacco control policies.

Density of Fast Food Outlets around Educational Facilities in Riyadh, Saudi Arabia: Geospatial Analysis.

BACKGROUND: Childhood obesity remains a public health issue globally. The latest estimate from the World Health Organization showed that over 340 million children and adolescents aged 5-19 were overweight or obese in 2016. OBJECTIVE: Our study aimed to assess the density of fast food outlets around educational facilities in Riyadh, Saudi Arabia. METHODS: We employed geospatial and quantitative analyses using data on fast food outlets (from surveys conducted between November 2019 and May 2020) and educational facilities in Riyadh city. Data analyses conducted using ArcMap 10.6 and Stata 15 compared the density within 500 m and 500-1000 m from the facilities. RESULTS: We found a high density of fast food outlets around educational facilities. Nearly 80% of fast food were within twelve-minute walking or five-minute driving distances from schools, and nearly 70% of all educational facilities had at least one fast food outlet within the buffer. We also found the densities were high within both the areas closer and the areas farther away from educational facilities. In addition, the density was significantly higher around private schools compared to government schools, and the density around girls-only schools and both-gender schools was higher than that around boys-only schools. CONCLUSION: There is a high density of fast food outlets around educational facilities in Saudi Arabia. Effective policies are needed to help reduce potential exposure to fast food among young people in Saudi Arabia and other countries with similar settings.

Parental Perception Towards Flu Vaccination for Asthmatic Children in Saudi Arabia.

Background  Asthma is a major noncommunicable disease that affects around 235 million people, including children, globally. In the Kingdom of Saudi Arabia (KSA), the incidence of childhood asthma continues to increase. The Ministry of Health in Saudi Arabia has attempted to put policies in place to prevent the occurrence of asthma-related complications by encouraging parents to vaccinate their diagnosed asthmatic children with the flu vaccine. To date, however, there have been no studies investigating the use of flu vaccine among asthmatic children in KSA. Our research aims to explore the perception of parents with asthmatic children towards flu vaccination and its effect on the decision to vaccinate their children. Methods Our research was a cross-sectional study of 190 parents who presented with asthmatic children at King Fahad Medical City (KFMC) in Riyadh, KSA from October 2016 to April 2017. The study tools included structured and semi-structured questionnaires with demographic information, types of healthcare, and perceptions of parents towards flu vaccination. Data analysis was done using Statistical Package for the Social Sciences (SPSS; IBM, Armonk, NY). Results Samples were mostly Saudis (97%), who were married (92%), and in the age group of 21-40 years (70%). Most of them were females (59%). More than two-thirds of the parents had a middle school education or bachelor's degree, and more than half were employed. Parents with higher education had a higher rate of vaccination for their children, and they were more likely to believe that a non-vaccinated child is more likely to get flu. Almost 76% of parents with vaccinated children agreed that the flu vaccine could safeguard children against flu. Doctors' opinion about flu vaccination was significantly associated with the parents' decision. The multivariate regression analysis results showed that easy access to services and parents' beliefs regarding vaccination are positively associated with influenza vaccination status. Conclusion Among the essential factors positively associated with the influenza vaccination status were a perception of easy access to vaccination services and the belief that non-vaccinated children are more likely to contract the flu virus. In contrast, the belief that vaccination prevents infection by the flu virus was negatively associated with vaccine uptake.