Knowledge, Attitude, and Practice (KAP) of COVID-19 Vaccine Among Saudi Mothers.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) vaccine is a novel vaccine that was created during the midst of the COVID-19 pandemic in 2020 to combat the highly contagious COVID-19 infection. Since the initiation of vaccine administration campaigns globally, lots of research was simultaneously being done to study the vaccine's side effects and possible complications, especially in vulnerable groups such as pregnant women and children. Saudi Arabia is one of the leading countries in administering the COVID-19 vaccine to its population. However, due to the exchange of a lot of incorrect information through social media platforms about the vaccine's safety, people, particularly women expecting a child, breastfeeding, or having younger children, started to display some vaccine hesitancy. This study aims to assess the knowledge, attitude, and practice (KAP) of the COVID-19 vaccine among Saudi mothers and to recognize how certain individual characteristics affect it. METHODS:  This is an observational cross-sectional study that was carried out among 293 Saudi mothers attending primary healthcare clinics at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia from April 2022 to July 2022. The participants completed a pre-validated self-administered questionnaire that was composed of 39 closed-response questions divided into four sections: participant characteristics, knowledge, attitude, and practice towards the COVID-19 vaccine. The English questionnaire was translated to Arabic, retranslated back to English, and then compared to the first English version by a different translator to ensure translation accuracy. A pilot study was conducted on 20 participants before the survey was distributed for data collection. Statistical analysis was done using SPSS version 23.0 (IBM Corp., Armonk, NY). The association between the four sections of the questionnaire was assessed using Chi-square test of proportion.  Results: The study found that 64% of the participants were below the age of 40. The majority (56%) have earned a bachelor's or a higher degree. According to 41%, "Ministry of Health official channels" was the most important source of COVID-19 vaccine-related information. Almost half of the respondents (45%) showed to have an excellent knowledge of the COVID-19 vaccine and 62% showed to have a positive attitude towards it. Around 40% of the participants reported that they delayed taking the COVID-19 vaccine until it was mandatory. For those who have children aged between 12 and 18 years, 78% stated that their children took the COVID-19 vaccine. Mothers aged below 40 years showed to have significantly better vaccine knowledge compared to the older group. Mothers who received the influenza vaccine over the past three years were less likely to delay taking the COVID-19 vaccine until it became mandatory compared to those who did not receive it.  Conclusion: Younger age, higher educational level, flu vaccine administration in the previous three years, and adherence to child immunization schedules were all factors that had a significant impact on the KAP towards the COVID-19 vaccine. Correcting misunderstandings about vaccine safety through educational campaigns and providing timely information through the Ministry of Health channels can all contribute to achieving better practice related to vaccine uptake in this group.

The Early and Late Postoperative Complications of Pediatric Neuromuscular Scoliosis at King Abdulaziz Medical City, Riyadh, Saudi Arabia: A Case Series.

Background  Neuromuscular Scoliosis (NMS) is defined as "a coronal plane spinal curvature of 10 degrees or more, measured by the Cobb method, in the setting of muscle imbalance secondary to an underlying neuropathic or myopathic disease". Patients who have the disease usually manifest with diminished balance, asymmetrical seating, abnormal gait, and decreased pulmonary function, which are related to the change in spine posture. Surgery benefits patients with NMS in terms of stopping disease advancement and improving quality of life, but is known to be associated with certain complications in this population. The aim of this study is to identify the most common complication in NMS patients after surgical correction. Methods This study is a chart review-based retrospective case series that has covered patients' data going from 2015 to 2019. The study focused on patients who underwent scoliosis correction surgery of both genders and mainly of a single ethnicity, with the inclusion of patients aged 9 to 18 years old. Under consecutive sampling, the study has met a sample size of 14 patients.  Results Most of the study subjects nine (64%) were female. The age median was 13 years (2.25). The highest documented intraoperative complication was blood loss in 11 (79%) patients. The most prevalent early postoperative complication was urinary tract infection in two (14%) patients. No late postoperative complications were documented in the study. Conclusion  The study concluded that blood loss was the most common intraoperative complication. Pulmonary problems were one of the least reported complications. Possible reasons for these findings and prevention methods should be the focus of future studies.

Humoral Response of Patients With Autoimmune Rheumatic Disease to BNT162b2 Vaccine: A Retrospective Comparative Study.

Objective The effectiveness and safety of SARS-CoV-2 vaccines in patients with autoimmune rheumatic diseases (ARDs) treated with immunomodulators remain uncertain. Therefore, this study aimed to evaluate whether the humoral immune response to the BNT162b2 vaccine differs between patients without and with ARDs treated with immunomodulators. Methods We retrospectively reviewed 3208 electronic medical records from the database of the Hamad Medical Corporation (HMC) outpatient rheumatology clinics to capture patients with ARDs and control patients without autoimmune inflammatory diseases. All patients who were SARS-CoV-2 infection-naïve, had received two doses of BNT162b2 vaccination, and had been serologically tested using Elecsys® anti-SARS-CoV-2 S immunoassays (Roche Holdings AG, Basel, Switzerland), were included in the analysis. Patients with ARD were classified into six subgroups according to the received ARD immunomodulators: methotrexate monotherapy (MTXM), a combination of conventional synthetic disease-modifying antirheumatic drugs (Cs-DMARDs), tumor necrosis factor inhibitor (TNF-i), rituximab, interleukin-6 inhibitor (IL6-i), and Janus kinase inhibitor (JAK-i). Samples with an anti-SARS-CoV-2 S titer of <0.8 and <132 binding antibody unit (BAU)/mL were defined as negative and poor seroconversion, respectively. The overall mean of anti-SARS-CoV-2 S titer and its level at <0.8 and <132 were compared between the six subgroups of patients with ARD and the controls by performing an unpaired t-test and Chi-squared or Fisher's exact test as appropriate. Results The mean (SD) age of 110 patients with ARDs and 20 controls was 47.1 (12) and 59.3 (8.9) years (P < 0.001), respectively, and women predominated both groups (60% vs. 75%, P = 0.20). The most frequently prescribed Cs-DMARDs was methotrexate in 50 (45.5%) patients, followed by TNF-i in 46 (41.8%), rituximab in 20 (18.2%), JAK-i in 12 (10.9%), and IL6-i in 7 (6.4%) patients. The mean (SD) anti-SARS-CoV-2 S antibody titer of only the rituximab subgroup significantly differed from the controls (P = 0.012). Conclusion The most prevalent ARD immunomodulators (Cs-DMARDs, TNF-i, JAK-i, and IL6-i) were associated with comparable seroconversion rates to the BNT162b2 vaccine. In comparison, rituximab was significantly associated with decreased immunogenicity.

Characteristics and Obstetric Outcomes in Women With Autoimmune Rheumatic Disease During the COVID-19 Pandemic in Qatar.

OBJECTIVE: Pregnant women with autoimmune rheumatic diseases are considered to have a high risk of obstetric complications with the emergence of the Coronavirus disease (COVID-19) pandemic. Therefore, we aimed to assess the impact of COVID-19 on this high-risk group. METHODS: This cross-sectional cohort study (March to December 2020) was conducted at the largest tertiary center in Qatar (Hamad Medical Corporation). Eighty consecutive patients following up at the center during pregnancy were surveyed through telephonic interviews. Data on COVID-19 and pregnancy outcomes were extracted from electronic hospital records. RESULTS: Eighty pregnant women with autoimmune rheumatic diseases were included. Among them, 17 (21.3%) (95% confidence interval [CI]: 12.9-31.8%) were diagnosed with COVID-19, five were hospitalized, and only one required intensive care unit admission. The proportion of adverse obstetric outcomes in the cohort was 29.5% (n = 23; 95% CI: 19.7-40.9%). Prematurity (n = 14; 19.4%) and caesarean section (n = 30; 41.1%) were the most prevalent adverse events. There was no statistical difference in adverse pregnancy outcomes between women with and without COVID-19. CONCLUSION: COVID-19 did not affect pregnancy outcomes in women with autoimmune rheumatic diseases.

Patient-guided modifications of oral anticoagulant drug intake during Ramadan fasting: a multicenter cross-sectional study.

Fasting Ramadan is known to influence patients' medication adherence. Data on patients' behavior to oral anticoagulant (OAC) drug intake during Ramadan is missing. We aimed to determine patient-guided modifications of OAC medication regimen during Ramadan and to evaluate its consequences. A multicenter cross-sectional study conducted in Saudi Arabia. Data were collected shortly after Ramadan 2019. Participants were patients who fasted Ramadan and who were on long-term anticoagulation. Patient-guided medication changes during Ramadan in comparison to the regular intake schedule before Ramadan were recorded. Modification behavior was compared between twice daily (BID) and once daily (QD) treatment regimens. Rates of hospital admission during Ramadan were determined. We included 808 patients. During Ramadan, 53.1% modified their intake schedule (31.1% adjusted intake time, 13.2% skipped intakes, 2.2% took double dosing). A higher frequency of patient-guided modification was observed in patients on BID regimen compared to QD regimen. During Ramadan, 11.3% of patients were admitted to hospital. Patient-guided modification was a strong predictor for hospital admission. Patient-guided modification of OAC intake during Ramadan is common, particularly in patients on BID regimen. It increases the risk of hospital admission during Ramadan. Planning of OAC intake during Ramadan and patient education on the risk of low adherence are advisable.