Prevalence, factors associated and management of needle phobia among the general population in Saudi Arabia and Egypt.

OBJECTIVE: This study aims to assess the prevalence of needle phobia among Saudi and Egyptian adult populations. In addition, underlying causes and strategies that can be utilized to address needle fear were investigated. METHODS: A cross-sectional online survey study was conducted in Saudi Arabia and Egypt between 1 May and 30 June 2023. Participants aged 18 years and above and living in Saudi Arabia and Egypt were eligible to complete the survey. Participants were invited to participate in this study through social media platforms (Facebook, X, Snapchat, and Instagram). A convenience sampling technique was used to recruit the study participants. A 21-item questionnaire consisting of four sections including a Likert scale score was used to answer the research objectives. Numeric data were presented as mean ± SD. For categorical variables, percentages were used. Comparison between groups were made by Student's t-test or Mann Whitney test according to data distribution. Chi squared tests for categorical values were conducted. A binary logistic regression analysis was conducted to investigate factors associated with needle phobia. RESULTS: A total of 4065 participants were involved in this study (Saudi Arabia: 2628 and Egypt: 1437). Around one-third of the study participants (36.5%) confirmed that they have needle phobia. Most of the study participants (81.1%) reported that they have had needle phobia since they were under 18 years of age. Pain, general anxiety, and fear of making a mistake during the procedure were the most commonly reported contributors for fear of needles during or before a medical procedure. Around 15.8% of the study participants reported that they have tried to get rid of phobia from needles. Non-surgical alternatives (such as oral medications and patches) and using smaller/thinner needles were the most commonly reported interventions that reduced fear of needles. Binary logistic regression analysis identified that females, those who are aged (41-50 years), widowed, those with bachelor's degrees and higher education, and those unemployed were more likely to have needle phobia compared to others. CONCLUSION: Our study highlighted the high prevalence of needle fear within an adult population in Egypt and Saudi Arabia. Females, those who are aged (41-50 years), those widowed, those with higher education degrees, those unemployed, those working in the health sector and people with low income were more likely to have needle phobia compared to others.

COVID-19 vaccination side effects among the child age group: a large cross-sectional online based survey in Saudi Arabia.

BACKGROUND: Multiple vaccines have been tested in clinical trials for their efficacy and safety. In Saudi Arabia, Pfizer-BioNTech or Moderna were approved for children, however, previous studies to report their safety profile are limited. This research aims to understand the side effect of children's vaccination against SARS-CoV-2 infection in Saudi Arabia. METHODS: This was an observational retrospective cross-sectional study was conducted using an online survey in Saudi Arabia from March to May 2022. The inclusion criteria were parents aged 18 years and above who live in Saudi Arabia and have vaccinated their children. The self-reported questionnaire was adopted from published studies to investigate the study objectives Descriptive statistics were used to describe patients' demographic characteristics, continuous data were reported as mean ± S.D., categorical data were reported as percentages (frequencies), and logistic regression was used to identify predictors of persistent post-COVID-19 symptoms. RESULTS: This study had a total of 4,069 participants. Only 41.9% of the participants reported that their child(ren) had been infected with the coronavirus. 2.00 was the median number of children (IQR: 1.00-4.00). More than half of the study participants (64.2%) reported that a family member had been infected with the coronavirus. Both parents received COVID-19 vaccination, according to most participants (88.7%). Most participants (70.5%) stated that all children who met the vaccination criteria had received the vaccine. Most participants (83.5%) said their child or children had two doses of their vaccine, and about half (50.4%) of those who received the vaccine reported experiencing side effects. In addition, the majority (78.9%) reported that the side effects appeared within one day of receiving the vaccine, and nearly two-thirds (65.7%) reported that the side effects lasted between one and three. A total of 11,831 side effects cases were documented. Pain at the injection site, hyperthermia, and fatigue were the most reported side effects, accounting for 15.3%, 14.1%, and 13.2%, respectively. CONCLUSION: It appears that the side effects of the COVID-19 vaccine for children are minor, tolerable, and like those described previously in clinical trials. Our data should encourage the public about the safety of receiving the COVID-19 vaccine for children.

Prevalence and predictors of nomophobia among the general population in two middle eastern countries.

BACKGROUND: Nomophobia is a psychological condition caused by a fear of disconnecting from others through mobile phones. AIM: This study aims to determine the prevalence of and predictors of nomophobia and anxiety symptoms among the general population in Saudi Arabia and Jordan. METHODS: This study was an observational cross-sectional study using a web-based online survey distributed in two middle eastern countries (Saudi Arabia and Jordan) between Jun 24 and Jul 20, 2021. A convenience sample was used to recruit the study participants. Categorical variables were identified as frequencies and percentages. In addition, a binary logistic regression analysis was used to determine the factors associated with nomophobia symptoms. The Statistical Package for Social Science (SPSS) software, version 27 (IBM Corp, Armonk, NY, USA), analyzed the data. RESULTS: A total of 5,191 responded to the online survey. Around (26.5%) reported that they suffer from an anxiety problem or use a treatment for anxiety. The median daily time spent using a mobile phone (IQR) (minutes) was around 210 min per day. About half of the study sample (51.2%) are diagnosed with dependence syndrome. The binary logistic regression analysis revealed that those within the age group of 30-49 years and 50 years and above) are less likely to have mobile phone dependence compared to those less than 30 years old. Females were 16% at lower risk of developing mobile phone dependence compared to males Married participants were less likely to have mobile phone dependence compared to single participants (OR: 0.62 (95% CI 0.56-0.70)), while divorced participants were at a 46% higher risk of developing mobile phone dependence. CONCLUSION: Nomophobia prevalence among Saudi Arabia and Jordon's population is 51.2%. Several factors may predict mobile phone dependence including age, gender, marital status, and previous history of anxiety.

Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey.

INTRODUCTION: Health warnings on cigarette sticks are emerging as a tool to control tobacco consumption; hence, understanding how they are perceived is valuable in determining their effectiveness. Our study aimed to evaluate the perception of health-related messages and warnings on individual cigarette sticks. It also aimed to evaluate the perceptions of the effectiveness of cigarette packaging warnings and the acceptance level for the inclusion of health warnings on cigarette sticks. METHODS: This cross-sectional survey was conducted on 285 individuals in Al-Madinah, Saudi Arabia. The survey was distributed online using a non-probability convenience sampling technique. The chi-squared test and logistic regression analysis were used to determine the association of sociodemographic characteristics and smoking-related variables with participants' perceptions of health warnings on cigarette sticks and packaging. The responses were also assessed qualitatively using conceptual content analysis. RESULTS: In all, 18.6% of participants perceived that the package warnings were either 'quite effective' or 'very effective' in prompting smokers to quit. For health warnings on cigarette sticks, 28.1% of participants perceived that the theme of statistics on mortality was either 'quite effective' or 'very effective' in prompting smokers to quit, compared to 35.0 % for the theme of social and financial consequences. Respondents who had secondary education and lower were almost two times more likely to support the inclusion of health warnings than those who had a university education and higher (OR=1.9; 95% CI: 1.02-3.7, p=0.042). Most of the comments were positive for the inclusion of health warnings on cigarette sticks. CONCLUSIONS: Most participants perceived that package warnings were ineffective, but warnings on cigarette sticks were effective methods of dissuasion of cigarette use. Smokers were almost twice as likely to perceive as effective supportive messages to quit than non-smokers. The majority of participants 'agreed' or 'strongly agreed' to the inclusion of health warnings on cigarette sticks.

The Effects of Sociodemographic Factors and BMI on Weight Stigma Among Adults With Obesity in Madinah Region, Saudi Arabia: A Cross-Sectional Analytical Study.

Introduction Weight stigma (WS), characterized by discrimination and stereotyping based on a person's weight, remains understudied in Saudi Arabia despite the country's high obesity rates. Particularly, limited research has been conducted on WS in Madinah. Understanding the factors contributing to WS in this region is crucial for developing targeted interventions to effectively address it. Hence, this study aimed to explore the effects of sociodemographic characteristics and body mass index (BMI) on WS among adults with obesity in Madinah. Methods Individuals with obesity who were seeking care at primary healthcare centers were included in this study. This research was an analytical cross-sectional study; Madinah City was divided into four areas. One primary health center from each area was randomly selected. Subsequently, a consecutive sampling technique was used to collect questionnaires from participants during the period of December 2023 to March 2024. The participants completed a self-administered electronic questionnaire, which included the Arabic-translated and validated version of the Weight Self-Stigma Questionnaire (WSSQ). Data analysis included descriptive, simple logistic regression and multiple logistic regression with forward stepwise analysis. Results A total of 383 participants completed the questionnaire, of which 225 (58.7%) were men and 158 (41.3%) were women. The analysis showed that individuals without a family history of obesity experienced higher WS levels than those with a family history [adjusted odds ratio (AOR) = 1.853, 95% confidence interval (CI): 1.010-2.844]. Moreover, individuals with obesity demonstrated the lowest WS levels than those without obesity (AOR = 0.027, 95% CI: 0.009-0.08). These findings provide insights into the association among sociodemographic factors, BMI, and WS in adults with obesity residing in Madinah, Saudi Arabia. Conclusion This study provides evidence that WS is a complex issue that is not solely determined by an individual's obesity status; rather, it is influenced by a lack of family history of obesity, which establishes the impact of social factors on WS. Therefore, comprehending the role of family dynamics and societal norms in shaping an individual's weight status is crucial in managing WS.

Time-Ordered Recent Event (TORE) Volumes for Event Cameras.

Event cameras are an exciting, new sensor modality enabling high-speed imaging with extremely low-latency and wide dynamic range. Unfortunately, most machine learning architectures are not designed to directly handle sparse data, like that generated from event cameras. Many state-of-the-art algorithms for event cameras rely on interpolated event representations-obscuring crucial timing information, increasing the data volume, and limiting overall network performance. This paper details an event representation called Time-Ordered Recent Event (TORE) volumes. TORE volumes are designed to compactly store raw spike timing information with minimal information loss. This bio-inspired design is memory efficient, computationally fast, avoids time-blocking (i.e., fixed and predefined frame rates), and contains "local memory" from past data. The design is evaluated on a wide range of challenging tasks (e.g., event denoising, image reconstruction, classification, and human pose estimation) and is shown to dramatically improve state-of-the-art performance. TORE volumes are an easy-to-implement replacement for any algorithm currently utilizing event representations.

Retrospective Observational Assessment of the Impact of Cefepime Prophylaxis in Neutropenic Pediatric Patients With Acute Myelogenous Leukemia.

BACKGROUND: The potential for cefepime prophylaxis to reduce bloodstream infections (BSIs) in pediatric patients with acute myelogenous leukemia (AML) has been incompletely characterized. METHODS: A retrospective quasi-experimental study of patients under 21 years of age admitted with AML from 2010 through 2018 at two affiliated pediatric tertiary-care hospitals before and after the adoption of routine cefepime prophylaxis for afebrile AML patients during profound neutropenia. RESULTS: The rate of BSIs per 1000 neutropenia days was significantly lower in the prophylaxis group than the baseline group (2.6 vs 15.5, incidence rate ratio [IRR] 0.17, 95% CI 0.09-0.32). Interrupted time-series analysis showed that a sharp reduction in BSIs coincided with the implementation of prophylaxis. Bacteremia with viridans group streptococci was frequent in the baseline group but not observed after adopting prophylaxis. Despite the increased use of cefepime, the rate of cefepime-nonsusceptible BSIs per 1000 neutropenia days decreased (1.6 vs 4.1, IRR 0.40, 95% CI 0.16-0.99). The median number of febrile neutropenia episodes per patient also decreased in the prophylaxis group, as did the proportion of patients admitted to the intensive care unit (ICU) (22/51 (43.1%) vs 26/38 (68.4%); risk difference -25.3%, 95% CI -44.4 to -2.8). A trend was observed toward an increased proportion of patients with Clostridioides difficile infection in the prophylaxis group (10/51 (19.6%) vs 3/38 (7.9%); risk difference 11.7%, 95% CI -3.4 to 29.0). CONCLUSIONS: Cefepime prophylaxis was associated with a significant reduction in BSIs, febrile neutropenia, and ICU admission among pediatric AML patients.

A Rare Case of Progressive Familial Intrahepatic Cholestasis Type 4: A Case Report and Literature Review.

Progressive familial intrahepatic cholestasis (PFIC) is a group of genetic disorders characterized by progressive intrahepatic cholestasis. Different mutations in hepatocellular transport genes result in distinct PFIC subtypes with unique clinical manifestations, laboratory findings, and histopathological characteristics. Three PFIC genotypes have been commonly described (PFIC 1, 2, and 3), but in recent years, PFIC 4, 5, and 6 genetic mutations have been identified. Here, we report the first PFIC 4 case in the Middle East in a 46-day-old male infant who was successfully treated with a liver transplant. A 46-day-old, male, full-term infant presented with persistent jaundice and obstructive liver pathology suggested by liver profile and biopsy. Whole exome sequencing confirmed the diagnosis of PFIC 4. Medical treatment failed to improve the patient's symptoms. Therefore, the patient underwent hepatectomy and an unrelated liver transplant. He is currently exhibiting significant clinical improvements and is free of active complaints. PFIC is a rare disease that poses diagnostic and therapeutic challenges for clinicians. Infants presenting with unexplained cholestasis should have PFIC 4 as a differential diagnosis. Early recognition and treatment of PFIC 4 with liver transplantation may result in a more favorable prognosis.

Neonatal Septic Arthritis of the Hip: A Case Report.

Neonatal septic arthritis is a bacterial infection that, if not identified and treated right away, can affect human joints and result in osteonecrosis, joint destruction, and permanent abnormalities. Around 0.3 out of every 1,000 live births are impacted by septic arthritis worldwide. Although there is very little available data on the newborn population, we present a novel case of neonatal hip septic arthritis that was presented to our hospital and was successfully treated with surgical irrigation and debridement through arthrotomy with the Smith-Petersen approach in addition to antibiotics, despite its early vague presentation and lack of complications. Thus, it is crucial to clinically and radiologically evaluate neonates presenting with obscure symptoms and signs to prevent future disabilities and complications resulting from septic arthritis.

A Multicenter Cross-Sectional Study of the Awareness and Screening for Retinopathy of Prematurity Among NICU Pediatricians in Makkah and Jeddah, Saudi Arabia.

Purpose This study aims to evaluate neonatal intensive care unit (NICU) pediatricians' knowledge about retinopathy of prematurity (ROP) in the major tertiary centers in Makkah and Jeddah, Saudi Arabia. Methods This cross-sectional study uses a self-administered electronic questionnaire completed by NICU pediatricians at the main hospitals of Makkah and Jeddah cities. Based on the participants' correctly selected responses to the validated questionnaire, a scoring system was used in the data analysis to show their level of ROP knowledge. Results Seventy-seven responses were analyzed. The male gender was 49.4%. The majority were recruited from the ministry of health hospitals (63.6%). A small proportion (28.6%) correctly identified who performs the examination. Around three-quarters of the participants have correctly stated that ROP therapy is a very good option to prevent blindness (72.7%). The treatment should generally begin within 72 hours after diagnosis of sight-threatening ROP (79.2%). The requirements for ROP screening were unknown to more than half of our participants (53.2%). With the lowest score of 4.0 and a maximum score of 17.0, the median knowledge score was 13.0 (IQR = 11.0 to 14.0). Based on pediatricians' clinical qualifications, knowledge scores varied significantly. Residents had a significantly lower knowledge score than specialists and consultants (median = 7.0, IQR = 6.0 to 9.0, p = 0.001). Additionally, pediatricians with less experience (<5 years) performed significantly lower on the knowledge score (median = 10.0, IQR = 6.2 to 12.8) than those with more experience (median = 13.0, IQR = 11.0 to 15.0) for participants with 5-10 years of experience, and (median = 13.0, IQR = 11.0 to 14.0) for participants with >10 years of experience). Conclusion Our study showed that NICU pediatricians understood ROP risk factors and treatment options. Nevertheless, they needed to understand the ROP screening inclusion criteria and when the screening could be stopped. Residents scored substantially lower in knowledge overall. Accordingly, we emphasized the need for NICU pediatricians to increase their level of awareness by having regular educational sessions and standardizing one guideline to be strictly followed.

An Unusual Case of Isolated Duodenal Varices With Superior Mesenteric Vein Thrombosis.

Duodenal varices usually occur due to portal hypertension and are rare causes of gastrointestinal tract bleeding. We report a unique case of a previously fit patient who presented with melena and was found to have isolated duodenal varices (DV) in the third part on esophagogastroduodenoscopy. No esophageal or gastric varices were noticed. The duodenal varices were successfully managed by endoscopic banding. A computerized tomography scan of the abdomen to further investigate the cause confirmed duodenal varices and revealed superior mesenteric vein thrombosis. The liver was normal with patent hepatic and portal veins. No evidence of thrombophilia was found. Apixaban was prescribed for superior mesenteric vein thrombosis and on follow-up. no further bleeding was reported.

Predictors of Parental Recall of Newborn Hearing Screening Program in Saudi Arabia.

Hearing impairment is a prevalent disabling condition among children; all newborns should undergo a universal newborn hearing screening (UNHS). Unfortunately, many newborns who fail the screening test are lost to follow-up. Our study aims to evaluate parents' perceptions of UNHS and to identify predictors for newborn hearing screening recall in Saudi Arabia. A cross-sectional study involving Saudi parents with 0-to-18-year-old children born in Saudi Arabia was conducted. Descriptive statistics and binary logistic regression were used to describe the participants' characteristics and to identify UNHS recall predictors. A total of 1533 parents were surveyed. Overall, 29.9% of them recalled a hearing screening at birth, while 22.2% reported no hearing screening, and 47.8% were unable to remember. Only (6.9%) participants reported a failed hearing screening, of which 75.9% recalled a follow-up recommendation. Females, parents aged 30-34 years, consanguineous parents, and parents of newborns who were treated with antibiotics were more likely to recall hearing screening compared to others. This study highlights inadequate awareness of UNHS among parents. Our findings support the need to improve the reporting system of UNHS results and implement educational programs to increase parents' recall of hearing test results and ensure early follow-ups for neonates with failed test results.

Physician's Knowledge and Attitudes on Antibiotic Prescribing and Resistance: A Cross-Sectional Study from Hail Region of Saudi Arabia.

BACKGROUND: Antibiotic (AB) resistance is caused partly by overuse, varies by region, and is influenced by prescriber perspectives. This study sought to determine physicians' knowledge and attitudes toward AB prescribing, particularly in the Hail region of Saudi Arabia. METHODS: An interdisciplinary team created and validated an electronic questionnaire via the test-retest method that measured reliability and consistency. The 19 questions covered the following subjects: demographic information (7), experience with AB resistance in daily work (3), AB prescribing behavior (2), communication with patients regarding AB resistance (3), and prescribing practices (4). The revised questionnaire was prepared and distributed to physicians in the Hail region via multiple electronic communication channels. Inferences were drawn based on descriptive statistics and multivariate regression analysis. RESULTS: The questionnaire responses of 202 participants were eligible for analysis. A total of 70 (34.80%) participants were general practitioners, 78 (38.12%) were engaged in daily work that was only mildly related to AB resistance, and 25 (12.37%) performed work that was substantially related to AB resistance. A total of 88 (43.56%) physicians believed that prescribing behavior contributed to the emergence of AB resistance, whereas 68 (33.66%) did not. Regarding exposure, 51 (25.24%) physicians reported encountering instances of AB resistance monthly, whereas 104 (51.48%) reported seeing cases of AB resistance very rarely. In terms of prescribing practices, 99 (49.0%) physicians prescribed ABs to patients daily and 73 (36.13%) weekly. Regarding AB-resistance-related communication with patients, 73 (36.13%) physicians frequently discussed AB resistance with patients suffering from infections, whereas 13 (6.4%) never discussed it with patients. CONCLUSION: General practitioners in the Hail region exhibited comprehensive awareness of the elements that contribute to AB resistance but only rarely communicated about the issue with their patients, presuming the latter to be oblivious to the science behind AB resistance. Our findings suggest that the features underlying practitioners' AB prescribing behavior could be a powerful strategy for lowering AB resistance.

Attitudes and Practices of the Public Toward Precautionary Measures Post-COVID-19 Pandemic in Saudi Arabia.

Objective: This study aimed to assess the practices and attitudes of the general population towards coronavirus disease-2019 (COVID)-19 after the removal of precautionary and preventive measures in Saudi Arabia. Methods: A cross-sectional study was conducted among the general population in all regions of the Kingdom of Saudi Arabia, from September 2022 to October, 2022 via a virtual survey to evaluate the practices, and attitudes of the general population towards COVID-19. A stratified random sampling technique was applied to collect the sample with inclusion criteria for all individuals who are Arabic language speakers using social media platforms. The individuals selected for this study were 18 years and older. Results: A total of 2406 responses were received for the study questionnaire. Most of participants (66.3%) were females aged 18 to 29 years (61.8%). Half of the participants reported a positive history of COVID-19 infection. Nearly 90% of participants still wear masks, 80% attended a crowded event, and 60% often wash their hands even though the Saudi government has erased the precautions. Females, young (30-39 years) and elderly (60 years and over) individuals, singles, those with a postgraduate degree, those who are employed, and healthcare workers were more likely to adhere to COVID-19 precautionary measures (p<0.05). Conclusion: The study's findings indicate that most of the population discontinued practicing precautionary measures after lifting the measures in Saudi Arabia. More public health initiatives should raise the scores of sanitary best practices to prevent the spread of viral illnesses.

A Pediatric Case of Basidiobolomycosis Presenting With an Abdominal Mass.

Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum. The condition has been reported in children and adults presenting with abdominal pain, weight loss, abdominal distension, vomiting, diarrhea, fever, and an abdominal mass. We report a case of a previously healthy 2.5 years old male who presented to the ER complaining of abdominal pain and distension for two weeks together with significant weight loss. He looked ill and cachectic. He had tachycardia but was afebrile. His abdominal examination showed a right-sided abdominal mass. His initial abdominal ultrasound (US) suggested an abdominal tumor. The patient was referred to a tertiary center where he had an ultrasound-guided biopsy that showed fungal hyphae consistent with basidiobolomycosis.

De Novo Heterozygous Mutation in FGFR2 Causing Type II Pfeiffer Syndrome.

Pfeiffer syndrome (PS) is an autosomal dominant disorder with three subtypes stemming from heterozygous mutations in the fibroblast growth factors FGFR1 and FGFR2. The subtypes overlap with heterogeneous clinical manifestations and variable prognosis dependent on neurological and respiratory compromise that impact short- and long-term outcomes and survival. We present a male, term infant with type II PS that was diagnostically suspected antenatally based on three-dimensional ultrasonographic findings that were confirmed postnatally by craniofacial tomography and magnetic resonance imaging. A new generation sequencing panel identified a unique de novo FGFR2, c.335 A > G p. Tyr112Cys variant, the first of its kind, and features that closely aligned with subtype II PS. Initial molecular results categorized the mutation as nonpathogenic, but it was later reclassified as pathogenic. Antenatal, multidisciplinary parental counseling about the tentative diagnosis and prognosis facilitated postnatal decisions that culminated in an informed choice for palliative care and early demise.

A child with bronchiectasis, chronic mucocutaneous candidiasis, and hypothyroidism secondary to STAT1 gain-of-function mutation: A case report and review of the literature.

STAT 1 GOF mutations are a rare cause of childhood primary immunodeficiency. Recurrent mucocutaneous candidiasis, chest infections, and autoimmune disease are all classic phenotype presentations. Rapid identification and diagnosis of this debilitating disease using whole exon sequencing may improve outcomes and minimize long-term sequelae.

Evaluation of Medical Students' Knowledge on Palliative Care: A Single Institution Cross-sectional Study.

Background: Palliative care is the branch of medicine which has a target of setting focus on the improvement of the quality of life of patients, particularly toward their end of life, such as cases of terminal diseases with low prognosis. Despite growing recognition of the importance of palliative care, a gap remains in medical education. Our study aims to evaluate the current level of knowledge of medical students in regard to palliative care. Methods: A cross-sectional descriptive study was conducted in Batterjee Medical College, Jeddah, Saudi Arabia, through a period of three months from December 2021 to March 2022. Results: A total of 254 students participated in our study. Psychosocial and spiritual needs of the patient alongside definition of palliative care were perceived the most important by the students with a mean score of 3.9 each. Conclusion: Our study concludes that there is an overall lack of confidence among medical students in providing palliative care. We recommend further enhancement and implementation of palliative care as part of undergraduate mandatory courses.

Assessment of Nurses' Knowledge and Confidence Regarding Tracheostomy Care in a Pediatric Long Term Care Hospital in Saudi Arabia.

Background: The incidence of tracheostomy insertion in pediatric patients has increased over the last few decades. Tracheostomized pediatric patients need daily, meticulous care by qualified nurses to minimize severe, avoidable complications. Adequately trained nurses facilitate patients' stability, accelerate weaning from the ventilator, and reduce potential tracheostomy dislodgement. Methods: A cross-sectional, retrospective cohort survey was conducted in September 2021, using an electronic version of a self-questionnaire, to assess nurses' knowledge and comfort level regarding tracheostomy care of pediatric patients at the International Extended Care Center in Jeddah, Saudi Arabia. Statistical analysis of the accrued data was performed using the SPSS 21.0 software package and a P-value <0.05 calculated by t-Test, was considered significant. Results: Among 43 nurses included in the study, 14 (32.6%) were very comfortable taking care of tracheostomized patients, 13 (30.2%) were comfortable, and 16 (37.2%) were uncomfortable. Regarding knowledge, three main aspects of tracheostomy care were correctly answered (%) by all the nurses: knowledge of routine tracheal care (55%), tracheal care skills (11.6%), and tracheal emergency care (2.3%). The study showed a significant positive correlation between nurses' comfort level with tracheal care and academic degree, duration of pediatric experience, completion of more than one life support course, and attendance at the annual local tracheostomy care competency learning program (TCCLP; all P <0.05). Conclusion: Deficits exist in nurses' knowledge of tracheostomy care. Improved knowledge garnered through repetitive participation in tracheostomy competency programs and life support courses correlate with greater comfort and more than 5 years of pediatric experience. Nurses' deficits in emergency care knowledge and skills should be addressed through a structured educational program and a simulation, hands-on based TCCLP course, irrespective of comfort level with tracheostomy care.

Patterns of Functional Gastrointestinal Disorders Among Children in Makkah City: A Single Institutional Experience.

Background Functional gastrointestinal disorders (FGIDs) are syndromes identified based on a group of symptoms defined according to the criteria of the Rome Foundation. The most commonly observed disorders among the pediatric population are functional abdominal pain disorders and functional constipation. This study aims to identify the patterns of FGIDs among children in Makkah, Saudi Arabia. Methods A retrospective cohort study was conducted at pediatric gastroenterology clinics from 2015 to 2019 in a tertiary centre in Makkah, Saudi Arabia. The FGID outcomes were compared with the patient's gender, age, and other characteristics using Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) software to analyze the data. Results One hundred and fifty-two participants met the inclusion criteria, with a mean age of 5.49 ± 3.27 and an average weight of 20.68 ± 12.15 kg. Male patients account for 59.2% of the total population. The prevalence of abdominal pain was 17.84%, while constipation was 50.93%. There was a statistically significant association between abdominal pain and independent variables such as family history (p=0.004) and age, particularly in older children (5-12 years; p=0.001). A statistically significant correlation was found between constipation with gender (p=0.032) and family history (p<0.001). Conclusion The prevalence of functional constipation and abdominal pain increased with age among children in Makkah City, with constipation being significantly more prevalent than functional abdominal pain. There is a significant relationship between age and family history with abdominal pain, whereas gender and family history are associated with a greater likelihood of constipation.