Establishing local diagnostic reference levels for computed tomography examinations using size-specific dose estimates.

OBJECTIVES: To establish local DRL (LDRL) for computed tomography (CT) examinations based on size-specific dose estimates (SSDEs), which consider patient size. The concept of diagnostic reference level (DRL) was introduced to limit patient exposure to unnecessary radiation. However, traditional DRL values do not consider patient size. METHODS: Following institutional committee approval, data were collected from CT examinations of adult patients at Madinah General Hospital, Al Madinah Al Munawwarah, Saudi Arabia from January to March 2023. The SSDE was calculated for each patient using the effective diameter (Deff). RESULTS: The LDRLs of the brain, cervical spine, chest, thoracic spine and kidneys, ureters, and bladder (KUB) examinations were 118 mGy, 12 mGy, 8 mGy, 17 mGy, and 7 mGy, respectively. A strong correlation was observed between SSDEs and the volume computed tomography dose index (CTDIvol) for all examinations except chest scans (p<0.05). Size-specific dose estimates were higher than the CTDIvol, with a greater difference for patients with smaller Deff (p<0.05). CONCLUSION: The established LDRL was within the international DRL. The use of SSDE has the potential to provide more accurate and relevant data for radiation safety practices; however, widespread adoption of SSDE in new CT scanners is necessary for promoting consistency and standardization methodologies.

Knowledge and Practice of Primary Health Care Providers in the Management of Asymptomatic Hyperuricemia and Gout in the Qassim Region of Saudi Arabia.

Introduction & Aim The most prevalent type of inflammatory arthritis is gout. It develops because of hyperuricemia, which makes monosodium urate (MSU) crystals accumulate in the joints. However, hyperuricemia does not always cause gout. Methodology The following is a cross-sectional study conducted in the Qassim region of Saudi Arabia. 133 PHPs in this region were given a self-administered questionnaire through an online survey. The questionnaire included four sections: Demographic data (i.e., age, gender, years of experience) Knowledge of asymptomatic hyperuricemia; Management practices of asymptomatic hyperuricemia; Knowledge and practice of gout management Results One hundred thirty-three primary healthcare providers took part (males 63.9%; females 36.1%). The proportion of PHPs who attended continuing medical education (CME) on AH or gout was 32.3%. Moreover, 67.7% already knew the guidelines for managing AH or gout. PHPs' level of knowledge regarding the management of AH and gout was good (45.9%), but their level of practice was poor (23.3%). Greater experience and CME attendance on AH and gout contributed to better understanding and higher practice scores. Conclusion Although PHPs' knowledge of managing AH and gout was adequate, this did not reflect in their practice. Physicians with more years of experience who attended CME on AH and gout demonstrated better knowledge and practice than the rest of the PHPs. It is necessary to address the gaps in the practice of our PHPs, which could be done through in-depth training about AH and gout. Our study could guide other researchers to assess the gaps in other clinical practices that PHPs face.