Public awareness about glaucoma, cataract, and diabetic retinopathy in Saudi Arabia: a systematic review and meta-analysis.

PURPOSE: To identify the public level of knowledge about the common ophthalmological conditions in Saudi Arabia. METHODS: We searched Medline, Embase, and CENTRAL for relevant literature. We included questionnaire-based cross-sectional studies performed in Saudi Arabia assessing the public awareness and attitude about general knowledge, causes/risk factors, signs/symptoms, disabilities/consequences, and relieving/management measures of the common ophthalmological conditions including glaucoma, cataract, and diabetic retinopathy (DR). The meta-analysis was performed on outcomes reported in ≥ 2 studies utilizing the random-effects model. Quality assessment was done using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. RESULTS: Twenty-eight studies were deemed eligible for inclusion in this review. A total of 72 questions were reported in ≥ 2 studies and were included in the meta-analysis. The total number of participants was 14,408. The meta-analysis estimated that 57.63% (95% confidence interval (CI) 56.87-60.07%), 69.90% (95% CI 67.02-76.07%), and 68.65% (95% CI 65.94-71.23%) of the Saudi public have you ever heard or read about glaucoma, cataract, and DR, respectively. Of the public surveyed in the included studies, 43.68% (95% CI 41.54-45.85%), 55.43% (95% CI 54.03-56.82%), and 63% (95% CI 60.8-65.1%) believed that glaucoma, cataract, and DR could be treated. CONCLUSION: This systematic review showed that the level of knowledge among the Saudi population about the common ophthalmological conditions was the highest with respect to cataract, followed by DR and glaucoma. The areas of unsatisfactory level of awareness about the common ophthalmological conditions included risk factors, signs/symptoms, complications, and management options. These areas need to be addressed appropriately by future educational interventions.

Noninvasive Neurally Adjusted Ventilation versus Nasal Continuous or Intermittent Positive Airway Pressure for Preterm Infants: A Systematic Review and Meta-Analysis.

The noninvasive neurally adjusted ventilatory assist (NIV-NAVA) is a newly developed noninvasive ventilation technique with promising clinical and ventilatory outcomes for preterm infants. This systematic review and meta-analysis aimed to investigate whether NIV-NAVA has better clinical and ventilatory outcomes than nasal continuous airway pressure (NCPAP) or noninvasive positive pressure ventilation (NIPP) on premature infants. MEDLINE, Embase, and CENTRAL were searched, and randomized controlled trials (RCTs) that compared NIV-NAVA with NCPAP or NIPP for preterm infants (gestational age: <37 weeks) were included. We evaluated the following outcomes in the neonatal intensive care unit: the desaturation rate, failure of noninvasive modality requiring intubation when received as the primary mode or the need for re-intubation after extubation from mechanical ventilation in the secondary mode (weaning), length of stay, and fraction of inspired oxygen. The mean difference and risk ratio were used to represent continuous and dichotomous outcomes, respectively. We included nine RCTs involving 339 preterm infants overall. NIV-NAVA showed similar clinical and ventilatory outcomes to NCPAP or NIPP, except for the maximum diaphragmatic electrical activity. The rate of failure of the noninvasive modality was not statistically different between NIV-NAVA and NCPAP. The pooled estimates for the maximum electrical activity were significantly reduced in NIV-NAVA compared with those in NIPP. The findings suggest that NIV-NAVA may be as safe and effective as NCPAP and NIPP for preterm neonates, particularly those who may not tolerate these alternative noninvasive methods. However, further trials are recommended for greater evidence.

Environmental Risk Factors for Childhood Inflammatory Bowel Diseases: A Multicenter Case-Control Study.

Objective: Multiple environmental factors can be linked to the development of inflammatory bowel disease (IBD).With an increase in the cases of IBD, the objective of this research is to investigate environmental risk factors for IBD in the Saudi population. Methods: A retrospective multicenter case−control study was performed among IBD children from 2009 to 2021.The variables analyzed to be the possible risk factors included their socioeconomic status, living and demographic characteristics, and lifestyle related to IBD. The questionnaire included a list of IBD risk factors that was given to the control and the patient group. For every variable, the 95% confidence interval (CI) and odds rations were also estimated. Results: There were 335 individuals considered in this study: 168 controls (50.1%) and 167 IBD patients (49.9%). Of these, 93 IBD patients (56%) had CD and 74 patients (44%) had UC. Most of participants were female (72.1%) and were aged above 10 years (51.5%). Vaginal delivery (OR 0.551, 95% CI: 1.59−4.14), age above 10 years (OR 1.040, 95% CI: 1.012−1.069), deficient fruit intake (OR 2.572, 95% CI: 1.59−4.14), no exposure to antibiotics (OR 2.396, 95% CI: 1.51−3.81), appendectomy (OR 2.098, 95% CI: 1.87−2.35), less physical activity (OR 2.033, 95% CI: 1.05−3.93) and gastroenteritis admissions > 2 times/year (OR 0.107, 95% CI: 0.037−0.311) were the risk factors for IBD. These factors depicted a more significant link with CD than UC (p < 0.05). Interestingly, sleep disturbance was estimated to be a CD risk factor (adjusted OR: 3.291, 95% CI = 0.97−11.22). Pets in house was risk factor for UC (p < 0.001). Conclusions: This study highlights association between vaginal delivery, age above 10 years, deficient fruit intake, low physical activity, exposure to antibiotics, appendectomy, and frequent gastroenteritis admissions as risk factors for IBD. Knowledge of these risk factors can help pediatricians to prospectively identify patients at risk of environmental exposure.

Pediatric Inflammatory Bowel Disease Associated With Celiac Disease: A Retrospective Study in a Tertiary Care Hospital in Saudi Arabia.

Background. Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a chronic relapsing disease indicated by inflammation of the gastrointestinal tract. Celiac disease (CeD) is a chronic autoimmune disease of the small bowel. The prevalence of CeD in IBD patients is unknown. Some studies have described the coexistence of the 2 diseases in the same patient. This study aimed to investigate the prevalence of CeD in Saudi Arabian children with IBD. Methods. We used a retrospective study design because data can be collected immediately and is easier to analyze afterward. The study was conducted on IBD patients in the Pediatric Gastroenterology Department at National Guard Hospital, Jeddah, Saudi Arabia. We enrolled Saudi patients aged between 1 and 18 years who had been diagnosed with IBD and CeD based on positive biochemical serology and histology from January 2011 to January 2020. We excluded patients with immunodeficiency disorders. Results. Among the 46 enrolled patients with IBD, CeD was identified in 4, and they did not develop any relapses. We discovered that the weight at IBD diagnosis improved significantly compared to current weight (P-value < .0001). We also discovered that the height at diagnosis of IBD improved significantly compared to the current height (P-value < .0001). Additionally, we found no significant associations between UC and CeD (P-value = 1), or CD and CeD (P-value = .625). Conclusion. No significant associations were evident between the prevalence of CeD and IBD. More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.