Glycated hemoglobin predicts coronary artery disease in non-diabetic adults.

BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Due to increased CAD risk factors in Saudi Arabia, research on more feasible and predictive biomarkers is needed. We aimed to evaluate glycated hemoglobin (HbA1c) as a predictor of CAD in low-risk profile non-diabetic patients living in the Al Qassim region of Saudi Arabia. METHODS: Thirty-eight patients with no history of CAD were enrolled in this cross-sectional study. They provided demographic data, and their HbA1c estimation followed the National Glycohemoglobin Standardization Program parameters. All patients underwent coronary computed tomography angiography (CCTA) for evaluation of chest pain. The extent of coronary artery stenosis (CAS) was quantified as percentage for each patient based on plaques detected in CCTA. RESULTS: Mean blood pressure of the patients was (91.2 ± 11.9 mmHg), BMI (28.3 ± 5.8 kg/m2), serum cholesterol level (174 ± 33.1 mg/dl), and HbA1c levels (mean 5.7 ± 0.45, median 5.7 and range 4.7-6.4%). Eighteen patients showed no CAS (47.4%), 12 showed minimal stenosis (31.6%), 3 showed mild stenosis (7.9%), 3 showed moderate stenosis (7.9%) and 2 showed severe stenosis (5.3%). A moderate correlation was detected between HbA1c and CAS percentages (r = 0.47, p < 0.05) as well as between HbA1c and the number of affected coronary vessels (r = 0.53, p < 0.001). CONCLUSION: Glycated hemoglobin can be used as a predictive biomarker for CAD in non-diabetic low-risk patients.

Perrault syndrome with amenorrhea, infertility, Tarlov cyst, and degenerative disc.

Perrault syndrome is a rare autosomal recessive disorder that affects both males and females. The syndrome causes deafness in males, however females display gonadal dysgenesis along with sensorineural hearing loss. Herein, we present a 27-year-old female patient who is deaf and mute along with primary amenorrhea. Hormonal assays revealed hypergonadotropic hypogonadism and the karyotype was 46 XX. Pelvic ultrasound described a hypoplastic uterus and streak ovaries. MRI of the spine showed degenerative discs and Tarlov cysts. Whole exome sequencing identified a LARS2 mutation and the patient was diagnosed with Perrault syndrome type four (PRLTS4).

COVID-19-Induced Encephalitis: A Case Report of a Rare Presentation With a Prolonged Electroencephalogram.

Encephalitis is one of the rare complications of coronavirus disease 2019 (COVID-19) that can be missed and confused with other causes of encephalitis. There was a 36-year-old male known to have glucose-6 phosphate dehydrogenase deficiency, who was brought to the emergency department with fever and confusion of one-week duration. Altered mental status work-up, including cerebrospinal fluid analysis, was done and turned out to be nondiagnostic. Multiple prolonged video-electroencephalographic recordings were done and showed different abnormalities suggestive of encephalitis. The diagnosis of COVID-19-induced encephalitis was made by exclusion of other encephalitis-related etiologies in the presence of a positive COVID-19 polymerase chain reaction (PCR) test, and treatment was initiated accordingly. Over a period of three weeks, the patient showed progressive improvement and was discharged home with regular follow-up in the neurology clinic. Upon follow-up in the clinic, the patient was fully independent but with multiple abnormal electroencephalographic recordings showing generalized encephalopathy with no epileptic discharges.

Gender Differences in Sleep and Mental Health among Saudi Adolescents.

Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.

The associations of religiosity and family atmosphere with lifestyle among Saudi adolescents.

There have been gradual sociocultural changes in Saudi Arabia due to globalization. This allows a unique opportunity to examine religiosity and family atmosphere in relation to lifestyle among Saudi adolescents. In this cross-sectional study, 2067 school students (grades 7-12) from 32 randomly selected schools in Al-Qassim, Saudi Arabia were enrolled. Perceived religiosity, family atmosphere, lifestyle (e.g., physical activity, diet, screen time, obesity, and smoking), demography, parental attributes, and religious practices were assessed with validated scales and questions. A risk profile was created from the lifestyle variables (none, one, two, or ≥ three), and the students were grouped into low versus high religiosity and low versus high family atmosphere using a median split. Multinomial regressions were used to model the lifestyle risk profile. The mean age ±standard deviation was 15.5 years ±1.7, and 35% were girls; 28% had no risk factors, 32% had one, 25% had two, and 15% had ≥3. After adjustment, both low religiosity and low family atmosphere were significant correlates of the lifestyle risk profile (e.g., ≥3 risk factors: religiosity OR = 2.9, 95% CI: 2.1, 4.0; family atmosphere OR = 2.0, 95% CI: 1.5, 2.8). Those with both low religiosity and low family atmosphere were more likely to have a higher lifestyle risk profile than those who scored high in religiosity and better in family atmosphere (e.g., ≥3 risk factors: OR = 5.9, 95% CI: 3.7, 9.5). Hence, higher religiosity and better family atmosphere are associated with less risky lifestyles among Saudi adolescents.

Methicillin-resistant Staphylococcus aureus development in intensive care patients. A case-control study.

OBJECTIVES: To determine the factors associated with the development of methicillin-resistant Staphylococcus aureus (MRSA), hospital stay and mortality, and early versus late MRSA infection. METHODS: Cases (n=44) were intensive care unit (ICU) patients admitted to King Fahd Specialist Hospital, Al-Qassim, Saudi Arabia between 2015 and 2019 who developed MRSA during their hospital stay. Controls (n=48) were patients from the same place and period who did not develop MRSA. Data were abstracted from hospital records. RESULTS: Admission with sepsis (case: 46% vs. control: 2%, p less than 0.001) and having at least one comorbid condition (case: 95% vs. control: 46%, p less than 0.001) were significantly associated with the development of MRSA. Age (mean ±SD: case: 65±18, control: 64±18, p=0.7) and gender (% male, case: 52%, control: 56%, p=0.70) were not associated with the development of MRSA. Approximately 73% of all MRSA cases developed within the first 2 weeks of admission. Among the early cases, 44% died during their ICU stay; the corresponding percentage among the late cases was 42% (p=0.69). There was no difference between early and late MRSA cases in terms of non-sepsis admissions (50% vs. 67%, p=0.32) or comorbid status (at least one: 97% vs. 92%, p=0.17).  Conclusion: Sepsis and comorbid conditions were significant risk factors for MRSA development among hospital patients.

Gaming addiction and perceived stress among Saudi adolescents.

INTRODUCTION: Adolescents (age: 10-19 years) make up 15% of the Saudi population and have easy access to electronic gadgets and the Internet, yet data on gaming addiction among adolescents are negligible. We aimed to determine the prevalence of gaming addiction and its association with stress among Saudi school students. METHODS: In this cross-sectional survey, 2675 school students (grades 7-12) from 40 randomly selected schools in four main cities of Al-Qassim province in Saudi Arabia participated. The questionnaire inquired about demography, lifestyle, gaming addiction (7-item Game Addiction Scale), and stress (10-item Perceived Stress Scale). Multinomial logistic regression assessed the association between gaming addiction (yes, no) and stress (high, moderate, low). RESULTS: Participants' mean age was 16.1 (SD = 1.6) years; 50% were female; 64% reported >3 h of daily screen time; 5% were addicted to gaming; 11.4% had high-level stress. Addiction to gaming was strongly associated with stress in the adjusted analysis (moderate OR = 6.7, 95% CI = 2.9-15.5; high OR = 11.9, 95% CI = 4.7-30.1). Additionally, those who were older, female, had poor grades, unhealthy dietary habits, an inactive lifestyle, and smoked were more likely to experience high stress. CONCLUSIONS: Gaming addiction is strongly associated with stress among Saudi adolescents.