Efficacy of home healthcare on the management of tracheostomy patients.

OBJECTIVES: To evaluated the home healthcare efficacy in managing tracheostomy patients at King Abdulaziz Medical City under the Ministry of National Guard Health Affairs. Home healthcare is care provided to patients in the convenience of their homes to ensure high-quality care based on healthcare providers' supervision. METHODS: This retrospective cohort study utilizing a non-probability consecutive sampling technique, including all available tracheal patients with no exclusion criteria, was carried out in Riyadh, Saudi Arabia, between January 2019 and June 2022. The collected data included patient demographic variables and respiratory settings (ventilation type, daily ventilation need, tracheostomy duration, and ventilator settings). The outcomes included mortality rate and therapeutic outcomes of tracheal management. RESULTS: Of the 183 patients in the study, the most common type of respiratory-related infection was pneumonia (53%). Unlike respiratory-related causes, The mortality rate of patients admitted to the intensive care unit that was unrelated to respiratory causes was statistically significant (57%) (p=0.003). The mortality rate of patients who used aerosol tracheal collars (34%) was markedly higher than mechanically ventilated patients (57%) (p=0.004). The mortality rate following discharge from HHC was 40%, and was higher among patients aged >70 years (47%) (p=0.04). CONCLUSION: Pneumonia was associated with the majority of ventilator-related infections and resulted in hospital readmissions. Ensuring proper practices and caregiver education is crucial to decrease the incidence of ventilator-related infections.

Appraising the degree of physical activities among male students at a Saudi medical school.

OBJECTIVES: This study aimed to assess the degree of physical activity among male medical students. We also investigated the association between their physical activity and academic performance. METHODS: In this cross-sectional study, we distributed the International Physical Activity Questionnaire among male medical students of the first year through the fourth year by using a convenient sampling technique. Physical activity was measured by using the Metabolic Equivalent Task (MET) score. The demographic variables included academic year and age of the participants. RESULTS: The study included 317 students; of those, 219 were pre-clinical (first and second year), and 98 were clinical (third and fourth year) students. According to the MET score, the degree of physical activity was categorized into three groups. As many as 140 (44%) students were classified as highly active (MET>3000) and 98 (34%) moderately active (MET 600-3000), while 69 (22%) students were inactive (MET<600). The second-year students had a higher degree of inactivity than others (p = 0.004). Additionally, there was a significant difference in the amount of siting time during the week, with a higher median sitting time by second-year students than by third- and fourth-year students (p = 0.001). CONCLUSION: In our study, most male medical students showed moderate or high physical activity. However, second-year students were physically inactive. Hence, the reason for such inactivity among second-year students should be explored. This study calls for the implementation of university-level programs that can motivate students to participate in physical activities.

Cherry angioma: A case-control study.

BACKGROUND: Cherry angiomas (CAs) are very common asymptomatic vascular skin lesions. There are only a few studies on CAs in the literature and those assessing risk factors of CAs are scarce. The aim of our study was to determine risk factors for the development of CAs. MATERIALS AND METHODS: A case-control study was conducted at a tertiary care center in Riyadh, Saudi Arabia. Patients underwent a full-body examination for CAs. Demographics and other data including medical history and medications were extracted from electronic medical records. RESULTS: A total of three hundred patients were enrolled: one hundred cases with at least five CAs and two hundred controls without CAs. Bivariate analysis identified benign prostatic hyperplasia (odds ratio [OR]: = 2.591), malignancy (OR = 2.567), tamsulosin (OR = 3.171), and clopidogrel (OR = 0.321) as statistically significant associations. After multivariate logistic regression analysis, only tamsulosin (OR = 3.475, P = 0.009) and clopidogrel (OR = 0.281, P = 0.028) were found to be independent risk factors for CAs. Malignancies tended to be more associated with CAs, but this did not reach statistical significance (P = 0.07). CONCLUSION: Tamsulosin is a possible risk factor for the development of CAs. Clopidogrel seems to have a protective role preventing the development of CAs.

Development of type 2 diabetes mellitus after gestational diabetes in a cohort in KSA: Prevalence and risk factors.

OBJECTIVES: KSA has the highest prevalence of diabetes mellitus among Middle Eastern countries with a prevalence range of 21%-24%. Gestational diabetes (GDM) is a well-known risk factor for type 2 diabetes mellitus (T2DM). GDM is associated with a 7-fold increased risk of T2DM. Thus, this research assessed the prevalence and risk factors associated with the development T2DM in a cohort of patients with GDM in KSA. METHODS: The medical records of patients with GDM who visited the outpatient clinics of a tertiary care hospital from 2011 to 2014 were included in this study. Patients with a prior diagnosis of diabetes mellitus before pregnancy and those with GDM who did not have postpartum diabetes screening were excluded. RESULTS: A total of 123 women with GDM and underwent postpartum diabetes screening, 82 (67%) developed T2DM based on follow-up records. Approximately 45% (37/82) of patients who developed T2DM were screened ≤6 months after delivery, whereas 55%(45/82) were screened >6 months after delivery. Older patients, patients who had a higher number of pregnancies (gravidity and parity), and patients with previous GDM were more likely to develop T2DM. CONCLUSION: In KSA, women who developed GDM, particularly those who are older, multigravid, and multiparous and who have a prior history of GDM, are at an increased risk of developing T2DM. Postpartum diabetes screening of patients with GDM within the recommended period need to be improved.

Prevalence and characteristics of abnormal Papanicolaou smear in Central Saudi Arabia.

OBJECTIVES: To assess the prevalence and characteristics of abnormal pap smear in the central region of Saudi Arabia. METHODS: In this retrospective case control study conducted in the Departments of Obstetrics and Gynecology, and Histopathology at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, all pap smears screened for Saudi women between 2008 and 2011 were reviewed. Approximately 5000 pap smears are screened annually at King Abdulaziz Medical City utilizing the Bethesda III System (2001). All abnormal smears patients' data were collected and compared to the data of randomly selected 200 normal smears' patients. RESULTS: Abnormal pap smear prevalence was found to be 4.3% (841/19,650 Saudi patients were found with atypical epithelial cells abnormalities). Its prevalence in the years 2008 was 5.7%, 2009 was 4.9%, 2010 was 4.2%, and 2011 was 2.5%. Abnormal smear patients have lower parity (p=0.001), and were less likely to use intra-uterine devices (p=0.03) compared with normal smear patients. Presence of abnormal cervical appearance was associated with increased epithelial cell abnormalities (p=0.045). The only positive history that has characterized patients with epithelial cell abnormalities was their previous history of abnormal pap smear (p=0.001). Squamous cell abnormalities were identified in 91% of the patients (767/841), and glandular cell abnormalities were identified in 9% of the patients (74/841). CONCLUSION: Prevalence of abnormal pap smears in central Saudi Arabia is relatively low, while advanced glandular abnormalities prevalence was observed to be high.