Awareness and Knowledge of Venous Thromboembolism Among Saudi Adults in the Dawadmi Province: A Cross-Sectional Study.

Background Venous thromboembolism (VTE) significantly contributes to the global disease burden. The annual incidence of VTE is one to two per 1,000 adults worldwide. We aimed to evaluate the awareness and knowledge of VTE risk factors, manifestations, prevention, and treatment options among the general adult population of Dawadmi, Riyadh, Saudi Arabia. Methodology We conducted a cross-sectional study using the self-designed and validated VTE knowledge questionnaire. A survey was conducted online via Google Documents, composed of 12 questions. Participants included in the study were over 18 years old, regardless of their medical history. However, medical students and healthcare providers were excluded. Results A total of 384 participants (46.4% men and 53.6% women) completed the survey; most respondents were between 18 and 28 years of age. Majority of the participants recognized that immobility, obesity, complicated surgery, road traffic accidents, smoking, and old age are the most common risk factors for VTE. However, more than half of the elderly and lower-educated participants did not identify complicated surgery and consumption of oral contraceptive pills as risk factors for VTE. Awareness of VTE was significantly higher among those with a family history of VTE and a graduate degree (p<0.001). Results showed a deficit of awareness and information about VTE, especially among males, those with low education, and elderly participants. Conclusion This study demonstrates the need for more awareness of VTE among the Saudi adult population. The urge to spread awareness and knowledge about VTE among the public in Dawadmi province is required.

The assessment of knowledge and awareness about iron deficiency anemia among the population of Riyadh province.

Background: Iron deficiency anemia (IDA) is considered the most common micronutrient deficiency and the greatest health concern throughout the globe. The main causes of anemia are iron deficiency, parasitic infestations, viral infections (human immunodeficiency virus), hemorrhage, and renal and hepatic diseases. Therefore, it is mandatory to be equipped with the proper knowledge regarding the causes, signs, symptoms, and diets containing iron, which can be a good initiative for the proper treatment and management of the health hazards; also, it will help primary care physicians to differentiate the degree of the disease and further treatment, planning, and management. The recent study was performed to understand the level of knowledge and awareness about IDA and its causes, prevention, and treatment. Methods: The study was carried out through an online survey using Google forms, which were distributed to the population residing in Riyadh Province. Results and Discussion: The responses received about the knowledge regarding IDA and its symptoms indicated weakness [565 (52.9%)], cold hands and feet [593 (55.5%)], and hair loss [663 (62.1)], and the majority (84.3%) of the participants believed that the major cause for IDA is malnutrition. Conclusion and Recommendations: Conclusively, it was believed that the presented study will be helpful to primary care physicians, the patients suffering from IDA, and the general population with a better understanding of the causes, additional signs and symptoms, proper treatment, timely management, sources of iron, and how to avoid the worse outcomes and complications of the disease. It will also help the health agencies in the kingdom to set further planning for the treatment and management of the disease through awareness platforms.

Blood Pressure Control and Prescription Pattern of Antihypertensive Drugs in Adherence to the 2020 International Society of Hypertension (ISH) Global Hypertension Practice Guidelines in Saudi Arabia: A Retrospective Study.

Background Hypertension is the leading risk factor for cardiovascular disease and death. Appropriate treatment of hypertension is necessary to reduce mortality. A prescription-based study is one of the most influential and helpful methods to examine physicians' irrational prescribing practices. This study was designed to investigate the antihypertensive prescription of physicians and their adherence to the treatment guidelines, as well as the blood pressure (BP) control rate in a general hospital in the Kingdom of Saudi Arabia. Methodology A retrospective, cross-sectional study was conducted between February 2020 and June 2021 in an outpatient department. Patients diagnosed with hypertension as per the 2020 International Society of Hypertension guidelines and those who received antihypertensive drugs were included. Study data included prescriptions, patient's age, duration of hypertension, comorbidities, BP, drug therapy type, and antihypertensive class. Results Overall, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (67.1%) were the most prescribed agents, followed by dihydropyridine-calcium channel blockers (62.6%), diuretics (26.1%), and ß-blockers (10.1%). Comorbid and stage 2 hypertensive patients mainly received combination therapy (51.6%) rather than monotherapy (48.4%). The study revealed an 83.5% prescription adherence to the treatment guidelines. However, non-adherence was encountered in monotherapy, polytherapy, and elderly-treated patient groups. A 66.4% (at target BP in all cases <140/90 mmHg) and 39.3% (at target BP in comorbid patients <130/80 mmHg) rate of BP control was observed. Furthermore, the rate of BP control was significantly associated with prescription adherence (χ2 = 71.316; p < 0.001). Conclusions The degree of prescription adherence and rate of BP control were found to be compatible with other published hypertension studies. However, considerable scope exists for improvement in rational drug utilization and rate of BP control, particularly in high-risk patients. Therefore, treatment guidelines must be followed by clinicians to achieve BP goals and reduce cardiovascular events among the Saudi population.

Awareness of Myocardial Infarction Symptoms and Risk Factors in Saudi Arabia: A Cross-Sectional Study.

Background Cardiovascular disease is the leading global cause of mortality. Recognition of myocardial infarction (MI) symptoms is crucial as it influences clinical outcomes. Furthermore, awareness of MI risk factors assists in obtaining healthier lifestyles, alleviating its burden and mortality rates. This study aims to evaluate the awareness levels of the general population in Saudi Arabia regarding MI symptoms and risk factors and to identify its determinants. Methods A descriptive cross-sectional study was conducted among the general Saudi population, with 1,247 participants, excluding those residing outside Saudi Arabia and healthcare-related individuals. An online self-administered questionnaire encompassed sociodemographic characteristics, awareness of MI symptoms and risk factors, and participants' perceptions concerning appropriate responses during an MI event. Results The majority of participants recognized chest pain and shortness of breath as MI symptoms, with a percentage of 87.1% and 86%, respectively. Risk factors awareness was substantial at 90.3% for smoking and 76.1% for obesity. The mean overall awareness score was 26.6±7.5, and around 36% were aware of both symptoms and risk factors. Higher education levels were positively associated with both risk factors and symptom awareness, while employment status showed negative associations with both. Higher-income correlated with greater risk factors awareness. Gender remained significant, with males exhibiting a lower awareness of risk factors and symptoms. Region and chronic disease status were positively associated with risk factors and symptom awareness. More than 90% of participants perceived going to the emergency room immediately if they recognized an MI attack. Conclusion This study highlights the necessity for inclusive awareness campaigns to enhance the identification of MI symptoms and risk factors in Saudi Arabia. It should focus on groups with limited awareness, such as males, employed and retired individuals, and specific pronounced regional disparities.

Monitoring of iron, lipid and liver profiles in Egyptian hepatitis C virus patients on sofosbuvir therapy.

Hepatitis C virus is a major cause of inflammation of liver tissue. In serious cases the disease can progressed to cirrhosis, fibrosis, hepatocellular carcinoma and end stage liver disease. The research was designed to monitoring the iron, lipid and liver profiles in hepatitis C patients before and during treatment with sofosbuvir antiviral drug. To achieve this aim, the study was conducted on 22 patients with hepatitis C virus infection and 9 control normal volunteers after taking their consent. The monitoring done through biochemical determination of serum iron, ferritin, transferrin as well as total iron binding capacity. Also, serum cholesterol, triglycerides, HDL, LDL, VLDL, AST, ALP, total protein and albumin was determined. The result showed that, the increased serum iron (205.59±8.27 µg/dl), cholesterol (237.96 ± 10.92 mg/dl), triglycerides (246.58 ± 8.23 mg/dl), LDL (172.82 ± 8.47 mg/dl), VLDL (50.91 ± 1.65 mg/dl), AST (164.58 ± 8.45 U/L), ALP (142.61 ± 7.41 U/L) in hepatitis C virus patients was significantly decreased (P < 0.05) upon treatment with sofosbuvir and the decreased serum ferritin (18.55±1.39 ng/dl), transferrin (128.41 ± 6.43 mg/dl), total iron binding capacity (204.41 ± 8.82 mg/dl), total protein (5.81 ± 0.24 g/dl), albumin (2.83 ± 0.09 g/dl) and HDL (14.22 ± 1.17 mg/dl) in hepatitis C virus patients was significantly increased (P < 0.05) upon treatment with sofosbuvir. According to our finding we concluded that, treatment with sofosbuvir 12 week ameliorate disruption of iron, lipid and liver parameters caused by infection with Hepatitis C virus.

Storage of urine specimens in point of care (POC) urine drug testing cups reduces concentrations of many drugs.

BACKGROUND: Many clinical toxicology laboratories receive urine specimens in urine cups that contain point of care (POC) drug testing strips. We conducted this study to evaluate the effect on the stability of commonly measured drugs in the clinical toxicology laboratory when urine is exposed to POC urine drug testing cups. METHODS: Drug free urine was spiked with 85 drugs that were measured by a validated liquid chromatography mass spectrometry (LCMS) method after exposure to POC urine drug testing cups at ambient and 2-6 °C temperatures. Alterations ≥20% were defined as significant changes in the drugs concentration. RESULTS: Concentrations of amitriptyline, cyclobenzaprine, fentanyl, fluoxetine, flunitrazepam, nortriptyline, paroxetine, and sertraline were significantly reduced when urine specimens were stored inside POC urine drug testing cups for 24 h at ambient temperature. Storage of urine in urine chemistry dipsticks reduced the concentration of several drugs. When spiked urine was exposed to an increasing number of POC urine drug testing strips, the concentrations of some drugs were reduced in a dose-dependent manner. The drugs that were absorbed by POC urine drug testing strips were partially back extracted from the strips. CONCLUSION: Exposure of urine specimens to POC urine drug testing strips reduces the concentration of several drugs measured by LCMS method.

Consumption of Movantik™ (Naloxegol) results in detection of naloxone in the patient's urine evaluated by confirmatory urine drug testing.

BACKGROUND: Many patients on chronic opioid therapy suffer from constipation, one of the most common side effect of opioids. Movantik™ (naloxegol) is an opioid antagonist that is recently introduced in the market to treat opioid-induced constipation and contains naloxegol as the active ingredient. Naloxegol is a pegylated (polyethylene glycol-modified) derivative of α-naloxol. Detection of naloxone in the patients urine after consumption of naloxegol was not reported by the manufacturer and may mislead the prescribing clinicians. This study was conducted to investigate the presence of naloxone in the urine of patients that consume movnatik in pain management clinics. METHODS: The presence of naloxone and naloxol in the urine of 45 patients that consumed naloxegol and 25 patients that consumed suboxone™ were investigated using a liquid chromatography mass spectrometry (LCMS) method. The urinary concentration of naloxone, naloxol, and their glucuronide conjugates were evaluated in five volunteers that took one pill of naloxegol for one day and one volunteer who took the pill for three days. RESULTS: Naloxone was detected in the urine of 45 individuals that were prescribed naloxegol. Urinary concentration of naloxone showed a distribution with a mean of 25 ±â€¯18 ng/ml. Consumption of one pill of 25 mg naloxegol resulted in the detection of naloxol and naloxone in the urine of 5 volunteers 1 h after taking the pill. Evaluation of urine specimens from 25 patients that consumed suboxone™, resulted in the detection of naloxone (180 ±â€¯187 ng/ml) and naloxol (6.3 ±â€¯7.2 ng/ml). CONCLUSIONS: This study demonstrated that consumption of naloxegol leads to appearance of naloxone in the urine of patients receiving opioid therapy in pain management clinics.