Incidence of seizures in ICU patients with diffuse encephalopathy and its predictors.

Encephalopathy is a diffuse brain dysfunction that results from systemic disorder. Patients with diffuse encephalopathy are at risk of developing clinical and electrographic seizures. The aim of this study is to assess the prevalence of electrographic seizures in a setting of encephalopathy and the clinical and electroencephalogram predictors. We retrospectively reviewed all continuous electroencephalograms done between 2019 and 2022. Continuous electroencephalograms with diffuse encephalopathy were included in the study. A total of 128 patients with diffuse encephalopathy were included in this study. Patients' ages ranged from 18 to 96 years old with a mean age of 55.3 ±â€…19.2 years old. Nine out of 128 patients had seizures with an incidence of 7%. Sixty-six point six percent were nonconvulsive electrographic seizures. Fourteen point three percent of the female patients with diffuse encephalopathy had seizures as compared to none of the male patients (P = .002). Also, 12% of patients with a history of epilepsy experienced seizures versus 5.8% of patients without this history (P = .049). Among electrographic features, 25% of patients with delta background had seizures versus 2.3% of the other patients (P = .048). Likewise, 90% of patients with periodic discharges developed seizures in comparison with none of the patients without (P = .001). Seizures are seen in 7% of patients with diffuse encephalopathy. Female gender, past history of epilepsy, delta background and periodic discharges are significant predictors of seizure development in patients with diffuse encephalopathy.

Knowledge of and attitude toward attention-deficit/ hyperactivity disorder (ADHD) assessed among primary schoolteachers of Makkah City in Saudi Arabia.

Background: One of the most prevalent pediatric medical conditions is attention-deficit/hyperactivity disorder (ADHD). It is characterized by symptoms of hyperactivity, impulsivity, and/or inattention. The first people to notice a child's ADHD symptoms are typically their teachers, who may then offer data that are typically helpful in its diagnosis. The purpose of this study was to assess teachers' knowledge of ADHD, its causes and etiology, as well as the key demographic factors that influence said knowledge. Method: The study was conducted among schoolteachers of primary schools located in different regions of Makkah City, Kingdom of Saudi Arabia. We used a stratified random sampling technique to collect our sample, with the inclusion criteria being teachers who were working in a primary school and who were directly involved in teaching students. Data analysis was performed using the IBM SPSS Statistics software version 21. Results: We received 335 responses to our questionnaire. The age of the participants ranged from 18 to 59 years, with the mean age being 40.2 ± 13.8 years. About 66.9% of teachers were women. Most of the teachers in this sample had a bachelor's degree (73.4%), and only 21.8% had diplomas. Regarding the years of teaching experience, 34.6% had teaching experience exceeding 20 years, whereas 20.6% had less than five years of teaching experience. Regarding general knowledge of the teachers, (5.4%) of the teachers had a good level of knowledge. Only 63.6% of teachers were aware that ADHD students frequently struggled with task and activity organization, and only 7.5% of teachers had good knowledge of ADHD treatment, compared to 40.9% who had a good awareness of symptoms and diagnosis. Only the teachers' education level was significantly associated with their knowledge level of ADHD: 25% of teachers with a postgraduate degree had an overall good level of knowledge versus 2.7% of those with a diploma (P = 0.006). Conclusion: The findings of this study lead to the conclusion that elementary school instructors have an inadequate understanding of ADHD. Some teachers misunderstand the signs and general facts associated with ADHD, thereby indicating the need for further training in this area.

Localization of ictal Islamic rituals: Study of epilepsy center in Makkah.

BACKGROUND: Ictal semiology is important to aid the diagnosis of seizure type. Patients frequently require admission to an epilepsy monitoring unit (EMU) to reach a correct diagnosis of epilepsy type. Some patients may exhibit unusual ictal phenomena that can lead to the diagnosis of psychogenic seizures. Unusual ictal phenomena include ictal kissing, praying, and drinking. Ictal religious speech and praying are other examples of unusual ictal phenomena. This study aims to assess the localization value of ictal Islamic rituals. METHODS: We retrospectively reviewed all patients admitted to the EMU at King Abdullah Medical City in Makkah between 2017 and 2021. Patients with ictal Islamic rituals were included in the study. RESULTS: Nine out of the 279 cases admitted to the EMU have different ictal Islamic rituals. Some patients exhibited multiple Islamic rituals during their seizures. Six patients performed Islamic religious speech, including asking Allah to help, asking for forgiveness, and making basmala (in the name of Allah). Three patients exhibited self-immunization patterns (tahseen). Three patients repeatedly raised their right index fingers (shahada movements). All nine patients had seizures originating from the right temporal lobe. CONCLUSIONS: Islamic rituals are rare ictal phenomena localized to the right temporal lobe.

Factors associated with delayed hospital presentation for patients with acute stroke in Makkah: A cross-sectional study.

Despite the recent advancements in the treatment of acute ischemic stroke, the delayed patient arrival to emergency department or hospital serve as crucial factor for the selection of appropriate intervention program. This study was aimed to identify factors associated with late hospital arrival for patients with acute ischemic stroke in Makkah, Saudi Arabia. A prospective cross-sectional study was carried out at Al-Noor Specialist Hospital among 98 enrolled patients with the mean age of 60.4 ± 10.3 years over the period of March 2019 and June 2019. The data were collected through review of patient records and interview of patients and attendants. Fifty-four of these (55%) presented early (within 4.5 hours) and 44 (45%) presented late (after 4.5 hours). Factor associated with late arrival included low educational level (P = .01) and unemployment status (P = .033). The relationship between time of presentation and computed tomography findings showed statis,tically significant relationship between the former and early computed tomography findings (P = .017). A statistically significant relationship between time of presentation and knowledge of stroke was also observed (P = .013). Increased public awareness is important in order to minimize the time between stroke onset and emergency room presentation.

Epilepsy Stigma Among University Students in Makkah: A Cross-Sectional Study.

Background: Epilepsy is a neurological disorder characterized by a persistent propensity to generate recurring epileptic seizures. Young adults such as university students can bridge the gap and improve attitudes toward patients with epilepsy and reduce stigma. This study aims to assess the knowledge and attitude of university students in the city of Makkah about epilepsy. Methods: This cross-sectional descriptive study was carried out at main universities in the Makkah region of Saudi Arabia. The study was conducted after getting approval from Umm Al-Qura University's ethics and research committee. A total of 394 participants were enrolled in the study, and a stratified random sampling (probability sampling) technique was used to select respondents. Results: The study included students with a mean age of 20.9 ± 4.6 (18-28 years), 271 (68.8%) students were females, 374 (94.9%) of the students agreed that epilepsy is not contagious, and 215 (54.6%) refused the impact of epilepsy on patients' marital status, relationships and fertility, respectively, 213 (54.1%) of the students reported that they feel scared to witness a seizure. About 334 (84.8%) respondents believed that epilepsy is an affliction, and 123 (31.2%) reported that they thought epilepsy was a supernatural phenomenon or black magic. Conclusion: The study concluded a satisfactory level of awareness among university students in Makkah related to dealing with patients with epilepsy. Further scientific studies will help build student's positive attitudes through simulation programs and interventional studies.

Effect of health education on female primary school teachers' knowledge of seizure first aid: An interventional study.

INTRODUCTION: Epilepsy is a common neurological disease. Patients with epilepsy are at risk of developing seizure at any time. The aim of this study was to assess the effects of health education on schoolteachers' first aid management of epileptic seizure. METHODS: A self-administered questionnaire was distributed to participating primary school teachers in the city of Makkah. It included baseline demographic data, a teacher's awareness about epilepsy, as well as first aid measures. An educational lecture was later delivered to teachers and was followed by a discussion. Awareness and attitude were re-assessed using the same questionnaire. RESULTS: A total of 259 female primary school teachers completed the study. Before intervention, 134 (51.7%) of the teachers had good awareness regarding epilepsy, which was significantly increased to 86.9% after the intervention. For seizure first aid, 45.9% of teachers correctly reported that would make sure the person is safe and ask for help in the case of witnessing a seizure attack, which was improved to 84.2% after intervention, with a percent change of 38.2% (p = 0.001). In addition, rolling a person onto their side and asking for help after the end of a seizure was known by 53.3% of the teachers before the intervention and increased to 84.6% after the intervention, showing a percent change of 31.2% (p = 0.001). CONCLUSION: The health education program resulted in significant improvements to teachers' responses to seizure and improvements in all aspects of epilepsy awareness.

Public awareness of the neurological manifestation of COVID-19 in Saudi Arabia.

OBJECTIVES: To assess awareness of the neurological manifestation of COVID-19 on the Saudi population. METHODS: This was a cross-sectional study conducted using a Google Form survey to obtain responses randomly from the Saudi population between February and March 2021 using social media. RESULTS: A total of 831 participants completed the questionnaire. The distribution of the identified isolated neurological manifestations of COVOD-19 infections by participants' age was assessed among the respondents. Loss of smell (88.9%), loss of taste (86.8%), and headache (72.6%) were the most identified first manifestations among all the age groups, while stroke (13.4%) was the least identified for all ages with no statistical significance (p>0.05 for all). Regarding COVID-19 related neurological symptoms, the same was reported: loss of smell, taste, and headache were the most identified symptoms among all the age groups, while stroke was the least identified for all ages with no statistical significance (p>0.05 for all). CONCLUSION: The study concluded that awareness of COVID-19's neurological symptoms could help detect an atypical case, which can help in early intervention and its medical treatment. Moreover, the study also suggested conducting educational programs that emphasize the early identification of neurological symptoms of COVID-19.

Teachers and Epilepsy in Saudi Arabia: Gaps in Knowledge and Potential Roles.

In young children, epilepsy, a disorder marked by recurring seizures, is frequent. Schoolteachers play an important role in the development of young children and hence have a big impact on their psychosocial development. This study was carried out to examine the available data from Saudi Arabia in order to better understand the knowledge gap among Saudi instructors. Although schoolteachers' knowledge in Saudi Arabia has improved over time, such that they now have significant knowledge that can affect student performance, social skill development, future endeavors, and life quality, a significant percentage still believes that epilepsy is linked to psychiatric illness. Few teachers have obtained first-aid training in the area of seizure treatment. It is consequently vital to improve instructors' knowledge of seizure first aid. Teachers' understanding and attitudes concerning epilepsy could be improved by health education. Schoolteachers should get focused and guided health education to improve their knowledge of epilepsy and change their attitudes.

Impact of COVID-19 on the rate of stroke cases at a tertiary hospital in Makkah, Saudi Arabia.

OBJECTIVES: To assess and quantify the impact COVID-19 has had thus far on ischemic stroke admission rate and severity (National Institutes of Health Stroke Scale (NIHSS) score) at a single tertiary center in Makkah, Saudi Arabia. METHODS: This is a retrospective analysis performed on admitted cases with definitive final diagnoses of transient ischemic attack (TIA) and ischemic stroke at King Abdullah Medical City in Makkah between January 1, 2020 and July 2020. RESULTS: Sixty-nine patients were included in our study, 41 of whom presented at our facility before the pandemic and 29 during the pandemic. No statistical significance was observed between rate of admission, stroke severity, and rate of thrombolysis before the COVID-19 pandemic and after the outbreak. We observed a reduction of mean arrival time after the pandemic began, as well as a reduction of hospital stay days. CONCLUSION: A 29% reduction of admission secondary to acute ischemic stroke was noted during the pandemic. However, COVID-19 did not affect acute stroke care at our institute. The study is limited because of its small sample size, as we assessed just one medical center.

Prevalence of Anxiety and Depression in Patients With Multiple Sclerosis in Saudi Arabia: A Cross-Sectional Study.

Introduction Multiple sclerosis (MS) is a chronic disease of progressive demyelination in the central nervous system and carries a significant risk for depression and other psychological difficulties associated with low quality of life. There is a paucity of data on the prevalence of anxiety and depression in Saudi Arabia among patients with MS. We conducted a cross-sectional study to determine the prevalence of anxiety and depression in Saudi Arabia among patients with MS by age, disease severity, compliance to medication, and social support. Methods This cross-sectional study measured the prevalence of anxiety and depression in 184 adult patients with MS. The patients were selected through a random sampling method from a pool of MS societies in Saudi Arabia. The participants completed self-administered questionnaires that included demographic variables. The participants also completed the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) questionnaire. Results Depression was detected among 139 (75.5%) patients with MS, with most participants having mild depression (31%). More women (83.1%) experienced depression than men (62.1%; p = 0.002). Anxiety disorder was present in 123 (66.8%) patients with MS, and most had mild anxiety (n = 56; 30.4%). Conclusion We found a very high rate of depression and anxiety among patients with MS in Saudi Arabia. Our results highlight the need for periodic screening and examination of patients with MS by psychiatrists to facilitate the early detection and treatment of these comorbidities, potentially improving patient quality of life and health outcomes.

Makkah female teachers' knowledge of seizure first aid.

BACKGROUND: Epilepsy is a common disorder in Saudi Arabia, with a prevalence of 6.54/1000 people. Most patients with epilepsy in the country are younger than 19 years of age, and thus, many occurrences of epileptic seizures can occur in schools. As such, teachers are often faced with the challenge of responding to the attack and providing first aid and post-event care to the child with epilepsy. OBJECTIVES: The objective of this study was to assess the knowledge school teachers in the Makkah region possess about seizure first aid. METHODS: A self-administered questionnaire was distributed electronically among school teachers in the Makkah region, with the aim to assess basic demographic data about the teachers as well as their knowledge about epilepsy, seizure first aid, and postseizure care. RESULTS: Out of the teachers who responded to the questionnaire (n = 426), 89% were female teachers; 85.7% recognized epilepsy as a neurological disease. The majority (55%) stated that they would open a patient's mouth and insert an object during a seizure. Those with less teaching experience (1-10 years) correctly identified how to ensure safety in comparison with the more experienced teachers (≫10 years) (P value ≪ 0.001), and 45% of the overall participants recognized when to transfer patients to a medical facility. Both teachers with postgraduate degrees and the more experienced teachers recognized when to transfer students to hospital. CONCLUSION: Female school teachers in the Makkah region significantly lack adequate training and knowledge of seizure first aid. A health education policy targeting teachers may improve this.