Hopelessness and Social Support among Cancer Patients in Saudi Arabia.

BACKGROUND: Receiving a cancer diagnosis can be extremely stressful for patients, as it is a life-threatening disease. However, when this topic is discussed or researched, the psychological state of cancer patients is often ignored or forgotten. The study aimed to measure the levels of hopelessness and social support among cancer patients. It also aimed to assess the relationship between different demographic variables, hopelessness, and social support of these patients. METHODS: The study followed a cross-sectional quantitative design. The setting included Princess Norah Oncology Center, at King Abdul-Aziz Medical City, Jeddah.   A convenience sampling technique including 300 cancer patients was followed. Data collection included a demographic questionnaire, the Beck Hopelessness Scale (BHS), and the Multidimensional Scale of Perceived Social Support (MSPSS).  Ethical principles of anonymity and confidentiality were followed. RESULTS: The total number of respondents was 300, with 50% being male and 50% being female. The mean age of patients was 52.6±14.83 years. The most prevalent types of cancer were breast cancer (21.4%), colorectal (15.2%), and lymphoma (12.1%) respectively. Most of the patients were married (71.3%). The mean value of the BHS was 4.5, whereas the mean value of the MSPSS was 67.7. Moreover, the type of cancer showed a significant association between family support and total social support. In colorectal cancer patients, the total social support (71.2 ± 20.1) and family support (26.2 ± 5.0) provided was the highest followed by leukemia (70.3 ± 15.5 and 25.2 ± 5.1) and breast cancer (68.3-± 20.3. and 24.3 ± 6.8). CONCLUSION: The findings of the present study suggest that the levels of hopelessness in cancer patients are moderate, and the levels of social support received by participants are high. In addition, the relationship between the levels of hopelessness and the levels of social support received is inversely proportional.

Prevalence and Severity of Dry Eye Disease Symptoms Among Diabetics: A Nationwide Survey.

INTRODUCTION: Diabetes mellitus (DM) microvascular complications can impair corneal sensitivity and lacrimal gland functioning, leading to dry eye disease (DED). Hence, this study aimed to measure the prevalence and severity of DED symptoms, and the related risk factors, among the Saudi diabetic population. METHODS: This is a retrospective, cross-sectional, survey-based study which targeted Saudi adults (20 years and older) previously diagnosed with type 1 or type 2 DM. It was conducted in eight primary healthcare centers (PCHs) scattered around eight different provinces of Saudi Arabia (SA). The prevalence and severity of DED were measured by the Ocular Surface Disease Index (OSDI). RESULTS: The total study population was 389 subjects, of which 182 (46.8%) were males and 207 (53.2%) were females. The overall prevalence of DED was 51.7%. Among those, 20.3% of patients had mild dryness, 11.1% had moderate dryness, and 20.3% had severe dryness. Glycosylated hemoglobin (HbA1c) levels of 6.5% or higher proved to be an independent risk factor for the development of DED symptoms, 3.6-folds higher for HbA1c levels of 6.5% to 9% (AOR=3.573; p=0.001), and 2.3-folds higher for HbA1c levels higher than 9% (AOR=2.293; p=0.013). The long duration of diabetes did not show a significant association with manifesting DED symptoms (p=0.263). CONCLUSION: Half of the diabetic population complained of DED symptoms, compared to one-third of the previously studied general Saudi population. Patients with mild to moderate HbA1c elevation were more likely to report DED symptoms than those with severe elevation, which could be related to impaired corneal sensation. Therefore, a routine ophthalmological examination is recommended.

Knowledge and Attitude towards Obstructive Sleep Apnea among Primary Care Physicians in Northern Regions of Saudi Arabia: A Multicenter Study.

Obstructive sleep apnea (OSA) is a serious and often underreported condition, despite its highly prevalent distribution. Primary care physicians (PCPs) play an integral role in screening and managing patients with a high risk of developing OSA. This northern Saudi Arabian cross-sectional survey assessed the knowledge and attitude towards OSA among 264 randomly selected PCPs using the OSA Knowledge and Attitude (OSAKA) questionnaire. Among the participating PCPs, 43.9% and 45.1% had low scores in the knowledge and attitude categories, respectively. More than three-fourths (78%) of them recognized that an overnight sleep study is the gold standard for diagnosing OSA. Regarding referral, 39.4% of the OSA patients encountered by the PCPs were referred to ENT specialists, while 21% were referred to sleep clinics, and 18.2% were referred to pulmonologists. Nearly half (50.8%) of the participants recognized OSA as an important clinical disease, and 56.8% were confident in caring for OSA patients. Spearman's correlation of the current study identified a positive correlation between knowledge scores and attitude scores (rho-0.151, p = 0.017). It is important to improve PCPs' knowledge regarding OSA and the necessity for referral through different training methods. Furthermore, the study findings emphasize the need to include appropriate OSA programs and continuing medical education for PCPs.

Recommendations for the treatment of rheumatoid arthritis in Saudi Arabia: adolopment of the 2021 American College of Rheumatology guidelines.

BACKGROUND: The 2021 American College of Rheumatology (ACR) rheumatoid arthritis (RA) guideline considers the specific context of the United States which differs from that of Saudi Arabia in many aspects that may impact recommendations. The objective of this project was to adapt a set of prioritized recommendations from the 2021 ACR guideline for the treatment of rheumatoid arthritis RA for the context of Saudi Arabia, by the Saudi Society for Rheumatology (SSR). METHODS: The process followed the GRADE-ADOLOPMENT methodology, and the reporting adhered to the RIGHT-Ad@pt checklist. Working groups included a coordination group and a 19-member panel representing different stakeholder groups. The Evidence to Decision (EtD) tables included evidence on health effects from the source guideline and contextual information from the Saudi setting. RESULTS: The panel prioritized and adapted five recommendations from the source guideline. The process led to modifying two out of the five prioritized recommendations, all listed here. In naive patients with low disease activity, methotrexate (MTX) is conditionally recommended over sulfasalazine (SSZ) (modified direction); hydroxychloroquine (HCQ) is conditionally recommended over SSZ (unmodified). Initiation of csDMARDs with short-term glucocorticoids is conditionally recommended over csDMARDs alone in naive patients with moderate to high disease activity (modified direction). Switch to subcutaneous MTX is conditionally recommended over addition/switch to alternative DMARD(s) in patients taking oral MTX who are not at target (unmodified). Discontinuation of MTX is conditionally recommended over gradual discontinuation of the bDMARD or tsDMARD for patients taking MTX plus a bDMARD or tsDMARD who wish to discontinue a DMARD (unmodified). CONCLUSION: Rheumatologists practicing in Saudi Arabia can use the adoloped recommendations generated by this project while adopting the rest of the recommendations from the 2021 ACR guidelines.

Acute Vasitis clinical picture mimicking inguinal hernia: Case report and review.

Acute Vasitis a rare condition, but one that can present with a diagnostic dilemma, if not recognized and managed appropriately, may lead to unnecessary surgical interventions with consequent morbidity for the patient. A 27 year old healthy male, presented with left scrotal pain associated with inguinoscrotal swelling. Physical examination revealed left scrotum tenderness and swelling extended along left inguinal area. CT showed multi loculated cystic fluid collection within left seminal vesicle. Acute Vasitis is a rare differential diagnosis for acute scrotum and This case report summarizes the importance of identifying it and how imaging can prevent unnecessary surgical intervention.

Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study.

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.