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Background Thyroid disorders are caused either by excessive or inadequate thyroid hormone production or by the enlargement of the thyroid gland. Various types of thyroid disorders exist, including primary (related directly to the gland itself), secondary (related to thyroid function), and other types. This study aimed to assess the knowledge of thyroid disease manifestation and its risk factors among individuals living in Tabuk, Saudi Arabia. Methodology An observational cross-sectional study was conducted among 400 adults living in Tabuk city of Saudi Arabia aged 18 years or above. Data was collected using an electronic questionnaire through a simple random sampling method. Data was then coded, entered, and analyzed using both descriptive and inferential statistical methods using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States). Results A total of 403 participants were enrolled in this study. More than half (n=265, 65.8%) were females, and 188 (46.7%) were in the age group of 18-35 years. The educational level of the majority of them was a bachelor's degree (n=296, 73.4%). Hypothyroidism was the most common thyroid disorder among family members (n=51, 62.4%). Inadequate iodine intake was thought to be a risk factor for thyroid disorders, as mentioned by 276 (68.5%) participants. Exact 284 (70.5%) participants believed that females are more at risk of having thyroid disease. The mean total knowledge score was found to be 25.1±4.48 out of a total of 34. Exact 216 (53.6%) participants had good knowledge about thyroid disorders. The female gender had significantly higher levels of knowledge as compared to males (p-value=0.002) regarding the manifestation and risk factors of thyroid disorders. In terms of educational level, a bachelor's or above was found to be significantly associated with a higher level of knowledge (p-value=0.003). Conclusion A good level of knowledge and awareness about thyroid disorders was observed among more than half of the participants. Few knowledge gaps were identified regarding knowledge about symptoms of hypothyroidism and certain medications which might cause thyroid disorders.
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INTRODUCTION: Kidney transplantation is a definitive treatment for end-stage renal disease. It is associated with improved life expectancy and quality of life. One of the most common complications following kidney transplantation is graft rejection. To our knowledge, no previous study has identified rejection risk factors in kidney transplant recipients in Saudi Arabia. Therefore, the purpose of this study was to determine the specific risk factors of graft rejection. METHODS: A multicenter case-control study was conducted at four transplant centers in Saudi Arabia. All adult patients who underwent a renal transplant in the period between 01/01/2015 and 31/12/2021 were screened for eligibility. Included patients were categorized into two groups (cases and control) based on the occurrence of biopsy-proven rejection within two years. The primary outcome was to determine the risk factors for rejection within the first two years of transplant. Exact matching was utilized using a 1:4 ratio based on patients' age, gender, and transplant year. RESULTS: Out of 1320 screened renal transplant recipients, 816 patients were included. The overall prevalence of two-year rejection was 13.9%. In bivariate analysis, deceased donor status, the presence Donor Specific Antibody (DSA), intraoperative hypotension, serum Chloride levels, Pseudomonas aeruginosa, Candida, and any Infection within two years were linked with increased risk of two-year rejection. However, in the logistic regression analysis, DSA was identified as a significant risk for two-year rejection (Adjusted OR 2.68; 95% CI, 1.10, 6.49, p = 0.03). While, the presence of Panel-reactive antibody (PRA) and higher serum chloride levels one week prior to transplant was associated with lower odds of rejection (Adjusted OR 0.12; 95% CI, 0.03, 0.53, p = 0.005 and Adjusted OR 0.93; 95% CI, 0.86, 0.98, p = 0.02, respectively). Furthermore, blood infection, infected with Pseudomonas aeruginosa or BK virus within two years of transplant was associated with higher odds of two-year rejection (Adjusted OR 3.10; 95% CI, 1.48, 6.48, p = 0.003, Adjusted OR 3.23; 95% CI, 0.87, 11.97, p = 0.08 and Adjusted OR 2.76; 95% CI, 0.89, 8.48, p = 0.07, respectively). CONCLUSION: Our findings emphasize the need for appropriate prevention and management of infections following kidney transplantation to avoid more serious problems, such as rejection, which could significantly raise the likelihood of allograft failure and probably death. Further studies with larger sample size are needed to investigate the impact of serum chloride levels prior to transplant and intraoperative hypotension on the risk of rejection.
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Ectodermal dysplasia is a genetic disorder characterized by the abnormal development of two or more ectodermally driven structures, leading to various clinical manifestations such as sparse hair, dry skin, and hypodontia or anodontia. The absence of teeth significantly impacts the quality of life for individuals affected by this condition. This article presents a clinical case report of a patient with ectodermal dysplasia who underwent full mouth rehabilitation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate a mandibular complete denture and a maxillary overdenture.
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Background: Social history taking is an important element of a medical interview. No previous studies, however, addressed public attitudes regarding social history taking in Saudi Arabia. Objective: This study explores public attitudes about the importance of social history taking by doctors in Southern Saudi Arabia. Methods: A cross-sectional study was conducted to collect public opinion about social history taking using a self-administered questionnaire. Social history taking was defined as questions about general sociodemographics (job, income, marital status, housing conditions, and animal contact) and social habits (travel, smoking, alcohol drinking, illicit drug use, and sexual history). Descriptive statistics were conducted, along with a comparison between categorical variables. Results: A total of 510 respondents completed the questionnaire, of which 381 (74.7%) had a medical history taken before. A complete social taking was not obtained from those with medical history previously taken. Marital status (73.2%), smoking (49.1%), and occupation (32.8%) were the commonest inquiries, while income (3.7%) and sexual history (6.6%) were the least. Most respondents had no reservations about answering questions about their social history. Among the general demographic questions, job and marital status were more likely to be answered, whereas income and housing inquiries were less likely to be answered. Among social habits, sexual history followed by illicit drug use and alcohol drinking inquiries were less likely to be answered. Conclusion: Detailed social history taking is uncommon among doctors. The public is open to discussing their social status and habits. However, questions involving income, housing, and some social habits like illicit drugs, alcohol, and sexual history are less likely to be faithfully reported and thus need to be handled appropriately. It is crucial for healthcare providers to approach social history taking with sensitivity and respect and to create a private environment for patients where they can freely and accurately share their social histories.
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Pulmonary embolism (PE) is a significant consequence that is becoming more common in COVID-19 patients. The current study sought to determine the prevalence and risk factors for PE in a study population of COVID-19 patients, as well as the relationship between PE and neurological sequelae. The research also sought to analyze the consistency of neurological examination and imaging techniques in detecting neurological problems. The research comprised a total of 63 individuals with COVID-19. The incidence of PE in the study group was 9.5% for smokers, 23.8% for obese patients, 33.3% for hypertensive patients, and 19% for diabetic patients, according to the findings. After adjusting for possible confounders such as age, gender, BMI, smoking, hypertension, and diabetes, a logistic regression analysis indicated that the probabilities of having neurological complications were 3.5 times greater in individuals who had PE. In conclusion, the present study highlights the high incidence of PE among patients with COVID-19 and the association between PE and neurological complications. The study also emphasizes the importance of a thorough neurological examination and imaging studies in the detection of neurological complications in patients with PE.
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Leflunomide (LF) represents the prototype member of dihydroorotate dehydrogenase (DHODH) enzyme inhibitors. DHODH is a mitochondrial inner membrane enzyme responsible for catalytic conversion of dihydroorotate into orotate, a rate-limiting step in the de novo synthesis of the pyrimidine nucleotides. LF produces cellular depletion of pyrimidine nucleotides required for cell growth and proliferation. Based on the affected cells the outcome can be attainable as immunosuppression, antiproliferative, and/or the recently gained attention of the antiviral potentials of LF and its new congeners. Also, protein tyrosine kinase inhibition is an additional mechanistic benefit of LF, which inhibits immunological events such as cellular expansion and immunoglobulin production with an enhanced release of immunosuppressant cytokines. LF is approved for the treatment of autoimmune arthritis of rheumatoid and psoriatic pathogenesis. Also, LF has been used off-label for the treatment of relapsing-remitting multiple sclerosis. However, LF antiviral activity is repurposed and under investigation with related compounds under a phase-I trial as a SARS CoV-2 antiviral in cases with COVID-19. Despite success in improving patients' mobility and reducing joint destruction, reported events of LF-induced liver injury necessitated regulatory precautions. LF should not be used in patients with hepatic impairment or in combination with drugs elaborating a burden on the liver without regular monitoring of liver enzymes and serum bilirubin as safety biomarkers. This study aims to review the pharmacological and safety profile of LF with a focus on the LF-induced hepatic injury from the perspective of pathophysiology and possible protective agents.
