Hand Grip Strength as an Index of Health Does Not Associate With Insomnia: A Cross-Sectional Study.

Introduction Insomnia is one of the most prevalent diseases globally, with many adults around the world suffering from at least one of its symptoms. It has a significant effect on the body's normal physiology and may lead to the development of chronic diseases that impair the main functional domains of health and cognition if left untreated. Handgrip strength (HGS) has previously been linked to several diseases that occur in tandem with insomnia. Thus, this study aimed to investigate the association between HGS and insomnia. Materials and methods This is a cross-sectional study in which the involved participants were approached in different locations. The participants were surveyed using the Insomnia Severity Index (ISI) to evaluate the presence of insomnia. A hydraulic hand dynamometer was used to measure the HGS of the participants' right and left hands. Results A total of 494 questionnaires were collected, including 365 (74%) males and 129 females (26%). About 16% of females had insomnia, compared to 15% of males. There was no significant association between gender and insomnia (P=0.873). The difference between the mean HGS for the right and left hands among males and females was not statistically significant (P>0.05). The correlation coefficients of the right and left HGS scores with insomnia were r=0.019 and r=0.018, respectively, which showed no statistically significant association (P>0.05). Conclusions The study found no significant association between HGS and insomnia. The study recommends conducting further large-scale studies focusing on specific groups in the population to understand the relationship between HGS and chronic sleep disturbance.

The Influence of Diet, Water Intake, Exercise, Education Level, and Income on the Quality of Sleep in the Saudi Population: A Cross-Sectional Study.

BACKGROUND: Sleep quality is known to affect and be affected by multiple factors in one's life through physiological and psychological manners. The study aimed to assess the influence of diet, water intake, exercise, level of education, and income on the quality of sleep of the Saudi population. MATERIALS AND METHODS: The study was a cross-sectional design that used a validated standardized fact-based questionnaire developed based on the Insomnia Severity Index. The data collection continued for three months, during which subjects were approached and interviewed in many locations, ensuring the Saudi population's best representation. RESULTS: The study included 496 subjects, of whom 74% were men. Most of the participants (51.4%) were aged between 18 and 25 years old and were unmarried (64.2%). The education level of participants was between high school and bachelor's level (45-43%), respectively. Around 53% believed that they were following an unhealthy diet, although 42% of the total had a normal BMI. About 44% of participants consumed about 1-2 L of water daily, and 42% never exercised. The majority (39%) earned an income of >5000 Saudi Riyals. Forty-two percent of the participants reported subthreshold insomnia. The data analysis showed that social status and diet were significantly related to sleeping quality (P = 0.051, P = 0.027). Additionally, the level of education was found to be an important confounding factor. CONCLUSION: Diet and social status were significantly related to insomnia, and educational level served as a significant confounding factor. Neither water intake, exercise, BMI category, age, nor gender were associated with insomnia.

Trans-Biliary Gastric Outlet Recanalization and Stenting: A Case Report.

Gastric ischemia is a condition of hypo-perfusion associated with hypotension, vasculitis, and thromboembolism. We report a case of a gastric outflow obstruction due to sizeable visceral artery thrombo-embolism leading to the ischemic conclusion, the frailty, multiple comorbidities deeming general anesthesia (GA) risky, and the patient's decision not to have an open surgery under GA. Invasive procedures in patients with similar profiles like our patient are usually not risk-free, this leads the intervention radiology team to believe a minimally invasive procedure while avoiding GA might be optimal. A 63-year-old female with multiple comorbidities came eight weeks after significant surgery complaining of severe acute epigastric pain, abdominal distention and rigidity, and persistent vomiting. Further investigations showed obstruction in the gastric antrum and pyloric canal. Three separate endoscopic attempts to find and cross the stricture failed. Firstly, gastrostomy access was established, but due to the stomach being massively distended, passing a guidewire through the pylorus failed despite using multiple hydrophilic wires and pre-shaped catheters, this is due to the collapsed pylorus. Subsequently, two attempts under ultrasound guidance to puncture the duodenal bulb and pass a wire and catheter through the antrum stricture were unsuccessful, and another attempt was considered of high risk. An alternative approach through the gallbladder was established, and cholangiography was performed to delineate the anatomy. Then an approach through the right hepatic duct and ampulla of Vater was successfully performed. The attempted passage through the stricture was successful. The dilation was successful, and the patient tolerated both fluid and solids orally. Due to having such a frail patient, interventions of minimal invasiveness and favorable outcome are welcomed. This case report suggests that this technique showed satisfactory results and achieved the goal to improve the overall quality of life where the patient had a good oral intake with no post-operation complications.

Do Parental Comorbidities Affect the Severity of Autism Spectrum Disorder?

Background Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by defective social communication and interaction with a repetitive pattern of monotonous or stereotyped behavior. Although the exact etiology of ASD is unknown, many factors may be implicated in the development of ASD. We aimed to determine the correlation between specific parental factors and Autism Treatment Evaluation Checklist (ATEC) scores. Methods This cross-sectional study was conducted at the Prince Nasser Bin Abdulaziz Center for Autism, Autism Center for Excellence, and Academy of Special Education for Autism in Riyadh, Saudi Arabia. We enrolled children diagnosed with ASD and their parents from these centers. Data were collected through self-administered questionnaires to the patients' parents. Results All included children were <18 years old. In total, 71 (92.2%) children were male and six (7.8%) were female. Further, 77 (100%) patients were diagnosed with autistic disorder. Children of consanguineous parents, underweight mothers and obese fathers, mothers with a history of depression during pregnancy, and mothers aged ≥31 years during pregnancy tend to have a higher mean ATEC score. The health domain was the most significantly correlated with ATEC scores, with a Pearson correlation of 0.880. In linear regression analysis, only maternal depression during pregnancy was significantly correlated with ATEC scores. Conclusion Our patients had a mean ATEC score of 86.2. The health domain was the most significantly correlated with ATEC scores, with a Pearson correlation of 0.880. Linear regression analysis revealed that consanguinity, parental chronic disease, parental allergy, smoking, drug use during pregnancy, paternal and maternal body mass index (BMI), and sibling number were not significantly correlated with ATEC scores (P=0.701, 0.693, 0.133, 0.874, 0.982, 0.255, 0.778, and 0.502, respectively). However, maternal depression during pregnancy was significantly correlated with ATEC scores (P=0.055).

Efficacy and Safety of Thromboprophylaxis Post-Orthopedic Surgery.

Given the high risk of venous thromboembolism (VTE) post-orthopedic surgery and the vital role of thromboprophylaxis in preventing VTEs, this meta-analysis aimed to assess the efficacy of thromboprophylaxis post major orthopedic surgery and the relevant safety measures. In this review, we conducted a computer-aided search of Google Scholar, PubMed, CINAHL, Cochrane, Medline, and EMBASE databases. We included all published randomized clinical trials (RCTs) that utilized enoxaparin, fondaparinux, dabigatran, rivaroxaban, apixaban, and aspirin for VTE prophylaxis in patients undergoing total hip arthroplasty (THA), hip fracture surgery, and total knee arthroplasty (TKA) based on primary and secondary outcomes. The Cochrane Collaboration tool was used to evaluate the risk of bias. All statistical analyses were performed using Review Manager Software. A total of 23 RCTs were included with a total sample of 48,424 patients and an overall low risk of bias. The efficacy of enoxaparin in preventing VTEs in the TKA group was significantly better than fondaparinux. In the THA group, the efficacy of enoxaparin was significantly better than apixaban. The efficacies of fondaparinux, dabigatran, rivaroxaban, apixaban, and aspirin were comparable to that of enoxaparin in reducing VTE-associated mortality, major bleeding, and adverse events. In conclusion, we found that all included drugs were non-inferior to enoxaparin in VTE-associated mortality, major bleeding, and adverse events.

The Effect of Curfew on the General Mental Well-Being of the Population in Saudi Arabia After the COVID-19 Outbreak.

Introduction Mental well-being is an essential aspect of general health. Assessing mental well-being is crucial to leading a healthy life. The global population is, presumptively, affected at a ratio of one out of four individuals with a mental or neurological disorder. This further emphasized the importance of the financial, social, and health implications that ensue. Methods and materials Data collection was performed using the symptoms checklist-90 (SCL-90) survey between March and April of 2021. The data collected included demographic data as well as nine domains that include some of the most common psychiatric symptoms. The collected questionnaires were analyzed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Non-parametric tests were utilized, as the SCL-90 dimensions and global index scores follow a non-normal distribution. Results The questionnaire yielded 387 responses. Females comprised the majority of the participants. The most prevalent symptom described as extremely common by females was waking up early in the morning. The most commonly described symptom described as not at all by females was hearing words that others do not hear. There was no statistical difference in mental well-being between males and females. Older participants (>40 years old) had better mental well-being in comparison to their younger counterparts. Conclusion During the fallout of the coronavirus disease 2019 (COVID-19) pandemic, much attention and resources were allocated toward the physical aspect of the pandemic, yet the psychological implications must not be understated. Multiple variables, such as age, marital status, and unemployment, may impact the mental well-being of the population and must be further assessed.

Factors and Determinants of Choosing Pathology as a Future Career: Results From a Multi-Institution Study.

Background Globally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. Methods This cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. Results Out of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. Conclusion In this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.