Awareness and knowledge of cardiovascular disease and their associations with the lifestyles of 8-16-year-old girls: a perspective from Saudi Arabia.

BACKGROUND: There has been an increased focus on children as a target for primordial prevention of cardiovascular disease (CVD). In particular, girls should receive attention to combat the burden of CVD in women, because women have higher CVD mortality and morbidity rates than men do. As health literacy is paramount, the evaluation of awareness, and knowledge of CVD and its risk factors and their associations with the lifestyles of girls forms the basis for planning cardiovascular health promotion programs aiming to improve girls' immediate health and reduce the future burden of CVD among women. METHODS: A prospective cross-sectional study was conducted on a random sample of girls attending elementary and intermediate schools in Riyadh, Saudi Arabia. The girls completed a newly validated 24-item questionnaire that assessed their demographic data, lifestyles, and awareness and knowledge of CVD and its risk factors. Anthropometric and blood pressure measurements were obtained. Knowledge scores were calculated on the basis of correct responses and compared between subgroups via analysis of variance to determine associated factors. RESULTS: In total, 469 girls (mean age of 12.5 years) were included. Approximately 41.4% of them did not exercise or only exercised once a week. The dietary intake of important food groups was below or just at the minimal recommended servings for most. Overall, 44.1% were overweight/obese, and almost half were identified as hypertensive on the basis of a single resting measurement. Awareness of CVD as a dangerous disease in adults was 50.3%, whereas, cancer was identified by 61% of participants. Individual risk factors were identified by ≈ 25%, and 16.6% were not aware of any risk factors. The overall knowledge score of the participants was 2.6 (± 1.6) out of a total possible score of 8 representing 32.5% (± 20%). Knowledge levels were positively influenced by increasing school grade (P = 0.001) and family history of CVD (P < 0.001). There was no significant favorable association between improved knowledge level and lifestyle factors. CONCLUSION: The awareness and knowledge of CVD among girls aged 8-16 years are poor and are largely dissociated from their lifestyle. Improved knowledge scores with increasing school grade and family history of CVD confirm a role for schools and families in improving girls' knowledge. Our findings mirror those obtained in older women, showing that misinformation among women starts in childhood and should be targeted early in life.

Retrieval of Gastric Band Eroding Into the Stomach: A Gastrointestinal Fistula Case Managed Through a Combined Laparoscopic and Colonoscopic Approach.

Obesity is an important public health concern worldwide. In Saudi Arabia, the overall prevalence of obesity has increased in both men and women in recent decades. The laparoscopic approach to bariatric surgery was first reported in the 1990s, with laparoscopic adjustable gastric banding (LAGB) developed soon after. The performance of bariatric procedures has increased rapidly in recent years, with safety and efficacy data available for the surgical treatment of obesity and related metabolic disorders. Herein, we report a challenging condition of a female patient who underwent LAGB insertion in 2013. The patient presented with a complaint of a foreign body passing through her rectum during defecation that was manually pushed back by the patient. Radiological imaging and upper/lower endoscopy confirmed the diagnosis of complete gastric band erosion into the stomach, and the reservoir with the remaining tube was observed inside the colon near the splenic flexure. This case was complicated by complete band erosion and gastrointestinal (GI) fistula formation following the delivery of her second child in January 2022. Colonic band erosion is a rare complication of LAGB. Most patients with gastric band erosion are asymptomatic or exhibit nonspecific symptoms. The definitive management of gastric band erosion involves band removal. Several approaches are commonly used in clinical practice. In our case, the band was removed using a combined laparoscopic and endoscopic retrieval approach, which is the first such report in the literature.

Prevalence and Etiology of Community- and Hospital-Acquired Pneumonia in Saudi Arabia and Their Antimicrobial Susceptibility Patterns: A Systematic Review.

(1) Background and Objectives: Pneumonia is a major cause of morbidity and mortality worldwide, including in Saudi Arabia, and the prevalence and etiology of the disease varies depending on the setting. The development of effective strategies can help reduce the adverse impact of this disease. Therefore, this systematic review was conducted to explore the prevalence and etiology of community-acquired and hospital-acquired pneumonia in Saudi Arabia, as well as their antimicrobial susceptibility. (2) Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations were followed for this systematic review. Several databases were used to perform a thorough literature search, and papers were then assessed for eligibility by two independent reviewers. The Newcastle-Ottawa Scale (NOS) was used to extract the data from the relevant research and evaluate its quality. (3) Results: This systematic review included 28 studies that highlighted the fact that gram-negative bacteria, particularly Acinetobacter spp. and Pseudomonas aeruginosa, were the common cause of hospital-acquired pneumonia, while Staphylococcus aureus and Streptococcus spp. were responsible for community-acquired pneumonia in children. The study also found that bacterial isolates responsible for pneumonia showed high resistance rates against several antibiotics, including cephalosporins and carbapenems. (4) Conclusions: In conclusion, the study found that different bacteria are responsible for community- and hospital-acquired pneumonia in Saudi Arabia. Antibiotic resistance rates were high for several commonly used antibiotics, highlighting the need for rational antibiotic use to prevent further resistance. Moreover, there is a need to conduct more regular multicenter studies to assess etiology, resistance, and susceptibility patterns of pneumonia-causing pathogens in Saudi Arabia.

Gastric perforation leading to the diagnosis of classic Ehlers-Danlos syndrome: a case report.

BACKGROUND: Ehlers-Danlos syndrome is a clinically and genetically heterogeneous group of heritable connective tissue disorders caused by a defect in collagen synthesis and structure. The vascular subtype (Ehlers-Danlos syndrome IV) is reported to be associated with a higher incidence of gastrointestinal perforations. The most reported site of perforation is the colon, followed by the small bowel. Perforation of the stomach is very rare, and there are no reported cases to date of classic types I and II. CASE PRESENTATION: We present the case of a 14-year-old Saudi girl who visited our emergency department with abdominal pain and vomiting. Initially, she was diagnosed with gastroenteritis and discharged once her condition stabilized. After 48 hours, she developed severe abdominal pain with recurrent vomiting and peritonitis evident on clinical examination. Initial abdominal x-ray failed to show any free air; however, enhanced computed tomography revealed free air and contrast extravasation in the proximal gut. During exploratory laparotomy, a large perforation was found on the anterior wall of the stomach due to the underlying ischemia. The posterior wall had ischemic mucosa with an intact healthy serosa. A free-hand partial gastrectomy was performed to resect all ischemic parts of the stomach. Detailed examinations and laboratory workup were carried out after the surgery to figure out the possible underlying cause. The clinical findings during the physical examination supported marfanoid features. Marfan's syndrome and related disorders sequencing panel was requested, and Deoxyribonucleic acid (DNA) samples were sent. Given results were supporting the diagnosis of classical Ehlers-Danlos syndrome, the patient was labeled as a case of Ehlers-Danlos syndrome. During the postoperative period, she developed a wound infection that was managed successfully with vacuum-assisted closure dressing. She recovered well without gastrointestinal sequelae in the 4 years of follow-up. CONCLUSIONS: Heritable systemic connective tissue diseases must be given serious consideration in young patients with unusual spontaneous perforation. Such patients might develop life-threatening conditions that require immediate intervention. Hence, correct and timely diagnosis is important to prepare for the anticipated complications.

Osteoporosis knowledge, attitudes, and practices among female Princess Nourah University students in Riyadh, Saudi Arabia.

BACKGROUND AND OBJECTIVE: Osteoporosis is characterized by decreased normal bone density. More than 8.9 million fractures worldwide annually are caused by osteoporosis; these fractures are a significant cause of morbidity and mortality. Evidence suggests that the modification of several lifestyle habits could assist in lowering the incidence of osteoporosis. However, limited studies have been conducted in Saudi Arabia to assess the knowledge, attitudes, and lifestyles associated with osteoporosis among college-age females. This study aimed to provide evidence to assist in the development of effective strategies against osteoporosis. MATERIALS AND METHODS: This cross-sectional study was conducted at Princess Nourah Bint Abdul Rahman University (PNU), in February 2018; a self-administered questionnaire was used. The different components of the questionnaire assessed knowledge, attitudes, and lifestyles with regard to osteoporosis. The participants were divided into groups on the basis of their age as follows: juniors, 17-20 years of age; seniors, 21-25 years of age. RESULTS: Of the 250 included participants, 122 (49%) and 128 (51%) were seniors and juniors respectively. Only 16% of all participants achieved a good score on the knowledge questionnaire; in particular, knowledge regarding osteoporosis risk factors was inadequate. Media was the only source of information of the included participants. Only 49% of participants believed that osteoporosis is a serious disease. Overall, only 32% and 27% of juniors and seniors are consumed sufficient dairy products, and 13% and 11% of juniors and seniors engaged in physical exercise, respectively. CONCLUSION: Osteoporosis misconceptions were extremely prevalent among PNU students, as was poor knowledge and lifestyle habits regarding osteoporosis. Information regarding osteoporosis presented through the media needs to be revised and simplified. Concerned institutions should combine their efforts eventually practice. Information about osteoporosis presented through media need to be revised, simplified, and implement a national program to improve osteoporosis awareness and prevention.

Wound Care Knowledge and Perception of the Saudi General Population in Riyadh Region.

Objective: Proper wound care and management are essential in health care facilities to prevent complications. There are many statistical studies on wound management both globally and in the Middle East. However, patient perception and knowledge regarding wound care have not been assessed in depth. Therefore, this study explored patient perception, attitude, and knowledge of wound care as well as the factors influencing patient perception among the Saudi population. Approach: This cross-sectional study included 414 individuals (mean age, 34 years; females, 64%) from varied social backgrounds who met the inclusion criteria. It was conducted in Riyadh, Kingdom of Saudi Arabia (KSA), from June to December 2019. Data were obtained from the participants using a pretested, validated self-administered questionnaire. Results: Of the participants, 78.0% completed a bachelor's degree or higher. The majority (71.7%) had an average level of knowledge regarding wound care. Most of the participants sought medical information from nonmedical resources-from social media (42.8%) and from relatives and friends (40.6%). Moreover, most of them (73.3%) used home remedies, 77.1% Vaseline, 71% butter, 70.2% coffee beans, 71.5% toothpaste, and 83.1% Zamzam water for their wounds. Innovation: This study is the first study to address the beliefs of the Saudi nonhealth care community toward wound care. Conclusion: Our findings revealed a gap between the level of education and knowledge and beliefs of our population, which could negatively affect clinical outcomes. To address this issue, there is a need to develop an awareness program on wound care and management for patients and providers.