Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study.

BACKGROUND AND AIMS: Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department. MATERIALS AND METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms. RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients. CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.

Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?

Background: Atrial fibrillation after cardiac surgery (POAF) is associated with increased morbidity and mortality. Several scores were used to predict POAF, with variable results. Thus, this study assessed the performance of several scoring systems to predict POAF after mitral valve surgery. Additionally, we identified the risk factors for POAF in those patients. Methods: This retrospective cohort included 1381 recruited from 2009 to 2021. The patients underwent mitral valve surgery, and POAF occurred in 233 (16.87%) patients. The performance of CHADS2, CHA2DS2-VASc, POAF, EuroSCORE II, and HATCH scores was evaluated. Results: The median age was higher in patients who developed POAF (60 vs. 54 years; p < .001). CHA2-DS2-VASc, POAF, EuroSCORE II, and HATCH scores significantly predicted POAF, with areas under the curve of the receiver operator curve (AUCROC) of 0.56, 0.61, 0.58, and 0.54, respectively. We identified age > 58 years, body mass index > 28 kg/m2, creatinine clearance < 90 mL/min, reoperative surgery, and preoperative inotropic and intra-aortic balloon pump use as predictors of POAF. We constructed a score from these variables (PSCC-AF). A score > 2 significantly predicted POAF (p < .001). The AUCROC of this score was 0.67, which was significantly higher than the AUCROC of the POAF score (p = .009). Conclusion: POAF after mitral valve surgery can be predicted based on preoperative patient characteristics. The new PSCC-AF score significantly predicted POAF after mitral valve surgery and can serve as a bedside diagnostic tool for POAF risk screening. Further studies are needed to validate the PSCC-AF-mitral score externally.

Knowledge and Perception of Radiation Risk From Computed Tomography Scans Among Patients Attending an Emergency Department.

To evaluate the level of knowledge about radiation dose and possible risks related to computed tomography (CT) scans among patients visiting emergency departments (EDs), a survey was conducted over a two-month period. A total of 357 adult patients (44% men and 56% women) presenting for diagnostic imaging in the ED answered a survey consisting of 15 questions. The survey included questions about the participants' demographics and knowledge of radiation. Most of the respondents (58.5%) reported that the physician did not explain the potential risk of radiation before the procedure. In addition, more than half of the respondents (58.1%) expressed feeling anxious about the potential risk of radiation. Most respondents (84.9%) stated that the potential radiation risk did not affect their decision to proceed with the procedure. Overall, the findings highlight a lack of information about radiation and its potential risks provided to patients prior to the diagnostic procedure. Increasing awareness and understanding of the risks associated with these imaging modalities should be considered essential in modern communities. Efforts should be made to ensure that patients undergoing diagnostic imaging are aware of the radiation risks they may encounter.

The economic burden of viral severe acute respiratory infections in the Kingdom of Saudi Arabia: A nationwide cost-of-illness study.

Objectives: The authors conducted a study to estimate the rising disease and economic burden of viral severe acute respiratory infections and their management, including COVID-19, respiratory syncytial virus, and influenza types A and B, in early and delayed diagnosis scenarios in the Kingdom of Saudi Arabia from a national perspective. Methods: This cross-sectional study was conducted in May 2022 using a de novo Excel-based universal cost-of-illness calculator model. The study used primary data, such as expert interviews, as well as secondary data from a thorough literature search. Results: The total economic burden of viral severe acute respiratory infections in patients with an early diagnosis was lower than those with a delayed diagnosis among patients with complications, both from the payer's (United States dollar [USD] 3846 million vs USD 4726 million) and societal (USD 4048 million vs USD 5020 million, respectively) perspectives. The major cost driver of the total economic burden for both early and delayed diagnosis was disease management costs: 49% (USD 1880 million) and 58% (USD 2730 million), respectively. Conclusions: In the Kingdom of Saudi Arabia, the total economic burden for COVID-19, influenza (epidemic phase), and respiratory syncytial virus was higher with a delayed diagnosis vs an early diagnosis, emphasizing the importance of using a broader diagnostic method.

Mevacor/Poly(vinyl acetate/2-hydroxyethyl methacrylate) as Solid Solution: Preparation, Solubility Enhancement and Drug Delivery.

Mevacor/Poly(vinyl acetate-co-2-hydroxyethyl methacrylate) drug carrier systems (MVR/VAC-HEMA) containing different Mevacor (MVR) contents were prepared in one pot by free radical copolymerization of vinyl acetate with 2-hydroxyethyl methacrylate using an LED lamp light in the presence of camphorquinone as a photoinitiator and Mevacor as a drug filler. The prepared material was characterized by FTIR, 1H NMR, DSC, SEM and XRD methods. Different parameters influencing the efficiency in the Mecvacor-water solubility and the drug delivery of this system, such as the swelling capacity of the carrier, the amount of Mevacor loaded and the pH medium have been widely investigated. The results obtained revealed that the Mevacor particles were uniformly dispersed in their molecular state in the copolymer matrix forming a solid solution; the cell toxicity of the virgin poly(vinyl acetate-co-2-hydroxy ethyl methacrylate) (VAC-HEMA) and MVR/VAC-HEMA drug carrier system exhibited no significant effect on their viability when between 0.25 and 2.00 wt% was loaded in these materials; the average swelling capacity of VAC-HEMA material in water was found to be 45.16 wt%, which was practically unaffected by the pH medium and the solubility of MVR deduced from the release process reached more than 22 and 37 times that of the powder dissolved directly in pH 1 and 7 media, respectively. The in vitro MVR release kinetic study revealed that the MVR/VAC-HEMA system containing 0.5 wt% MVR exhibited the best performance in the short gastrointestinal transit (GITT), while that containing 2.0 wt% is for the long transit as they were able to considerably reduce the minimum release of this drug in the stomach (pH1).

Prevalence of Multidrug-Resistant Bacteria in Healthcare-Associated Bloodstream Infections at Hospitals in Riyadh, Saudi Arabia.

Bloodstream infection (BSI) prevalence in hospitalized patients has increased owing to the spread of antibiotic-resistant pathogens; moreover, antimicrobial resistance in bacteria is a global problem. Here, BSIs are investigated in several patients at a hospital in Saudi Arabia, and the resistance of bacterial isolates to widely used drugs is determined. Throughout 2020, bacteria isolated from patients were identified and subjected to antibiotic susceptibility testing. In total, 1125 bacterial isolates were obtained from 1039 patients; among them, gram-positive bacteria were significantly more abundant than gram-negative bacteria. The most prevalent bacteria were Staphylococcus epidermidis and Klebsiella pneumoniae. Notably, gram-negative bacteria were mainly isolated from adult patients, and 20.63% of the gram-positive isolates were from pediatric patients, which was significantly higher than the corresponding percentages in elders and adults. The gram-positive isolates were mainly resistant to cephalothin, oxacillin, amoxicillin-clavulanate, and erythromycin and susceptible to penicillin, gentamicin, ciprofloxacin, and vancomycin. Additionally, the gram-negative isolates were mainly resistant to ampicillin, cephalothin, and amoxicillin-clavulanate and susceptible to amikacin, ertapenem, aztreonam, colistin, and trimethoprim-sulfamethoxazole. Consequently, the high prevalence of infective multidrug-resistant bacteria may account as a significant health issue; it is considered a hazard in Riyadh hospitals and must be prevented at all costs.

Long-Term Effects of Postoperative Atrial Fibrillation following Mitral Valve Surgery.

BACKGROUND: New-onset postoperative atrial fibrillation (PoAF) is one of the most frequent yet serious complications following cardiac surgery. Long-term consequences have not been thoroughly investigated, and studies have included different cardiac operations. The objectives were to report the incidence and short- and long-term outcomes in patients with PoAF after mitral valve surgery. METHODS: This is a retrospective cohort study of 1401 patients who underwent mitral valve surgery from 2009 to 2020. Patients were grouped according to the occurrence of PoAF (n = 236) and the nonoccurrence of PoAF (n = 1165). Long-term outcomes included mortality, heart failure rehospitalization, stroke, and mitral valve reinterventions. RESULTS: The overall incidence of PoAF was 16.8%. PoAF was associated with higher rates of operative mortality (8.9% vs. 3.3%, p < 0.001), stroke (6.9% vs. 1.5%, p < 0.001), and dialysis (13.6% vs. 3.5%, p < 0.001). ICU and hospital stays were significantly longer in patients with PoAF (p < 0.001 for both). PoAF was significantly associated with an increased risk of mortality [HR: 1.613 (95% CI: 1.048-2.483); p = 0.03], heart failure rehospitalization [HR: 2.156 (95% CI: 1.276-3.642); p = 0.004], and stroke [HR: 2.722 (95% CI: 1.321-5.607); p = 0.007]. However, PoAF was not associated with increased mitral valve reinterventions [HR: 0.938 (95% CI: 0.422-2.087); p = 0.875]. CONCLUSIONS: Atrial fibrillation after mitral valve surgery is a common complication, with an increased risk of operative mortality. PoAF was associated with lower long-term survival, increased heart failure rehospitalization, and stroke risk. Future studies are needed to evaluate strategies that can be implemented to improve the outcomes of these patients.

Adsorption Kinetics of Methyl Orange from Model Polluted Water onto N-Doped Activated Carbons Prepared from N-Containing Polymers.

This study aimed to assess the role of polymeric sources (polypyrrole, polyaniline, and their copolymer) of nitrogen (N)-doped activated carbons (indexed as PAnAC, PPyAC, and PnyAC, respectively) on their adsorption efficiency to remove methyl orange (MO) as a model cationic dye. The adsorbents were characterized using FTIR, SEM, TGA, elemental analysis, and surface area. The kinetic experiments were performed in batches at different MO concentrations (C0) and adsorbent dosages. The adsorption kinetic profiles of pseudo-first-order, pseudo-second-order (PSO), Elovich, intraparticle diffusion, and liquid film diffusion models were compared. The results showed a better fit to the PSO model, suggesting a chemisorption process. The adsorption capacity (qe, mg/g) was found to have increased as MO C0 increased, yet decreased as the adsorbent quantity increased. At the adsorption operating condition, including MO C0 (200 ppm) and adsorbent dose (40 mg), the calculated qe values were in the order of PAnAC (405 mg/g) > PPyAC (204 mg/g) > PnyAC (182 mg/g). This trend proved the carbon precursor's importance in the final properties of the intended carbons; elemental analysis confirmed that the more nitrogen atoms are in the activated carbon, the greater the number of active sites in the adsorbent for accommodating adsorbates. The diffusion mechanism also assumed a rate-limiting step controlled by the film and intraparticle diffusion. Therefore, such an efficient performance may support the target route's usefulness in converting nitrogenous-species waste into valuable materials.

Nitrogen-Rich Polyaniline-Based Activated Carbon for Water Treatment: Adsorption Kinetics of Anionic Dye Methyl Orange.

In the present work, a nitrogen-rich activated carbon (PAnAC) was prepared using polyaniline (PAn) as a precursor to represent one possible conversion of nitrogen-containing polymeric waste into a valuable adsorbent. PAnAC was fabricated under the chemical activation of KOH and a PAn precursor (in a 4:1 ratio) at 650 °C and was characterized using FTIR, SEM, BET, TGA, and CHN elemental composition. The structural characteristics support its applicability as an adsorbent material. The adsorption performance was assessed in terms of adsorption kinetics for contact time (0-180 min), methyl orange (MO) concentration (C0 = 50, 100, and 200 ppm), and adsorbent dosages (20, 40, and 80 mg per 250 mL batch). The kinetic results revealed a better fit to a pseudo-second-order, specifically nonlinear equation compared to pseudo-first-order and Elovich equations, which suggests multilayer coverage and a chemical sorption process. The adsorption capacity (qe) was optimal (405.6 mg/g) at MO C0 with PAnAC dosages of 200 ppm and 40 mg and increased as MO C0 increased but decreased as the adsorbent dosage increased. The adsorption mechanism assumes that chemisorption and the rate-controlling step are governed by mass transfer and intraparticle diffusion processes.

Overlap Between Gastroesophageal Reflux Disease and Irritable Bowel Syndrome and Its Impact on Quality of Life.

Background Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) are common gastrointestinal disorders that can negatively affect quality of life and healthcare costs. The co-occurrence of these conditions can lead to more complex symptomatology and therapeutic challenges. Therefore, understanding the extent of overlap between GERD and IBS is paramount. This study aims to estimate the overlap between GERD and IBS in Saudi Arabia and its impact on quality of life. Methods Patients with GERD at primary care clinics at King Khalid University Hospital in Riyadh, Saudi Arabia, were the subjects of cross-sectional research. The patients were selected using a simple random sampling technique, and an electronic questionnaire was utilized to collect data. Symptoms of IBS were assessed based on Rome IV criteria, and quality of life was evaluated using the GERD quality of life tool. Results Of the 293 GERD patients, the prevalence of co-occurrence of IBS among GERD patients was 35.8%. The GERD health-related quality of life (GERD- HRQL) scores ranged from 0 to 50, with a median and interquartile range (IQR) of 14 (8.5-20). Those with GERD and IBS had a significantly higher GERD-HRQL score than the patients with GERD alone (11 vs. 9, p-value: 0.049). Furthermore, patients with GERD and IBS had a significantly higher GERD-HRQL score than the patients with IBS alone (15 vs. 11, p-value: 0.001). Of the total participants, 29.4% reported having abdominal pain in the last three months. The majority of the participants (55.6%) reported experiencing abdominal pain one to two times per week, while 22.2% reported experiencing it two to three days per month. Conclusion The high prevalence of IBS co-existence among GERD patients highlights the importance of considering both diseases in clinical practice to improve patient outcomes. The study also found that patients with both GERD and IBS had a significantly lower quality of life than those with GERD or IBS alone.

Full-Length Genome of the Equine Influenza A Virus Subtype H3N8 from 2019 Outbreak in Saudi Arabia.

Equine influenza is a major cause of respiratory infections in horses and can spread rapidly despite the availability of commercial vaccines. This study aimed to screen the incidence of equine influenza virus (EIV) and molecularly characterize the haemagglutinin and neuraminidase from positive EIV field samples collected from Saudi Arabia. Six-hundred twenty-one horses from 57 horse barns were screened for the presence of the clinical signs, suggestive for equine influenza, from different parts of Saudi Arabia. Nasopharyngeal swabs were collected from each horse showing respiratory distress. Samples from the same horse barn were pooled together and screened for the presence of the influenza A virus using quantitative real time reverse transcriptase polymerase chain reaction (qRT-PCR). Selective positive samples were subjected to full-length genome sequencing using MiSeq Illumina. Out of the total 57 pools, 39 were found positive to EIV using qRT-PCR. Full-length gene sequences were compared with representative EIV strains selected from the GenBank database. Phylogenetic analysis of the HA and NA genes revealed that the identified virus strains belong to H3N8 clade 1 of the Florida sublineage and were very similar to viruses identified in USA in 2019, with no current evidence for reassortment. This is one of the first reports providing detailed description and characterization of EIVs in Saudi Arabia. Detailed surveillance and genetic information sharing could allow genetic evolution of equine influenza viruses to be monitored more effectively on a global basis and aid in refinement of vaccine strain selection for EIV.

Risk factors of SARS-CoV-2 infection in cancer patients pre- and post-vaccination.

BACKGROUND: Severe complications from COVID-19 and poor responses to SARS-CoV-2 vaccination were commonly reported in cancer patients compared to those without cancer. Therefore, the identification of predisposing factors to SARS-CoV-2 infection in cancer patients would assist in the prevention of COVID-19 and improve vaccination strategies. The literature lacks reports on this topic from the Kingdom of Saudi Arabia (KSA). Therefore, we studied clinical and laboratory data of 139 cancer patients from King Abdulaziz Medical City, Riyadh, KSA. METHODS: The cancer patients fall into three categories; (i) uninfected with SARS-CoV-2 pre-vaccination and remained uninfected post-vaccination (control group; n = 114; 81%), (ii) pre-vaccination infected group (n = 16; 11%), or (iii) post-vaccination infected group (n = 9; 6%). Next, the clinical and lab data of the three groups of patients were investigated. RESULTS: Comorbidity factors like diabetes and hemodialysis were associated with the risk of infection in cancer patients before the vaccination (p<0.05). In contrast to breast cancer, papillary thyroid cancer was more prevalent in the infected patients pre- and post-vaccination (p<0.05). Pre-vaccination infected group had earlier cancer stages compared with the control group (p = 0.01). On the other hand, combined therapy was less commonly administrated to the infected groups versus the control group (p<0.05). Neutrophil to lymphocyte ratio was lower in the post-vaccination infected group compared to the control group (p = 0.01). CONCLUSION: Collectively, this is the first study from KSA to report potential risk factors of SARS-CoV-2 infection in cancer patients pre- and post-vaccination. Further investigations on these risk factors in a larger cohort are worthwhile to draw a definitive conclusion about their roles in predisposing cancer patients to the infection.

Outcomes of single dose COVID-19 vaccines: Eight month follow-up of a large cohort in Saudi Arabia.

BACKGROUND: Two vaccines for COVID-19 have been approved and administered in the Kingdom of Saudi Arabia (KSA); Pfizer-BioNtech BNT162b2 and AstraZeneca-Oxford AZD1222 vaccines. The purpose of this study was to describe the real-world data on the outcome of single dose of these COVID-19 vaccines in a large cohort in KSA and to analyse demographics and co-morbidities as risk factors for infection post one-dose vaccination. METHODS: In this prospective cohort study, a total of 18,543 subjects received one dose of either of the vaccines at a vaccination centre in KSA, and were followed up for three to eight months. Data were collected from three sources; clinical data from medical records, adverse events (AEs) from a self-reporting system, and COVID-19 infection data from the national databases. The study was conducted during the pandemic restrictions on travel, mobility, and social interactions. RESULTS: The median age of participants was 33 years with an average body mass index of 27.3. The majority were males (60.1%). Results showed that 92.17% of the subjects had no COVID-19 infection post-vaccination as infection post-vaccination was documented for 1452 (7.83%). Diabetes mellitus 03), organ transplantation (p = 0.02), and obesity (p < 0.01) were associated with infection post-vaccination. Unlike vaccine type, being Saudi, male, or obese was associated with the occurrence breakthrough infections more than other parameters. AEs included injection site pain, fatigue, fever, myalgia, headache and was reported by 5.8% of the subjects. CONCLUSION: Single dose COVID-19 vaccines showed a protection rate of 92.17% up to eight months follow-up in this cohort. This rate in AZD1222 was higher than what have been previously reported in effectiveness studies and clinical trials. Obese, male, and Saudi were at higher risk of contracting the infection post-vaccination, Saudi and male might have more social interaction with the public when mobility and social interactions were limited during the pandemic. Side effects and AEs were within what has been reported in clinical trials.

Synthesis and Characterization of Cellulose Triacetate Obtained from Date Palm (Phoenix dactylifera L.) Trunk Mesh-Derived Cellulose.

Cellulosic polysaccharides have increasingly been recognized as a viable substitute for the depleting petro-based feedstock due to numerous modification options for obtaining a plethora of bio-based materials. In this study, cellulose triacetate was synthesized from pure cellulose obtained from the waste lignocellulosic part of date palm (Phoenix dactylifera L.). To achieve a degree of substitution (DS) of the hydroxyl group of 2.9, a heterogeneous acetylation reaction was carried out with acetic anhydride as an acetyl donor. The obtained cellulose ester was compared with a commercially available derivative and characterized using various analytical methods. This cellulose triacetate contains approximately 43.9% acetyl and has a molecular weight of 205,102 g·mol-1. The maximum thermal decomposition temperature of acetate was found to be 380 °C, similar to that of a reference sample. Thus, the synthesized ester derivate can be suitable for fabricating biodegradable and "all cellulose" biocomposite systems.

A Low-Viscosity BisGMA Derivative for Resin Composites: Synthesis, Characterization, and Evaluation of Its Rheological Properties.

This study aimed to synthesize new bisphenol A-glycidyl methacrylate (BisGMA) derivatives, targeting a reduction in its viscosity by substituting one of its OH groups, the leading cause of its high viscosity, with a chlorine atom. Hence, this monochloro-BisGMA (mCl-BisGMA) monomer was synthesized by Appel reaction procedure, and its structure was confirmed using Fourier transform infrared spectroscopy, 1H and 13C-nuclear magnetic resonance spectroscopy, and mass spectroscopy. The viscosity of mCl-BisGMA (8.3 Pa·s) was measured under rheometry conditions, and it was found to be more than 65-fold lower than that of BisGMA (566.1 Pa·s) at 25 °C. For the assessment of the viscosity changes of model resins in the presence of mCl-BisGMA, a series of resin matrices, in which, besides BisGMA, 50 wt % was triethylene glycol dimethacrylate, were prepared and evaluated at 20, 25, and 35 °C. Thus, BisGMA was incrementally replaced by 25% mCl-BisGMA to obtain TBC0, TBC25, TBC50, TBC75, and TBC100 blends. The viscosity decreased with temperature, and the mCl-BisGMA content in the resin mixture increased. The substantial reduction in the viscosity value of mCl-BisGMA compared with that of BisGMA may imply its potential use as a dental resin matrix, either alone or in combination with traditional monomers. However, the various properties of mCl-BisGMA-containing matrices should be evaluated.

Influence of Feeding Quinoa (Chenopodium quinoa) Seeds and Prickly Pear Fruit (Opuntia ficus indica) Peel on the Immune Response and Resistance to Aeromonas sobria Infection in Nile Tilapia (Oreochromis niloticus).

In recent times, nutraceuticals have been used extensively to identify promising feed additives for the improvement of the aquaculture industry through the enhancement of growth and survival rates, potentiation of the immune responses, and fortification of the resistance against infectious bacterial diseases. In this study, Nile tilapia (Oreochromis niloticus) were fed with diets supplemented with quinoa seeds (QU) or prickly pear fruit peel (PP) at the dose levels of 10% or 20% of the diet. After 45 days of the feeding trial, the fish were exposed to Aeromonas sobria (A. sobria) challenge. The pre-challenge indices indicated that both supplements mediated a significant improvement in most of the estimated parameters, including survival rate, antioxidant status, hematological and immunological indices, and hepatoprotective potential. These effects were recorded in the groups fed with high doses of the supplements (20%). The least changes were observed in the QU10-supplemented fish. In the spleen tissue, the TGF-ß gene was upregulated in the PP10-, PP20- and QU20-supplemented groups, while the expression of the IFN-γ gene remained unaffected in all the supplemented groups, except for the PP20-supplemented group, which showed an upregulation. After the challenge with A. sobria, the relative survival percentage was improved by the supplementation of PP and QU, particularly in the PP20-supplemented group, possibly via the promotion of immunological responses, hepatoprotective potency, and modulation of the studied genes. Moreover, the morphological structure of the tissues showed marked recovery. The findings suggest that Nile tilapia fed with different levels of PP peel and QU seeds, particularly at the level of 20%, enhanced the immune response in fish and improved their resistance against A. sobria infection.

The relation between teeth loss and cognitive decline among Saudi population in the city of Riyadh: A pilot study.

BACKGROUND: Teeth are necessary for sensory input to the brain during the chewing process, but how the decrease in this sensory input, due to loss of teeth, may cause weak memory and lead to cognitive decline is not well understood. This pilot public survey aiming to assess the correlation between the number of missing teeth, periodontal disease, and cognitive skill in the city of Riyadh. MATERIAL& METHODS: A multicenter cross-sectional survey, targeting geriatric population aged ≥60 years, was performed in Riyadh City, Saudi Arabia. The Montreal Cognitive Assessment (MoCA) was conducted to all participants to assess their cognitive function. Assessment of oral health status was carried out, including the number of present dentation and their periodontal status. Community periodontal-index (CPI) was used to assess the periodontal condition. The primary variables were number of missing teeth, periodontal disease and MoCA test scores. Chi-square test and Pearson's correlation coefficients were computed and the significant P- value was set at <0.05. RESULTS: Of 95 participants, overall, 57 (60%) and 38 (40%) were male and female, respectively, with a mean age of 65.67 ±â€¯6.32 years. Females showed more significant cognitive decline than males (P < 0.001). Cognitive decline was significantly high in participants with low educational level 19 (95%), unemployment 41 (79%), and lower income people 26 (79%), while being cognitive intact was significantly higher in highly educated 13 (87%), retired 21 (62%), and higher income people 28 (74%) at (P < 0.001). An advanced age and greater number of missing teeth are associated with lower MoCA test scores. No statistical significant correlation with regard to periodontal disease and MoCA test scores. CONCLUSION: Based on the preliminary data, positive correlation was confirmed when the number of missing teeth and cognitive skill were assessed. Therefore, larger, multi-center regional surveys are needed to investigate further this relationship.