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BACKGROUND: Inferior vena cava (IVC) filter is indicated in patients with acute venous thromboembolism (VTE) in whom therapeutic anticoagulation is contraindicated. While prophylactic insertion of an IVC filter may be considered for patients at high risk of VTE, there are significant differences between clinical guidelines on the role of IVC filters. These discrepancies have arisen predominantly because of the paucity of data on the efficacy and safety of IVC filters. We, therefore, evaluated the indications for filter insertion, the rate of filter retrieval and complications in patients who received IVC filters at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. METHODS: A descriptive, retrospective review of electronic- and paper-based medical records was performed. Consecutive sampling was used to study all adult patients who received an IVC filter at KAMC between 2007 and 2016 and met the inclusion criteria. RESULTS: A total of 382 IVC filters were inserted. 113 patients (30%) had an acute VTE and a contraindication to anticoagulation while 53 patients (14%) received an IVC filter in the absence of VTE (i.e., prophylactic). Only 124 (32.5%) IVC filters were eventually retrieved. The most common reason for nonretrieval was the need for permanent filtration (155, 60%). Thrombotic complications developed in 72 (19%) patients; nine patients had fatal pulmonary embolism. CONCLUSION: The insertion of IVC filters in this cohort was associated with low retrieval rate and relatively high incidence of thrombotic complications. Follow-up of patients is required to detect IVC filter-related complications and to increase retrieval rate.
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BACKGROUND: Data are required on ophthalmic cases that present to the emergency eye clinics in Madinah, Saudi Arabia for proper allocation of healthcare resources. OBJECTIVES: To determine the frequency and various diagnoses of patients presenting to the A&E at Ohud Hospital, Madinah, Saudi Arabia. METHODS: Data was collected prospectively for all patients who presented to the A&E ophthalmology clinic from June 2014 to September 2014. The data was analyzed and presented using frequency of incidence and percentages. Chi-square tests were used to evaluate the diagnoses based on age, sex and nationality. P ≤ 0.05 indicated statistical significance. RESULTS: The study sample included 868 patients. The male-to-female ratio was 1.1:1.0. The main age categories included patients ≥45 years of age (256 patients) and 251 patients between the ages of 15-30 years. Various types of Conjunctivitis was the most common diagnosis, reported in 282 patients (32.5%), and followed by dry eye syndrome in 156 (18%) patients. Nasolacrimal duct obstruction in 156 patients (18%). Eyelid infections were detected in 102 patients (12%), corneal abrasion in 102 patients (9.3%). Various eye traumas was diagnosed in 30 patients (3.5%), increased intraocular pressure (IOP) in 17 patients (2%), ruptured globe in 2 patients (0.2%) and various other non-emergency pathologies in the remaining eyes. There were no significant differences in patient's characteristics and categories of diagnoses. CONCLUSION: Non-emergent ophthalmic cases were the most common reason for the ophthalmology emergency room visits. It was observed that most cases could be referred to outpatient departments and potentially be managed by primary healthcare providers. This would be more cost effective and will also allow for better management of vision threatening ocular emergencies.
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OBJECTIVES: To determine the optimal cutoff value for neck circumference (NC) that define overweight/obesity and assess its predictive potential for cardiometabolic risks (CMR) among Saudi subjects. Methods: A cross sectional study of 785 adults recruited from a public health awareness campaign in Medina, Saudi Arabia during June 2015. Waist circumference (WC), NC, body mass index (BMI), blood pressure (BP), and random blood glucose (RBG) were assessed, and the presence of CMR were collected by a questionnaire. Pearson's correlation coefficients were used to evaluate the associations of NC with other anthropometric indices and CMR. The optimal cutoff value for NC to identify overweight/obesity was determined by receiver operating characteristic (ROC) curves. Results: There were significant correlations between NC and BMI, weight, WC, age, RBG, and BP. The area under the curve for NC and WC in the ROC analysis was 0.86 for men and 0.77 for women, and NC ≥39.25 cm for men and ≥34.75 cm for women were the best cutoff levels for identifying subjects with central obesity with an 89% sensitivity and a 71% specificity for men and an 80% sensitivity and a 65% specificity for women. These cutoff levels for NC were associated with a significantly increased risk for diabetes, dyslipidemia, and hypertension. Conclusion: Neck circumference is positively correlated with BMI and WC, and can be used to identify overweight/obesity and predict CMR in Saudi individuals.