Drinking water, sanitation, hygiene, and health conditions in India: Findings from the national sample survey.

Introduction: Uncertainty exists in the drinking water, sanitation, hygiene, and health conditions due to mosquitoes and flies across India. Therefore, this study aimed to assess the availability of drinking water, sanitation, hygiene, and health in India. Methods: We used secondary analysis data on 95,548 household members from the National Sample Survey, which included 113,822 homes and 555,351 persons across India between June 2017 and 2018. Results: About 36.4% of household members stated that tube wells or boreholes outside the property at a distance of less than 0.2 km were their main source of drinking water. More than 87% of respondents said that the water they drank was free of impurities, and 55.1% said that it had not been treated. About 45.7% of respondents stated that there were no bathrooms in the dwellings. More than 50% of the time, according to the respondents, garbage was not collected. A flea or mosquito problem was reported by about 97% of households. Around 97% of households reported fevers that were caused by a disease. Conclusion: In India, poor access to drinking water, sanitary facilities, good hygiene, and healthcare existed. The results will support the next visionary programs to increase living standards in the country.

Association Between Musculoskeletal Pain and Frailty Over Time in Older Adults.

BACKGROUND AND PURPOSE: There is a high frequency of frailty in patients with musculoskeletal pain. Pain from osteoarthritis and lower back pain may be associated with frailty. However, the future risk of frailty among older adults with pain remains unclear. Thus, the primary objective of this study was to examine the association between musculoskeletal pain and the risk of becoming prefrail and frail in older adults. PARTICIPANTS AND METHODS: A secondary analysis was performed using data from baseline and 1-, 2-, 3-, 4-, 6-, and 8-year follow-ups of the Osteoarthritis Initiative (OAI). The OAI recruited participants from 4 clinical sites in the United States, between February 2004 and May 2006. A self-reported questionnaire was used to determine the baseline musculoskeletal pain status in older adults (n = 1780) 65 years and older, including pain in the lower back, hip, knee, and at 2 or more sites. Using the Fried phenotypic criteria, participants were classified as nonfrail, prefrail, and frail at each period over 8 years. RESULTS: After adjusting for age, sex, race, education, marital status, annual income, smoking status, comorbidities, and body mass index, binary logistic regression modeling using generalized estimating equations revealed that in older adults musculoskeletal pain in the lower back and at multiple sites was associated with a slightly but significantly decreased risk of prefrailty over time (adjusted odds ratio [AOR] = 0.98, 95% CI = 0.95-0.99, P = .019; AOR = 0.96, CI = 0.92-0.99, P = .032). The association between musculoskeletal pain and frailty among older adults was not statistically significant (all P > .05). CONCLUSIONS: Musculoskeletal pain did not independently significantly increase the risk of prefrailty or frailty over time. It remains possible that when musculoskeletal is combined with other factors, the risk of prefrailty and frailty may be heightened. Further research into the combination of characteristics that best predict prefrailty and frailty, including but not limited to musculoskeletal pain, is warranted.

Association between chronic disease, sensory impairment, walking limitation, and activities of daily living of community-dwelling older Indians.

Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34-1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70-2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82-2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15-1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42-1.65, P < .0001; aOR = 1.27, 95% CI = 1.17-1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.

Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults.

A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999-2000 and 2017-2018. The cross-sectional National Health and Nutrition Examination Survey dataset covered ten cycles between 1999-2000 and 2017-2018. All individuals aged ≥18 years were included. The simultaneous use of at least five medications by one person is known as polypharmacy. Multivariable logistic regression showed that there was a statistically significant association between polypharmacy sociodemographic factors (such as age between 45 and 64 (odds ratio [OR] = 3.76; 95% confidence interval [CI] = 3.60-3.92; p < 0.0001) and age of 65 years or above (OR = 3.96; 95% CI = 3.79-4.13; p < 0.0001), especially women (OR = 1.09; 95% CI = 1.06-1.13; p < 0.0001), non-Hispanic blacks (OR = 1.66; 95% CI = 1.51-1.83; p < 0.0001), and veterans (OR = 1.27; 95% CI = 1.22-1.31; p < 0.0001)) and SES (such as being married (OR = 1.14; 95% CI = 1.08-1.19; p = 0.031), widowed, divorced, or separated (OR = 1.21; 95% CI = 1.15-1.26; p < 0.0001), a college graduate or above (OR = 1.21, 95% CI = 1.15-1.27, p < 0.0001), and earning > USD 55,000 per year (OR = 1.86; 95% CI = 1.79-1.93; p < 0.0001)). Individuals aged 45 years and above, women, and non-Hispanic blacks with higher educational levels and yearly incomes were more likely to experience polypharmacy in the US between 1999-2000 and 2017-2018.

Anticoagulation dosage strategy therapy, length of stay, and all-cause mortality in critically ill COVID-19 patients admitted to the intensive care unit.

Few studies examined several anticoagulation (AC) dosage strategy therapies for various outcomes among coronavirus disease-2019 (COVID-19) patients. However, this AC dosage strategy therapy has not been investigated to assess the length of stay (LOS) and all-cause mortality among critically ill COVID-19 patients admitted to the intensive care unit (ICU), especially in the eastern province of Saudi Arabia. Thus, this study aimed to examine the association of AC dosage strategy therapy with the LOS and all-cause mortality among critically ill COVID-19 patients admitted to the ICU. We enrolled 170 patients aged 18 years or older, had a confirmed COVID-19, and were hospitalized in a tertiary care facility in the eastern province of Saudi Arabia between March 1, 2020, and January 31, 2021. Patients (n = 56) who received Enoxaparin at a dose of less than or equal to 5000 units of unfractionated heparin thrice daily were categorized as receiving a "prophylaxis" dose. Patients (n = 114) who received a therapeutic dose but not a prophylaxis dose were categorized as receiving a "therapeutic dose." The 30-day ICU LOS was the main outcome, while all-cause mortality was the secondary outcome. The covariate-adjusted logistic regression analysis revealed that the therapeutic dose was significantly associated with a 1.74-fold longer ICU LOS and 6.60-fold greater mortality risk than the prophylaxis dose. Critically ill COVID-19 patients who received the therapeutic dose had a longer ICU LOS and higher mortality than those who received the prophylaxis dose.

Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study.

BACKGROUND: Evidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature. METHODS: In this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world's most extensive and India's first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley's Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders. RESULTS: Compared to those between the ages of 60-64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength. CONCLUSIONS: The results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.

The Relationship Between Knee Osteoarthritis-Related Pain Severity and Daily Activities Involving the Upper and Lower Limbs in Saudi Adults: A Cross-Sectional Study.

Introduction Earlier research has shown an association between pain intensity and everyday activities in adults. However, it is vital to examine the relationship within the context of Saudi people who have knee osteoarthritis. Therefore, this study aimed to explore the connection between pain intensity and daily activities involving the lower and upper limbs among patients with knee osteoarthritis in Saudi Arabia. Methods This study enrolled 209 individuals aged 55 years and above who were diagnosed with radiographic knee osteoarthritis by physicians from five hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. Participants were divided into two groups based on their pain intensity, measured using the visual analog scale. The first group included 141 individuals with mild or moderate pain, while the second group comprised 68 individuals with severe pain. The study assessed the physical functioning of these individuals by evaluating their ability to perform daily activities involving the lower and upper limbs, using the Physical Functioning Subscale of the 36-item Short Form Health Survey, which includes 10 items. Results Adjusted logistic regression analysis revealed that individuals experiencing severe pain related to knee osteoarthritis were more likely to encounter difficulties in climbing several flights of stairs (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.09-1.29), and one flight of stairs (OR = 1.19, 95% CI = 1.06-1.34), with challenges in bending, kneeling, or stooping (OR = 1.14, 95% CI = 1.05-1.23), walking more than one mile (OR = 1.15, 95% CI = 1.06-1.25), walking several blocks (OR = 1.17, 95% CI = 1.08-1.27), and walking one block (OR = 1.19, 95% CI = 1.06-1.34) than those with mild or moderate pain. Conclusion Our study results highlight the significant impact of severe pain on activities like climbing stairs, bending, kneeling, stooping, and walking longer distances among people with knee osteoarthritis in Saudi Arabia.

Associations Among Knee Osteoarthritis Severity, Body Mass Index, and Physical Functions in Saudi Arabian Adults: A Multi-Center Cross-Sectional Study.

Background The purpose of this study was to investigate the associations among knee osteoarthritis severity, body mass index, and physical functions in Saudi Arabian adults. Methodology In this multi-center, cross-sectional study, we performed a secondary data analysis that included 189 adults aged 55 years or above with doctor-diagnosed knee osteoarthritis enrolled in five hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. According to knee osteoarthritis severity, all of the individuals were divided into the following three groups: mild (n = 36), moderate (n = 75), and severe (n = 78). A high body mass index was defined as a body mass index score of >25 kg/m2. Physical function was evaluated using the 36-item physical functioning subscale. Results Severe knee osteoarthritis had a significantly 6.47-fold (95% confidence interval (CI) = 2.95-14.22, p < 0.0001) higher risk of physical function than those with mild knee osteoarthritis after adjusting for age, sex, educational status, occupational status, affected knee with osteoarthritis, knee pain, and body mass index. However, moderate knee osteoarthritis had a 1.22-fold higher risk of physical function, but the association was not statistically significant (95% CI = 0.60-2.49, p = 0.578). Conclusions Severe but not moderate knee osteoarthritis was more likely to have the worst physical function than mild knee osteoarthritis among adults with a high body mass index in Saudi Arabia.

The Severity of Pain and Comorbidities Significantly Impact the Dependency on Activities of Daily Living among Musculoskeletal Patients in Jizan, Saudi Arabia.

Limited research has been carried out on the effects of pain, comorbidity, and impaired function in musculoskeletal patients in Jizan, Saudi Arabia. A cross-sectional study was conducted on 115 patients (aged ≥ 55 years) with physician-diagnosed musculoskeletal conditions in Jizan to investigate the association between pain severity, comorbidities, and dependence on activities of daily living (ADLs). Self-reported questionnaires were used to collect data on pain, comorbidities, and physical function measured by ADLs. In ADLs, participants were categorized as dependent (n = 36) or independent (n = 79). Logistic regression analysis was employed to determine the predictors of dependence. The results showed that higher pain severity (adjusted odds ratio (OR): 1.69, 95% confidence interval (CI): 1.21-2.38, p = 0.002) and a greater number of comorbidities (adjusted OR: 1.52, 95% CI: 1.06-2.17, p = 0.021) were independently associated with dependence in ADLs. These associations remained significant even after controlling for covariates. This study concluded that patients with musculoskeletal conditions in Jizan who experience high levels of pain and comorbidities are at risk of dependence on basic daily activities. Therefore, addressing pain and comorbidities is crucial for maintaining independence and improving quality of life. Personalized rehabilitation programs are needed to manage these conditions in this region.

A conceptual model of factors associated with health-related quality of life in men and women with knee osteoarthritis in Riyadh, Saudi Arabia: A multicenter cross-sectional study.

This study used a conceptual model to examine the factors influencing physical, mental, and overall health-related quality of life (HRQoL) in women and men aged 45 and older with knee osteoarthritis (KOA) in Saudi Arabia. In this multicenter cross-sectional study, we randomly included 356 individuals aged 45 years or above with doctor-confirmed KOA from the orthopedic and physiotherapy departments of the 5 tertiary hospitals in Riyadh, Saudi Arabia, between March 2016 and March 2017. We split all participants into men (n = 146) and women (n = 210) based on gender. A conceptual model was developed using the HRQoL influential potential factors, such as age, sex, education, occupation, and way of eating (sociodemographic), and clinical factors, such as osteoarthritis knee and its severity, duration, pain, and body mass index. The 36-item short form health survey and its subscales of the physical composite scale and mental composite scale were used to evaluate overall HRQoL, physical, and mental health, respectively. We used unadjusted multiple linear regression analyses to investigate the associations between gender-specific potential factors and HRQoL outcomes. Women and men aged between 60 and 64 years were more strongly associated significantly with less physical composite scale score by -3.17, (standard error [SE] = 1.71, P = .021) and -3.18 (SE = 1.69, P = .023) respectively, followed by the primary school or less education by -3.40 (SE = 1.27, P = .0002), severe KOA of -8.94 (SE = 0.99, P < .001), eating on the floor bending the knee of -3.93 (SE = 1.63, P = .042), and pain of -2.39 (SE = 0.26, P < .0001). Women and men with primary school or less education significantly had low mental composite scale and 36-item short form health survey scores of -3.07 (SE = 1.22, P = .041) and -3.23 (SE = 0.99, P = .018), respectively, followed by severe KOA of -4.07 (SE = 1.22, P = .001) and -6.50 (SE = 0.83, P < .0001) and eating on the floor, extending the knee at -3.35 (SE = 1.74, P = .043). Risk factors like age, education, pain, body mass index, and severe KOA are linked to poor physical, mental, and overall HRQoL among women and men in Saudi Arabia.

Association between non-communicable diseases and physical activity level in older adults visiting primary health care centers in Jizan, Saudi Arabia.

OBJECTIVES: To examine the association between the number of non-communicable diseases (NCDs) and physical activity (PA) in older adults visiting primary healthcare centers (PHCCs) in Jizan, Saudi Arabia. METHODS: This cross-sectional study was carried out on men and women aged ≥60 who visited PHCCs, Jizan City between June and September 2021. Eleven self-reported NCDs were identified and summed to produce a single score, and PA scores were calculated based on the self-reported PA Scale for the Elderly (PASE). Multiple linear regression models were used to examine the association between the number of NCDs and PA in the included population. RESULTS: In total, 94 participants were included in this study. Of these, 62 were men, and 32 were women. The mean age was 67.29±6.58 years, and the mean PASE score was 53.67±29.72. A significant negative association was found between the number of NCDs and PA, even after a fully adjusted analysis. CONCLUSION: This study found a significant inverse association between the number of NCDs and PA in older adults. In addition, age was associated with lower PA, even among older adults. PA should be recommended to older adults to prevent or reduce the number of NCDs. Future research should focus on examining cause-and-effect associations at a national level.

Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial.

Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.

The risk of venous thromboembolism and blood hyperlactatemia is associated with increased mortality among critically ill patients with Covid-19.

INTRODUCTION: Coronavirus disease 2019 (Covid-19) following venous thromboembolism (VTE) and blood hyperlactatemia are associated with higher mortality. However, reliable biomarkers for this association remain to be elucidated. This study investigated the associations of VTE risk and blood hyperlactatemia with mortality among critically ill Covid-19 patients admitted to the intensive care unit (ICU). METHODS: In this single-centre retrospective study, we included 171 patients aged ≥18 years with confirmed Covid-19 admitted to the ICU at a tertiary healthcare clinic in the Eastern region of Saudi Arabia between 1 March 2020 and 31 January 2021. Patients were divided into two groups: survivor and non-survivor. The survivors have been identified as the patients discharged from the ICU alive. The VTE risk was defined using a Padua prediction score (PPS) >4. The blood lactate concentration (BLC) cut-off value >2 mmol/L was used to determine the blood hyperlactatemia. RESULTS: Multi-factor Cox analysis showed that PPS >4 and BLC >2 mmol/L were more likely to be significantly associated with higher odds of ICU mortality in critically ill Covid-19 patients (hazard ratio [HR] = 2.80, 95% confidence interval [CI] = 1.00-8.08, p = 0.050; HR = 3.87, 95% CI = 1.12-13.45, p = 0.033, respectively). The Area under the Curve for VTE and blood hyperlactatemia were 0.62 and 0.85, respectively. CONCLUSION: VTE risk and blood hyperlactatemia have been associated with a higher mortality risk in critically ill Covid-19 patients who are hospitalized in the ICU in Saudi Arabia. According to our findings, these people needed more effective VTE prevention strategies based on a personalized assessment of their risk of bleeding. Moreover, persons without diabetes and other groups with a high risk of dying from COVID-19 may be recognized by measuring glucose as having elevated glucose and lactate jointly.

National and Regional Rates of Chronic Diseases and All-Cause Mortality in Saudi Arabia-Analysis of the 2018 Household Health Survey Data.

The disease burden and mortality were estimated in Saudi Arabia between 2010 and 2017 but were unknown in 2018. This study aims to assess the 2018 national and regional rates of chronic diseases and all-cause mortality among the total and Saudi populations. In this descriptive cross-sectional study, we obtained data from 24,012 households from the 2018 household health survey. We included doctor-diagnosed chronic conditions such as diabetes mellitus (DM), hypertension (HTN), cardiovascular diseases (CAD), and cancer (CN). A secondary analysis was performed by the total and Saudi populations. Both citizens and residents comprised the total population. Makkah and Al-Medina had greater rates among the total population; however, Al-Baha and Ha'il had high rates of chronic diseases and related mortality in the Saudi population. Age-adjusted mortality rates were 286 per 100,000 population-year. The age-adjusted mortality rate among those aged 65 and above was 3428 per 100,000 population in the same age group. Men had a rate of 1779 per 100,000 men, which was higher than the rate of 1649 for women. In 2018, most citizens in Ha'il had DM, most Al-Baha had HTN and CAD, and most Al-Qassim had CN. People aged 65 and older had the highest death rate.

Deaths, causes, and their frequency among Saudi citizens: A descriptive analysis of data from the 2017 Population Characteristics Survey.

BACKGROUND: The number of deaths, causes, and frequency measures are crucial in determining the health of a country's population. OBJECTIVE: The current study aimed to estimate deaths, causes of death, and their frequency for Saudi nationals in 2017. METHODS: In this descriptive study, we used data from the 2017 Population Characteristics Survey (n = 14,215,901) and performed secondary data analysis between November 2021 and February 2022. We used a total number of survey samples to compute the deaths. The cause of death was determined by dividing the total number of fatalities according to sex. We calculated the overall population-, administrative region-, and gender-wise percentages, rates per 1,000 people per year, the ratios for mortality, and their reasons. RESULTS: There were 58,915 (0.4%) total deaths, including 0.3% and 0.2% deaths among females and males, respectively. The illness was the most frequent cause of mortality (46.5% or 465 per 1,000 population/year), notably in women (52.5% or 525 per 1,000 population/year). The fatality rate was higher due to traffic accidents (a total of five in every female and four males in every female). CONCLUSION: In 2017, illness-especially in women-was the cause of death. Road car accidents had a high mortality rate, especially among males. Saudi Arabia has lower death rates than other Arab nations and high-, moderate-, and low-income nations.

Development and Validation of a New Patient-Reported Outcome Measure in the Arabic Language for Patients with Knee Osteoarthritis in Saudi Arabia.

Purpose: In Western countries, several patient-reported outcomes (PROs) measures have been developed and validated for knee osteoarthritis (OA) patients. While few PROs have been adopted for these patients in Saudi Arabia, which do not reflect all aspects of the Saudi socio-cultural context. Given this shortcoming, this study aimed to develop a new PRO measure in Arabic that covers all concepts related to health, function, and participation encompassing environmental and personal factors. Patients and Methods: A cross-sectional study was conducted on 73 males and females aged ≥55 diagnosed with radiographic knee OA recruited from the orthopedic and physiotherapy departments of five hospitals in Riyadh, Saudi Arabia, between September 2016 and March 2017. Physicians confirmed knee OA according to the American College of Rheumatology standards. We examined the psychometric properties of the new Arabic PRO measure. Results: The internal consistency and test-retest (a one-week interval) reliabilities were found acceptable and excellent with Cronbach's alpha and the intra-class correlation coefficient, ranging from 0.69 to 0.85 and 0.88 to 0.91, respectively. The construct validity was found fair with the correlation between the subscales Body Function and Physical Function (rs =0.63), Activity & Participation and Physical Function (rs =0.72), and Body Function and Bodily Pain (rs =0.58). We found a weak to fair correlation between the new Arabic PRO measure's subscales and the SF-36 physical composite scale (PCS: rs =0.34-0.69) compared to the mental-composite scale (MCS: rs =0.16-0.55). Conclusion: The 33-item new Arabic PRO measure is a well-accepted, reliable, and valid tool for use in knee OA patients in the Saudi cultural context.

Metabolic syndrome is associated with an increased risk of falls in the elderly.

Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. We did a literature search in electronic databases to look for studies that assessed a link between MS and falls among people over the age of 55 years. We found three studies of high quality. These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.

Gait Speed as a Predictor for Diabetes Incidence in People with or at Risk of Knee Osteoarthritis: A Longitudinal Analysis from the Osteoarthritis Initiative.

BACKGROUND: This study examined the association between baseline gait speed with incident diabetes mellitus (DM) among people with or at elevated risk for knee OA. MATERIALS AND METHODS: Participants from the Osteoarthritis Initiative, aged 45 to 79 years, where included. Participants with or at risk of knee OA from baseline to the 96-month visit were included. Participants with self-reported DM at baseline were excluded. DM incidence was followed over the 4-time points. Gait speed was measured at baseline using a 20-m walk test. Generalized estimating equations with logistic regression were utilized for analyses. Receiver operator characteristic curves and area under the curve were used to determine the cutoff score for baseline speed. RESULTS: Of the 4313 participants included in the analyses (58.7% females), 301 participants had a cumulative incidence of DM of 7.0% during follow-up. Decreased gait speed was a significant predictor of incident DM (RR 0.44, p = 0.018). The threshold for baseline gait speed that predicted incident DM was 1.32 m/s with an area under the curve of 0.59 (p < 0.001). CONCLUSIONS: Baseline gait speed could be an important screening tool for identifying people at risk of incident diabetes, and the determined cutoff value for gait speed should be examined in future research.

The quantity of health-related article publications from universities in Saudi Arabia: A bibliometric analysis, 2008-2017.

Several studies have summarized the biomedical publications in Arab countries. However, the quantity of health-related article publications from universities in recent years in Saudi Arabia is unknown. Therefore, this study aimed to perform a bibliometric analysis that showcases the quantitative health-related article publications output from universities in Saudi Arabia between 2008 and 2017. An extensive literature search was conducted using the PubMed database. The search was limited to original research articles, systematic reviews, and meta-analyses published in the English language reporting on humans from medicine and health sciences colleges by researchers affiliated with any university in Saudi Arabia between January 2008 and December 2017. A total of 3172 articles were found published between January 2008 and December 2017. The number of publication output increased significantly (p = 0.0027) from 73 (2.3%) in 2008 to 721 (22.7%) in 2017. The highest quantity of publications came from the Riyadh region (n = 2257), specifically King Saud University (n = 1538). Of specific journals, the BioMed Central journals published the most articles by Saudi Arabian researchers (n = 112). The total number of publications increased from 2% to 24.8% by region. However, approximately 80% of the papers were published in journals with an impact factor (IF) <3. Around 3.8% of the papers were published in journals that had an IF ≥6 and has increased significantly (p = 0.030) from 0% to 1.2% in the past decade. The journal with the highest IF that published a high quantity of articles was the American Journal of Human Genetics. This study has identified a continuous significant increase in the publication of health-related articles from universities in Saudi Arabia. This study extended our knowledge of the quantity of scientific productivity in the field of medicine and health sciences over a recent decade.

Metabolic Syndrome and Coronary Artery Disease Risk: A Meta-Analysis of Observational Studies.

Although numerous studies have described the link between metabolic syndrome (MetS) and Coronary Artery Disease (CAD), no meta-analysis has been carried out on this relationship. Thus, the present study intended to address this limitation. A systematic search was carried out using electronic databases, such as PubMed, CINAHL Plus, Medline, and Web of Science. A sum of 10 studies (n = 9327) was incorporated in the meta-analysis. Compared with non-MetS, MetS was significantly associated with high CAD risk (OR = 4.03, 95% CI = 3.56-4.56). The MetS components were also significantly correlated with high CAD risk (OR = 3.72, 95% CI = 3.22-4.40). The presence of two (OR = 3.93, 95% CI = 2.81-5.49), three (OR = 4.09, 95% CI = 2.85-5.86), four (OR = 4.04, 95% CI = 2.83-5.78), or all five MetS components (OR = 3.92, 95% CI = 3.11-4.93), were significantly associated with a high risk of CAD. MetS and its individual or combined elements were linked with high CAD risk based on contemporary evidence. Thus, the assessment of MetS and its components might help identify people at a higher risk of advancing CAD in the future.