The barriers, motives, perceptions, and attitudes toward research among radiology practitioners and interns in Saudi Arabia: a cross-sectional study.

Background: Research and the use of evidence-based practices are imperative to the advancement of diagnostic imaging modalities. The aim of this study was to assess the perceptions and attitudes of radiology practitioners (i.e., Technicians, Technologists or Specialists, and Senior Specialists) and interns in King Abdulaziz Medical Cities (KAMCs), Kingdom of Saudi Arabia, toward research, and to explore the various barriers and obstacles that hinder their research efforts. Methods: A cross-sectional descriptive investigation was carried out from December 2022 to March 2023 among 112-KAMCs' radiology practitioners and interns, using previously developed and validated questionnaire comprised of five distinct sections, each serving a specific purpose, and with a non-probability convenient sampling technique. Descriptive statistics were generated for participants' demographics, and chi-square and fisher's exact tests were used to examine the association between participants' demographics and their involvement in research. Results: Among the 137 KAMCs' radiology practitioners and interns who were invited to participate, 112 responded and completed the questionnaire, resulting in an overall response rate of 81.75%. Radiology practitioners and interns from various medical imaging subspecialties were found to be involved in research to the extent of 83%, with nearly half (40.9%) of them have had publications, and 53.3% of these publications being either cross-sectional studies or retrospective clinical studies. A lack of time (66.1%), a lack of a professional supervisor support program (50.9%), and deficiency in research skills (45.5%) were common obstacles that may impede the participants' ability to conduct research. The most common motives for participants to conduct research were the desire to improve their resumes (69.6%), get accepted into postgraduate radiology programs (58%), and improve their research skills (52.7%). Conclusion: KAMCs' radiology practitioners and interns have a positive attitude toward performing research. Despite the high percentage (83%) of those involved in research, the number of publications remains low. A crucial step to advancing the profession's evidence base is engaging radiology practitioners and interns in research and encouraging radiology practitioner-led research. The study findings can serve as a valuable basis for designing developmental programs aimed at overcoming research obstacles among healthcare professionals in Saudi Arabia.

Burnout Among Saudi Radiological Sciences Undergraduate Students During COVID-19 Pandemic: A Cross-Sectional Study.

Background: The novel Coronavirus Disease 2019 (COVID-19) pandemic has posed unprecedented new stressors and challenges to the applied health sciences' education. This study explored the prevalence of burnout among Saudi radiological sciences students at King Saud bin Abdulaziz University for Health Sciences during the COVID-19 pandemic. Methods: A cross-sectional study was conducted between November and December 2020 among 176-Saudi radiological sciences students, using the 16-item questionnaire of Maslach Burnout Inventory-General Survey for Students and through non-probability convenient sampling technique. The 16 items of the questionnaire were scored on a 7-point frequency rating scale ranging from 0 (never) to 6 (every day) and consisted of three distinct burnout dimensions/subscales: a) emotional exhaustion (5-items), cynicism (5-items), and professional efficacy (6-items). The means of individual items that make up each scale of burnout were calculated, and statistical analysis was performed using the Mann-Whitney U-test. Results/Observations/Findings: From the 176-radiological sciences students approached, 96 (54.5%) completed the questionnaire. The percentage of students who were at moderate to high risk of burnout was 70.8% for emotional exhaustion, 75% for cynicism, and 74% for professional efficacy subscales. Emotional exhaustion was significantly higher among fourth-year students (P = 0.042), than third-year students. Cynicism was significantly higher among fourth-year female students (P = 0.035), than third-year female students. The professional efficacy was significantly lower among fourth-year female students (P = 0.007) than males. Conclusion: Our study shows 73.3% moderate to high burnout rates among Saudi radiological sciences students during the COVID-19 pandemic. Burnout increases as students advance to the fourth year. A block/modular curriculum structure for fourth-year courses may be necessary to reduce burnout among fourth-year students. Academic counseling can ease students' emotional stress and reduce burnout risk.

Clinical Outcomes of Radiological Treatment Modalities of Hepatocellular Carcinoma: A Single-Center Experience from Saudi Arabia.

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Most patients with HCC are unsuitable for surgical therapies. Therefore, nonsurgical therapies play a central role in the management of this disease. Several percutaneous treatment modalities are available for HCC including radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE). In this study, we aim to evaluate the clinical outcomes, morbidity and mortality rates, and survival rates of four treatment modalities for HCC (RFA, TACE, TARE, and Sorafenib) and compare the success rate of each modality. METHODS: A retrospective observational study was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The inclusion criteria were composed of patients diagnosed with HCC who received RFA, TACE, TARE, or Sorafenib treatments between 2008 and 2017. The primary outcome of this study was recurrence-free patients at the last follow-up. RESULTS: A total of 108 patients were included in this study. The mean age of the patients was 68.01 ± 9.98 years. Eighty-Two patients (75.9%) underwent interventions with the intention to cure or stabilize HCC, while twentysix patients (24.1%) were started on Sorafenib as a palliative treatment. The five years recurrence-free rates were 41.2% with RFA, 40% with the combination of TACE and RFA, 23.3% with TACE, and 0% with TARE. All patients on Sorafenib died from advanced-stage HCC. CONCLUSION: This study provides further evidence for the efficacy of several treatment modalities for the management of HCC. RFA and the combination of TACE and RFA showed better outcomes with a recurrence-free rate reaching up to 40%. TACE had a moderate survival benefit up to 23.3%. TARE showed negative survival benefits. Sorafenib continues to be an important palliative treatment but does not offer curative potential.

Patient-Based Dose Audit for Common Radiographic Examinations With Digital Radiology Systems: A Retrospective Cross-Sectional Study.

This study aims to audit radiation doses of adult patients who underwent common diagnostic X-ray examinations and compare dose area product (DAP) values with the established International Diagnostic Reference Level (IDRLs). Retrospective cross-sectional records of 339-patients who underwent 699-radiographic examinations between October 2018 and March 2019 were obtained. Patient-related factors, exposure, and DAP data were recorded for the six most common examinations. The mean and 75th percentile of DAPs were recorded and compared to IDRLs values. The 75th percentiles of the locally measured DAPs were below IDRLs for all examinations except for lateral lumbar, AP, and lateral thoracic spine, in which DAP-75th-percentile exceeded all IDRLs by up to 40.7%, 2.8%, 365.5%, respectively. Considering the type of detector used, the mean of the locally measured DAPs significantly exceeded the UK DRLs for the lateral thoracic spine and lateral lumbar spine. Locally measured DAP values were below the IDRLs except for thoracic and lumbar spine projections, which significantly exceeded.

Umbilical vein injection of 400 versus 800 µg misoprostol for the treatment of retained placenta: A multicenter, randomized double-blind controlled trial.

AIMS: This trial was conducted to determine the efficacy of umbilical vein injection of 400 versus 800 µg misoprostol to deliver retained placenta and to compare both regimens regarding the time of placental delivery and amount of vaginal blood loss. METHODS: A double-blind, multicenter randomized clinical trial was undertaken in four teaching hospitals in the North of Iraq and Al-Azhar University Hospital in Egypt, from March 2016 to May 2019. Group I (274 women) received 400 µg misoprostol and group II (249 women) received 800 µg misoprostol. Data regarding the time of placental separation and amount of vaginal blood loss were analyzed and proportions were compared between groups using Chi-squared test. Mean values were compared using the Student's t-test. The Mann-Whitney test was used to determine the median of vaginal blood loss. RESULTS: The proportion of placental separation was 84.3% among women in group I and 86.7% of women in group II. The mean time of placental separation was 18.86 ± 234.2 and 17.86 ± 213.09 min in groups I and II, respectively (P < 0.05).The mean hemoglobin levels on admission and 24 h after placental deliveries were significantly higher in group I than group II. CONCLUSIONS: Intra-umbilical injection of 400 and 800 µg misoprostol were both safe and effective methods for delivery of retained placenta.

Ultrasound-Driven Two-Dimensional Ti3C2Tx MXene Hydrogel Generator.

Ultrasound is a source of ambient energy that is rarely exploited. In this work, a tissue-mimicking MXene-hydrogel (M-gel) implantable generator has been designed to convert ultrasound power into electric energy. Unlike the present harvesting methods for implantable ultrasound energy harvesters, our M-gel generator is based on an electroacoustic phenomenon known as the streaming vibration potential. Moreover, the output power of the M-gel generator can be improved by coupling with triboelectrification. We demonstrate the potential of this generator for powering implantable devices through quick charging of electric gadgets, buried beneath a centimeter thick piece of beef. The performance is attractive, especially given the extremely simple structure of the generator, consisting of nothing more than encapsulated M-gel. The generator can harvest energy from various ultrasound sources, from ultrasound tips in the lab to the probes used in hospitals and households for imaging and physiotherapy.

Relationship Between Antimicrobial Prescribing and Antimicrobial Resistance Among UTI Patients at Buraidah Central Hospital, Saudi Arabia.

INTRODUCTION: Most of the decisions regarding diagnosis and treatment are based on laboratory test results. Urinary tract infections (UTIs) are among the most common infections in humans. The changing antimicrobial sensitivity in UTI requires appropriate antibiotics. Antimicrobial resistance is an emerging problem in the Kingdom of Saudi Arabia where the complete reversal of antimicrobial resistance is difficult due to irrational use of antibiotics. OBJECTIVES: This study aimed to determine the most common bacterial agents causing UTI in different seasons among patients who were admitted to Buraidah Central Hospital (BCH), Saudi Arabia. The study also evaluated the link between prescribing and resistance toward antimicrobials. MATERIALS AND METHODS: A 6-month retrospective study was conducted among adult patients who were admitted to the inpatient department at BCH. A total of 379 files were collected from microbiological laboratory for inpatients. RESULTS: Most UTI-causing bacteria prevailed in the same season. Of 15 bacterial strains, 12 were significantly correlated with 20 (of a total of 40) antibiotics that were used. Most bacteria were gram-negative. Gram-negative bacilli including Escherichia coli, Klebsiella spp., and Pseudomonadaceae and gram-positive Enterococcus faecalis were most frequently causing UTIs. CONCLUSION: Overall prevalence of antibiotic resistance was negative in bacterial isolates. However, the relationship between antimicrobial prescribing and antimicrobial resistance was significantly negative among UTI patients in BCH, Saudi Arabia.

Pharmacometabonomics Technique to Identify Warfarin Response Using Nuclear Magnetic Resonance Spectroscopy.

BACKGROUND: Warfarin, an anticoagulant medication, is prescribed regularly despite of its bleeding tendency for the prevention and/or treatment of various thromboembolic conditions, such as deep vein thrombosis, and complications associated with atrial fibrillation, and myocardial infarction, but because of its narrow therapeutic window, it has a lot of interactions with drugs and diet. METHODS: Warfarin relies on regular monitoring of International Normalized Ratio which is a standardized test to measure prothrombin time and appropriate dose adjustment. Pharmacometabonomics is a novel scientific field which deals with identification and quantification of the metabolites present in the metabolome using spectroscopic techniques such as Nuclear Magnetic Resonance (NMR). Pharmacometabonomics helps to indicate perturbation in the levels of metabolites in the cells and tissues due to drug or ingestion of any substance. NMR is one of the most widely-used spectroscopic techniques in metabolomics because of its reproducibility and speed. RESULTS: There are many factors that influence the metabolism of warfarin, making changes in drug dosage common, and clinical factors like drug-drug interactions, dietary interactions and age explain for the most part the variability in warfarin dosing. Some studies have showed that pharmacogenetic testing for warfarin dosing does not improve health outcomes, and around 26% of the variation in warfarin dose requirements remains unexplained yet. CONCLUSION: Many recent pharmacometabonomics studies have been conducted to identify novel biomarkers of drug therapies such as paracetamol, aspirin and simvastatin. Thus, a technique such as NMR based pharmacometabonomics to find novel biomarkers in plasma and urine might be useful to predict warfarin outcome.

Iron Overload and Platelet Function Defects: Possible Correlation.

Acquired platelet function defect might be a consequence of iron overload. Even though there are various complications of iron overload, only few reports have indicated some correlations with platelets dysfunction. We report a child with Diamond-Blackfan anemia who has significant complications from iron overload due to chronic blood transfusion, and one of these complications is acquired platelet function defect that manifests with frequent episodes of epistaxis. Therefore, we emphasize the necessity for further studies to confirm direct correlation between iron overload as a causative agent and platelets dysfunction. And we recommend screening for platelets function in patients receiving chronic blood transfusion aiming at possible prevention of any life-threatening bleeding.

Using geographical information systems for defining the accessibility to health care facilities in Jeddah City, Saudi Arabia.

Spatial data play an important role in the planning of health care facilities and their allocation. Today, geographical information systems (GIS) provide useful techniques for capturing, maintaining and analysing health care spatial data; indeed health geoinformatics is an emerging discipline that uses innovative geospatial technology to investigate health issues. The purpose of this paper is to define how GIS can be used for assessing the level of accessibility to health care. The paper identifies the advantages of using GIS in health care planning and covers GIS-based international accessibility with a focus on GIS applications for health care facilities in Jeddah city, Saudi Arabia. A geodatabase that includes location of health services, road networks, health care demand and population districts was created using ArcGIS software. The geodatabase produced is based on collected data and covers issues, such as defining the spatial distribution of health care facilities, evaluating health demand types and modelling health service areas based on analysis of driving-time and straight-line distances.

Frequency of blood-borne viral infections among leukemic patients in central Iraq.

OBJECTIVE: To determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV) and other epidemiological criteria among leukemic patients to establish basic knowledge for future leukemic patients care. METHODS: This cross-sectional study was carried out between February 2006 and June 2008 in the Children's Central Teaching Hospital and Medical City Teaching Hospital in Baghdad, Iraq. A total of 641 blood samples (291 samples from leukemic patients and 350 samples from controls) were collected and the sera were tested for the presence of HBV, HCV, CMV, EBV, and HIV serological markers. RESULTS: A significantly higher prevalence of hepatitis B surface antigen (HBsAg) was detected among leukemic patients (32.3%) than controls (2.3%). The seroprevalence of anti-HBs was 29.9% among patients, and 20.6% among controls. This difference was also found to be statistically significant. A significantly higher prevalence of anti-HCV antibodies among leukemic patients (3.4%) than controls (0.3%) was also detected. A higher prevalence of IgG and IgM markers specific for CMV (96.2% and 12% for patients; 91.6% and 8% for controls), and for EBV (88.3% and 26.5% for patients; 75.1% and 13.4% for controls), were detected among leukemic patients than controls, while none of the patients and controls were positive for HIV I and II markers. CONCLUSION: We conclude that HBV, HCV, CMV, and EBV infections are more prevalent among leukemic patients. There was an increase in the seropositivity rates of HCV, CMV, and EBV infections with increasing ages of leukemic patients. The male leukemic patients were more exposed to HBV, HCV, and EBV infections than females.

Defining health catchment areas in Jeddah city, Saudi Arabia: an example demonstrating the utility of geographical information systems.

A tool, based on a geographical information system (GIS) approach, has been developed for the location and organization of public health care centers in Jeddah city, Saudi Arabia. The potential of GIS for visualizing and modeling available information on health-care has been utilized to produce a "best-fit application". This paper identifies and deals with the manner in which GIS can successfully be used for evaluating the demand and supply of health care facilities as well as be applied for defining health catchment areas. The study uses the essential achievements gained to analyze the advantages of GIS for health care planning and the location of health care centers. Some specific GIS tools, as well as single and multiple spatial search functions, are presented.

Creating a GIS application for health services at Jeddah city.

This paper explores the possibilities of using GIS for private hospitals at Jeddah city, Saudi Arabia. A GIS application is created to cover three main health planning issues which are distribution of health demand, classification of hospital patients and the definition of hospital service area. Each one of these issues is covered using several GIS functions including network analysis and overlay analysis. The former is used to produce drive-time hospital service area and the latter is applied at the selected hospital to calculate the size of its served demand. GIS has several useful functions and tools that can be used in health planning field. This paper uses some of these functions for one private hospital. These functions are used to help health planners on evaluating the spatial distribution of hospital demand and for defining hospital service area. All the produced models can be applied on any private or public hospital in Jeddah city. They can be used to build a spatial decision support system for hospitals in Jeddah city.

Creating a GIS application for local health care planning in Saudi Arabia.

The purpose of this paper is to show how Geographical Information Systems can be used to support health planners on a micro-scale. The first part of this paper discusses the issue that affect local health care planning which include monitoring of catchment area and facilities management. The second part defines GIS and its possible uses in the health care field. The relevant GIS functions have also been explained. The third part of this paper discusses the created GIS application, which is made for a local health centre in Makkah City, Saudi Arabia. In this application, three sets of GIS models have been produced. These are catchment area, patient profile and patient distribution and patient flows models. The created GIS models are produced to help local health planners in their health care decision output.

Piracetam for the treatment of sickle cell disease in children- a double blind test.

Full text is available as a scanned copy of the original print version.

The antimicrobial activity of endodontic sealers to anaerobic bacteria.

The effect of five root canal sealers and two root canal dressing materials on the growth of three anaerobic bacteria associated with endodontic infections was determined using the agar diffusion inhibitory test. Samples of the following endodontic sealers (Apexit, Ketac-Endo, Roth Sealer, Sealapex and Tubliseal) and root canal dressing materials (Pulpdent and Root-cal) were incubated for 48 h with the following anaerobic bacteria: Capnocytophaga ochracea, Porphyromonas gingivalis and Peptostreptococcus micros. Statistically significant zones of bacterial growth inhibition for all the bacteria tested were observed in descending order of antimicrobial activity: Roth Sealer, Ketac-Endo, Tubliseal, Apexit and Sealapex. Root-cal and Pulpdent also showed statistically significant antimicrobial activity, but only to Capnocytophaga ochracea, not to the other two bacteria tested, with Pulpdent being the least active.

Piracetam is useful in the treatment of children with sickle cell disease.

The management of children suffering from sickle cell disease [sickle cell anaemia (SCA) and sickle cell beta degree-thalassaemia (S beta degree-thal.)] has been the concern of all clinicians caring for these patients. Several agents have been tried for treatment, often limited by toxic side effects. Piracetam (2-oxo-l-pyrrolidine acetamide, Nootropyl), a cyclic derivative of gamma-amino butyrate, used for the treatment of psychosenescent syndromes with no known side effects, was considered as a possible therapeutic agent for sickle cell disease. Interest was focused on the use of piracetam when it was shown that it had an antisickling effect, both in vivo and in vitro. We initiated multicentre double-blind investigations in two groups of children suffering from sickle cell disease ranging in age from 3-6 to 6-12 years. The total number of patients included in the study were 87 (SCA = 79 and Hb S beta degree-thal. = 8) in 13 centres in 10 different regions of Saudi Arabia. Coded boxes of the drugs were received from the company (UCB) and were administered as intravenous infusion during crises and orally during the follow-up, for a period of up to 1 year. After decoding the code at the end of the study, the patients were grouped into those receiving placebo (n = 39), i.e. controls, or piracetam (n = 48), i.e. study cases. In terms of age, weight, height and severity index, number of blood transfusions received and number of hospitalization, both groups were statistically homogenous. Data analysis showed that the clinical severity of the disease, the number of crises, the extent of hospitalization and the blood transfusion requirements significantly decreased during piracetam treatment (p < 0.001), though no statistically significant changes occurred in the placebo group. However, in the levels of the haematological and biochemical parameters no significant changes were documented in both groups. In addition, the improvement in the clinical presentation of the disease continued even several months after discontinuation of the drug in the majority of the children, as judged from the low severity index value. Though our results point to the recommendation that piracetam can be used for the treatment of children suffering from sickle cell disease, both SCA and S beta degree-thal, it is advisable to conduct long-term and close follow-up treatment programmes using piracetam to establish its therapeutic value particularly in adults and to ascertain that there are no long-term toxic side effects.

Management of an unusually high postpubertal presentation of cryptorchidism.

A high proportion (43%) of postpubertal presentation of cryptorchid testes was found in 114 patients with undescended testes (UDT). Bilateral presentation of UDT was observed in 25% of patients. Orchiopexy was performed on 75% of postpubertal cases, the determinant factor for choice of operation being cosmetic and psychological. Follow-up results appear to be promising in this environment with very low incidence of testicular cancer.

Prognosis of radiologically non-functioning obstructed kidneys.

Twenty patients found to have unilateral radiologically non-functioning obstructed kidneys on excretory urography (IVU), and who had normal contralateral kidneys, were further evaluated. Ultrasonography, radionuclide imaging and CT scan were carried out pre-operatively to try to predict which of the kidneys were potentially recoverable after relief of obstruction. Percutaneous nephrostomy was also performed on the last consecutive 7 patients 4 weeks before definitive treatment and the function of the kidneys determined daily. The patients were re-evaluated 2 months after the relief of obstruction. Ultrasonography, radionuclide imaging and CT scan were not found to be reliable in predicting whether these kidneys were potentially recoverable. We consider percutaneous nephrostomy a good procedure for obtaining prognostic information prior to definitive surgery.