Risk Factors of Microvascular Complications Among Type 2 Diabetic Patients Using Cox Proportional Hazards Models: A Cohort Study in Tabuk Saudi Arabia.

Purpose: The burden of type 2 diabetes (T2D) is high in Saudi Arabia, but data related to its complications are limited. This study aimed to determine the incidence of microvascular complications caused by T2D and evaluate the impact of the associated risk factors. Patients and Methods: This retrospective cohort study was conducted at two military hospitals in Tabuk, Saudi Arabia. Data on the socio-demographics, glycaemic profile, blood lipid indices, duration of T2D, and associated microvascular complications were collected from electronic health records and medical files. Descriptive statistics and Cox proportional hazards models were used for data analysis. Results: This study included 1563 T2D patients. The incidence of microvascular complications was 34.3% (95% confidence interval [CI], 32.0-36.6). Retinopathy was the most common complication (incidence=20.0%; 95% CI, 18.0-22.0%), while nephropathy was the least common complication (incidence=12.2%; 95% CI, 10.6-13.8%). Advanced age (≥65 years) showed the highest risk of retinopathy (Hazard ratios [HR], 2.86; 95% CI, 2.56-3.21), neuropathy (HR, 2.70; 95% CI, 2.40-3.05), and nephropathy (HR, 2.37; 95% CI, 2.12-2.64) compared with their counterparts. After adjusting for potential confounders, the study found that the significant risk factors for microvascular complications were longer duration (≥10 years) of T2D (HR, 5.3; 95% CI, 5.1-5.6), uncontrolled hypertension (HR, 3.9; 95% CI, 3.3-4.2), poor glycaemic control (HR, 4.6; 95% CI, 4.3-5.1), obesity (HR, 2.3; 95% CI, 2.2-2.6), and dyslipidaemia (HR, 1.6; 95% CI, 1.2-2.0). Conclusion: Given the high burden of microvascular complications in military healthcare facilities in Tabuk, Saudi Arabia, a context-specific accessible public health program focusing on the promotion of a healthy lifestyle, physical activity, and consumption of a healthy diet, as well as the early diagnosis and management of diabetes, needs to be developed and implemented.

Investigating the incidence and risk factors of hypertension: A multicentre retrospective cohort study in Tabuk, Saudi Arabia.

BACKGROUND: Hypertension is a major global health concern affecting approximately 1.13 billion people worldwide, with most of them residing in developing countries. The aim of this study was to determine the incidence of different stages of hypertension and its associated modifiable and non-modifiable risk factors among patients in military-setting hospitals in Tabuk, Saudi Arabia. METHODS: This retrospective cohort study was conducted at two hospitals in Tabuk, Saudi Arabia. The data were collected from hospital electronic records from 1 January 2019 to 31 December 2019. The blood pressure levels of patients from the last three separate medical visits were recorded. Descriptive statistics and multinomial logistic regression were used for the data analysis. RESULTS: The study included 884 hypertensive patients. The incidences of stage of elevated BP, stage 1, stage 2, and hypertension crisis were 60.0, 29.5, 7.0, and 3.5 cases per 1000 persons. Multivariate analysis indicated that progression from the stage of elevated blood pressure to hypertension crisis was significantly associated with advanced age (odds ratio [OR] = 3.62, 95% confidence interval [CI] = 1.99-8.42), male sex (OR = 2.84, 95% CI: 0.57-5.92), and a positive family history of hypertension (OR = 1.95, 95% CI: 1.23-3.09). Other key determinants of the development of stage of elevated blood pressure to hypertension crisis were current smoking status (OR = 1.74, 95% CI: 1.23-4.76), and physical inactivity (OR = 6.48, 95% CI: 2.46-9.14). CONCLUSION: The incidence stage of elevated blood pressure was high among the patients investigated at armed forces hospitals in Tabuk, Saudi Arabia. The logistic regression model proposed in the present study can be used to predict the development of different stages of hypertension. Age, sex, marital status, family history, smoking status, and physical activity play an important role in the development of hypertension. Better strategies to improve awareness, screening, treatment, and management of hypertension are required in Saudi Arabia.

Augmentation Rhinoplasty Using Iliac Crest Graft in Saddle Nose Deformity.

Autologous bone graft is one of the management solutions for saddle nose deformity. This helps from both functional and esthetic perspective. Several features of autologous graft specify the best material used to repair bony and cartilaginous nasal defects. This article describes a case of a female who presented with saddle nose deformity after incidental insertion of a button battery in her nostril during childhood which was followed by depressed nasal dorsum. It was managed with good outcomes by augmentation rhinoplasty using an iliac crest bone graft.

Antibiotic resistance: a hospital-based multicenter study in Tabuk city, Kingdom of Saudi Arabia.

Background: During the 21st century, antimicrobial resistance (AMR) has emerged as one of the greatest public health challenges worldwide. In the coming 20 years, health care systems may be unable to treat bacterial diseases efficiently due to this phenomenon. Objective: To determine the level of knowledge regarding AMR among patients attending two hospitals in Tabuk city in northeast Kingdom of Saudi Arabia (KSA). Materials and Methods: This cross-sectional study was conducted at King Salman Armed Forces Hospital and King Khalid Armed Forces Hospital in Tabuk city. The study participants were selected from different outpatient departments using a simple random sampling technique. Data collection was performed using a self-reported questionnaire. All of the questions were closed-ended to facilitate study participation and were translated into Arabic. The data were entered into SPSS version 22 for Windows, cleaned and managed before analysis. Results: Our results showed that 26.85% of the respondents had knowledge regarding antibiotic resistance. Knowledge regarding the use of antibiotics for treating bacterial infection was good among participants (60%), but responses related to viral infection indicated confusion (23.06%), and misconceptions were observed. Several factors were significantly associated with knowledge regarding AMR among participants: 1) the use of antibiotics in the last year (OR: 2.102, CI: 0.654-6.754); 2) the discontinued use of antibiotics when feeling better (OR: 8.285, CI: 3.918-17.523); 3) giving antibiotics to friends or family members to treat the same illness ([False]: OR: 108.96, CI: 29.98-395.93) and 4) asking doctors to prescribe antibiotics that had been previously administered for the same symptoms (OR: 9.314, CI: 3.684-23.550). Conclusion: Our results revealed a very high unawareness of AMR and its contributing factors among the study participants. Thus, health education and awareness are highly and urgently recommended to address AMR in the Tabuk area.

A Rare Incidental Finding of a Foreign Body in the Nasopharynx during Adenotonsillectomy.

Diverse foreign bodies may become lodged in the aerodigestive tract, and the discovery of such foreign bodies is an expected scenario for health-care practitioners. The foreign body insertion may be accidental or deliberate, and the object may be organic or inorganic. Most accidental foreign body aspirations occur in children, and some such cases are potential threats that go unnoticed. Very few cases of foreign bodies in the nasopharynx have been reported. Herein, we describe an unusual case in which a foreign body in a child's nasopharynx went unnoticed for 1 year and was detected intraoperatively.

Peripheral ulcerative keratitis: Our challenging experience.

A 52 year old male presented with peripheral ulcerative keratitis in the right eye. Patient's history included retinitis pigmentosa, pseudophakia (right eye), cataract (left eye), bilateral partial deafness, ischemic heart disease, hypertension, type 1 diabetes mellitus, depression, hyperparathyroidism, hypertriglycemia and renal failure. The patient was on weekly hemodialysis. The peripheral corneal ulceration remained stable until he developed sudden and rapid thinning after eight months of regular follow up and management. Laboratory investigations including immunological studies were negative and we had to rely on treatment based on clinical signs, including the visual acuity, size, depth and staining of the ulcer and perilimbal, episcleral, scleral, corneal and anterior chamber reactions. The patient was treated with medical and conservative approaches and the eye was protected with a plastic shield to avoid injury. Despite our efforts, the patient perforated his eye due to a trivial trauma during sleep. He was managed successfully with cyanoacrylate glue and a bandage contact lens. The anterior chamber reformed after the perforation was sealed and the patient is on a regular follow up with a multidisciplinary approach.

Arachnoid pit and extensive sinus pnematization as the cause of spontaneous lateral intrasphenoidal encephalocele.

Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF) rhinorrhea. Computed tomography demonstrated bilateral arachnoid pit, extensive sphenoid sinus pneumatization, and a defect in the superior wall of the left lateral recess of the sphenoid sinus. Magnetic resonance imaging demonstrated anteromedial temporal lobe herniating through the bony defect.