Knowledge and Awareness of Parents and the General Population Living in Riyadh About Amblyopia.

Introduction Amblyopia is a neurodevelopmental disorder of the visual cortex that usually occurs due to abnormal visual development early in life. The clinical importance of amblyopia is that it is a significant cause of visual loss in the pediatric population. Knowing and understanding amblyopia plays a crucial role in management since the earlier the intervention, the better the results. Aim This study aimed to assess the knowledge and awareness of amblyopia among the general population in Saudi Arabia. Subject and methods This cross-sectional study was conducted among the general population in Riyadh, Saudi Arabia. A self-administered Arabic questionnaire was distributed to the general population through social media using Google Forms. The questionnaire includes sociodemographic characteristics (e.g., age, gender, marital status, etc.) and questions to assess the knowledge about amblyopia, including its definition, etiologies, and treatment. Results Of the 488 participants, 57.4% were females, and 38.3% were aged between 26 and 39 years old. Of the participants, 46.5% have heard of amblyopia. The overall mean knowledge score was 16.9 (SD 3.09) out of 32 points. In terms of knowledge, 64.5% had moderate knowledge, 1.8% had good knowledge, and 33.6% had poor knowledge levels. Factors associated with increased knowledge were being older, female gender, married, having children, having a family history of eye disease, and hearing of amblyopia. Conclusion Consistent with the literature, this study finds a need for more knowledge about amblyopia among the general population. Significant predictors of increased knowledge include younger age group, female gender, having children, family history of eye disease, and ever heard of amblyopia.

Ophthalmology workforce over a decade in the Kingdom of Saudi Arabia: demographics, distribution, and future challenges.

BACKGROUND: The ophthalmology workforce is an integral component of any health care system. However, the demand for eye care has imposed a heavy burden on this system. Hence, this study aimed to estimate the trends, demographic characteristics, distribution, and variation between Saudi and non-Saudi ophthalmologists and the future challenges of the ophthalmology workforce in the Kingdom of Saudi Arabia (KSA). METHODS: This study was conducted in the KSA and included ophthalmologists practicing from 2010 to 2023. From the Saudi Commission for Health Specialties, we obtained the number, gender, nationality, and rank of ophthalmologists. The geographic distribution of ophthalmologists in the KSA was obtained from the Ministry of Health Statistical Yearbook 2021. RESULTS: As of January 2023, the KSA had a total of 2608 registered ophthalmologists, with approximately 81.06 ophthalmologists per 1,000,000 people. Only 38% of all ophthalmologists in the country were Saudis. The percentage of Saudi female graduates increased from 13.3% to 37.2% over 12 years [Sen's estimator of slope for median increase per year = 1.33 (95% CI 1.22-1.57) graduates; trend test P < 0.001). Additionally, we found that the geographic distribution of ophthalmologists varied (test for homogeneity of rates, P < 0.0001), with the larger regions having a higher concentration of ophthalmologists than the smaller regions (75.6 in Riyadh versus 42.8 in Jazan per 1,000,000 people). However, the World Health Organization's target for the ophthalmologist-to-population ratio has been achieved in all 13 health regions of KSA. CONCLUSION: The recommended ophthalmologist-to-population ratio has been achieved in the KSA, and the number of Saudi ophthalmologists has almost doubled over the past 8 years. However, the majority of ophthalmologists are still non-Saudi, as Saudi ophthalmologists constitute approximately one-third of the ophthalmology workforce in the KSA. The geographical distribution of ophthalmologists varies, which might affect access to care in peripheral regions. In response to the growing demand for eye care in the KSA, several more effective measures might need to be considered.

Phenotype and Genotype of Saudi Pediatric Patients With Neurofibromatosis Type 1: A Seven-Year Multicenter Experience From Saudi Arabia.

Background Neurofibromatosis type 1 (NF1) is a complex disorder. Genetics and environment might be attributed as the leading cause of NF1, which is characterized by multisystemic involvement. We aim to elaborate on Saudi children's NF1 phenotypes and genotypes. Methods This study was conducted in the Ministry of National Guard Health Affairs (MNGHA), Saudi Arabia including three tertiary hospitals, using a retrospective cohort method. Electronic charts were reviewed to extract the variables. All Saudi pediatric patients aged less than 18 with NF1 were included. Consecutive sampling was used due to the limited number of patients. Results The study included 160 patients (81 males) with an average age of 8.08 years. Also, 33 (20.6%) patients had cutaneous neurofibroma while 31 (19.4%) patients had plexiform neurofibromas. Iris lisch nodules were seen in 33.75%. Optic pathway glioma was seen in 29 (18%) cases while non-optic pathway glioma was seen in 27 (17%) cases. Skeletal abnormalities were seen in 27 (17%) of cases. A first-degree relative with NF1 was seen in 83 (52%) of cases. Epilepsy was the presenting feature of 27 (17%) cases. Cognitive impairment was found in 15 (9.4%) patients. Genetic mutation was seen in 82/100 cases, the rest were negative. The types of mutations were as follows: nonsense 30 (36.6%); missense 20 (24.4%); splicing site mutation 12 (14.6%); frameshift 10 (12.2%); microdeletion 7 (8.5%); and whole gene deletion 3 (3.75%) patients. No phenotype-genotype correlation was seen. Conclusion In this cohort of Saudi pediatric patients with NF1, optic pathway glioma and other brain tumors were prevalent. The most common mutation is the nonsense mutation.

Use of the Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Saudi Postmenopausal Women.

BACKGROUND: Osteoporosis is commonly referred to as the "silent disease," as bone loss is gradual and asymptomatic. In older women and men, osteoporosis can lead to increased bone fragility, thus increasing the risk of fractures. These fractures are associated with healthcare costs, physical disabilities, impaired quality of life, and mortality. Therefore, the study's main objective was to assess the applicability of the osteoporosis self-assessment tool (OST) in predicting osteoporosis in Saudi postmenopausal women who are 60 years of age and older and to give a thorough understanding of how such a method can aid in the early diagnosis of osteoporosis in Saudi Arabia and give physicians enough time to treat it.  Methods: This study was done at King Abdulaziz Medical City, Riyadh, Saudi Arabia, where we included postmenopausal Saudi women 60 years of age and older who took the bone mineral density (BMD) test in the family medicine department. The approximate target population in this group, between the years 2016 and 2022, was 2969 patients. All data was taken from the BestCare database at King Abdulaziz Medical City in Riyadh. Data were typed in an Excel sheet (Redmond, USA), then transferred to the R Studio software. The data collection method was chart review, so no informed consent was needed from patients. Names and medical record numbers were not stored.  Results: The study included 2969 participants. According to the bone mineral density (BMD) T score results, 490 participants (16.5%) were normal, 1746 participants (58.8%) had osteopenia, and 733 participants (24.7%) suffered from osteoporosis. BMD T scores for normal, osteopenia, and osteoporosis participants were -0.6 (-0.9, -.3), -1.8 (-2.1), and -3 (-3.5, -2.7), consecutively. Estimated OSTI scores for those patients were 2 (0, 4), 1 (-2, 3), and -1 (-4, 1), consecutively. According to the OSTI score for normal participants, 4.29% were classified as being at high risk of osteoporosis. A high risk of osteoporosis was identified in 0.74% of those with osteopenia. 27.83% of osteoporosis patients were classified as being at high risk of osteoporosis. To differentiate normal individuals from those with osteopenia, the cutoff value with optimal sensitivity was 3.5. At such a cutoff value, the test sensitivity was 81.04%. To differentiate normal participants from those with osteoporosis, the cutoff value with optimal sensitivity was 2.5. At such a cutoff value, the test sensitivity was 86.49%. To differentiate osteopenia from osteoporosis patients, the cutoff threshold with optimal sensitivity was 1.5. At such a threshold, sensitivity was 78.44%.  Conclusion: OSTA is a simple and validated tool that can identify subjects at increased risk of osteoporosis. Its use could facilitate a more cost-effective use of BMD; by avoiding measurements in low-risk groups.

Obesity and Kidney Transplant Candidates: An Outcome Analysis Based on Body Mass Index.

Background Obesity is a well-established risk factor for a decline in renal function and post-operative complications. Also, obese patients suffer worse outcomes such as higher rates of wound complications, longer hospital stays, and delayed graft function (DGF) when compared to nonobese patients. The correlation between having a high BMI and the postoperative outcomes of kidney transplantation has not been investigated yet in Saudi Arabia. There is scarce evidence that patients with obesity who have undergone kidney transplantation are devoid of any complications before, during, or after their procedure. Methodology A retrospective cross-sectional study was conducted using charts of nearly 142 patients in King Abdullah Specialist Children's Hospital in Riyadh, who had kidney transplant surgery in the organ transplantation department. All Obese patients with BMI >29.9 who underwent Kidney Transplant Surgery in King Abdulaziz Medical City from 2015 to 2022 were used. Details of hospital admissions were retrieved. Results A total of 142 patients fulfilling the inclusion criteria were included. There was a significant difference between patients regarding pre-surgical history where all cases (100%; 2) with class three obesity were hypertensive and on dialysis versus (77.8%; 21) and (70.4%; 19) of class two obesity and (86.7%; 98) and (78.8%; 89) of class one obesity cases, respectively (P = 0.041). Regarding medical history, hypertension was reported among 121 (85%), followed by dialysis (77%; 110), diabetes mellitus (DM) (52%; 74), dyslipidemia (24%; 35), endocrine diseases (15%; 22), and cardiovascular diseases (16%; 23). Considering post-transplant complications, 14.1% (20) of the study cases had DM (16.8% of obese class one, 3.7% of obese class two, and none of obese class three; P = 0.996) and urinary tract infection (UTI) among 7% (10) of the cases (6.2% of obese class one, 11.1% of obese class two, and none of obese class three; P = 0.996). All these differences according to patients' BMI were statistically insignificant. Conclusion Obese patients are more likely to experience difficult intraoperative management along with a complicated postoperative course due to numerous concomitant comorbidities. Post-transplant DM (PTDM) was the most prominent post-transplant complication followed by UTI. A remarkable reduction in serum creatinine and blood urea nitrogen (BUN) has been observed at the time of discharge and after six months compared to pre-transplant measurements.