Assessment of knowledge towards first aid skills of epilepsy among undergraduate health students in Riyadh province of Saudi Arabia: A cross-sectional study.

BACKGROUND: Applying proper first-aid measures to patients with seizure episodes plays a vital role in preventing the adverse consequences of seizures. Most previous data focused on teachers, healthcare providers and the general public. This study aimed to assess the knowledge of seizure first-aid measures among undergraduate health students. METHODS: This descriptive, cross-sectional study was conducted between May 16 and 31, 2023, with 493 undergraduate health students of Riyadh Province who answered online surveys. The data were collected using the descriptive information form. The chi-square (χ2) test was employed to compare knowledge of seizure first aid between demographic variables. The relationship between knowledge score and independent variables was evaluated using multiple linear regression technique. RESULTS: Only 1.6 % of participants demonstrated good knowledge scores toward seizure first-aid measures. The skill most frequently reported was to remove all harmful objects from their vicinity and loosen the tight clothes around the neck during a seizure; 68.7 % of the participants correctly answered with agreed. Conversely, the skill that received the lowest knowledge score among participants was putting a piece object such as a cloth, wallet, or spoon between the teeth to prevent tongue biting during a seizure; only 37.3 % of the participants correctly answered with disagree. Moreover, participants in the advanced age group, medicine and fifth-year, were found to be significant predictors of knowledge and exhibited better knowledge scores toward seizure first aid measures than their peers (p < 0.001). Furthermore, lectures and books were identified (69.6 %) as the most common source of information about seizure first aid. CONCLUSION: The study concluded that most undergraduate health students demonstrated poor knowledge scores in delivering seizure first aid. This finding suggests that introducing epilepsy education from the first year in all health-related courses is crucial to improving overall awareness and skills in providing seizure first aid.

Pulmonary Manifestations of Systemic Lupus Erythematosus Among Adults in Aseer Region, Saudi Arabia.

Background: Nearly half of the Systemic lupus erythematosus (SLE) patients develop lung involvement. The study assessed the extent of pulmonary involvement among SLE patients and to identify the associated factors in the population. Methodology: This retrospective cohort study was conducted at Aseer Hospital and Khamis Myshat Hospital in the Southern region of Saudi Arabia. The study spanned from January 1, 2016, to June 3, 2023. Patient inclusion criteria encompassed individuals who received a definitive diagnosis and classification as per American College of Rheumatology criteria, while patients under 18 years of age and those with mixed connective tissue diseases were exclude. Results: A total of 247 participants were included. 41.7% (n=103) aged 41 years and older, 95.1% (n = 235) were females. Around 10.10% had diabetes mellitus and 17.00% had hypertension and hypothyroidism. Lupus Nephritis was in 15.40%. Chest involvement was reported in 21.9%, in the form of pleuritis (6.10%), pleural effusion (4.00%), and lupus pneumonitis (4.00%), interstitial lung disease (4.00%), pulmonary embolism (3.60%) of individuals, and pulmonary hemorrhage (2.80%). The respiratory symptoms reported by SLE were; dyspnea, cough, and chest pain each having a prevalence of around 18.0%. Palpitations have a relatively high occurrence at 13.80%. Meanwhile, hemoptysis (blood coughing) has a lower prevalence of 1.20%, and fever is reported at 2.80%. Having chronic kidney disease and hypertension were significantly associated with having pulmonary involvement; (χ2=3.308, p=0.027) and (χ2=7.782, Fisher's p=0.002) respectively. The seropositivity for antiphospholipid Abs, anti-CCP, and antids-DNA were significantly associated with pulmonary involvement (χ2=3.239, =p=0.049), (χ2=4.621, Fisher's p=0.023), and (χ2=8.248, p=0.010) respectively. Conclusion: The study found that 21.9% of SLE patients experience chest involvement, with varying degrees of pulmonary symptoms. Factors such as chronic kidney disease, hypertension, antiphospholipid antibodies, Anti-CCP positivity, and seropositivity for Anti-dsDNA were found to be significant associations with lung involvement, contributing to our understanding of SLE.

The Diagnostic Value of Fine-Needle Aspiration Cytology in Cervical Lymphadenopathy in Correlation to Postoperative Histopathological Results in a Tertiary Care Center in Saudi Arabia.

Background Lymphadenopathy is a frequently encountered presentation in the clinical practice. Cervical lymphadenopathy implies that the cervical nodal tissue measures more than 1 cm in diameter. It requires prompt and accurate diagnosis to begin an appropriate treatment plan. Fine-needle aspiration cytology (FNAC) is considered an initial diagnostic method due to its simplicity, minimal invasiveness, quick availability of results, and low risk of complications. This study aimed to evaluate the diagnostic value of FNAC by comparing the cytological and histological diagnoses of patients with cervical lymph node enlargement at Aseer Central Hospital, Southern Region, Saudi Arabia. Methodology This observational, retrospective, record review study was conducted at the Otorhinolaryngology Head and Neck Surgery Department in Aseer Central Hospital, Abha, Saudi Arabia. Using a data collection sheet, the data of 102 patients were collected from electronic records and reviewed retrospectively. The study included patients who underwent cervical lymph node excision biopsy between 2020 and 2023 due to enlargement of the cervical lymph node. The cytological diagnoses were compared with the histopathological diagnoses of the same enlarged cervical lymph nodes. Results The most common FNAC findings were lymphomas and reactive lymph nodes (26.2% and 19.7%, respectively). The positive predictive value of FNAC was 100% and the negative predictive value was 86.7%. Overall, the diagnostic accuracy was 95.3%. Conclusions FNAC is a safe diagnostic method with minimal invasiveness and complications. This study showed that FNAC and tru-cut biopsy have good diagnostic value in examining patients with cervical lymphadenopathy regardless of their limitations and drawbacks. They have good sensitivity, specificity, positive and negative predictive values, and accuracy.

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults.

INTRODUCTION:  One of the major global risk factors for cardiovascular morbidity and death is hypertension. Earlier research has been conducted on the connection between calcium consumption and blood pressure. OBJECTIVE: This study aims to investigate the association between calcium serum levels and hypertension in older hypertensive adults. METHODS:  A retrospective cohort study of 121 of hypertension patients was conducted in Prince Faisal Bin Khalid Cardiac Center. The data of all patients were collected by records, including lab, pathology, and medical review, in order to determine the effects on patients, providers, and institutions. Statistical analyses were performed using SPSS Statistics version 26.0. A p-value of <0.05 was considered statistically significant. RESULTS:  The study included 121 adult hypertensive patients with a mean of age 60.29 ± 13.92. The majority of included patients were male (81%). More than one-third of patients were obese (39.7%), about one-third (33.9%) were overweight, and 26.4% of patients were in normal weight. The majority of patients had co-morbidities (68.3%); about one-half of them had diabetes mellitus (52.1%). The calcium level mean was 5.07 ± 1.26. The creatine kinase (CK) (initial day) mean ± SD was 813.22 ± 1146.37 became 221.4 ± 330.67 on the last day. The CK-myocardial band (CK-MB) (initial day) was 65.43 ± 118.9 and became 24.38 ± 23.26 on the last day. Additionally, the troponin (initial day) mean was 23.49 ± 104.26 and became 1.65 ± 2.66 on the last day. The most common discharge medications were anti-platelets (95%), beta-blockers (78.5%), statins (70.2%), and proton-pump inhibitors (PPI) (64.5%). The hospital stay days ranged from 1 to 20 days with a mean of 4.83 ± 3.38. The ICU stay days ranged from 1 to 15 days with a mean of 3.57 ± 2.72. Most of the patients (90.9%) improved. CONCLUSION: There is no significant correlation between calcium levels in hypertensive patients and the demographic characteristics of patients, home or current medications, ECHO findings, or procedures done. However, there is a significant correlation between the calcium level and CK level among patients with hypertension. Further investigations are required to verify the relationship between CK and calcium levels in hypertensive patients.

Hypokalemia as a responsible factor related with the severity of hepatic encephalopathy: a wide multination cross-sectional study.

Several precipitating factors of hepatic encephalopathy have been recognized and studied. Hepatic encephalopathy which is a frequent and grave complication of liver failure, is associated with multiple biochemical changes like high serum ammonia, mercaptan and phenol levels, low albumin levels and derangements in electrolytes. It is characterized by a range of neuronal and psychological aberrations mainly due to the inability of liver to metabolize different neurotoxic chemicals produced in the body. Hypokalemia is one of the most important findings in hepatic encephalopathy and postulated as a precipitating factor of the condition. The authors aimed to know the frequency of hypokalemia and its relation to the severity of hepatic encephalopathy. Methods: After taking approval from the hospital ethical review committee, a total of 5000 patients with hepatic encephalopathy were recruited by consecutive sampling. They were interviewed, examined and investigated for serum potassium levels and other precipitating factors of hepatic encephalopathy. Results: Total of 5000 patients including 3070 (61.4%) males and 1930 (38.6%) females, aging 13 years and above were studied. The frequency of hypokalemia was 78% (3900 patients). Relating the serum potassium level with the severity of hepatic encephalopathy, 1200 (60%) out of 2000 patients with serum potassium below 2.5 mEq/l were in grade 4 (40%) and 800 out of 2000 were in grade 3 encephalopathy. On the other hand, only 700 patients (6.4%) out 1100 with serum potassium above 3.4 mEq/l were in grade 4 encephalopathy. Conclusion: Hypokalemia is a frequent finding in patients with hepatic encephalopathy and found to be directly related to its severity.

Oral Antispasticity Drugs and Non-Progressive Neurological Diseases: A Meta-Analysis on Safety and Efficacy.

Background: Spasticity is a pathophysiological outcome of impaired muscle motor activity, primarily the muscle tone. Muscle tone problems are signs of several neurological conditions, such as multiple sclerosis, movement disorders, spine damage, stroke, and traumatic brain injury. Antispasticity therapeutics belong to a class of treatments that restore motor function and muscle tone. There are several routes of therapeutic administration of antispastic medications; among them, the oral drug delivery system plays a significant role. Objective: The purpose of the study was to present a complete synthesis of the scientific evidence on the safety and efficacy of antispasticity medicines used orally for the management of nonprogressive neurological disorders. Materials and Methods: In order to carry out a comprehensive meta-analysis, the most pertinent scientific studies on the use of oral antispasticity medications to treat non-progressive neurological illnesses were identified. A search was conducted across a number of databases, including SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed. MedCalc statistical software was used to perform a meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards for odds ratio across the studies, relative risk, and risk factor analysis. Results: In the present study, a total of 252 original records were retrieved from different predefined databases on oral antispasticity drugs and their association with non-progressive neurological disorders. After several screening steps, 12 studies were found to be eligible for meta-analysis. These studies represented different antispasticity therapeutics that were administered via the oral route. Based on the meta-analysis, oral antispasticity drugs were found to be moderately effective (P < 0.001). Conclusion: The findings of the meta-analysis showed that the interventions of tizanidine, diazepam, dantrolene, baclofen, and gabapentin were more effective in tackling spasticity than the control. Therefore, in the treatment of non-progressive neurological diseases, oral antispasticity medications are only modestly effective.

Oral health knowledge, attitude, and practice of pregnant women in Deccan, South India: a cross-sectional prenatal survey.

Pregnancy is a unique condition for women, associated with physiological and emotional changes in the body. Various research showed an association between periodontal disease and adverse pregnancy outcomes. Importance to hygiene maintenance should be given during pregnancy and improve the wellbeing of the mother and child. This study assessed oral health knowledge, attitude, and practices among pregnant women in Hyderabad. The study design was cross-sectional and included 445 women who responded and completed the survey. Subjects were selected using a random sampling technique in gynecology clinics. The questionnaire form consisted of four sections: demographic data, knowledge, attitude, and oral hygiene practice. Out of the 482 pregnant females invited to participate in the study, 445 women completed the survey, giving a response rate of 92%. The majority of women showed good knowledge and attitude regarding oral hygiene and its relation to pregnancy. However, the participants showed poor compliance with the recommended protocol. There are certain myths and barriers to dental treatment that need to be considered in the prenatal education of women. If explained by the gynecologist, the importance of oral health and its correlation with systemic health will play a crucial role in improving oral hygiene practice and regular dental visits.

Dietary Supplement Use among Primary Health Care Attendants in Abha City, Southwestern Saudi Arabia.

Dietary supplements are commercially available manufactured products used as an addition to the normal diet and involve vitamins, minerals, herbs (botanicals), amino acids, and various other products. With the use of a cross-sectional survey, the present paper intended to analyze dietary supplement usage and its health and sociodemographic determinants among attendants of primary health care centers in Abha City, southwestern Saudi Arabia. The sample was selected randomly using the two-stage cluster sampling technique. The study included 438 participants (115 males and 323 females). Their ages ranged from 18 to 59 years, with an average of 36.2 ± 11.7 years. The study showed that 330 people used dietary supplementation, giving a prevalence of 75.3% (95% CI: 71.1-79.2%). The most commonly used supplements were multivitamins (215, 65.2%), specific vitamins (60, 18.2%), and mineral pills (38, 11.5%). Advice from health care workers was the most frequent reason for using dietary supplements (49.4%). The majority (71.2%) reported feeling a better quality of life after using dietary supplements. The most frequent disadvantages of using dietary supplements were constipation and headache (30%) and the most frequent advantage was increasing appetite (59.8%). The people who most frequently recommended the use of supplements were health care workers (190, 57.6%), followed by friends or family members (62, 18.8%), and people on social media (43, 13%). Females had a significantly higher probability of using dietary supplements than males did (Cor = 2.0, 95% CI = 1.21-3.27), and those with a chronic disease had a considerably higher likelihood of using dietary supplements (cOR = 3.48, 95% CI = 2.04-6.06). Age, educational level, and marital status were not significantly related with dietary supplement usage. In conclusion, health care workers should focus on females and persons with chronic diseases in their practice. They should provide them with evidence-based advice regarding the use of dietary supplements. Continued medical education training programs tailored to the needs of health care staff addressing this issue should be provided. New guidelines should be developed to help health professionals to provide their patients with comprehensive care at the primary health care level.

Horizontal Gaze Defect as a Result of Subcortical Stroke: Case Report and Review of the Literature.

Gaze palsies are commonly observed in the setting of acute stroke; such strokes are nearly always localized to either cerebral cortical or brainstem areas. Much less common are lesions localized at the subcortical pathways involved in the control of eye movements. We report a patient with subcortical white matter ischemic stroke who suffered horizontal gaze defects.

Influence of Spiritual Coping and Social Support on the Mental Health and Quality of Life of the Saudi Informal Caregivers of Patients with Stroke.

The research explored the influence of spiritual coping and social support on mental health and quality of life (QOL) of informal caregivers of stroke survivors in Saudi Arabia. The respondents were frequently using religious coping strategies than existential coping strategies. The respondents received higher support from significant others and lowest support from friends. The majority of the respondents had mild to moderate depression, while more than one-third had mild to severe anxiety. Psychological health received the highest QOL, while physical health received the poorest QOL. Spiritual coping and social support significantly influenced the informal caregivers' mental health and QOL.

Burnout syndrome among southern region orthopedic surgeons, Saudi Arabia.

BACKGROUND: Burnout is known as result of long term exposing to stress. There are some factors that may cause stress in physicians: nature of work, their training, their public image, their families and themselves. The person who has burnout syndrome (BOS) seems like to have tiredness, low energy, nervousness, and mentally unstable. The aim of the study is to assess the pattern and magnitude of burnout among orthopedic surgeons in southern region, Saudi Arabia. METHODOLOGY: A descriptive cross-sectional survey was applied targeting all orthopedic surgeons in 12 hospitals all southern region, Saudi Arabia during the period from December 2018 to April 2019. Data were collected using self-administered questionnaire that was developed by the researchers. The questionnaire included personal data. Burnout was assessed using Maslach Burnout Inventory Scale. RESULTS: A total sample of 107 orthopedic surgeons were included with their ages ranged from 25 to 65 years old with mean age of 38.1 ± 8.9 years. About 94% of the surgeons were males and 43.9% were Saudi. Generally, the surgeons recorded mean score for emotional exhaustion of 18.9 points out of 54 with mean score% of 35.1%. Regarding depersonalization, the surgeons had mean score % of 30.7% and had a score of 39.6% for personal accomplishment. CONCLUSIONS: The study revealed that all included physicians had moderate levels of burnout. Personal accomplishment was the highest level of burnout recorded. Health education sessions and periodic training is required to improve surgeons coping strategies to overcome burnout.

Quality of life and social support: Perspectives of Saudi Arabian stroke survivors.

Given that stroke is an indispensable health burden in Saudi Arabia and around the world, great importance has been attached on studies of social support and other factors that could improve the quality of life of stroke survivors. Perceptions of quality of life and social support may vary depending on patients' cultural and societal background. This research assessed the quality of life and social support of community-dwelling Saudis who survived stroke. A quantitative study was performed among 123 Saudi stroke survivors. Questionnaire-guided interviews measuring social support and quality of life were performed, and the multivariate effects of predictor variables on the four domains of quality of life were determined through multivariate multiple regression analysis. Among the dimensions of social support, support from family members had the highest average, whereas support from friends had the lowest. The environmental domain of quality of life was perceived to be the best aspect, whereas physical health was perceived to be the poorest. Multivariate analysis revealed that age, gender, employment status, monthly family income, type of community, education, type of stroke, side of stroke and support from significant others had multivariate influences on the domains of quality of life. Several sociodemographic and disease-related variables and social support influence patients' quality of life. The study adds critical knowledge as to how Arab stroke survivors perceive their quality of life and social support. Ensuring that stroke survivors receive adequate social support is imperative because it can improve their quality of life.

Knowledge, attitude, and believes of epilepsy in local communities of Saudi Arabia.

AIM OF THE STUDY: To assess public knowledge, attitude, and believes toward the epilepsy among local community populations in Shaqra Area, Kingdom of Saudi Arabia. METHODS: An organized 14 questionnaire was prepared to analyze public knowledge attitudes and believes about epilepsy. Study was conducted randomly in common public places in Shaqra City, Saudi Arabia, during the months of April and May 2016. Sample size includes 155 males and 130 females from Shaqra City of Saudi Arabia. RESULTS: The study analyzed the 285 local public including 155 male and 130 female contributors. About 68.38% male contributors and 63.07% female contributors studied Diploma or Bachelor education program. Female contributors (71.53%) were aware about epilepsy as compared with male contributors (58.70%). Maximum number of female contributors (82.30%) believes that epilepsy is treated by medication as compared with male contributors (58.70%). CONCLUSION: The knowledge, awareness, and attitudes of the epilepsy are found to be much improved in local community of Saudi Arabia. In the modern era, people assume that epilepsy is still due to evil spirit. Many contributors think there should be restrictions on driving and getting jobs in epilepsy patient. Public awareness and educational campaigns should be included in modern methods of education to develop well-knowledged community, which will improve the quality of life of epileptic patients.

Awareness of disc herniation among general population in Aseer province, Saudi Arabia.

BACKGROUND: Herniated lumbar disc is a depositions of discs material (nucleus pulposus and annulus fibrosus) behind the intervertebral disk. Intervertebral disc connected the vertebral bodies together by pad of fibrocartilage. The major functions of intervertebral disc are mechanical, transferring load coming from the body weight and muscle contractions by spinal columns and letting the curving, flexion, and contortion. AIM: To assess the awareness of general population in Aseer region, southern of Saudi Arabia, regarding disc herniation and to identify the predictors for their awareness. METHODOLOGY: A descriptive cross-sectional approach was conducted through a questionnaire designed to examine the public herniated disc awareness and knowledge. The questionnaire given to individuals from general population visiting general public places in Aseer region. Content validity for the questionnaire was done as it was reviewed by three experts for any modification of corrections. RESULTS: The study included 1,044 participants aged between 15 and 70 years with mean age of 36.3 ± 11.2 years old. The majority of respondents were males (62.4%) and Saudi (98.9%). About 71% of the participants were university graduated. Generally, only 9% of the study participants recorded good awareness level regarding all aspects of disc herniation. CONCLUSION: This study showed that awareness regarding disc herniation among the general population was very poor for all domains.

A reappraised meta-analysis of the genetic association between vitamin D receptor BsmI (rs1544410) polymorphism and pulmonary tuberculosis risk.

BsmI (rs1544410) polymorphism located in intron 8 at the 3'-end of the vitamin D receptor (VDR) gene is known to be involved in the regulation of mRNA stability. Many studies evaluated the possible correlation between VDR BsmI polymorphism and the risk of pulmonary tuberculosis (PTB), and reported conflicting results. In the present study, an updated meta-analysis was performed to evaluate the above-said association. PubMed, Embase, and Google Scholar web-databases were searched for the relevant studies and a meta-analysis was performed by calculating pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for all the genetic models. A total of 19 studies comprising 3644 controls and 2635 cases were included in the present study. Overall no association of PTB in allelic contrast (b compared with B: P=0.285; OR =0.909, 95% CI =0.762-1.083), homozygous (bb compared with BB: P=0.881; OR =0.975, 95% CI =0.700-1.359), heterozygous (bB compared with BB: P=0.834; OR =1.017, 95% CI =0.872-1.185), dominant (bb compared with BB + Bb: P=0.451; OR =0.954, 95% CI =0.843-1.079) and recessive (bb + Bb compared with BB: P=0.983; OR =1.002, 95% CI =0.868-1.156) genetic models in comparison with wild-type allele and genotype BB were observed. However, variant allele (b compared with B: P=0.001; OR =2.289, 95% CI =1.661-3.154) showed increased risk of PTB in Asians. In conclusion, VDR BsmI polymorphism is not a risk factor for PTB in overall population. However, this polymorphism may be interrelated to an increased risk of PTB amongst Asians.

Effect of genistein, a natural soy isoflavone, on pancreatic ß-cells of streptozotocin-induced diabetic rats: Histological and immunohistochemical study.

Diabetes mellitus is one of the oldest disorders that is rapidly emerging as a global health problem. Soy genistein is a legume that has numerous health benefits. This work aimed to study the effect of different doses of genistein on histological, immunohistochemical and morphometrical changes in ß-cells of streptozotocin (STZ)-induced diabetic rats and to correlate these effects with plasma glucose and insulin levels. Fifty adult male rats were divided into five equal groups. Group I served as a control. Group II received genistein. Group III comprised STZ-induced diabetic rats. Group IV diabetic animals treated with low dosage genistein. Group V diabetic animals treated with high dosage genistein. Genistein was given for 4 weeks after STZ injection. Rats were sacrificed and pancreatic specimens were taken for light and electron microscopic examination. Blood samples were collected for detection of serum glucose and insulin levels. After diabetic induction, the islets appeared shrunken with cytoplasmic vacuolation of their cells and negative insulin immunoreaction. Ultrastructurally, ß-cells showed darkly stained nuclei with marked loss of granules. Morphometrically, significant loss of ß-cells was detected. The serum insulin level was decreased with elevation in the serum glucose. High-dose but not low-dose genistein improved the morphology of islets with increased insulin immunoreaction. Genistein also significantly decreased ß-cells loss and improved glucose and insulin levels. In conclusion, genistein has a protective effect on pancreatic ß-cells damage, possesses the ability to regenerate ß-cells and improves serum levels of insulin and glucose in STZ-induced diabetic rats in a dosage-dependent manner.

Central fever due to hypothalamic lesion in a patient with tuberculous meningitis.

Abnormalities of body temperature are perhaps the most common features in many systemic pathologic processes. Such pathologic alterations are nearly always the result of extrinsic factors (for example, systemic pyrogens) which affect the hypothalamic thermoregulatory center by way of circulatory system. Much less common is alterations in temperature regulation resulting from intrinsic lesions of the thermoregulatory center in the hypothalamus. We report a patient with tuberculous meningitis who continued to have persistent fever despite the satisfactory treatment of her tuberculosis. A central thermoregulatory defect was documented and was attributed to a small structural lesion in the anterior hypothalamus.