Awareness of Anti-adhesive Barriers Among Surgeons in Saudi Arabia.

Introduction Post-operative adhesions present a number of difficulties, including intestinal obstruction and infertility, and they frequently require readmission due to adhesion-related problems. Notwithstanding these ramifications, there are surprisingly few thorough national surveys that address surgeons' awareness of adhesives. By assessing Saudi surgeons' knowledge of post-operative adhesions and their use of anti-adhesive medications, this study aims to close this knowledge gap. Methods This study is a cross-sectional observational research study aimed at Saudi Arabian surgeons utilizing a self-administered, semi-structured online questionnaire. The questionnaire was distributed to participants via social media and in-person email using basic random selection. It included adhesion morbidity and prevalence, pre-operative informed consent issues, adhesion preventive viewpoints, and anti-adhesive chemical use. Results There were 111 participants in total, of 41% were experienced surgeons with more than five years of experience. According to the survey, the majority of surgeons occasionally employed anti-adhesive compounds, especially during laparotomies (28%), and 38% never used them during laparoscopies. The study found that participants varied in what they informed patients regarding adhesion complications: 25% of participants informed 5%-10% of the patients about the possible adhesion complications in laparotomy procedures, whereas 26% of participants informed 10-25% of the patients in laparoscopic procedures. Compared with their specialist peers, general surgeons agreed more on the clinical significance of adhesions and prevention. Notably, three-quarters of participants were unclear about when to use anti-adhesive compounds. Conclusion While acknowledging the clinical significance of post-operative adhesions and recognizing the potential for prevention, most surveyed surgeons did not include adhesions as a post-operative complication in informed consent. The study underscores a belief in the efficacy of anti-adhesives yet reveals a widespread lack of clarity regarding specific indications for their use. Recommendations include implementing educational sessions during surgical training to heighten awareness of adhesions as a major post-operative complication and to encourage the appropriate utilization of available barriers and pharmacological anti-adhesive products.

Impact of Eco-Friendly Plaster Using Epoxy Resin and Epoxy Hardener on Mechanical Properties under Compression and Tension.

BISCO plaster (BRP) is an environmentally friendly material with high mechanical properties and is considered a great elective to conventional materials such as gypsum and cement. Our investigation seeks to examine BISCO plaster (BRP) and a mixture of resin and hardener in three proportions (30%, 45%, and 60%) to achieve our ultimate goal, which is to preserve the environment and achieve the vision of the Kingdom of Saudi Arabia 2030 to reach zero carbon emissions by 2060? Emissions tests were performed, and although the CO2 level was zero, they emitted SO2 sulfur dioxide and NO2 nitrogen dioxide, and 60% was the lowest emission rate. We also used ANSYS 2023 R1 software to compare them with their mechanical properties resulting from tensile and compression testing. In this study, we looked closely at the mechanical characteristics of different materials designed for wall coverings, with particular emphasis on their environmental sustainability. We carried out experiments to gauge the tensile and compressive stress on samples with varying mixing ratios. Our main objective was on crucial mechanical properties such as the modulus of elasticity, ultimate tensile strength, yield strength, yield strain, modulus of resilience, and ductility. Through meticulous scrutiny, we determined that the amalgamation of these mechanical attributes at the 30% mixing ratio provides an optimal combination for attaining structural integrity, adaptability, and resilience in wall coverings. Significantly, this ratio also underscores a commitment to environmentally conscious material selection. Our study offers important new insights into the selection of wall covering materials by providing a detailed understanding of their mechanical behavior under various stress conditions. It aligns with the increasing significance of environmental responsibility in contemporary design and construction. By emphasizing the 30% mixing ratio, our findings establish a foundation for informed decision making, promoting the utilization of sustainable materials that achieve a balance between strength, flexibility, and longevity. This ensures optimal performance in practical applications while simultaneously minimizing the environmental impact.

Awareness of Risk Factors for Coronary Artery Disease in the Population of Al-Majma'ah Region, Saudi Arabia.

BACKGROUND: Coronary artery disease (CAD) is a significant global health concern and a leading cause of morbidity and mortality. As a complex cardiovascular condition, CAD arises from the accumulation of atherosclerotic plaques within the coronary arteries, leading to restricted blood flow to the heart muscle. While CAD has been extensively studied, its prevalence remains a challenge, particularly in diverse populations with distinct cultural and lifestyle practices. OBJECTIVES:  To assess the awareness of risk factors for CAD in the population of Al-Majma'ah Region, Saudi Arabia. METHODS:  The purpose of this cross-sectional descriptive study was to determine participants' awareness of CAD risk factors among the population of Al-Majma'ah Region, Saudi Arabia. It was conducted by the use of a self-administered questionnaire that had been validated in prior research publications. Sociodemographic information as well as the prevalence of cardiovascular disease risk factors were covered in the survey. The data analysis was done using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). RESULTS: A total of 919 individuals were enrolled in the current study after meeting the inclusion criteria. The results showed that most of the respondents 626 (68.1%) had a good level of awareness, 261 (28.4%) had a fair level of awareness, while only 32 (3.5%) of the respondents had a poor level of CAD risk factors awareness. CONCLUSION: The majority of participants had a good level of knowledge regarding CAD risk factors. The correlation between monthly income and awareness of coronary artery risk factors was statistically significant.

Awareness, Knowledge, and Attitudes Regarding Basic Life Support Among the General Population in the Al-Majma'ah Region, Saudi Arabia.

BACKGROUND: Cardiac arrest is a critical medical emergency that can strike individuals of any age or background, often occurring suddenly and unpredictably. The administration of Basic Life Support (BLS) techniques by laypersons in the first few crucial minutes following a cardiac arrest can substantially increase the chances of survival and minimize potential neurological damage. Despite the vital role of BLS in saving lives, there remains a gap in public awareness, knowledge, and attitudes regarding BLS among the general population in many regions worldwide, including Saudi Arabia. In recent years, there has been a growing emphasis on the importance of community-based interventions to enhance cardiac arrest survival rates. Public involvement in the early stages of cardiac arrest management is a key component of the chain of survival, and improving BLS awareness and knowledge among the general population is central to this effort. OBJECTIVE: This study aimed to assess the awareness, knowledge, and attitudes with regard to BLS among the general population in the Al-Majma'ah region, Saudi Arabia. METHODS: This is a descriptive cross-sectional study adopted among the population living in the Al-Majma'ah region of Saudi Arabia. The data was collected by a pre-tested and self-administered questionnaire. Data was analyzed by using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The questions included information on social demographic information, awareness and knowledge, and attitudes related to BLS. RESULTS: More than half the participants (n=352; 52.5%) understand that during cardiac arrest, the heart is still beating and pumping blood, but the person is not breathing normally. This is an important understanding for providing proper care during a cardiac arrest situation. On the other hand, the study found that 384 (57.2%) had various reasons for their lack of knowledge about cardiopulmonary resuscitation (CPR). The biggest reason was lack of interest (n=98; 14.6%). This highlights a need for increased awareness and education about the importance of CPR. The findings from the Pearson correlation conducted in this study show that age has a significant influence on the level of awareness and knowledge of cardiac arrest BLS. The p-value obtained for the test was 0.014, indicating that there is a significant relationship between age and awareness and knowledge of BLS. Similarly, the study findings also show that gender has a significant influence on the attitude of cardiac arrest BLS. CONCLUSION: The participants had a decent understanding of BLS, particularly regarding concepts like cardiac arrest and the role of automated external defibrillators (AEDs). However, they showed confusion or gaps in awareness, especially concerning the correct initial steps when encountering a collapsed person. Many participants felt uncomfortable performing Hands-Only CPR in a real-life situation due to a lack of knowledge and skills, which acted as a significant barrier to public CPR performance.

Effect of hyperbaric oxygen treatment on diabetic foot ulcers: A meta-analysis.

The meta-analysis aimed to assess the effect of hyperbaric oxygen treatment on diabetic foot ulcers. Using dichotomous or contentious random or fixed effect models, the outcomes of this meta-analysis were examined and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. 17 examinations from 1992 to 2022 were enrolled for the present meta-analysis, including 7219 people with diabetic foot ulcers. Hyperbaric oxygen treatment had a significantly higher healed ulcer (OR, 14.39; 95% CI, 4.02-51.52, p < 0.001), higher adverse event (OR, 2.14; 95% CI, 1.11-4.11, p = 0.02), lower mortality (OR, 0.22; 95% CI, 0.07-0.71, p = 0.01) and higher ulcer area reduction (MD, 23.39; 95% CI, 11.79-34.99, p < 0.001) compared to standard treatment in patients with diabetic foot ulcers. However, hyperbaric oxygen treatment and standard treatment had no significant difference in amputation (OR, 0.62; 95% CI, 0.22-1.75, p = 0.37), major amputation (OR, 0.59; 95% CI, 0.18-1.92, p = 0.38), minor amputation (OR, 0.64; 95% CI, 0.15-2.66, p = 0.54) and healing time (MD, -0.001; 95% CI, -0.76 to 0.75, p = 0.99) in patients with diabetic foot ulcers. The examined data revealed that hyperbaric oxygen treatment had a significantly higher healed ulcer, adverse event, and ulcer area reduction and lower mortality, however, there was no significant difference in amputation and healing time compared to standard treatment in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size and some of the comparisons had a low number of selected studies.

Flexural Behaviour of GFRP-Softwood Sandwich Panels for Prefabricated Building Construction.

Studies have shown that the proper selection of core materials in sandwich structures improves the overall structural performance in terms of bending stiffness and strength. The core materials used in such systems, such as foam, corrugated, and honeycomb, are frequently applied in aerospace engineering. However, they are a costly option for civil engineering applications. This paper investigates the bending performance of the proposed GFRP softwood sandwich beams assembled using pultruded GFRP with adhesive connection methods for potential applications in prefabricated building construction. The ultimate load capacity, load-deflection responses, failure modes, bending stiffness, load-axial-strain behaviour, and degree of composite action were experimentally evaluated. The effects of varying shear-span-to-depth ratios a/d between 2 and 6.5, as well as different timber fibre directions of the softwood core, on the overall structural performance were clarified. The results showed that changing the timber fibres' orientation from vertical to longitudinal shifted the failure mode from a brittle to progressive process. Moreover, the adhesive bonding was able to provide full composite action until the failure occurred. Finally, numerical modelling was developed to understand failure loads, deformation, failure modes, and strain responses, and to evaluate bending stiffness and composite action. The results showed satisfactory agreement with the experiments.

The Incidence of Long-Term Fatigue in Patients Who Achieved Remission From COVID-19 at King Abdulaziz Medical City.

Introduction Long-term fatigue is a common condition that involves both physical and psychiatric symptoms, and it affects multiple age groups and causes morbidity and disabling symptoms that range from mild to severe symptoms. Many patients are discharged following coronavirus disease 2019 (COVID-19) infection without proper follow-up and evaluation of long-term effects, resulting in the improper treatment of the long-term symptoms, which increases the burden on the patients and healthcare systems. Coronavirus disease 2019 (COVID-19) is a disease caused by the novel SARS-CoV-2. It results in a variety of symptoms, including fever, cough, respiratory distress, the loss of the sense of smell and taste, and long-term effects such as post-severe acute respiratory syndrome (SARS), which is characterized by chronic fatigue, sleep disturbances, myalgia, weakness, and depression. The aim of this study is to assess the incidence of long-term fatigue in patients who achieved remission from COVID-19 at King Abdulaziz Medical City (KAMC), National Guards Health Affairs, Riyadh. Methods We conducted a cross-sectional, non-probability convenience sampling study. All participants who were diagnosed with COVID-19 and achieved remission were approached in an outpatient department (OPD) setting and signed an informed consent form and were evaluated by standard questionnaires at clinics after remission from COVID-19 at King Abdulaziz Medical City in Riyadh, Saudi Arabia. A total of 343 subjects who fit the inclusion criteria of any patients who have been diagnosed with COVID-19 and achieved remission were included in the study. This study included patients from the National Guard Hospital, students, and staff members. The primary outcome variable was the incidence of long-term fatigue in patients who achieved remission from COVID-19 as measured by the Chalder fatigue scale (CFQ). The participants were approached in clinics and general OPD by one of the research teams. Results Based on the study design, 343 patients were selected from King Abdulaziz Medical City in Riyadh, the incidence of long-term fatigue in patients who achieved remission from COVID-19 was 55.7%, and the rest were normal (44.3%). The incidence of long-term fatigue was statistically significantly higher in females and those who had been diagnosed with COVID-19 and achieved remission for more than two months. The age of the participants ranged from 18 to more than 45, with a predominance of females (60.6%). Regarding body mass index (BMI), 39.9% were overweight, and 29.2% were obese. Additionally, the incidence of patients with associated chronic disease was 27.4%; among these chronic diseases, hypertension was the most common one (18.1%), followed by diabetes (17%) and thyroid diseases (14.9%). Conclusion To the best of our knowledge, this is one of the few studies that were carried out in Saudi Arabia that assess long-term fatigue post COVID-19 infection. In our study, we discovered that long-term fatigue was highly prevalent (55.7%). We found that among those participants, more than half of those who reported chronic fatigue had a COVID-19 diagnosis for longer than two months. Furthermore, females made up the majority of those who had long-term fatigue. We urge that additional longitudinal and standardized studies be carried out in order to thoroughly determine the severity of long-term fatigue in patients who obtained remission from COVID-19.

Practices of Cancer Screening for Average-Risk Cancer Patients Among Primary Healthcare Center Physicians in Al-Qassim Region, Saudi Arabia.

OBJECTIVE: Cancer screening programs exist in Saudi Arabia for some types of cancers. However, data on primary healthcare center (PHC) physicians' practices in referring patients for screening tests or procedures remain unclear. METHODOLOGY: A cross-sectional study was conducted with a self-reported survey that included 141 PHC physicians affiliated with the Ministry of Health in the Al-Qassim region of Saudi Arabia. The primary outcome was the practice of recommending to average-risk patients screening tests for different types of cancers including breast, colorectal, cervical, prostate, and lung, and testing if sociodemographic, specialty, job level, years of experience, a family history of cancer, and patients encountered per day affect their decisions. Secondary outcomes were the barriers perceived by physicians to recommending a screening test. p-value <0.05 was considered significant. RESULTS: The study included 141 respondents, of which 60.3% were males, and the mean age of the entire population was 35.7 ± 8.3 years. The rate of recommending cancer screening varied by the type of cancer, with screening for colorectal cancer being the most prominent (64.5%), followed by breast cancer (51.8%). Fear of finding cancer, poor patient compliance, and difficulty in scheduling the test were the most common patient, physician, and system-related barriers as perceived by PHC physicians. Male physicians were less likely to recommend patients for breast (0.10, 95%CI 0.04-0.23, p < 0.001) and cervical (0.26, 95%CI 0.08-0.78, p = 0.017) cancer screening. However, they were 3.74 times more likely to recommend prostate cancer screening (95%CI 1.20-11.68, p = 0.023) and 5.79 times more likely to request lung cancer screening (95%CI 1.27-26.39, p = 0.023).  Level of education, specialty, and being a senior physician were factors associated with cervical cancer screening. Physicians who work in non-general practice specialties were more likely to recommend cervical cancer screening than those who work in general practice (95%CI 0.04-0.48, p = 0.002). Senior physicians such as registrars/senior registrars and consultants were more likely to request or recommend a patient for breast cancer screening (2.85, 95%CI 1.11-7.35) and cervical cancer screening (6.35, 95%CI 2.10-019.19). CONCLUSION: Screenings for colorectal and breast cancer were the commonly recommended screening tests. Patients' fear of finding cancer, poor patient compliance, and delays or difficulty in scheduling the procedures were the commonly identified barriers as perceived by physicians that influenced physician decisions in referring patients for cancer screening. Our findings suggest that cancer screening rates may be improved by educating individuals on the benefit of early detection of cancers and providing assurance for them with regard to the availability of effective treatments. More research is needed on ways to overcome the obstacles physicians encounter and the outcomes of these measures with regard to improved screening practices.

A Single-Center Study of the Utility of Bronchoalveolar Lavage in Critically Ill Patients With Haematological Malignancy or Stem Cell Transplants.

INTRODUCTION: The aim of this study was to evaluate the yield of bronchoscopy-guided bronchoalveolar lavage (BAL) and decisions on management of antimicrobials in critically ill patients with hematological malignancy and/or hematological stem cell transplant (HSCT). The safety and tolerance of bronchoscopy were also reported. METHODS: A retrospective cohort study was conducted by reviewing health charts of all adult patients with a hematological malignancy and/or an HSCT who were admitted to the intensive care unit and underwent bronchoscopy and BAL over four years from April 2016 to April 2020 at King Abdulaziz Medical City, Riyadh.  Results: The cohort included 75 critically ill patients. Of these 75 patients, 53 (70.7%) had HSCT (allogenic 66%, autologous 32.1%, haplogenic 3.8%). Computed tomography of the chest was abnormal in all patients. Predominant findings included airspace abnormalities, ground glass opacities, and others. The positive yield was found to be 20% for bacterial, 22% for viral, 21% for fungal, and other organisms were identified in 2%. Although cytology was not performed in 18 patients, malignant cells were identified on BAL in two patients. While the overall mortality of the cohort was high (46.7%), the vast majority (94.7%) tolerated bronchoscopy and BAL without any complications. However, three patients (4%) developed a pneumothorax and one patient bled and developed the acute respiratory distress syndrome post bronchoscopy. CONCLUSIONS: BAL can identify and detect microorganisms directly influencing the clinical care of patients who have received non-invasive diagnostic tests that yielded negative culture results. Bronchoscopy and BAL are generally safe and well tolerated by critically ill patients with hematological malignancy or HSCT.

Awareness of Myocardial Infarction Symptoms and Risk Factors in Saudi Arabia: A Cross-Sectional Study.

Background Cardiovascular disease is the leading global cause of mortality. Recognition of myocardial infarction (MI) symptoms is crucial as it influences clinical outcomes. Furthermore, awareness of MI risk factors assists in obtaining healthier lifestyles, alleviating its burden and mortality rates. This study aims to evaluate the awareness levels of the general population in Saudi Arabia regarding MI symptoms and risk factors and to identify its determinants. Methods A descriptive cross-sectional study was conducted among the general Saudi population, with 1,247 participants, excluding those residing outside Saudi Arabia and healthcare-related individuals. An online self-administered questionnaire encompassed sociodemographic characteristics, awareness of MI symptoms and risk factors, and participants' perceptions concerning appropriate responses during an MI event. Results The majority of participants recognized chest pain and shortness of breath as MI symptoms, with a percentage of 87.1% and 86%, respectively. Risk factors awareness was substantial at 90.3% for smoking and 76.1% for obesity. The mean overall awareness score was 26.6±7.5, and around 36% were aware of both symptoms and risk factors. Higher education levels were positively associated with both risk factors and symptom awareness, while employment status showed negative associations with both. Higher-income correlated with greater risk factors awareness. Gender remained significant, with males exhibiting a lower awareness of risk factors and symptoms. Region and chronic disease status were positively associated with risk factors and symptom awareness. More than 90% of participants perceived going to the emergency room immediately if they recognized an MI attack. Conclusion This study highlights the necessity for inclusive awareness campaigns to enhance the identification of MI symptoms and risk factors in Saudi Arabia. It should focus on groups with limited awareness, such as males, employed and retired individuals, and specific pronounced regional disparities.

Comprehensive Strategies in Endodontic Pain Management: An Integrative Narrative Review.

This narrative review comprehensively examines the current and emerging strategies for pain management in endodontics, encompassing a wide range of pharmacological and non-pharmacological approaches. Through an extensive exploration of 20 distinct parts, the review discusses traditional analgesics, antibiotics, the use of corticosteroids, and the role of novel treatments such as platelet-rich fibrin (PRF) and cryotherapy. The review also delves into the intricacies of clinical methods, such as trephination and occlusal reduction, and discusses the potential of advanced techniques such as GABAergic signaling, acupuncture, in silico modulation, and low-level laser therapy (LLLT) for the effective management of endodontic pain. The analysis reveals a trend toward integrative methods that combine established practices with cutting-edge research, highlighting the importance of a tailored approach in endodontic pain management. The findings underscore the significance of understanding the complex nature of dental pain and the need for multifaceted treatment strategies. The review emphasizes that while traditional pharmacological methods remain foundational, emerging therapies offer promising adjuncts or alternatives, especially in cases where conventional treatments may be inadequate or unsuitable. This review aims to serve as a comprehensive resource for endodontic practitioners and researchers, offering insights into the multifarious aspects of pain management in endodontics. It underscores the ongoing evolution in the field and suggests directions for future research, particularly in refining and validating new pain management techniques.

Medication Adherence Among Multimorbid Patients With Polypharmacy and Its Relation to Social Support at National Guard Primary Health Care Centers, Riyadh.

OBJECTIVE: The aim of the present study was to estimate the prevalence of nonadherence to medication in multimorbid patients with polypharmacy and its relationship to social support in primary healthcare centers in Riyadh, Saudi Arabia. METHODS: We conducted a cross-sectional, convenience-sample, non-randomized study in three primary healthcare centers managed by National Guard Health Affairs. The participants included 417 adult patients - (a) with two or more chronic illnesses and (b) who were taking two or more medications. The primary outcome variable was the prevalence of medication nonadherence in multimorbid patients with polypharmacy as measured by the modified Morisky Medication Adherence Scale (MMAS-8). The second main variable was the impact of functional social support, as measured by the Duke-UNC Functional Social Support Questionnaire (FSSQ), on medication adherence. RESULTS: The level of medication adherence was low for 194 (46.5%) of the 417 patients, medium for 127 (30.5%), and high for 96 (23%). There were 256 (61.4%) male participants and 161 (38.6%) females, and their mean age was 59.15 (SD ± 11.186) years. Additionally, 171 (41%) participants used two or three medications, 127 (30.5%) used four or five medications, and 119 (28.5%) used more than five medications; 178 (42.7%) of the patients had two comorbidities, 136 (32.9%) had three comorbidities, 69 (16.5%) had four comorbidities, and 31 (7.5%) had five comorbidities. Some social support data from the Duke-UNC Functional Social Support Questionnaire (FSSQ) was missing for 58 (13.9%) of the participants. Among the rest of the sample, reported levels of social support levels were high for 246 (59%) patients, medium for 101 (24.2%), and low for 12 (2.9%) patients. None of the differences between social support and medication adherence were statistically significant. However, 61 (24.8%) patients reported both high social support and high medication adherence; 173 (48.2%) had low social support and low medication adherence (p = 0.470). CONCLUSION: We found that medication nonadherence in multimorbid patients with polypharmacy was high (46.5%). Although there were no statistically significant relationships between social support and medication adherence, certain patient characteristics were associated with low medication adherence - age over 60 years, male gender, and number of medications.

Analysis of Factors Affecting Air Kerma Area Product Obtained during Uterine Artery Embolization Procedures Using Logistic Regression.

Purpose Uterine artery embolization (UAE) is a common interventional radiology procedure used in medicine; the procedure is safe but there is always a concern regarding radiation dose received by the patient. The aim of this study was to use multivariable logistic regression analysis (MLRA) to study a certain number of independent prognostic variables believed to provide an estimate of the likelihood of obtaining a high kerma area product ( P KA ) at the end of the procedure. Method Radiation dose indices registered by the angiographic system structured dose report, the total fluoroscopy time (FT), the patient' body mass index (BMI), the number of images taken during the procedures (IMGS), and the performing physician experience (EXPER) were used to drive a logistic regression model (LRM). Results The LRM found was: Logit ( P KA ) = -6.1525 + 0.0416 (FT) + 0.1028 (IMGS) + 0.1675 (BMI) - 0.1012 (EXPER). The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve; by calculating the area under the curve (AUC), we found AUC = 0.7896, with optimal ROC point of 0.3261, 0.8036. Conclusion The suggested LRM seems to indicate that patients with higher BMI, have taken longer FT, acquired higher IMGS and the procedure done by a less experienced performing physician is more susceptible to receive a higher P KA at the end. The proposed LRM is useful in predicting the occurrence of higher radiation exposure interventions and can be used in patients' radiation dose optimization strategies during UAE procedures.

The Reasons and Associated Injuries Related to Baby Walkers Use Among Children in Riyadh, Saudi Arabia.

BACKGROUND: Baby walkers (BW) are devices commonly used for helping babies' mobility. However, it is associated with different types of injuries. Parents still use BWs and believe that it promotes early walking. OBJECTIVES: This study aimed to estimate the use of baby walkers among children in Riyadh, Saudi Arabia, to identify the parental reasons for using BW, and to list their associated injuries. METHODS: This is a descriptive, cross-sectional study conducted between January 9, 2021, and January 31, 2021. A self-administered questionnaire was distributed through online means. We included all families living in Riyadh who have at least one child that is older than six months and younger than 36 months. RESULTS: This study included a total of 977 responders, of which, the majority 765 (78.3%) were baby walker users and 212 (21.6%) were non-users. Among those families using BW, the highest reason behind using them was to help the baby walk earlier (27.3%). However, believing that there is no need for using BW is the highest reason in the non-user group (29.40%). Fifteen percent of the responders reported that they had injuries related to BW usage and most of those injuries were falling downstairs (51.7%). The level of awareness regarding the disadvantage of BW was high in BW non-users (21.1%) compared to BW users (5.1%). CONCLUSION: The results of our study show that the prevalence of BW usage is high in Riyadh, Saudi Arabia. The majority of the families lack knowledge of the benefits and hazards of BW. Thus, pediatricians and the Ministry of Health have to increase the awareness of BW. Furthermore, the government should ban their importation and selling.

Parental Attitude and Awareness toward Preventive Dentistry in Riyadh, Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION: Preventive oral health of a child is dependent on the parental knowledge toward caries control, care of deciduous tooth, use of space maintainers for malocclusion, and utilization of various procedures available for preventing oral diseases by oral health professionals. This study was aimed to assess the attitude and awareness of preventive dentistry among parents residing in Riyadh city, Kingdom of Saudi Arabia. METHODOLOGY: A cross-sectional, questionnaire study was conducted among 300 male parents. Questionnaire was sent through the use of social media, and responses were collected. RESULTS: Seventy-four percent of male Saudi parents were aware of prevention of oral diseases. 38.45% of male parents were aware of preventive dentistry procedure, but preventive dentistry utilization rate was seen among 6% population only. Attitude toward the prevention of oral disease was statistically not significant according to the age group and income but statistically significant according to education. The utilization of preventive procedures was significant according to education and income (P < 0.05). CONCLUSION: Awareness about preventive dentistry was more among Saudi parents but utilization rate was directly correlated to their education and income. After The utilization of preventive procedures was significant according to education and income (P < 0.05).

Maternal awareness to the timing of allergenic food introduction in Saudi infants: A cross-sectional study.

BACKGROUND: Current guidelines recommend the introduction of allergenic foods as early as 4-6 months of age to decrease the risk of food allergy. However, caregivers' knowledge about such practices and adherence to them is ambiguous. OBJECTIVES: The purpose of this study was to evaluate the timing of introduction of potentially allergenic foods into children's diet and the level of maternal awareness about and degree of compliance with current recommendations. MATERIALS AND METHODS: We conducted a cross-sectional study from May 2019 to January 2020 at Imam Mohammad Ibn Saud Islamic University Medical Center, Riyadh, Saudi Arabia. Data were collected through questionnaire-based surveys, and a total of 405 mothers were enrolled in the study. The eligibility criteria included mothers of children between the ages of 12 and 36 months. RESULTS: Most mothers in this study had initiated allergenic foods, and the average time of introduction was 9.84 ± 3.16 months for eggs, 14.6 ± 5.78 months for peanuts, and 13.6 ± 5.37 months for fish. Around one-quarter (n = 102, 25.2%) of the children were identified as being in the high-risk group. Most mothers did not know or disagreed that the timing of introducing allergenic foods might help in preventing food allergy, but there was no difference between the risk groups (33.8% and 26.2%, respectively). Moreover, only 18.6% and 13.2% of the high- and low-risk groups, respectively, received correct information from their health care providers (P = .004). Mothers with only one child were less likely to start eggs at an early age (odds ratio [OR] = 0.5 and P = .005). Furthermore, children at a high risk of food allergy were two times more likely to start eggs at an earlier age (OR = 2.12 and P = .003). CONCLUSION: In this study, the allergenic food feeding practices being followed for infants and young children were found to be suboptimal. Parental education level and the number of siblings were identified as potential barriers to the implementation of and adherence to recent guidelines. There is a need for corrective measures to ensure safe and appropriate feeding practices in the Saudi community.

Safety and Efficacy of Maxitrol in Pediatric Age Group Below Two Years With Adenoid Hypertrophy: A Retrospective Cohort Study.

Introduction Adenoid hypertrophy, a common condition in children, represents one of the common indications for surgery in pediatrics. Medical treatment alone is not effective, and most of the time patients are managed by surgical removal of the adenoid. The aim of this study is to assess the safety and efficacy of intranasal Maxitrol® drops (Novartis Pharmaceuticals, Basel, Switzerland) in pediatric patients with adenoid hypertrophy aged less than two years and to document any side effects during its use. Methods This retrospective cohort study was conducted at King Abdullah Specialist Children's Hospital (KASCH). We reviewed the charts of 86 pediatric patients aged less than two years who were diagnosed with adenoid hypertrophy between 2015 and 2018. Patients were grouped according to the type of intervention (use of Maxitrol®, and no use). The follow-up time was up to one year. Results Out of 86 patients, 55 (63.9%) patients had adenoid hypertrophy alone and 31 (36.1%) had adenoid hypertrophy plus another disease. Patients with obstructive sleep apnea symptoms (p=0.026) and grade of adenoid (p=0.040) showed a significant relationship with surgery booking after one year. The probability of booking for surgery for those who used Maxitrol® was 1.394 times higher than for those who were not using it (odds ratio [OR]=1.394; 95% confidence interval [CI]=0.549-3.537). Suppression of growth and eye complications were not reported in any of our patients. Conclusion In this small sample, the use of Maxitrol® in the pediatric age group below two years with adenoid hypertrophy was safe and effective in relieving nasal symptoms; however, eventually, surgery was needed in most of our patients. Suppression of growth and eye complications were not reported in any of our patients during the follow-up time.

Knowledge and Attitudes Among Medical Students Toward the Clinical Usage of e-Cigarettes: A Cross-Sectional Study in a University Hospital in Saudi Arabia.

BACKGROUND: To assess knowledge and attitudes about e-smoking among undergraduate medical students, specifically focused on favorable view of therapeutic e-cigarette use for smoking cessation or harm reduction. METHODS: This cross-sectional study included medical students at King Abdulaziz University, Saudi Arabia. A six-item subscale was used to explore knowledge and attitudes about the therapeutic use of e-cigarettes, measuring participants' likelihood of favoring such use. A four-item questionnaire measured confidence and importance of being educated about smoking and e-smoking, in addition to sources of knowledge about e-cigarettes. RESULTS: A total of 399 students participated. Smoking history included current smokers (19.8%) and ex-smokers (6.5%), while e-cigarettes were tried by 36.6% and are currently used by 11.5%. A minority (13.5%) believed that e-cigarettes are FDA-approved for smoking cessation, while approximately one-third believed e-smoking lowers cancer risks (31.1%) and could help with smoking cessation (31.1%). Further, 35.9% agreed or strongly agreed that e-cigarettes are better for patients than tobacco products, and 17.5% were likely to recommend e-smoking to their patients for smoking cessation. Reliability of the six-item scale showed Cronbach's alpha = 0.676, which was enhanced to 0.746 after deletion of one item about addictiveness. Using the corrected five-item scale, 23.6% of the participants would favor therapeutic use of e-cigarettes. CONCLUSION: We observed several misconceptions about addictiveness and inadequate awareness about e-cigarettes' harmful effects, leading to non-scientific opinions about its therapeutic use for harm reduction or in smoking cessation. Academic programs around this topic should be updated in accordance with majority expert recommendations.

Knowledge Assessment of Correct Infant Sleep Practices and Sudden Infant Death Syndrome Among Mothers.

INTRODUCTION: Sudden infant death syndrome (SIDS) is characterized as the sudden unexpected death of a healthy infant below the age of 12 months with an unknown cause even after careful death scene assessment. The aim of this study is to estimate the percentage of proper sleep practices among infants and assess the knowledge and awareness of SIDS and its associated risk factors among Saudi and non-Saudi mothers. METHODS: This cross-sectional study was done in Riyadh, Saudi Arabia. The data were collected using an anonymous, self-administered questionnaire that consisted of 36 items that were divided into demographic data of the parents and child, observations of the child's sleep practice, and knowledge and awareness of SIDS and its associated risk factors. RESULTS: A total of 667 participants completed the questionnaire. The mean age of the mothers was 31.44 + 7.55. As for the nationality, 527 (79%) were Saudi and 140 (21%) were non-Saudi. The majority had bachelors' degrees 407 (61%). Sleep practices assessment demonstrated that 391 (58.6%) of infants were sleeping in the supine position. A total of 329 (49.3%) participants reported hearing about SIDS from social media and websites as being the major source of information. SIDS acknowledgment was higher in non-Saudi mothers compared to Saudis. CONCLUSION: The results provide informative descriptive data on childcare practices in Saudi Arabia. Considerable variation was noted and the results from this study are intended to have a better understanding of the prevalence of childcare practices and knowledge of SIDS risk factors in Saudi and non-Saudi mothers.

Parental Knowledge of Children's Developmental Milestones in Riyadh, Saudi Arabia.

OBJECTIVE: Parental recognition of children's developmental milestones has been correlated with more effective childcare strategies and overall better outcomes for children. However, the knowledge that parents have about children's development remains uncertain which reflects serious concerns about children's health in Saudi Arabia. Therefore, this study was undertaken to identify parents' knowledge levels about children's developmental milestones and the information sources they rely on for this knowledge. Study Design. We recruited 1471 parents aged ≥18 with at least one child under 14 and living in Riyadh to participate in an online survey between July of 2019 and January of 2020. RESULTS: Most respondents showed a poor level of knowledge (80.0%) in all of four domains. However, mothers had more acceptable levels of knowledge (21.0%) than fathers (10.0%) (p ≤ 0.01). There was a significant association between knowledge and age at first child's birth; respondents who had their first child between 39 and 50 had the highest levels of knowledge (37.5%; p ≤ 0.01). In the four domains of development, parents were found to have the most knowledge about physical development (52.3%), followed by cognitive development (21.6%), social development (21.5%), and emotional development (21.2%). Only a few parents (5%) claimed to always rely on their healthcare professionals for information. CONCLUSION: There is a lack of appropriate knowledge about developmental milestones among parents, which reflects serious concerns about children's health in Saudi Arabia. Healthcare institutions and pediatricians currently play a minimal role in health education. Effective health education programs and strategies should be implemented to improve child development outcomes in the community.