Erectile Dysfunction and Depression Prevalence Among Male Patients with Type II Diabetes.

Background and Objective: Patients with Type 2 Diabetes (T2D) are at substantial risk for developing erectile dysfunction (ED). The primary goal of this study was to assess the prevalence of ED and depression among T2D patients and the associated risk factors. Methods: A cross-sectional study was conducted for adult T2D patients who had a routine clinic visit between January-August 2023. Structured questionnaires formed with two validated questionnaires - the International Index of Erectile Function short form (IIEF-5) and Patient Health Questionnaire (PHQ-9) - were used to screen for ED and depression, respectively. Results: A total of 478 male patients with T2D with a mean age of 59.2 ± 10.8 years, mostly married, with long standing T2D were included. Hyperlipidemia followed by hypertension were the most reported comorbidities. Of the patients, 61.3% had reported no depression and were less likely to have ED or severe ED (p <0.001) and more likely to be physically active and to report no smoking (p <0.0001) when compared to those with depression. Fifty-two percent of the patients reported moderate and severe ED and those were older in age (p = 0.031), had longer duration of T2D diagnosis (p = 0.005), were more likely to have any comorbidities (p <0.05), were less likely to have a university degree and higher income (both p <0.001), were less likely to be on oral hypoglycemic agents (OHA) (p <0.001), had worse glycemic control parameters (p = 0.463), were more likely to have positive urine microalbuminuria (p = 0.019), and were less likely to be physically active (p = 0.048) when compared to patients with no or milder degree of ED. Conclusion: ED is highly prevalent in our study sample, with half of the patients having moderate to severe ED and being more likely to have depression. Older age, long-standing T2D, comorbidities, socioeconomic disadvantage, and sedentary lifestyle were all significantly associated with ED.

Prevalence of Anxiety and Depression and Their Association With Migraine Among PHC Center Visitors in Madina, Saudi Arabia.

INTRODUCTION: This cross-sectional study addresses the global rise in mental health disorders, emphasizing the bidirectional relationship between migraines and conditions such as depression and anxiety. This study seeks to bridge a crucial gap by examining the prevalence of depression and anxiety and their potential role as predictors of migraine. METHODS: This study included 407 participants aged 16 and above, attending one of the major PHC centers in Madinah city between August 1, 2023, and October 1, 2023. The study employed the Migraine Screening Questionnaire (MS-Q) for migraine screening and the Patient Health Questionnaire-4 (PHQ-4) for identifying anxiety and depression. RESULTS: Among the 407 participants included in our study, the prevalence of anxiety and depression was 9.1% and 5.9%, respectively. The prevalence of individuals experiencing both anxiety and depression was 3.7%. Anxiety exhibited a robust and statistically significant prediction of having migraines (OR: 4, P<0.05), while depression showed no statistically significant association. Gender, working frequency, and a higher level of education emerged as significant predictors of anxiety. Conversely, working multiple shifts and increased coffee consumption were found to be protective against anxiety. Regarding depression, spending more screen time and a higher education level were identified as significant predictors, while higher coffee intake and current smoking status were protective against depression. CONCLUSIONS: This cross-sectional study concluded that anxiety significantly predicts having migraines, while depression did not emerge as a statistically significant predictor. The study's outcomes underscore the imperative for mental health screening and management in individuals with migraines in PHC settings. However, comprehensive efforts are warranted to be applied across diverse cities and demographics to attain a more nuanced understanding of this association.

Mucinous Differentiation in Colorectal Cancer: A 10-Year Experience Audit at King Faisal Specialist Hospital and Research Centre, Jeddah.

Given that colorectal cancer is one of the leading causes of mortality, mucinous adenocarcinoma is one of the subtypes and is characterized by the presence of mucin-producing tumor cells with mucin components and is more challenging to manage. In Saudi Arabia, it represents approximately 10-15% of all colorectal carcinoma. The main etiological cause of mucinous adenocarcinoma is yet not well understood. The main goal of our study is to discuss the histopathology and the molecular background of mucinous colorectal adenocarcinoma and also to provide an update on its prognosis and therapeutics from recent published literature. It is a retrospective cohort study that was conducted at King Faisal Specialist Hospital, Jeddah, Saudi Arabia. The study included 68 adult patients diagnosed with mucinous colon cancer, who did surgical resection alone or with or without adjuvant chemotherapy following from January 2011 to December 2020. The mucinous subtypes are found more commonly in the proximal colon. In our study, 26 patients (38.2% of the cases) were right-sided and 35 patients (51.5%) were from the left side, but these included the rectum as well and this reflects the higher incidence of diagnosis of rectal cancer in the region. Most tumors were classified as Grade II in 56 patients (82.4%), consistent with the intermediate differentiation status often associated with the mucinous subtypes. The most common symptom at presentation was abdominal pain in 38 patients (55.9%) followed by per rectal bleeding and abdominal mass. The management in our study was in line with the standard established practice and surgical resection as expected was the primary potentially curative approach. Notably of patients presenting with locally advanced rectal cancer, six patients underwent concomitant chemoradiotherapy followed by surgery and four patients had upfront surgery. The duration of the median follow-up was 32 months. At the time of analysis, 30 patients (44.1%) were alive and remained on regular follow-up, 17 patients (25%) had succumbed to the disease, and 21 patients (30.9%) were lost to follow-up. The median overall survival was not reached, and notably, 49 patients (71.6%) remained alive at the four-year mark. Whilst our study contributes to the current understanding of mucinous adenocarcinomas of the colon, further research in molecular profiling and genomic testing and larger clinical trials with tailored treatments is necessary to refine treatment strategies and improve outcomes.

Placement of immediate dental implants in extraction sockets exhibiting the apical pathosis. A meta-analysis.

Objectives: It is commonly accepted that immediate implantation is the best option for patients since it shortens the time patients must wait for ultimate restoration and provides a predictable functional and aesthetic result. However, this approach is still controversial in patients with apical pathosis. The goal of this systematic review and meta-analysis was to determine the efficacy of immediate implant insertion in patients with apical pathosis. Material and methods: Between 2000 and 2023, PRISMA-compliant keywords were used to search PubMed, MEDLINE, CENTRAL, and the Cochrane Library. All English-language clinical studies that met PICOS criteria were included in a manual search. The included studies' demographic profile and event data for immediate dental implantation success in patients with or without apical pathosis were meta-analyzed using RevMan. The implant survival rate was assessed using risk ratio of plaque index and bleeding index. Begg's test using MedCalc and RevMan risk of bias assessment assessed publication bias. Results: A meta-analysis of 10 trials with 849 dental implantation patients found a substantial difference in initial implant placement success rates in infected sites. The pooled risk ratio for plaque index is 0.59 (95% CI: 0.36-0.96) with heterogeneity of Tau2 = 0.62, chi2 = 109.69, df = 11, I2 = 90%, z = 2.12, and p < 0.05. While, the pooled risk ratio for bleeding index is 0.77 (95% CI: 0.60 to 0.98) with Tau2 = 0.16, chi2 = 103.67, df = 11, I2 = 89%, z = 2.12, and p < 0.05. The pooled odds ratio of implant survival rate is 2.08 (95% CI: 1.56 to 1.79) with Tau2 0.16; chi2 52.43; df 9; I2 83%; z 4.93 and p < 0.05. As evidenced by the funnel plot and statistically insignificant Begg's test p values of 0.45. Conclusion: The placement of immediate implants in locations affected by apical pathosis is a clinically beneficial surgery, resulting in favorable aesthetic and functional outcomes for patients.

Familial Hemophagocytic Lymphohistiocytosis (FHLH) Perforin Deficiency: A Case Study and Literature Review.

Hemophagocytic lymphohistocytosis (HLH) is a severe and fatal immunological disorder that is either primary (i.e., familial) or secondary (i.e., acquired). The primary type comprises autosomal recessive disorders with gene mutations related to natural killer cells and cytotoxic T-cells, whereas the secondary type is related to other pathological causes, such as Epstein-Barr virus, bacterial or fungal infection, autoimmune conditions or autoinflammatory diseases, metabolic disorders, and cancer. In this report, we discuss a 37-day-old male who was brought to the emergency room with fever, decreased activity, and hepatosplenomegaly, with a strong family history of unknown cause of death for three siblings who died at the ages of one to two months. A whole exome sequencing confirmed the clinical diagnosis of familial HLH due to mutation in the PRF1 gene. We note the special importance of genetic counselling and antenatal screening or early neonatal screening in families affected by HLH, as this case highlights the importance of early diagnosis and intervention of primary HLH.

Unmasking May-Thurner Syndrome: A Case Report of Massive Deep Vein Thrombosis.

Deep venous thrombosis is a significant medical condition that results in life-threatening complications such as pulmonary embolism. Various factors can contribute to the formation of deep venous thrombosis, including prolonged immobility, surgery, and specific health conditions. May-Thurner syndrome is an underrecognized cause of deep venous thrombosis due to the compression of the left common iliac vein by the right common iliac artery. It poses diagnostic challenges due to its varied clinical presentations. This report discusses a 42-year-old female with no notable medical history who presented with acute onset of left leg swelling, pain, and discoloration. Despite the absence of common risk factors for deep venous thrombosis, investigations revealed a massive left-sided deep venous thrombosis. Additional imaging studies revealed the diagnosis of May-Thurner syndrome, manifesting as significant compression of the left common iliac vein. The patient underwent anticoagulation therapy, catheter-directed thrombolysis, and stent placement, resulting in symptomatic improvement and no recurrence over a six-month follow-up period. This case underscores the necessity of considering anatomical variations like May-Thurner syndrome in patients with unexplained deep venous thrombosis, particularly without typical risk factors. It highlights the importance of a comprehensive diagnostic approach, including advanced imaging techniques, to uncover underlying causes of deep venous thrombosis.

Primary tooth vital pulp therapy techniques taught in dental schools in Saudi Arabia: a cross-sectional study.

Worldwide, dental schools employ varying approaches to teaching vital pulp therapy (VPT) for primary teeth. However, little is known about the VPT techniques taught in dental schools in Saudi Arabia. Therefore, this study aimed to describe the approaches of VPT for primary teeth taught in undergraduate dental schools in Saudi Arabia. A nationwide cross-sectional study was conducted between January and June 2022, using an online questionnaire distributed to pediatric dentistry faculty members at all dental schools in Saudi Arabia. The questionnaire collected information on socio-demographic characteristics, educational background, work setting, and VPT teaching approaches. Descriptive statistics and logistic regression models assessed the association between participants' characteristics and the VPT techniques taught. Seventy-seven faculty members from 17 out of 27 dental colleges in Saudi Arabia participated in the study. Most respondents reported teaching indirect pulp capping (95%), with glass ionomer cement and calcium hydroxide being the most popular materials. Only 11 participants (14%) taught direct pulp capping, with mineral trioxide aggregate and calcium hydroxide being the most commonly used materials. Pulpotomy procedures were taught in all dental schools, with formocresol being the most commonly used medicament (84%). No significant associations were found between faculty member characteristics and the likelihood of teaching indirect pulp capping. However, older age categories had a significantly higher chance of teaching direct pulp capping (trend odds ratio: 2.27, p = 0.02). In conclusion, most faculty members (95%) reported teaching indirect pulp capping using glass ionomer cement and calcium hydroxide for primary teeth. Only 14% of the respondents taught direct pulp capping, and the use of mineral trioxide aggregate for direct pulp capping appears to be increasing. Formocresol was the most commonly used pulpotomy medicament. Further research is needed to investigate factors that influence the teaching of VPT for primary teeth in Saudi Arabia.

Experience of Racial Discrimination was Associated with Psychological Distress and Worsening Sex Life Among Adult Americans During COVID-19.

The recent escalation of racism in the U.S. during the COVID-19 pandemic points to the importance of examining the association between experienced racism and sexual health. Based on data from a nationally representative survey conducted in the U.S. in October 2020 (n = 1,915), Chi-square tests and multivariable logistic regressions were estimated to examine the association between experience of racism and changes in sex life during the pandemic. We further performed a causal mediation analysis using the bootstrap technique to assess the mediating role of psychological distress in the observed association between the experience of racism and changes in sex life. Among the respondents, the proportions reporting better, worse, or no change in sex life were, respectively, 15%, 21%, and 64%. Experiencing racial discrimination during COVID-19 was significantly associated with worsening sex life (adjusted odd ratio [AOR] = 1.53; 95% confidence interval [CI] = 1.04, 2.25). Respondents with experienced racism were also more likely to report psychological distress (AOR = 1.68; 95% CI = 1.09, 2.59). About one-third (32.66%) of the observed association between experienced racism and worsening sex life was mediated through psychological distress. Addressing racism and its association with psychological distress has the potential to improve sexual health and reduce related racial and ethnic disparities.

Developing a co-production strategy to facilitate the adoption and implementation of evidence-based colorectal cancer screening interventions for rural health systems: a pilot study.

BACKGROUND: Evidence-based colorectal cancer screening (CRCS) interventions have not been broadly adopted in rural primary care settings. Co-production of implementation strategies through a bundled approach may be promising in closing this gap by helping rural healthcare practitioners select and implement the best fitting CRCS interventions to the local context. This paper describes the process and outcomes of co-development and delivery of the bundled implementation strategy to improve adoption and implementation of CRCS interventions with two rural clinics. METHODS: We used a bundle of implementation strategies with a core focus on academic-clinical partnership development (strategy 1) and Plan-Do-Study-Act cycles (strategy 2) to identify clinical partner interests/preferences on delivery methods and content needed to facilitate intervention identification and implementation that improves CRCS. We also developed an implementation blueprint for each clinic (strategy 3) through an online blueprinting process based on adapted "Putting Public Health Evidence in Action" (PPHEA) training curriculum. Clinic physicians and staff (n = 7) were asked to evaluate the bundled approach based on overall reactions and perceptions of innovation characteristics using 5-point Likert scale. After completing the bundled approach, we collected implementation outcomes and limited intervention effectiveness of the CRCS evidence-based interventions (EBIs) developed through the process. RESULTS: Our co-production strategy yielded a prototype online blueprinting process consisting of 8 distance-learning PPHEA modules that guide selection and implementation of EBIs tailored to CRCS. Modules were delivered to clinic participants with minor adaptations, using PDSA cycle to improve quality of module contents and formats. Overall, participants in both clinics reported positive reactions toward the bundled approach. Both clinics reported improvements in how they perceived the characteristics of the innovation (the bundled approach) to tailor selected CRCS EBIs. As a result of the bundled strategies, each clinic selected and adopted specific EBI(s) with the varying degrees of implementation and CRCS outcomes. CONCLUSIONS: The bundle of implementation strategies used were feasible and acceptable in rural primary care practices to facilitate the use of EBIs to improve CRCS.

The prevalence and determinants of anterior cruciate ligament rupture among athletes practicing football in Jeddah Avenues 2020.

Background: Anterior cruciate ligament (ACL) tear is a common sport injury and one of the most serious sport injuries affecting non-professionals and professional athletes. It is most commonly torn during sports that involve sudden stops and changes in direction such as football. Objective: To measure the prevalence and determinants of anterior cruciate ligament rupture as well as assess knowledge about it among young adult athletes practicing football. Materials and Methods: An analytical cross-sectional study based on a questionnaire was carried out during the period from December 2019 to March 2020 among a sample of Saudi athletes recruited from natural grass, artificial turf, and dirt football fields in the Jeddah region. A structured questionnaire composed of four parts was used to collect data: socio-demographic variables, questions to assess awareness and knowledge of ACL, questions to assess the prevalence and determinants of ACL, and description of cases and the Arabic version of the Lysholm Knee Score (LKS) to assess the impact of ACL injury on patients' daily life. Results: The study included 320 participants. Their age ranged between 15 and 40 years with an arithmetic mean of 27.9 and a standard deviation of ±6.8 years. The majority of them were males (97.8%). The prevalence of ACL injury was 14.7% among the participants; it was significantly higher among overweight and obese subjects (P = 0.042) as well as those who reported more than 10 training weekly hours (P = 0.034). Most of the playgrounds at the time of injury were either artificial turf (44.7%) or dirt football fields (34%). Overall, the level of adequate knowledge about ACL was observed among most of the participants (70.3%). The only factor significantly associated with the level of participants' knowledge about ACL was the level of physical activity, P = 0.011. The total of LKS ranged between 21 and 100 with a median (inter-quartile range) of 82.5 (57-91). Conclusion: The prevalence rate of ACL injury among athletes in Jeddah, Saudi Arabia, is within the world wide range. Their awareness and knowledge of ACL are encouraging, although some risk factors were not well known. The quality of life of injured athletes was high, irrespective of demographic as well as physical factors and the history of surgical repair.

Racism Experience Among American Adults During COVID-19: A Mixed-Methods Study.

Purpose: Despite escalating racism in the United States during COVID-19, few studies have identified correlates of racism experience among Americans using nationally representative data. This study seeks to quantitatively identify correlates of racism experience and qualitatively categorize racism experience and its coping using nationally representative survey data. Methods: Based on data from the "Health, Ethnicity and Pandemic Survey" (N=2,506), a nationally representative survey conducted in October 2020, multivariable logistic regression was estimated to examine the association between self-reported racism experience and selected correlates. Thematic analysis was conducted to qualitatively classify types of racism experience and related coping strategies. Results: When asked whether they had been discriminated or unfairly treated during COVID-19 because of their racial/ethnic background, 19% non-Hispanic Asian and Black respondents said yes, followed by 15% among Hispanics and 3% among non-Hispanic Whites. Besides significant correlates of racism experience identified at the individual and household level, three contextual factors at the neighborhood or state level were associated with lower odds of racism experience, including living in a blue state (adjusted odds ratio [AOR]=0.69, 95% confidence interval [CI]: 0.50-0.95; reference category: red state), living in the top third of the neighborhoods in the sample in terms of racial diversity (AOR=0.65%, 95% CI: 0.42-0.99; reference: bottom third), and coming from neighborhoods with a median population age of 35-39 (AOR=0.67, 95% CI: 0.46-0.98; reference: younger than 35). Prevailing coping strategies against experienced racism included social avoidance, direct confrontation, seeking social and religious support, resorting to hobbies for relief, and taking legal actions. Conclusion: Racism experience is not only correlated with factors at individual level, it is also associated with contextual factors such as political climate, neighborhood diversity, and population age structure. Future efforts in supporting victims of racism might be more cost-effective by focusing on the identified vulnerable groups and related contextual factors.

Traumatic superio-nasal subconjunctival dislocation of posterior chamber intraocular lens. A case report.

INTRODUCTION AND IMPORTANCE: Intraocular lens (IOL) implantation after cataract surgery is routine procedure. Traumatic dislocation of the posterior chamber IOL into the subconjunctival space following blunt ocular trauma is rare and it is considered an ophthalmic emergency. CASE PRESENTATION: We present a case of a 71-year-old male that presented to our institution with traumatic dislocation of a posterior chamber IOL into the superior-nasal subconjunctival space following blunt trauma to his left eye after an accidental fall on his head. DISCUSSION: Trauma in a pseduphakic eye can be devastating. Early recognition and treatment of IOL dislocation are of paramount importance to prevent further damage and infections. Half ring sign (Psudophacocele) recognition help in identifying and localizing the dislocated IOL in subconjunctival space. CONCLUSION: Traumatic dislocation of posterior chamber IOLs have been rarely reported in the literature. Nevertheless, it could happen years after implantation.

The changeable dynamics between glycaemic control and neuropathy risk across the lifespan of Saudi diabetic patients; A survey in diabetes healthcare facility.

Background and Aims: Peripheral neuropathy is a common diabetic complication. It is linked to poor glycaemic control and longer duration of diabetes. We explored the association between HbA1c and neuropathy risk considering the duration of diabetes in a sample of Saudi diabetic patients. Method: We conducted a monofilament test on 343 diabetic patients referred to our specialist diabetology centre in Saudi Arabia. We utilized a multiple generalized logistic regression model with a binary outcome related to neuropathy complications. Results: We found that over four out of every five patients have peripheral neuropathy. The interaction between HbA1c and duration was significant (estimate = -0.02802, P = 0.00534), a positive association between neuropathy and both HbA1c (increased risk by 46.2%, P = 0.03222) and DM duration (increased risk by 19.6%, P = 0.04497). Conclusions: The shorter the duration of diabetes, the more positive the relationship between HbA1c and peripheral neuropathy. In patients living for over 40 years with diabetes, HbA1c was higher among those who did not have peripheral neuropathy. It could be argued that this is an artefact of survival as poorer glycaemic control will likely result in higher mortality in earlier years of the diabetes career.

Income inequality and the disease burden of COVID-19: Survival analysis of data from 74 countries.

The COVID-19 pandemic presents a rare opportunity to assess national performance in responding to a historic crisis. It is not well understood how income inequality might be related to differential disease burden of COVID-19 across countries. Using recent data merged from Our World in Data 2020, the World Bank, and the Global Burden of Disease, we examined the association between income inequality (the Gini index) and COVID-19 infection and death rates among 74 countries with available data. After adjusting for differences in population size, age structure, longevity, population density, GDP per capita, health care expenditures, educational attainment, direct democracy index, stringency of implemented measures, and testing intensity for COVID-19, results from Cox Proportional Hazards regressions revealed that countries with more unequal income distribution carried a higher burden of COVID-19 infections and deaths in 2020. On average, each percentage point increase in the Gini index was associated with an 9% increase in the hazard of having a higher COVID-19 infection rate in the sample (AOR = 1.09, 95% CI 1.01, 1.18). The corresponding associated increase in the hazard of having a higher COVID-19 death rate was 14% (AOR = 1.14, 95% CI 1.06, 1.23). Countries with severe and persistent income inequality should develop national strategies to address this challenge to be better prepared for future pandemics.

Assessment of Type II Diabetes Patients' Caregivers' Burnout Level: A Cross-Sectional Study in Taif, Saudi Arabia.

Background: Diabetes mellitus type II (T2D) is a chronic condition that requires significant change in the family behavior and is associated with psychosocial conflicts for both patients and their family environment. The aim of this study is to assess burnout among relatives caring for patients with T2D. Methods: This cross-sectional study with random sampling was conducted on 501 caregivers of patients with T2D between April and September 2021 at Prince Mansour armed forces hospital in Taif city, Saudi Arabia. Data collection tool was a modified version of the caregiver stress self-assessment questionnaire. Data analysis was then carried out using t-test and chi-square test (SPSS v20). Results: The mean patient age was 64.4+12.0 years, female predominant with longstanding T2D. Metformin was the most prescribed T2D medication. The caregivers' mean age was 34.9+12.4 years, male predominant, and around 45% of them report low level of education and income; 63.9% of the caregivers report little to no stress. Compared with caregivers with mild/moderate stress and moderate/severe stress, caregivers with little to no stress were more likely to be younger in age (P <0.001), male (P = 0.464), single (P = 0.035), patient's offspring (P = 0.490), caring for T2D patients with younger age (P = 0.058) and shorter T2D duration (P = 0.074), patients who were less likely to use a wheelchair (P = 0.008), patients who were less likely to be prescribed a complex insulin regimen and with better glycemic control parameters (both P >0.05), and patients with higher HDL level (P = 0.037). Conclusion: There were no correlations between the caregivers' levels of stress and the T2D patients' HbA1c levels. There was a significant positive correlation between a caregiver's stress score and the caregiver's age. Future studies are needed to assess other caregivers' parameters and their relation to metabolic control of T2D patients.

Hyperglycaemic and hypoglycaemic emergencies among patients with diabetes mellitus who participated in pilgrims of the 2019/1440H Hajj season.

Background: Diabetic emergencies are serious acute life-threatening complications of diabetes mellitus (DM). The Hajj season requires the health system in Saudi Arabia to prepare efficiently for the healthcare of millions of pilgrims, particularly for diabetic emergencies. Thus, diabetic emergencies need rapid recognition, diagnosis and treatment. This study aimed to explore the frequency and associated factors of diabetic emergencies among the pilgrim's patients with DM during Hajj, Mecca 2019. Methods: This is a prospective study which was conducted on 153 patients with DM. They were selected from three major healthcare-providing facilities during Hajj, which are Arafat, Muzdelefah and Muna healthcare centres. The study was conducted from Aug 5 to 12, 2019. All the patients who presented with any of the hypoglycaemic or hyperglycaemic emergencies had their demographic and clinical characteristics recorded to estimate the prevalence of each emergency and identify its significant associated factors. Result: More than 90% of the study participants were patients with type 2 diabetes mellitus (T2DM), while around 7% had type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia were presented in (n = 11, 7.2%), (n = 19, 12.4%) and (n = 28, 18%), respectively, of the participants. Moreover, the study found that "younger age" (odds = 30.4, P = 0.0115) and "type of medication" are significantly associated with DKA. Furthermore, "older age", "type of medication", "having Cardiovascular Disease (CVD)" and "diabetes duration" were found to have a significant association with HHS. Moreover, hypoglycaemia was associated with neuropathy complication (odds = 3.54948, P = 0.0187). Conclusions: Among the pilgrims with diabetes participating in Hajj, a considerable proportion with a range of diabetic emergencies present to the onsite medical facilities. Preparation is required in terms of logistics and health education about diabetic emergencies to meet the needs of pilgrims with DM, especially those who use insulin and have longstanding diabetes. Further research on DM and the creation of guidelines for health providers and patients with DM during Hajj are important focuses for the future.

Prevalence of Sexual Dysfunction in Women with Type 1, 2 Diabetes and Thyroid Disorder: A Cross-Sectional Study in Taif City, Saudi Arabia.

Background: Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score. Methods: A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥19 or scored ≥5 on any item or ≥4 on three items were considered to have FSD. Results: A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master's degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). Conclusion: FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.

Prevalence of cardiovascular events among patients with type 2 diabetes in the west region of Saudi Arabia.

Background: Diabetes mellitus (DM) remains a concern globally and particularly in Saudi Arabia, where its prevalence is continuously increasing among the Saudi population. DM is known to increase the risk of cardiovascular disease (CVD), which can progress significantly if DM is poorly controlled. Aim: Determine the prevalence of cardiovascular events among patients with type 2 diabetes (T2DM) in the west region of Saudi Arabia, and additionally the use of antidiabetic agents with cardiovascular benefits (ADc) in T2DM patients with cardiovascular events (CVEs). Method: A retrospective cohort study was conducted among all patients with T2DM who presented to the diabetic center of Prince Mansour Military Hospital (PMMH), Taif city, between the 1st of January and 30th of June 2021. Data extracted from patient medical records included demographics, home medications, medications used to treat T2DM, lab results, and ECG data. Descriptive statistics were used to analyze and compare the results. The study was approved by the Research and Ethics Committee of Medical Services General Directorate, Armed Forces Hospitals, Taif region. Result: A total of 349 patients with T2DM were recruited and included in the final analysis. Of this study population, 132 patients had experienced at least one cardiovascular event while 54 were considered to be at risk of future cardiovascular events due to having risk factors for cardiovascular diseases above and beyond the presence of diabetes. A subgroup analysis was conducted to examine HbA1c% among all groups; interestingly, all were similar, with p > 0.05. Of all diabetic patients with CVEs, only 34.8 % were on at least one anti-diabetic agent known to have cardiovascular benefits; the remainder were on other anti-diabetic agents. A similar analysis was conducted on diabetic patients with risk of CVEs, of which only 13 % were on at least one anti-diabetic agent having known cardiovascular benefits; the remainder were on other anti-diabetic agents. Conclusion: The prevalence of CVEs among T2DM patients in Saudi Arabia is very close to the global prevalence, but ADcs are underutilized in this population. Tighter glycemic control is warranted to help rein in and reduce the CVE incidence among patients with T2DM.

Neoadjuvant lenvatinib for inoperable thyroid cancer: A case report and literature review.

BACKGROUND: Poorly differentiated thyroid cancer (PDTC) is now classified as a separate thyroid tumor entity. It has male predominance and poor prognosis compared to differentiated TC. CASE: We report a case of a patient with PDTC who was previously deemed inoperable. A trial of neoadjuvant lenvatinib therapy was given to the patient after that the tumor become operable and the surgery went successfully. CONCLUSIONS: Lenvatinib is a feasible option in patients with inoperable TC and can stabilize the lesion size or even reduce it, leading to a more favorable surgical outcome.

Relationship Between Loneliness and Hypothyroidism.

Aim This study aimed to assess the relationship between loneliness and hypothyroidism in patients with hypothyroidism and to determine predictors of loneliness. Materials and methods A cross-sectional study was conducted on hypothyroid patients attending the endocrine clinics at Alhada Military Hospital and Prince Mansour Military Hospital, Taif, Saudi Arabia between the period of December 2020 and May 2021. Patients with more than 18 years of hypothyroidism were included and those with other thyroid diseases were excluded as well as those with other comorbidities and psychiatric disorders and those who were living alone. Data were collected using an online pre-structured questionnaire. Results The study included 231 hypothyroid patients with a mean age of 43.34 ± 12.9 years, and 90.9% were females. The majority (96.5%) were taking levothyroxine, and 27.3% were practicing physical activity. Only 2.2% of the participants had a high degree of loneliness, whereas 47.2%, 34.6%, and 16% had low, moderate, and moderately high degrees of loneliness, respectively. Discussion In this study, 2.2% of sampled hypothyroid patients had high (2.2%) or moderately high degrees of loneliness feelings (16%). Duration of hypothyroidism was a significant predictor for high loneliness score.