A Cross-Sectional Study about Knowledge, Attitude, and Practices among Primary Health Care Physicians in Jazan Province, Saudi Arabia, Regarding Rome IV Criteria for Diagnosis of Irritable Bowel Syndrome.

Background and objectives: Most individuals with irritable bowel syndrome (IBS) are diagnosed by primary health care (PHC) physicians. However, a significant percentage of patients remain undiagnosed or misdiagnosed owing to the lack of knowledge or a systematic strategy regarding the use of ROME IV criteria for the diagnosis of IBS. Thus, in this study, we aimed to assess the knowledge, attitude, and practices among primary health care physicians in Jazan Province, Saudi Arabia, regarding ROME IV criteria for the diagnosis of IBS. Methods: A cross-sectional study was conducted using a pretested self-administered questionnaire that determines participants' sociodemographic data and measures knowledge about ROME IV criteria, targeting PHC physicians in Jazan Province, Saudi Arabia. Data were analyzed using the Statistical Package for Social Sciences (SPSS) v.23. Results: We included 200 participants, and the majority of participants in our study (approximately 78%) were aware of the ROME IV diagnostic criteria for IBS; this awareness was associated with age, nationality, specialty, and classification. The participants' mean level of knowledge was 4.30 (out of 6). However, knowledge was higher among Saudi and family medicine doctors in this study, as compared to non-Saudi and doctors of other specialties. More than two-thirds of participants who were aware of ROME IV criteria thought that they are sufficient to diagnose IBS; however, only 47.5% of physicians reported using ROME IV frequently in their daily practice. Conclusions: Most of the participants of this study are aware of ROME IV criteria, and better knowledge was noted among Saudi and family medicine physicians. About 70% thought that ROME IV criteria are effective enough to diagnose IBS, and only about half of the participants use ROME IV criteria in their practice. Therefore, due to its high prevalence in the region, further efforts are required to disseminate basic knowledge and improve attitudes and practices related to ROME IV criteria among PHC physicians of all specialties.

Ocular findings in the evaluation of abusive head trauma in children.

PURPOSE: Abusive head trauma (AHT) is a form of child physical abuse that can result in major ocular injuries. This study describes the clinical presentation and ocular manifestations of infants diagnosed with AHT in a tertiary care center in Saudi Arabia. METHODS: This is an observational, retrospective, cross-sectional study from 2015 to 2022 conducted at King Abdullah Specialized Children's Hospital (KASCH) in Riyadh, Saudi Arabia. Inclusion criteria include infants <2 years of age, diagnosed with AHT that had an eye examination as part of the evaluation. RESULTS: A total of 25 (50 eyes) cases of AHT had an eye examination documented in the electronic patients' records. The majority were males 19 (76%), and <6 months of age 10 (40%). About half of the children were healthy 13 (52%), and 12 (48%) had underlying physical illness. All patients had computed tomography scans. Subdural bleeding was noted in 22 (88%), 1 (4%) had epidural, and 4 (16%) had subarachnoid bleed. External ocular signs were noted in 8 (32%) patients only, including raccoon eyes, periorbital bruises, subconjunctival hemorrhage, and nonfixating eyes. Fundus findings were bilateral in 18 (72%), unilateral in 2 (8%), and normal in 5 (20%). In those with findings, the majority of 34 (68%) eyes had multiple retinal hemorrhages, 4 (8%) had vitreous hemorrhages, 2 (4%) retinal detachments, and 1 (2%) retinoschisis. CONCLUSION: Fundus examination is an important part of the comprehensive examination of children with suspected AHT; the majority of patients had an abnormal fundus examination with the tendency of bilateral findings.

Clinical presentation and outcomes of patients with rhabdomyolysis: A tertiary care center experience.

OBJECTIVES: To evaluate the clinical and laboratory features, complications, and outcomes of patients with rhabdomyolysis in the Saudi population. METHODS: Retrospectives descriptive study of adult patients who presented to King Abdulaziz Medical City (KAMC) withrhabdomyolysis between January 2016 and December 2022. RESULTS: Most of the participants (84.5%) were male, with a median age of 41 years and a body mass index of 26.5 kg/m2. Medications, mainly statins (22.4%) and illicit drugs (15.5%), constituted the root causes of rhabdomyolysis in the cohort (44.8%). The most common presenting complaints were myalgia (63.8%) and fatigue (37.9%). More than one-third of the participants (32.8%) developed AKI, with 3 patients requiring temporary hemodialysis, and only 8.6% developed acute liver failure (ALF). Intensive care unit (ICU) admission was required for 10 patients (17.2%), and the overall mortality rate was 8.6%. Patients who developed complications (composite outcomes of AKI, ALF, multiorgan failure, or death) had significantly reduced kidney function and higher levels of blood urea nitrogen, anion gap, and uric acid upon admission than those who did not. CONCLUSION: This study offers a thorough understanding of clinical and laboratory features, causes, complications, and outcomes of rhabdomyolysis among Saudi patients. The insights gained enhance our understanding of rhabdomyolysis within this population, providing a foundation for future research and improvements in clinical management.

Parasomnias and Associated Factors Among University Students: A Cross-Sectional Study in Saudi Arabia.

Background and aim Parasomnias are a group of sleep-related movements or emotions like sleepwalking, sleep talking, teeth grinding (Bruxism), nocturnal enuresis (sleep enuresis), sleep terrors (night terrors), sleep-related eating disorder (SRED), nightmare disorder, REM Sleep Behavior Disorder (RBD), and confusional arousals. Parasomnias are more common in children than in adults. This study aimed to estimate the prevalence of different parasomnias among university students in Saudi Arabia. Additionally, it aimed to study the relationship between different parasomnias and gender-associated sleep disorders, mental disorders, and other medical diseases, stress, substance use, and medications. Methods This study is a descriptive cross-sectional survey-based study. The target population for this study is university students from different regions of Saudi Arabia. Parasomnia was defined as having at least one of the 11 disorders (over the past six months). Data was collected through an online survey. The survey was distributed on different online platforms to collect data from other regions of Saudi Arabia. The study took place between August and November 2022. Results Among 1,296 participants, 934 (72.1%) were female, and 1,071 (82.6%) were aged 19-24 years. A total of 1054 (81, 3%) participants reported having at least one parasomnia disorder. The most prevalent parasomnias were sleep talking 656 (50.6%), nightmares 650 (50.2%), and confusional arousals 524 (40.4%). The least prevalent parasomnia was sleep-related eating disorder 98 (7.6%). Among participants, 580 (44.8%) had a family history of parasomnia, 439 (33.9%) were diagnosed with sleep disorders, 296 (22.8%) were diagnosed with mental illnesses, and 92 (7.1%) had other medical diseases. Conclusion Parasomnias are prevalent among university students in Saudi Arabia. Parasomnias were higher in female students and in students with a family history of parasomnia. Parasomnias in adults might be a chronic or recurrent disorder. Parasomnias are significantly associated with psychological stress, depression, and anxiety disorders.

Medication Adherence Status and Its Association With Quality of Life Among Individuals With Neurological Conditions in Saudi Arabia.

INTRODUCTION: Chronic disorders commonly require long-term therapies. Medication non-adherence can cause major morbidity and mortality in chronic illness individuals, as well as increase the financial burden on the healthcare system. It is considered that patients who adhere to their treatment may improve their quality of life (QoL). There is a scarcity of updated comprehensive data on medication adherence among Saudi patients with neurological disorders. Therefore, this study aimed to assess the medication adherence status among individuals with neurological conditions and its association with QoL. METHOD: A cross-sectional questionnaire-based study was conducted. The study included subjects individuals who have neurological conditions aged at least 18 from different regions of Saudi Arabia. The questionnaire measured medication adherence by using the 10-item version of the Medication Adherence Report Scale (MARS-10, ©Professor Rob Horne). The QoL was measured by employing validated Euro Quality of Life 5-dimension scale (EQ-5D). RESULTS: A total of 370 participants were included. Respondents aged 18 to 35 years represented 62.4% of the sample. More than half of the participants were females (65.7%). The most frequently reported chronic conditions were migraine (29.2%), epilepsy (20.8%), and multiple sclerosis (20.5%). The reliability of the EQ-5D questionnaire was acceptable (Cronbach's alpha = 0.764). In general, more than half of the participants indicated that had problems due to pain/discomfort (60.3%) and anxiety/depression (62.2%). The most common pattern of non-adherence was taking the medication only when a patient needed it followed by avoiding taking the medication as possible. Non-adherence to medications was less prevalent among participants with epilepsy (68.8%) and multiple sclerosis (65.8%). On the other hand, medication adherence was higher among respondents with migraine compared to participants without the condition (86.1% vs 73.7%, p = 0.009). A significantly lower proportion of participants who had some or extreme problems with self-care were non-adherent to medications compared to those who had no problems (68.1% vs 80.3%, respectively, p = 0.016). Results of the regression analysis showed that participants with epilepsy and multiple sclerosis were less likely to be non-adherence to medications. Furthermore, respondents with moderate and severe problems in self-care were less likely to be non-adherent. CONCLUSION: It was found that more than half of the participants had problems regarding their QoL due to pain/discomfort and anxiety/depression. The most prevalent pattern of non-adherence was taking the medication only when needed. Participants with epilepsy and multiple sclerosis were less likely to be non-adherent to medications. Furthermore, respondents with moderate and severe problems in self-care were less likely to be non-adherent. We recommend serial studies on the issue should be conducted to gather more evidence regarding this topic.

Prevalence and Risk Factors of Speech Delay in Children Less Than Seven Years Old in Saudi Arabia.

Introduction Verbal communication relies on the ability to speak and understand language. Speech is only one part of language; language can also be expressed through gestures, writing, and other nonverbal means. Speech and language disorders are impairments in the ability to produce and comprehend language, including problems with mouth movements and vocalization. There is a scarcity of literature on this topic in Saudi Arabia; therefore, the aim of this study was to assess the prevalence and risk factors of speech delay in children aged less than seven years in Saudi Arabia. Methods A cross-sectional self-reported descriptive study was conducted from May 2023 to June 2023 among parents of children less than seven years of age in the Kingdom of Saudi Arabia. Simple convenience sampling was implemented. A structured, self-administered questionnaire was designed and presented to the parents of children less than seven years of age. Categorical data were presented as frequencies and percentages. The analysis included a chi-squared test and a Fisher's exact test. Results A total of 617 participants were included in the study. The majority of children were between 1 and 3 years of age (223, 36.1%) and were male (336, 54.5%). Around 45.5% of the respondents reported that their children may have a speech delay. Children aged >3 to 5 years had a significantly higher prevalence of speech delay (112, 53.1%). Additionally, there was a significant difference in speech delay prevalence between male (170, 50.6%) and female (111, 39.5%, p = 0.006) children. A family history of a developmental communication disorder was significantly associated with speech delay (p < 0.001). Children with speech delay were more likely to have hearing issues (19, 70.4%) and motor issues (19, 70.4%). Moreover, autism spectrum disorder in the child was significantly associated with speech delay (p < 0.001). Conclusions The study found that children aged 3 to 5 years had a significantly higher prevalence of speech delay than younger children. There was a significant difference in speech delay prevalence between male and female children. Children with speech delays were more likely to suffer hearing and motor issues. Speech delay was significantly associated with a family history of a developmental communication problem.

Surgical Intervention for Spinal Lesions Due to Multiple Myeloma: A Case Report.

Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.

The Preferred Route for the Diagnosis and Management of Thyroid Carcinoma Among the General Population in Saudi Arabia.

BACKGROUND:  Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. Papillary thyroid microcarcinoma (PTMC) is a specific subgroup of PTC. Given their small size, PTMCs are often asymptomatic and behave benignly. This puts physicians in a challenging situation about how to prevent overdiagnosis and overtreatment of PTMC. This study aimed to assess the preferences regarding the route of PTMC diagnosis and treatment among Saudi Arabia's general population. METHODS:  This is a cross-sectional questionnaire-based-study conducted among the general population in Saudi Arabia. The target subjects were the general population of Saudi Arabia both genders and different age groups from various regions of Saudi Arabia (Western, Central, Eastern, Southern, and North). Participants who did not complete the questionnaire or did not agree to participate were excluded. A self-administered questionnaire was distributed on different social media platforms to collect data from different regions. Data analysis was conducted by using Statistical Package for the Social Sciences (SPSS) 24.0 version (IBM Inc., Chicago, USA) statistical software. A Chi-square test was used to compare categorical variables. RESULTS:  A total of 1,428 participants were included. The majority of them were females (64.4%), and most of them were aged between 19 and 25 years. Moreover, we found that 4.8% of the study population had a medical history of thyroid cancer. Our results revealed that more than half of respondents (54.6%) would select surgical operation immediately if they have a thyroid nodule less than 1 cm in maximal diameter, which turns out to be a PTC. The vast majority of participants (90.1%) would prefer to do cytologic confirmation immediately if they have a thyroid nodule less than 1 cm in maximal diameter, which has suspicious characteristics of PTC in neck ultrasound examination. Regarding PTMC operation, 59.8% of responders were more concerned about complications than recurrences. We found that neither age nor gender significantly affects decision-making for management or operative extent for PTC. There was a significant difference between age and decision-making for the diagnosis of suspicious thyroid nodules (p value = 0.041). CONCLUSION:  Our results concluded that most of the participants preferred to select immediate surgery and cytologic confirmation regarding the management and diagnosis of PTC. More research is advised. The need to inform patients about their disease state and treatment options should be highlighted more.

An Assessment of Dementia Knowledge and Its Associated Factors Among Health College Students in Saudi Arabia.

Background Dementia is a public health concern and the main cause of impairment and dependency among the elderly worldwide. It is characterized by a progressive decline in cognition, memory, and all domains of quality of life with preserving the level of consciousness. Accurate measurement of dementia knowledge among future health professionals is required to improve targeted educational initiatives and supportive care of patients. This study aimed to assess knowledge of dementia and its associated factors among health college students in Saudi Arabia. Methods A descriptive, cross-sectional study was conducted among health college students from various regions in Saudi Arabia. Data on sociodemographic characteristics and dementia knowledge were gathered using a standardized study questionnaire Dementia Knowledge Assessment Scale (DKAS) distributed on different social media platforms. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA) statistical software. A P-value of <0.05 was considered significant. Results A total of 1,613 participants were included in the study. The mean age was 20.5 ± 2.5 years (range 18-25 years). The majority of them were males (64.9%), and females represented 35.1%. The mean knowledge score of the participants was 13.68 ± 3.18 (out of 25). According to DKAS subscales, we found that the respondents scored the highest in care considerations (4.17 ± 1.30) and the lowest in risks and health promotion (2.89 ± 1.96). Furthermore, we found that the participants with no previous dementia exposure had a significantly higher level of knowledge than those with previous dementia exposure. In addition, we found that both genders, aged 19, 21, 22, 23, 24, and 25 years; the geographic distribution of respondents; and previous dementia exposure significantly affected the DKAS score. Conclusions Our findings showed that health college students in Saudi Arabia had poor knowledge about dementia. Ongoing health education and comprehensive academic training are recommended to improve their knowledge and provide competent care for dementia patients.

Online Health Information Seeking by Individuals With Physical Disabilities Caused by Neurological Conditions in Saudi Arabia.

Background In recent years, there has been an increase in the use of the internet and information technology for accessing health information. This study aimed to determine the factors that affect patients with neurological disabilities and their willingness to search for information via the internet. In addition, we aimed to assess how patients manage this information, considering the increasing availability of online information and websites that discuss health and diseases, as well as the spread of communication technology and its accessibility to the public. Methodology A cross-sectional, online, self-administered, questionnaire study was conducted in Saudi Arabia. The study targeted patients with neurological diseases who had disabilities. The questionnaire was designed to measure the demographic data, physical disability using the 10-item physical function component of the 36-Item Short Form Health survey, the perceived usefulness of online health information, the perceived ease of use, and the perceived risk of online health information. Lastly, the questionnaire measured online health information-seeking intentions and information use. Data analysis was performed using RStudio (R version 4.1.1, Posit, Boston, USA). Results We received 1,179 responses, of which 399 were excluded due to using another way to get information rather than the internet, 31 did not have neurological disabilities, and 136 did not complete the questionnaire. The remaining 613 responses were included in the final analysis. The participants were mostly male (54.6%), not married (54.6%), and had a bachelor's degree (49.99%). The average age of participants was 18-25 years (24.5%) and 26-35 years (23.2%), Additionally, most participants resided in the western (26.9%) and eastern (25.9%) regions. Most participants (39.5%) had a monthly income of 5,000 to 10,000 SAR. Further, the most common neurological diseases were multiple sclerosis and epilepsy (26.9% and 23.2%, respectively). Based on the analysis of the data, the most important factor affecting online health information-seeking intention was that people with higher monthly incomes were more likely to seek online health information; these included people with an income of 10,000-20,000 SAR and >20,000 SAR. The most common factor affecting information use was the region of residence. The southern and western regions were less likely to adopt information use. Conclusions The monthly income and the area of residence had the greatest impact on people with neurological disabilities who sought online health information in the Kingdom of Saudi Arabia. Educational campaigns and workshops should be arranged to increase the population's awareness of this topic, as well as to reveal the extent and prevalence of online health information seeking among disabled patients.

Clinicopathologic characteristics and outcomes of patients with mycosis fungoides: A single tertiary center retrospective analysis in Saudi Arabia.

OBJECTIVES: To determine the distinctive clinical and pathological characteristics and outcomes of MF in a Saudi population. METHODS: We conducted a retrospective analysis of all MF cases diagnosed clinically with pathological confirmation at King Abdulaziz Medical City in Riyadh from January 2016 to July 2022. Variables include demographical, clinical, and pathological MF traits and disease outcomes. RESULTS: A sum of 73 patients were enrolled. The mean age was 44 years. The female-to-male ratio was 1.3:1.The mean duration between cutaneous manifestations and MF diagnosis was 33 months (2.7 years). Classic MF was the most common variant (60.3%), followed by hypopigmented MF (20.5%). Most patients (82.2%) had early-stage MF (IA, IB, and IIA). Patients who had CD4+/CD8+ with CD8 predominance had a favorable disease course (p=0.029). Topical corticosteroids were the most frequently prescribed treatment (79.5%). Three patients (4.1%) died from MF. The disease-specific survival rate for advanced-stage MF was 84.6%, which was significantly lower compared to early-stage MF (p=0.032). CONCLUSION: Among the Saudi population, MF has an earlier onset and slightly higher prevalence in females. Hypopigmented MF is more prevalent in this ethnic group. Immunohistochemical staining of CD4+/CD8+ with CD8 predominance may elucidate a favorable disease course.

Regional and seasonal variations in functional abdominal pain and functional constipation prevalence among Saudi children.

Objectives: This study aimed to evaluate functional abdominal pain disorders and functional constipation prevalence in the central region of Saudi Arabia, and compare it to that of the western region. Methods: This was a cross-sectional study using online questionnaires targeting the general population of Riyadh region of Saudi Arabia. Subjects were randomly selected by sharing links on social media groups. Any parent with a 3-18-year-old child was included, and children with chronic medical illnesses or symptoms of organic GI disorders were excluded. Results: Three hundred nineteen subjects were included in the final analysis; the prevalence of functional abdominal pain disorders overall was 6.2% and the prevalence of functional constipation was 8.1%. Conclusions: Functional constipation diagnosis seems to be affected by life stressors or a previous viral illness. Seasonal variations had minimal effect on functional abdominal pain disorder and functional constipation symptom frequency and severity.

Determining the Prevalence of Child Maltreatment Among Young Adults in Saudi Arabia Using ISPCAN Child Abuse Screening Tool.

Background Child maltreatment is an important public health issue, thus determining its prevalence is critical to recognize the extent of the problem and mandate efforts to combat child abuse. We aimed to investigate child maltreatment prevalence among special populations of young adults in Riyadh, Saudi Arabia. Methods We used the retrospective version of the International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool (ICAST-R). The survey included Saudi students of both genders aged between 18 to 24 years old and attending King Saud bin Abdulaziz University for Health Sciences (KSAU-HS). The questionnaire was provided electronically using Survey Monkey (Momentive Global Inc., San Mateo, CA, USA). Results A total of 713 students completed all sections of the questionnaire. The prevalence of any type of child maltreatment was estimated to be 42%. Physical abuse was the most prevalent (51.1%), followed by emotional abuse (49.9%), lack of protection and safety (38%), and sexual abuse (29.6%). The most common form of physical abuse was being hit or punched at 77.5% followed by 'beaten very hard with an object' at 58.8% while touching was the most common form of sexual abuse at 68.7%, and only 13.7% encountered penetrating form of sexual abuse. In comparison to female victims, male victims were more likely to be physically abused (odds ratio (OR)=1.5; confidence interval (CI)=1.1-2.0). Participants who lived with a single parent were more likely to be victims of a lack of protection and safety than those who lived with both parents (OR=1.9; CI=1.0-3.7). Most participants reported the abuse to occur after the age of nine years, and the perpetrator was the parents in 17.5% of cases.  Conclusion Our findings demonstrated a high prevalence of child maltreatment among the young adult population in Saudi Arabia. It is vital to obtain more information on the prevalence and risk factors of child maltreatment in various populations and regions of Saudi Arabia to raise awareness and improve services for the victims of abuse.

The Impact of Urinary Tract Infections in Kidney Transplant Recipients: A Six-Year Single-Center Experience.

Background Urinary tract infections (UTIs) are the most common infections following kidney transplantation. Risk factors for UTIs in kidney transplant recipients include female gender, age, pre-transplant urinary tract abnormalities, diabetes, and recurrent UTIs. Infections of the bladder or urethra are termed lower UTIs, while those involving the kidneys or ureters are called upper UTIs. Methods We retrospectively screened our hospital information system to identify all patients who underwent kidney transplantation in the surgery department at King Abdulaziz Medical Center in Riyadh. A total of 553 records were ultimately included in the final analysis. Results A total of 553 patients were ultimately included in the analysis. More than half of the patients were males (62.4%), and 31.1% were aged between 45 and 60 years. Of these, 230 patients had a UTI, representing 41.59% of the sample. The most commonly reported causes were hypertensive nephrosclerosis (43.4%) and diabetic nephropathy (28.8%). The most frequently isolated causative agents were Escherichia coli (51.0%) and Klebsiella pneumoniae (21.8%). UTIs were significantly more prevalent among females, accounting for 73.6% of cases. Antibiotics were used in 86.5% of patients, with trimethoprim/sulfamethoxazole (65.8%) and ciprofloxacin (54.8%) being the most commonly prescribed. Conclusion About half of the patients in this study suffered from UTIs. E. coli and K. pneumoniae were the most commonly isolated organisms. Trimethoprim/sulfamethoxazole and ciprofloxacin were the most frequently prescribed antibiotics. A significant association was found between acquiring a UTI and being female (p < 0.001), as well as having pre-existing bladder dysfunction (p = 0.024).

Persistence of Symptoms Following Infection With COVID-19 Among Patients With Type 1 and Type 2 Diabetes Mellitus in Saudi Arabia.

BACKGROUND: In Saudi Arabia, information on the persistence of COVID-19-related complications in diabetic patients, their associations with the type of diabetes mellitus (DM), and the role of uncontrolled DM in the complications remains elusive. This study aims to fill this gap. This study aimed to examine the persistence of COVID-19 complications in diabetic patients. METHOD: A simple randomized, cross-sectional, questionnaire-based study among patients with type 1 and 2 DM following infection with COVID-19 in Saudi Arabia. RESULT: In the present study, a total of 674 participants were included. Among the COVID-19 symptoms, fatigue (65.6%) was reported the most frequently, followed by headache (62.3%) and cough (59.8%). About 44% of patients reported high blood sugar levels, including 25.5% with elevated fasting (>126 mg/dL) and 18.5% with elevated postprandial (>200 mg/dL) glucose levels. We also report that age > 55 years [OR= 1.66 (1.01-2.56), p=0.045], anti-diabetic medications [OR= 2.10 (1.82-3.91), p=0.022], multiple comorbidities [OR= 3.21 (1.98-4.85), p=0.005], chest pain [OR= 2.54 (0.96-3.81), p=0.003], and joint pain [OR= 1.64 (0.73-2.94), p=0.025] were independently associated with COVID-19-related complications in diabetic patients. CONCLUSION: The most common persistent symptoms in diabetic patients with COVID-19 infection are fatigue, headaches, and cough. Advanced age and use of antidiabetic medications were independently associated with COVID-19-related complications in diabetic patients.

The Association of Screen Time, Sleep Quality, and Dry Eye Among College Students in Saudi Arabia.

Background Dry eye is a serious public health issue that causes ocular discomfort, weariness, and visual disturbances that can disrupt everyday activities. Dry eye disease is one of the most common reasons people seek eye care. Therefore, this study aimed to assess the association between screen time, sleep quality, and dry eye among college students in Saudi Arabia. Methods This cross-sectional study was conducted among college students in Saudi Arabia. Data were collected through a validated questionnaire distributed via social media. Results A total of 1,593 participants were included. Many of them were aged between 18-25 years (80.7%) and females were (65.0%). Females and residents of the middle region had significantly more severe sleep-wake difficulties than other people (p<0.001). Participants with a master's degree had lower severe sleep-wake difficulties than other participants (p<0.001). Participants who spent between 4-6 hours on the screen showed high severe sleep-wake difficulties (p<0.001). Regarding eye dryness, females, participants with a bachelor's degree, and participants who spent more than six hours on screen had more severe symptoms of eye dryness. Nearly half of the participants with severe sleep-wake difficulties reported mild to moderate symptoms of dry eye (p<0.001). Conclusions Our study concluded that university students in Saudi Arabia had significant sleep-cycle difficulties and mild to moderate eye dryness symptoms. Age, female gender, sleep duration, educational level, monthly income, and excessive screen time were found to be associated with sleep-cycle problems and eye dryness symptoms.

Assessment of Public Knowledge of Hypertension Among the Saudi Population.

Background Hypertension is a major risk factor for cardiovascular illness and premature death and is becoming more prevalent worldwide. To promote better educational strategies regarding hypertension, it is crucial to identify the most significant knowledge gaps among the general public. This study aimed to assess the knowledge of hypertension among the general public in Saudi Arabia. Methodology A cross-sectional, questionnaire-based study was conducted in Saudi Arabia. The target population was the general public aged ≥18 in Saudi Arabia. Statistical analysis was conducted using RStudio (R version 4.1.1). Numerical data were described as mean ± standard deviation or median and interquartile range (IQR) whenever applicable. P-values <0.05 indicated statistical significance. Results A total of 1,404 respondents were collected. After exclusion, 1,399 records were analyzed in this study. More than half of the respondents were females (59.5%) aged 18-39 years (52.7%) and had a university degree (64.8%). Additionally, 46.0% were employed. Approximately one-quarter of the sample had hypertension (26.3%), while 73.3% had a family history of hypertension The median score was 16.0 (IQR = 12.0-18.0) with a minimum and a maximum of 0.0 and 22.0, respectively. Reliability testing revealed that knowledge items had a good internal consistency (Cronbach's alpha = 0.859 based on 22 knowledge items). There was no significant association between knowledge and gender and having a personal history of hypertension. However, the knowledge score differed significantly by age, educational level, employment status, and having a family history of hypertension. On the multivariate analysis, knowledge scores were independently higher among participants in the higher age categories. Moreover, having a university degree, a postgraduate degree, and a family history of hypertension were independently associated with higher knowledge scores. Conclusions This study found that the general public in Saudi Arabia had good levels of knowledge about hypertension. Being knowledgeable about hypertension not only improves adherence to treatment plans among antihypertensive patients but also aids in avoiding its occurrence and consequences among non-hypertensive patients by adopting self-care. Serial and frequent studies on this issue are recommended to gather more evidence on this topic. Ongoing hypertension education is essential to enhance knowledge to minimize the burden of this prevalent issue.

Assessment of Barriers and Challenges in Headache Education Among Neurology Residents in Saudi Arabia.

Background  Headache problems are among the most common medical conditions. There are major gaps in understanding headaches among healthcare practitioners. This study aimed to determine challenges and barriers to headache training among neurology residents in Saudi Arabia. Methods  A cross-sectional questionnaire-based study was conducted in Saudi Arabia. The target population was all Saudi neurology residents who were currently registered with the Saudi Commission for Health Specialties (SCHS). Statistical analysis was conducted using RStudio (R version 4.1.1). A chi-squared test is used for categorical variables whenever applicable. The statistical differences for continuous variables were assessed using a Wilcoxon rank sum test. Results A total of 227 respondents were included. More than half of the residents were male (56.8%). Large proportions of residents self-rated their knowledge as good for migraines (62.6%) and tension-type headaches (60.4%). The most experienced challenges included difficult diagnosis (30.4%) and treatment difficulties due to comorbidities (19.8%). The most stated barriers to optimal treatment of headache patients were the existence of challenges in collaboration between patient and therapist (24.7%). Most residents rely on the use of the International Classification of Headache Disorders (ICHD) in diagnosing and managing headache patients instead of the Saudi guidelines. The most reported reason for headache referral was suspicion of an underlying serious disease (31.7%). The most recommended non-pharmacological interventions were exercise (15.9%). Conclusion  We found that residents reported the diagnosis of headache as the most challenging barrier. The overuse of analgesics played a role in causing the headache. The most often cited barrier to providing headache patients with the best possible care was difficulties in patient-therapist collaboration. Ongoing headache education and comprehensive academic training are recommended to enhance knowledge during neurology residency training and offer competent care for their patients.

Implications of Early Diagnosis and Intervention in the Management of Neurodevelopmental Delay (NDD) in Children: A Systematic Review and Meta-Analysis.

Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental delays account for delayed skill development surrounding speech, social, emotional, behavioral, motor, and cognitive delays. NDD might affect the child's psychological and physical well-being, resulting in chronic disease and disabilities throughout adulthood. This review sought to investigate the implication of early diagnosis and intervention of NDD in children. In this regard, this research opted for a systematic meta-analysis that used keywords and Boolean operators to search through main databases, including the Web of Science, JStor, PsychINFO, Science Direct, Cochrane, Scopus, and ASSIA. The result identified that telehealth interventions improved the management of NDD in children. Also, the Early Start Denver Model (ESDM) model was determined to improve the quality of life for NDD children. Another model was LEAP (Learning Experience and Alternative Program for Preschoolers and Their Parents) and Leap (Learning, engaging, and Playing), which improved behavioral, education, and social interventions in NDD children. The study identified that technology could revolutionize NDD interventions in children, possibly improving the quality of life. The parent-children relationship was shown to enhance the management of this condition; thus, it is recommended as one of the best ways to intervene in the management of NDD. Most importantly, the integration of machine learning algorithms and technology can create models; while this may not be significant in the treatment of childhood NDD but instead might be ideal in improving the quality of life for NDD children. Moreover, their social and communication skills along with academic achievements will improve. The study proposes further research in order to understand the different types of NDDs and their intervention strategies to help the researchers identify the most accurate models to improve the conditions and support the parents and guardians in the management.

The Impact of COVID-19 on Preterm Birth Among Pregnant Women in Al-Qassim, Saudi Arabia.

BACKGROUND: Pregnant women are regarded as a unique group due to the distinct immunological condition that pregnancy produces, which makes pregnant women more susceptible to respiratory infections like coronavirus disease 2019 (COVID-19) and its consequences. During pregnancy, many viral infections have been recognized to increase the risk of adverse obstetrical outcomes such as preterm delivery. The purpose of this study was to investigate the effects of COVID-19 infection on preterm birth in pregnant women in the Al-Qassim region of Saudi Arabia. METHODS:  This retrospective cohort study was conducted in Saudi Arabia between December 2019 to October 2021. The target subjects were pregnant women with live singleton gestations who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing for COVID-19 infection during their delivery hospitalization. Data gathered included patient demographic information, clinical characteristics, and pregnancy outcomes. Data were analyzed using R version 4.1.1 (R Core Team (2021); R Foundation for Statistical Computing, Vienna, Austria). RESULTS:  A total of 381 pregnant women were included. The median maternal age of women was 31.0 years (IQR: 27.0, 35.0) and the median BMI value was 30.5 kg/m2 (IQR: 26.9, 34.8). The most common comorbidities were diabetes (7.1%) and asthma (4.5%). A known history of preterm birth was prevalent among 2.9%. Of the participants, 13.6% had a prenatal COVID-19 infection, of whom 57.7% had their infections resolved. The prevalence of positive PCR testing was 13.6%. Preterm birth occurred in 46 women (12.1%, 95%CI 9.1-15.9). Preterm birth was significantly associated with having a maternal age of ≥35 years, having high frequencies of parity, and having a past history of preterm birth, as well as having a history of hypertension and diabetes. Preterm birth was not significantly associated with having a confirmed COVID-19 infection at delivery. CONCLUSION: It was shown that preterm birth is evident among women with COVID-19 infection. Preterm birth is significantly associated with old age, multiparity, and a history of preterm delivery. Preterm birth is not significantly associated with having a confirmed COVID-19 infection at delivery. More research regarding infection-related adverse effects is advised and should be highlighted.