Prevalence and Associated Factors of Vitamin D Deficiency in High Altitude Region in Saudi Arabia: Three-Year Retrospective Study.

Background: Vitamin D has many functions in the human body, and its deficiency is associated with skeletal and non-skeletal diseases. Vitamin D deficiency (blood level of 25 (OH) vitamin D < 20 ng/mL) has been reported worldwide, including Kingdom of Saudi Arabia (KSA). Its prevalence and associated factors vary according to KSA region. Therefore, this study aimed to explore the prevalence and risk factors of vitamin D deficiency in the Taif region of KSA. Methods: This retrospective study included patients who attended outpatient clinics at the Alameen General Hospital from 2019 to 2021. Demographic, clinical, and laboratory data were collected using a hospital software system. Results: The study included 2153 patients and vitamin D deficiency was diagnosed in 900 (41.8%) of whom were diagnosed with vitamin D deficiency. It was more common in males (P=0.021), younger age (<0.001), and in patients without comorbidities. There was a positive correlation between 25 (OH) vitamin D levels and blood cholesterol, high-density lipoprotein, calcium, and vitamin B12 levels. In the binary logistic regression analysis, age was the most significant predictor (P<0.001), followed by the absence of thyroid disease (P=0.012) and asthma (P=0.030). Conclusion: Vitamin D deficiency is common in the Saudi population despite sunny weather in KSA. It is more prevalent among males, younger individuals, and those without comorbidities such as thyroid diseases and asthma.

Acquired long QT syndrome due to antiemetics, COVID-19 and Blastocystis hominis induced exacerbation of congenital chloride losing diarrhoea.

Congenital chloride losing diarrhoea (CCLD) is a rare disease caused by mutations in an intestinal chloride/bicarbonate ion exchange channel. Few reports describe CCLD in adults and none has described the impact of a parasitic infection on CCLD. Severe diarrhoea may result in hypokalaemia with QT interval prolongation. Treatment with antiemetics may further increase the QT interval. To raise awareness of this preventable complication, we describe the course of a woman in her 20s with CCLD who developed COVID-19 and a Blastocystis hominis infestation. Treatment with antiemetics and hypokalaemia resulted in prolongation of the QT interval to 640 ms. While, the QT interval normalised with discontinuation of antiemetics and electrolyte replacement, patients with CCLD must take precautions to prevent gastrointestinal infections. Regardless, whenever patients with CCLD present to hospital, the authors recommend monitoring the QT interval and avoiding medications that predispose to torsade de pointes.

Post COVID-19 Vaccination-Associated Neurological Complications.

PURPOSE: Neurological sequelae after COVID-19 vaccination are rare. We investigated the possible pathogenesis behind the development of neurological complications within a short period after Saudi residents received a COVID-19 vaccine. PATIENTS AND METHODS: We evaluated 18 patients who recently received a COVID-19 vaccine (Comirnaty and Vaxzevria vaccines) and presented with neurological complications to the Saudi German Hospitals in Jeddah, Saudi Arabia. Neurologists assessed the patients' clinical presentation, radiological investigations, and laboratory findings. RESULTS: Three patients who received the first dose of the Vaxzevria vaccine experienced severe cerebral venous thrombosis, two of them were complicated by intracranial hemorrhage. Their laboratory investigations showed very high d-dimers and severe thrombocytopenia, which have been linked to higher mortality and poor outcome. Ischemic stroke occurred in eight cases (44.4%) with a predominance in older male patients. Three patients presented with seizures, two had optic neuritis. Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) occurred in two male patients following vaccination with Comirnaty. CONCLUSION: Neurological complications after COVID-19 vaccinations are very rare, and only a few cases have been reported worldwide. The shared pathophysiological basis between COVID-19 viral infection and COVID-19 vaccines stands behind the very rare neurological complications resulting from the hypercoagulable state triggered by the general inflammatory condition. We suspect some differences in the pathogenesis of ischemic stroke caused by COVID-19 infection and COVID-19 vaccines, which render COVID-19 vaccine-associated ischemic stroke more responsive to treatment. To date, no definitive association between the vaccine and GBS has been proven by any strong evidence, but it has recently been added as a very rare side effect of the Janssen COVID-19 vaccine. No possible links of Miller Fisher syndrome to COVID-19 vaccines have been reported before the one reported in this study.

Association Between Dental Caries and Body Mass Index in Schoolchildren Aged Between 14 and 16 Years in Riyadh, Saudi Arabia.

BACKGROUND: Dental caries and obesity are multifactorial diseases that have common risk factors. Studies worldwide reported varied outcomes about the association between dental caries and obesity. There is no published study that investigates this association among schoolchildren in Arabic countries. The aim of this study was to evaluate the relationship between dental caries (DMFT) and body mass index (BMI) for children aged between 14 and 16 years old in Riyadh, Saudi Arabia. The role of oral hygiene habits, parent's education, sugar consumption and physical activity in causing both diseases was also evaluated. METHODS: This is a cross-sectional study that involved 610 schoolchildren aged between 14 and 16 years. The children were selected from 12 boy's intermediate schools distributed in Riyadh city. A questionnaire that asked about demographic data, oral hygiene habits, parents' education, sugar consumption and physical activity was distributed. Then, the mean DMFT and BMI were calculated by collecting the information from dental examination, body weight and height. Multivariate logistic regression model was used to explain the relationship between the teeth health and the BMI. Moreover, multivariate linear regression was conducted to model the relationship between DMFT and BMI and the socioeconomic score, sugar consumption and physical activity. RESULTS: The prevalence of dental caries (DMFT > 0) was 54.1%. Around 32% of the schoolchildren were either overweight or obese. A statistically significant association between dental caries (DMFT) and BMI was found (P = 0.008). It was found that obese schoolchildren are 1.79 times higher to be with healthy teeth (P = 0.02). In addition, it was found that schoolchildren with higher socioeconomic status are 1.26 times higher to be with healthy teeth group (P = 0.005). Similarly, schoolchildren who reported that they are using the fluoridated toothpaste were 1.63 times higher to be within the healthy teeth group (DMFT = 0) when everything else is controlled. Physical activity level affects the schoolchildren BMI significantly (P < 0.001). CONCLUSIONS: The study showed a statistically significant association between dental caries and BMI for this study sample. Obese schoolchildren showed healthier teeth than others did. Fluoride toothpaste usage and socioeconomic score were associated significantly with dental caries.