Impact of the COVID-19 pandemic on therapy compliance and lifestyle factors of patients with growth hormone deficiency.

OBJECTIVES: To recognize and assess treatment compliance in children and adolescents with growth hormone deficiency during the cronavirus disease-2019 (COVID-19) pandemic along with other lifestyle factors that might have been affected by the pandemic, such as diet, physical activity, sleep pattern, and screen time. METHODS: This descriptive, cross-sectional study was carried out between March 2020-2021 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Data were collected through clinical interview questions. RESULTS: The total sample size was 130 patients, 54 (41.5%) of whom were males and 76 (58.5%) were females. The mean age of the patients was 12.56±3.44 years. Comparisons of before and during the COVID-19 pandemic revealed significant changes in growth hormone therapy compliance (p=0.007), dietary changes (p=0.002) with an increase in vegetables and fruit consumption, a significant decrease in physical activity time (p<0.001), an increase in sleep time (p<0.001), and screen time (p<0.001). CONCLUSION: The COVID-19 crisis had an impact on growth hormone therapy compliance, with a significant impact on other lifestyle factors such as dietary habits, physical activity, sleep time, and leisure screen time.

Neurological Complications and Associated Risk Factors in Children Affected with Chronic Kidney Disease.

To investigate the correlation between chronic kidney disease (CKD) and the development of neurological disease among pediatric patients in Saudi Arabia. The present retrospective study recruited patients admitted to King Abdulaziz University Hospital during 2018. We reviewed electronic records to collect data on essential demographics including age, gender, and nationality; history of prior CNS disease or related symptoms; results of neurological physical examination; and findings of radiological investigations such as abdominal ultrasound, dimercaptosuccinic acid scan, micturating cystourethrogram, diethylene triamine pentaacetic acid scan, brain computed tomography, and magnetic resonance imaging. The most commonly diagnosed renal pathologies were neurogenic bladder and cystic kidney disease. The most common neurological manifestation was seizure disorder. Males were more frequently affected with neurological sequelae than females. The prevalence of neurological disorders was higher in patients over two years old. The most frequently observed stage of chronic kidney disease was stage 5. Most children who were affected with a neurological disorder required hemodialysis as part of their management plan. Patients with chronic kidney disease are at a high risk of neurocognitive defects. The type of management and renal diagnosis are significant factors that should be considered when anticipating central nervous system involvement in the case of chronic kidney disease.

Hospitalization rate and outcomes in patients with left ventricular dysfunction receiving hemodialysis.

INTRODUCTION: Left ventricular dysfunction (LVD) is characterized as left ventricular ejection fraction (EF) below half of the systolic capacity of the left ventricle. Patients on hemodialysis have higher risk of developing LVD than the general population. Our aim was to assess hospitalization rate and outcomes in hemodialysis patients with LVD. PATIENTS AND METHODS: All patients ≥18 years old, who started hemodialysis therapy at King Abdulaziz University Hospital between January 2011 and December 2011, were identified using medical records of hemodialysis unit. Patients were then divided into three groups, according to their EF results prior to the initiation of hemodialysis, as patients with EF <40%, EF between 40% and 49%, and EF ≥50%. Patients were then followed for 5 years by reviewing their hospital records to assess their outcomes, hospital admissions, and length of hospital stay. RESULTS: Analysis included 333 patients. Patients with EF <40% were 40, 36 patients with EF 40%-49%, and 257 patients had an EF >50%. Patients with EF <50% were significantly older than patients with EF >50% (P=0.002). Diabetes mellitus and hypertension were more prevalent in patients with EF <40% and EF 40%-49% when compared with patients with EF >50% (P<0.001, P=0.002). The average length of stay between the three groups was significantly different (P=0.007). Intensive care unit admissions were significantly different when comparing the three groups (P=0.013) and was found to be an independent risk factor for mortality in our patients. Half of the patients with EF <40% and 44% of patients with EF of 40%-49% died compared with only 27% of patients with EF >50% (P=0.002). However, Kaplan-Meier analysis showed no significant difference in the survival time among the three groups (P=0.845). CONCLUSION: Mortality and morbidity increased in patients with LVD on hemodialysis compared with patients with normal EF.