The Impact of Pediatric Epilepsy on Children and Families: A Multicenter Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Epilepsy is considered one of the most prevalent causes of morbidity in children. The aim of this study is to determine how epilepsy impacts the lives of children with epilepsy and their families. METHODS: A translated version of the "Impact of Pediatric Epilepsy Scale" (IPES) questionnaire was completed by the 80 mothers of children with epilepsy, recruited at three hospitals in Jeddah, Saudi Arabia This is a validated self-administered questionnaire used to assess the impact of epilepsy on the lives of the child and family, as well as the quality of life (QoL) of the child. RESULTS: The mean age of children epilepsy was 6.32 years (SD = 3.22). The mean IPES score was 6.28 (SD = 8.42) and the mean child's QoL was 2.85 (SD= 0.83). 87.5% of the mothers rated their child's QoL as low. IPES score was significantly associated with cause of seizure (ß=0.259; 95%-CI= 0.263 - 10.334; p = 0.039). Child's QoL was significantly associated with frequency of seizure (ß=0.251; 95%-CI= 0.016 - 0.568; p= 0.039) and child's nationality (ß=-0.270; 95%-CI -0.252, -0.013; p= 0.031). CONCLUSIONS: Pediatric epilepsy may have a greater impact on the lives of the child and the family when it is not comorbid with cerebral palsy. Quality of life tends to be lower for non-Saudi children, and children with more frequent seizures. Therefore, these groups may need more support in managing the impact that epilepsy has on their daily functioning and quality of life.

Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Dermatomyositis: A Case Series and Literature Review.

Background: Spontaneous pneumomediastinum and subcutaneous emphysema are rare and serious complications of dermatomyositis (DM). Case Presentation: Our article presents two clinically heterogeneous cases of DM who developed pneumomediastinum and subcutaneous emphysema. The first was a 24-year-old lady with a recently diagnosed DM. She developed rapidly progressive pneumonia, interstitial lung disease (ILD), pneumomediastinum, subcutaneous emphysema, and acute respiratory distress syndrome (ARDS). She died despite treatment with steroids and immunosuppressants (methotrexate and mycophenolate mofetil (MMF)). The second was a 30-year-old man diagnosed with amyopathic DM. He developed pneumomediastinum prior to ILD, which worsened over time, and subcutaneous emphysema evolved. However, he recovered completely after corticosteroid, MMF, and rituximab. Conclusion: Spontaneous pneumomediastinum and subcutaneous emphysema may complicate DM. Corticosteroids, immunosuppressants, and respiratory support are the mainstay of management for these conditions. Though they were reported to carry a poor prognostic value, the course and outcome are highly variable among the cases.

Dermatomyositis Flare After a COVID-19 Infection Successfully Treated with Rituximab: A Case Report and Literature Review.

Introduction: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there has been a sudden surge in the incidence of several immune-mediated diseases, including dermatomyositis. The reported cases of COVID-19-related dermatomyositis are heterogeneous in their clinical presentation and implemented therapies. Case Study: We report a 23-year-old female patient diagnosed with a 3-year history of dermatomyositis. She has been well-controlled on maintenance therapy. However, 6 weeks after a mild COVID-19 infection, she developed a dermatomyositis flare. She improved only after aggressive treatment with pulse steroids, intravenous immunoglobulin, and rituximab. Conclusion: Exacerbation of dermatomyositis can be encountered following a COVID-19 infection, even if the infection is mild. Aggressive therapy should be considered in such cases. The prognosis, however, is generally favorable.

Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review.

Introduction: Hypereosinophilic syndrome (HES) and immune thrombocytopenic purpura (ITP) have been reported to co-occur with ulcerative colitis (UC). However, the exact pathogenic mechanisms of their occurrence remain elusive. In this article, we aim to describe two cases of UC patients who developed refractory HES and ITP and elaborate on their potential pathogenesis. Case Study: We report two middle-aged patients diagnosed with UC. The first patient developed HES that was refractory to conventional medical therapy of idiopathic HES, and the second developed refractory ITP that failed steroid and immunosuppressive therapy. Both conditions improved considerably following colectomy, suggesting they are of a reactive rather than idiopathic nature. Conclusion: In patients with UC and refractory comorbid HES or ITP, the reactive nature of these comorbidities should be taken into consideration, and colectomy, therefore, should be considered if clinically indicated.

Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study.

Introduction: Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah. Methods: This descriptive cross-sectional study was conducted in the city of Jeddah. The Skin Picking Scale-Revised (SPS-R) scale was administered to a convenience sample of 520 respondents. A partial least squares path model (PLS-PM) for "impairment" and "symptoms severity" subscales was assessed by evaluating the validity of measurement and structural models. Results: Skin picking behavior was reported by 28.8% (n=150). A significant level of skin picking disorder symptoms was present in 1.2% (n=6). Skin picking visual effect, depressive symptoms, and being unmarried were the only positive independent predictors of the total SPS-R score. Conclusion: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.

Body Dysmorphic Disorder Symptoms: Prevalence and Risk Factors in an Arab Middle Eastern Population.

Background: The present study examined the prevalence of and risk factors for symptoms of body dysmorphic disorder (BDD) in the general population of Jeddah, a large port city in Saudi Arabia. Methods: This cross-sectional study surveyed a convenience sample of 520 adults. We used a validated self-screening measure to assess BDD, the body dysmorphic disorder questionnaire (BDDQ). Results: The prevalence of significant BDD symptoms among the general Saudi population was 8.8% (ie, those scoring above the cut off for BDD on the BDDQ). Over half (52%) of all respondents reported concerns about the attractiveness of their body parts, and of those expressing such concerns, 66% were preoccupied with these thoughts. Only 3% of all respondents opted for cosmetic surgery because of these concerns, and most of those individuals (69%) had only one surgery. Nearly 9% of all respondents reported that these concerns affected their relationships with family and friends. Almost 15% of all participants spent an hour or more each day thinking about these concerns. Patients who reported a history of depression were 3.8 times more likely to have BDD. Other variables included in the model predicting high BDD scores (eg, age, job status, and marital status) did not achieve statistical significance. Conclusion: Significant symptoms of BDD (based on the BDDQ) are not uncommon among the general population of Jeddah, Saudi Arabia. Risk factors for this condition were female gender, younger age, being unmarried, and in bivariate and multivariate analyses, history of depression and female gender. These findings underscore the need for increased awareness by clinicians of this disorder, particularly when treating patients with depressive disorder, particularly among women.

Medical Schools' Ophthalmology Course: An Appraisal by Ophthalmology Residents.

OBJECTIVE: To investigate the perception and satisfaction of ophthalmology residents with the currently provided ophthalmology curricula to medical students. METHODS: A cross-sectional survey involving first to fourth year ophthalmology residents (N = 106) from all regions of Saudi Arabia was conducted between December 2018 and February 2019. An online questionnaire explored opinions about the ophthalmology course regarding three dimensions. Firstly, adequacy in covering essential parts of the specialty; secondly, improvements required; and thirdly, effectiveness. A score (0-21) was calculated, indicating the overall suitability of the ophthalmology course. In addition, factors of good overall suitability (score ≥10) were analyzed. RESULTS: Regarding adequacy, respondents opined that the ophthalmology course did not reasonably cover the basic part (35.8%), clinical part (61.3%), common disease (26.4%), and emergencies (39.6%). Concerning improvements required, more than 80% of the participants expressed that the course required to be improved for all its features, including duration (80.2%), objectives (85.8%), content (82.1%), organization (83.0%), and supervision (81.1%). As to effectiveness, half of them deemed the course unhelpful in familiarizing general practitioners with common ophthalmic diseases and emergencies. Overall, the ophthalmology course was generally deemed suitable (score ≥10) for only 27.4% of the participants, with no differences across gender, level, or region. CONCLUSION: Ophthalmology residents perceived multiple deficits in the current Saudi ophthalmology teaching course. Significant improvements in ophthalmologic curricula are required, besides coping with unprecedented technological advancement in the ophthalmological field.

How Relevant is Obstetrician and Gynecologist Gender to Women in Saudi Arabia?

BACKGROUND: The patient-doctor relationship is one of the most important factors in determining the outcome of healthcare. The first step in establishing this relationship is choosing a physician. This study sought to identify patient preferences concerning the gender of their obstetrics and gynecology (OB-GYN) physician and the effect of religion and society on these choices. METHODS: A cross-sectional study was conducted at the OB-GYN outpatient clinics at King Abdulaziz University Hospital in Jeddah between February 2017 and June 2017. A total of 227 female patients were recruited. Eligible were women ages 18 years or older who had attended the clinic at least three times. A 30-item questionnaire was administered. RESULTS: Significantly, more female doctors were preferred for pelvic examination in lower income group (p=0.003), while male doctors were preferred for surgery (p=0.010) in higher income group. Significantly more male doctors were preferred for pelvic examination and gynecological surgery in >35-year age group (p=0.015 and p=0.017, respectively). With regard to predictors, embarrassment was the most significant factor reported for not choosing a male obstetrician/gynecologist (OB-GYN) in the younger age group. Nearly three-quarters (71.2%) of respondents with age ≤35 reported embarrassment as a factor for not choosing a male OB-GYN; 79.7% of this subgroup indicated that female doctors were more knowledgeable about women's health issues. CONCLUSION: Participants expressed a strong preference for female providers overall, although some women preferred male providers during certain circumstances (gynecologic surgery). Despite these gender preferences, more important to women in their choice of OB-GYN provider was the doctor's experience, qualifications, and reputation. Such trends are consistent with those culturally similar countries and in line with trends worldwide. These findings have the potential to significantly impact the personal health for women in Saudi Arabia and elsewhere in the Middle East where religious and cultural traditions are so important in decision-making.

Echocardiographic and Clinical Correlates of Ejection Fraction Among 2000 Patients with Heart Failure in Western Saudi Arabia.

INTRODUCTION: Heart failure (HF) affects about 320,000 Saudi individuals and is associated with a considerable negative impact on the patients' quality of life. In literature, there is a lack of data about the echocardiographic abnormalities of HF patients in Saudi Arabia. AIM OF WORK: To describe the echocardiographic findings of HF patients in Western Saudi Arabia. METHODOLOGY: This was a retrospective record review study conducted on 2000 patients with chronic HF in Saudi Arabia. Demographic, clinical and echocardiographic data were collected and compared among patients with HF with reduced ejection fraction (HFrEF), ie, EF≤40%; HF with mid-range EF (HFmrEF), ie, EF=41-49%; and HF with preserved EF (HFpEF), ie, EF≥50%. RESULTS: Among the 2000 patients studied, females constituted 46.3% of the sample. About 52% of females had HFpEF, whilst 70% of males had HFrEF (p<0.0001). Diastolic dysfunction occurred in 98% of HFpEF versus 78% of HFrEF (p<0.0001). Patients with HFrEF had higher left-ventricular diastolic (LVd) volume (1536 versus 826), higher left-ventricular systolic (LVs) volume (1660 vs 772), higher left atrial volume (1344 vs 875), higher aortic root dimension (1144 vs 929) and lower fractional shortening (FS) (267 vs 1213) than patients with HFpEF (p<0.0001). CONCLUSION: HFpEF was more common among females and was associated with higher rates of diastolic dysfunction and higher FS. HFrEF was prevalent among males and associated with higher LVd, LVs, left atrium volume and aortic root dimensions.

Utilization of cross-matched blood in elective thyroid and parathyroid surgeries: a single-center retrospective study.

BACKGROUND: Hospital blood banks face the common challenge of maintaining an adequate supply of blood products to serve all potential patients while minimizing the need to discard expired blood products. This study aimed to determine the risk of blood transfusion during elective thyroid and parathyroid surgery and potential factors related to blood loss and risk of transfusion in these cases. METHODS: The study included all thyroid and parathyroid surgeries performed at King Abdulaziz University Hospital between January 2015 and December 2017. After exclusion of patients with incomplete data, 179 patients with complete data who had undergone thyroid and parathyroid surgery were analyzed. RESULTS: Of the179 patients included in this study, 33 (18.4%) were male. Overall, patients had a mean age and body-mass index of 44.55±13.67 years and 27.66±5.38 kg/m2, respectively. The mean duration of surgery was 168.48±90.69 minutes. None of the patients had a history of previous radiotherapy, bleeding disorder, or blood transfusion. Benign goiter was the most common finding (n=78, 43.6%), followed by papillary carcinoma (n=49, 27.4%). During surgery, most patients (n=136, 76.0%) experienced minimal blood loss. None of the patients in our cohort (n= 179) required any blood transfusion or products. CONCLUSION: In this study, we aimed to audit the surgical blood-ordering and -transfusion practices associated with elective thyroid and parathyroid surgeries at our institution. These practices are intended to balance the availability of blood products with the avoidance of unnecessary wastage. In our study of patients who underwent elective thyroid and parathyroid surgeries, parathyroid surgeries, none required blood transfusion.

Fecal and Urinary Incontinence Associated with Pregnancy and Childbirth.

INTRODUCTION: Fecal incontinence (FI) and urinary incontinence (UI) are major problems faced by women worldwide, with pregnancy and delivery representing two major risk factors for these conditions. The prevalence of FI and UI varies across studies. In our region, only a few publications have addressed this topic. AIM: The aim of this study was to determine the prevalence of FI and UI in Saudi pregnant women, their characteristics, and a specific clinical pattern that could identify patients that are at a risk for incontinence. MATERIALS AND METHODS: This was a questionnaire-based crosssectional study conducted over a 3 months period in 2017, among pregnant women attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. RESULTS: Our study included 393 pregnant women. FI was reported by 24 patients (6.1%), and fecal urgency was reported by 30.5%. UI was reported by 84 patients (21.4 %). When patients with no UI were compared with patients with UI, the only statistically significant factor was BMI (p = 0.043). There were no statistically significant differences when comparing patients with FI versus no-FI, and fecal urgency versus no-fecal urgency. However, laceration (OR: 1.696, p = 0.036), episiotomy (OR: 1.413, p = 0.029), constipation (OR: 1.944, p < 0.001), hypertension (OR: 1.993, p = 0.022), and Bristol stool scale score (p = 0.002) were statistically significant factors for determining fecal control. CONCLUSION: FI and UI are frequently associated with pregnancy and delivery, but their prevalence is underestimated. The role of the practitioner is crucial in preventing and treating these conditions, and in impeding their harmful effects on the postpregnancy quality of life of Saudi women.

Trends in mitral valve prolapse: a tertiary care center experience in Jeddah, Saudi Arabia.

BACKGROUND: Mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in developed countries and it is associated with considerable morbidity and mortality. AIM OF WORK: To study the clinical presentations, risk factors, and echocardiographic features of patients with MVP in Jeddah, Saudi Arabia. MATERIALS AND METHODS: A retrospective chart review study was conducted in King Abdulaziz teaching hospital in Jeddah, Saudi Arabia, from 2007 to 2017. All patients with MVP who were admitted at the hospital during this time period were recruited to this study, and demographic, clinical, and echocardiographic variables were analyzed using IBM SPSS. RESULTS: Ninety-seven patients were recruited to this study, with a mean age of 43.82±16.16 years. Females constituted 67%. The body mass index (BMI) was 24.9±6.3 kg/m2. Hypertension, diabetes, and dyslipidemia occurred in 19.6%, 5.2%, and 5.2% of patients, respectively. A single patient had Marfan syndrome. Chest pain, palpitations, and dyspnea were the presenting symptoms in 23.7%, 11.3%, and 9.3% of patients, respectively, with elderly individuals presenting disproportionally (93.3%) with palpitations. Fifty-five percent of patients had an anterior leaflet prolapse. The presence of posterior leaflet prolapse and severe mitral regurgitation (MR) was significantly associated with left atrial and left ventricular dilatation (P<0.05 and P<0.001, respectively). CONCLUSION: MVP is more prevalent in women and middle-aged individuals with normal BMIs in this population. The most common clinical presentations were chest pain, palpitations, and dyspnea, which did not differ significantly with age or gender. The anterior leaflet was the most commonly prolapsed in the studied patients and presented with mild MR. Posterior leaflet MVP, while of low prevalence, was associated with severe MR and poor left ventricular function.

Population awareness of coronary artery disease risk factors in Jeddah, Saudi Arabia: a cross-sectional study.

BACKGROUND: Coronary artery disease (CAD) is a serious cardiovascular disorder affecting middle-aged individuals. It is a major cause of death among adults over the age of 35 years. In Saudi Arabia, CAD is associated with higher mortality rate, and Saudi patients are reported to have significantly higher prevalence of risk factors for CAD than the Western population. Furthermore, as, to date, there is no definite cure for CAD, prevention of the disease and tight control of the known risk factors are the cornerstones for reducing CAD-associated mortality. Thus, the present work aimed to assess the population awareness of CAD risk factors in Saudi Arabia. METHODS: A cross-sectional study was conducted in Jeddah during the period January 2017 to December 2017 by using an online survey questionnaire to assess participants' awareness of 14 risk factors for CAD, namely: smoking, lack of physical activity, fast food and soft drink intake, television and computer use; history of diabetes mellitus, myocardial infarction and stroke; as well as a family history of diabetes mellitus, diabetes, hypertension, hyperlipidemia, CAD and myocardial infarction. RESULTS: Of 468 respondents, 41% were males. The mean age was 31.9±12.4. Approximately 86% were Saudi, and ~60% had a university education. The mean overall awareness score was 4.31±1.36 (1.00-8.00). Fast food, soft drinks, and family history of diabetes were the most commonly identified risk factors, reported by 74.8%, 64.3%, and 47.2% of participants, respectively. There was a strong correlation between overall awareness score and awareness of each risk factor individually (P<0.003). CONCLUSION: There is an evident limited knowledge among the population in Jeddah, Saudi Arabia regarding the risk factors for CAD, and it is recommended that the healthcare sector in the country focus on public health education programs about the disease.

Atrial fibrillation: risk factors and comorbidities in a tertiary center in Jeddah, Saudi Arabia.

INTRODUCTION: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia worldwide and carries significant risk of morbidity and mortality. The prevalence of AF is high in significant parts of the world, but not much is known from countries, such as Saudi Arabia. AIMS: To study the risk factors, etiologies, comorbidities, and outcome of AF in Saudi Arabia. PATIENTS AND METHODS: A retrospective study was conducted in King Abdul-Aziz Hospital in Jeddah during the period 2010-2017. Data were collected from both the electronic-and paper-based medical records of patients with AF. The data included the demographic information, adverse lifestyle (smoking and obesity), cardiothoracic surgery, and comorbidities. RESULTS: A total of 167 patients were included in the analysis (43% were males). The mean age was 63.3±35 years and the mean body mass index was 28.8±83. Hypertension (HTN) was the most prevalent risk factor encountered (73.1%). This was followed by valvular heart disease, and type 2 diabetes mellitus (T2DM), which occurred in 58.7% and 53.3% of patients, respectively. Valvular heart disease was significantly associated with older age (P=0.002) and coronary artery disease (CAD) (P=0.001). Heart failure (HF) was associated with HTN (P=0.005), coronary heart disease (P=0.001), and chronic kidney disease (CKD) (P=0.003). CONCLUSION: AF was more prevalent among females in Saudi Arabia. HTN, valvular heart disease, and T2DM were the most prevalent risk factors of AF in Saudi Arabia. Valvular heart disease was more prevalent among older patients and significantly associated with CAD. HTN, CAD, and CKD were the most significant risk factors for HF in patients with AF.

Peripheral artery disease risk factors in Jeddah, Saudi Arabia: a retrospective study.

BACKGROUND: Peripheral artery disease (PAD) is a major health problem in Saudi Arabia with considerable implications for morbidity and mortality. Many risk factors have been established for developing PAD, but the prevalence of these risk factors is variable from one country to another. AIM: To identify the risk factors for PAD and study their prevalence in Jeddah, Saudi Arabia. METHODS: A retrospective chart review study was conducted in a tertiary center in Jeddah from July 2012 to September 2015. All patients with PAD were recruited into this study, and their data were analyzed using IBM SPSS. Correlation between PAD and various risk factors was studied using Spearman's coefficient. RESULTS: A total of 261 patients were recruited, of which 55% were males. Hypertension, diabetes type 2, and obesity were found among 34.2%, 33.3%, and 29.2% of the patients, respectively. About 45% had a history of previous vascular surgery, and amputation was performed in 6.9% particularly in legs. Hypertension and metabolic syndrome were the only risk factors that showed a significant correlation with PAD (P=0.039 and 0.040, respectively). CONCLUSION: The most prevalent risk factors for PAD in Jeddah were hypertension, diabetes, obesity, and smoking. Hypertension and metabolic syndrome were the only risk factors significantly associated with PAD. Males were often more affected by PAD than females. The most commonly affected site was the lower limbs.

Prevalence, Risk Factors, and Fetal and Maternal Outcomes of Hypertensive Disorders of Pregnancy: A Retrospective Study in Western Saudi Arabia.

OBJECTIVES: We sought to estimate the prevalence of hypertensive disorders of pregnancy (HDP) in Saudi Arabia as well as the risk factors of HDP, and maternal and fetal outcomes. METHODS: We retrospectively evaluated the medical records of 9493 women who delivered at King Abdulaziz University Hospital, a tertiary care center, between January 2015 and June 2017. All cases of HDP were included. RESULTS: We identified 224 pregnant women with HDP in our patient cohort, giving a prevalence of 2.4%. Their mean age was 31.3±6.7 years, with an average gravidity of 4.0 and average parity of 3.0. The most prevalent subtype of HDP was preeclampsia (54.9%) while 29.5% of the women had gestational hypertension, and 8.0% had eclampsia. The prevalence of subtypes of HDP differed significantly with gravidity, and mean age differed significantly with HDP subtype. Personal and family histories of preeclampsia and the presence of diabetes were more prevalent in women with preeclampsia and gestational hypertension; however, only the difference in diabetes prevalence was significant. The overall prevalence of maternal complications was 9.4% and the prevalence of maternal mortality was 1.3%. Multigravid women and women with chronic hypertension were at increased risk of prematurity compared to other pregnant women, but not significantly. CONCLUSIONS: The prevalence of HDP was relatively low in our cohort. However, to prevent harmful impacts on both the mother and fetus, screening for this disorder is recommended early in pregnancy.

Basic Life Support Knowledge Among a Nonmedical Population in Jeddah, Saudi Arabia: Cross-Sectional Study.

BACKGROUND: Providing basic life support (BLS) at the site of an accident is crucial to increase the survival rates of the injured people. It is especially relevant when health care is far away. OBJECTIVE: The aim of our study is to assess the BLS knowledge level of the Saudi Arabian population and identify influencing factors associated with level of knowledge about BLS. METHODS: Our study is a cross-sectional descriptive study, which was conducted using a self-administered online questionnaire derived from the BLS practice test. The Saudi population was the target population. The questionnaire was divided into two parts: one contained demographic data and the second part contained questions to test the population's perception about how to perform BLS techniques properly. The data were collected between July and August 2017. Statistically significant differences were defined as those with a P value <.05, and a score of five or more was considered a passing score on the second part. We used SPSS version 21 for data analysis. RESULTS: Our study included 301 participants. Our participants' BLS online exam scores ranged from 0 to 10, with a mean of 4.1 (SD 1.7). Only 39.2% (118/301) of the participants passed the test. The percentage of bachelor's degree or higher holders constituted 60.1% (181/301) of the study population. In addition, higher income was significantly associated with higher scores on the test (P=.04). CONCLUSIONS: This study demonstrated that the theoretical knowledge level of BLS among the general population in Jeddah was below average. There is a critical need to increase the public's exposure to BLS education through raising awareness campaigns and government-funded training programs that aim to curb the incidence of out-of-hospital cardiac arrest mortalities in the Saudi community.

Use of Electronic Entertainment and Communication Devices Among a Saudi Pediatric Population: Cross-Sectional Study.

BACKGROUND: Excessive use of various electronic entertainment and communication devices, particularly among children, has been associated with increased behavioral problems. Despite children's escalating use of these devices, parents' awareness about the impact thereof is still lacking. OBJECTIVE: The objective of this study was to assess the use of electronic entertainment and communication devices among children attending a health care facility in Jeddah, Saudi Arabia, as well as the parental impression regarding the impact of electronic devices use on the behavior of their child. METHODS: A focused 15-item questionnaire was designed for this cross-sectional study involving mothers of children attending the Well Baby Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia from July 1, 2016 to November 30, 2016. RESULTS: This study included 190 mothers. The mean ages of the children, mothers, and fathers were 7.3 (SD 3.5), 35 (SD 6.5), and 43 (SD 8.3) years, respectively. Most children were of Saudi Arabian nationality (106/190, 55.8%). The most used device in this study was television (154/190, 81.0%), followed by mobile phones (134/190, 70.5%), and tablets (116/190, 61.0%). Computers were the least used device in this study (59/190, 31.0%). In total, 24.7% (47/190) of children in this study used electronic entertainment and communication devices for more than 4 hours per day. Most mothers (129/190, 67.9%) felt that their child spends too much time on electronic devices. Hyperactivity or behavioral problems were reported by 20.0% (38/190) of mothers in this study. Children spending longer hours on electronic devices were much more likely to be perceived to suffer from hyperactivity or behavioral problems (P=.01). CONCLUSIONS: Parental awareness is necessary to counteract the harmful effects of using electronic devices for a prolonged period. Parents require help to cope with this problem effectively.

Parental perceptions of dental health and need for treatment in children with epilepsy: a multicenter cross-sectional study.

BACKGROUND: Epilepsy is a common neurological disorder in childhood. However, there have been limited studies on its impact on the oral health of affected children. Our study aimed to assess the oral health of children with epilepsy in the city of Jeddah, Saudi Arabia, as perceived by their mothers. METHODS: We conducted a cross-sectional study in three hospitals. We included children 2-18 years old with physician-confirmed epilepsy diagnosis. We assessed parental perception of dental status and need for dental care using a standardized questionnaire that was completed by the mothers. To adjust for potential confounding variables, we used univariate and multivariate logistic regression. RESULTS: We included 96 children with epilepsy in our study. Their mean age was 6.4±3.4 years. In 55.2% (n=53), dental status was rated as bad, and in 84.4% (n=81) a need for dental care was expressed. Cerebral palsy (OR 5.06, 95% CI 1.28-19.99; P=0.021), motor disability (OR 6.41, 95% CI 1.12-36.73; P=0.037), referral from a pediatric neurology clinic to a dentist (OR 10.755, 95% CI 3.290-35.151; P<0.001), and irregular brushing of teeth (OR 5.397, 95% CI 1.536-18.961; P=0.009) were significantly associated with increased risk of perceived bad dental status. Perception of the child as being overweight (OR 0.117, 95% CI 0.034-0.400; P=0.001) was significantly associated with decreased risk of perceived bad dental status. Motor disability (OR 5.73, 95% CI 1.64-20.04; P=0.006) was significantly associated with increased parental expression of need for dental care. CONCLUSION: In most children with epilepsy, perceived dental status was bad and there was a high expressed need for dental care. Interventions to improve the dental health of children with epilepsy should focus on those with cerebral palsy and motor disability.