VOL.30 2023 Issue 1 (January-March)

Permanent URI for this collectionhttps://repository.iau.edu.sa/handle/123456789/1022

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Relationship between the government implemented protective measures for coronavirus disease 2019 (COVID-19) during the pandemic and the understanding of religious evidence in Muslim community: A cross-sectional study from Saudi Arabia
(2023) Wali, Alzubair A.
Abstract: BACKGROUND: Coronavirus disease 2019 (COVID-19), which has swept across the Middle East has ignited religious tensions. Although the implementation of effective preventive measures is the best way to control the spread of COVID-19, in such countries as Saudi Arabia, these restrictions have sometimes been viewed as violations of religious practice. The present study explores the reasons for ignoring the authorities’ recommendations, and the inability of the authorities to create a sense of inclusion in the protective measures they introduce against the COVID-19 outbreak. MATERIALS AND METHODS: A cross-sectional community-based study was conducted in Saudi Arabia and data were collected from 922 participants. The questionnaire contained 17 questions on personal characteristics, compliance with governmental protective measures, and participants’ understanding of religious evidence. The SPSS was used for data analysis. Categorical data was presented as frequencies and percentages. Chi-square test was used to determine the association between people’s compliance to the protective measures and their understanding of religious evidence. RESULTS: The age of the study participants ranged between 17 to 68 years with a mean age of 43.9 (±12.69) years. About half of the participants reported always complying to Mosque precautions (49.9%) and keeping distance (53.7%). However, only 34.3% participants always maintained social distancing while visiting relatives; about 25.2% often kept a social distance. We found that an adequate understanding of religious principles was significantly associated with accepted overall commitment, and inadequate understanding was significantly associated with lack of commitment. An adequate understanding of religious principles was significantly associated with a positive attitude toward future commitment and inadequate understanding was significantly associated with a negative attitude. CONCLUSION: We recommend that the Ministry of Health in Saudi Arabia solicits the support of religious scholars to give a proper explanation of the religious evidence and eliminate misconceptions to promote compliance with the protective measures.
Association between diabetes-related distress and glycemic control in primary care patients with Type 2 diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Egypt
(2023) Elotla, Sally F.; Fouad, Ahmed M.; Mohamed, Samar F.; Joudeh, Anwar I.; Mostafa, Mona; Hayek, Samer El; Shah, Jaffer; Ahmed, Hazem A. S.
Abstract: BACKGROUND: Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients’ lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of ≥40 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level. RESULTS: Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25, P < 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41, P < 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20, P = 0.018). CONCLUSION: Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.
Adjustment disorder among first year medical students at King Saud University, Riyadh, Saudi Arabia, in 2020
(2023) Alhussain, Fahad A.; Onayq, Abdulhakim I. Bin; Ismail, Dawood H.; Alduayj, Mohammed A.; Alawbathani, Turki A.; Aljaffer, Mohammed A.
Abstract: BACKGROUND: The general health and well-being of medical students has become a matter of concern, as medical students have higher levels of stress than their nonmedical peers. Long-standing stress may lead to serious outcomes, such as depression, anxiety, poor quality of life, or adjustment disorders. This study aimed to estimate the proportion of first year medical students who have adjustment disorder and explore possible risk factors. MATERIALS AND METHODS: This cross-sectional study was conducted among all first-year medical students at King Saud University, College of Medicine, Saudi Arabia. The adjustment disorder-new model 20 (ADNM-20) was used to assess adjustment disorder with the stressor and item lists. The item list scores were summed and a cutoff point >47.5 was designated as a high risk of developing the disorder. Descriptive analysis included computing mean and standard deviation for continuous variable while frequency and percentages for categorical variables. Chi-square test and logistic regression analysis determined risk factors for having an adjustment disorder and the stress of attending a medical school. RESULTS: The study enrolled 267 students but only 128 completed the ADNM-20 survey. Out of 267 students, the most commonly reported recent stressor was too much/too little work, and 52.8% reported having difficulty in meeting deadlines. The most common core symptom expressed by the medical students was avoidance behavior with a mean score of 10.91 ± 3.12, followed by preoccupation with stressors with a mean score of 10.66 ± 3.10. The factors significantly associated with having adjustment disorder were being female, younger age, recent illness of a loved one, having family conflicts, and having too much or too little work. CONCLUSION: First year medical students are at increased risk of adjustment disorder. Screening and awareness programs may be considered for preventing adjustment disorder. Increased student-staff interactions may provide support to adapt to their new environment and help reduce social adjustment difficulties.
The degree of nicotine dependence among users of different tobacco and nicotine products in Madinah City, Saudi Arabia
(2023) Almutairi, Rami M.; Al-Dubai, Sami A. R.; Almutairi, Mai M.; Alharbi, Hani H.; Alshlahi, Hatim M.; Albadrani, Muayad S.
Abstract: BACKGROUND: Nicotine addiction has many consequences. The World Health Organization has classified nicotine dependence as a disorder of substance use. This study aimed to assess the dependence in users of different tobacco and/or nicotine-containing products (TNPs). MATERIALS AND METHODS: This analytical, cross-sectional study involved 211 TNP users in Madinah, Saudi Arabia. The data was collected using a self-administered questionnaire that consisted of two main sections. The first section included sociodemographic domain, TNP status domain, and the Stages of Change model domain. The second section of the instrument included the ABOUT dependence construct comprising 12 items. Independent t-test, analysis of variance, and correlation analysis were used to assess the relationship between the study variables. RESULTS: Most users of TNPs exclusively used tobacco cigarettes (53.1%). Total dependence score was significantly associated with gender, marital status, age group, monthly income, nicotine concentration in electronic cigarettes (e-cigarettes) liquid, and the number of cigarettes smoked per day (P < 0.05). Total dependence score was correlated with the duration of TNP usage (r = 0.24, P < 0.001), Switching attempts to another TNP (r = 0.16, P = 0.020), attempts of quitting TNPs (r = 0.25, P < 0.001), and willingness to quit (r = −0.37, P < 0.001). CONCLUSION: Dependence was associated with gender, marital status, age group, monthly income, nicotine concentration in e-cigarette liquid, and the number of cigarettes smoked per day. It was also associated with duration of TNP usage, Switching attempts to another TNP, attempts of quitting TNPs and the willingness to quit.
The effectiveness of self-empowerment-based patient-centered care for obese students in primary services: A randomized controlled trial
(2023) Dewi, Dian K.; Sekartini, Rini; Sunardi, Diana; Soewondo, Pradana; Yunir, Em; Widyahening, Indah S.; Asih, Sali R.; Seman, Anitawati; Latuasan, Kitra; Vidiawati, Dhanasari
Abstract: BACKGROUND: Self-empowerment-based patient-centered services with a coaching approach are imperative in the management of students with obesity. This study evaluated the applicability and effectiveness of self-empowerment-based patient-centered coaching for the weight loss program model for obese students. MATERIALS AND METHODS: This randomized control trial recruited 60 obese students aged 17–22 years in Universitas Indonesia from August to December 2021. Intervention group subjects were coached by a health coach. Each health coach assisted four subjects with SMART model coaching in six meetings every 2 weeks through a zoom platform. Both groups had instructions on obesity, nutrition, and physical activity from specialist doctors online. Paired t-test or Mann-Whitney test, as appropriate, to compare the measurements of anthropometry, body composition (bioelectrical impedance analysis), food intake (food record form), physical activity (physical activity form), subjective well-being (subjective well-being questionnaire), and healthy behavior habits (satisfaction scale) between the two groups before and after the intervention. RESULTS: A total of 41 obese students completed the study, 23 from intervention group and 18 from the control group. The change in total body fat (−0.9 [−12.9, 0.70] vs. 0.0 [−6.9, 3.50], P = 0.02) and healthy behavior habit (13.5 ± 11.85 vs. 7.5 ± 8.08, P = 0.04) in the intervention group was significantly greater than in the control group. The change in satisfaction scale of hobby/passion (2 [−4.6] vs. 1 [−2.2], P = 0.02), movement exercise (2.3 ± 2.11 vs. 1.2 ± 1.93, P = 0.03), sleep rest (2 [−6.5] vs. 1 [−3.2], P = 0.01), and spiritual (1 [0.6] vs. 0 [−1.3], P = 0.00) was significantly higher in the coached group. CONCLUSION: A weight loss program for obese students was tested through self-empowerment-based patient-centered care with a coaching approach and has proven to effect changes in anthropometric indicators, body composition, self-empowerment, food intake, and physical activity.
Dietary habits, lifestyle changes, and glycemic control in patients with type 2 diabetes mellitus during coronavirus disease 2019 (COVID-19): A cross-sectional study in Egypt
(2023) Hussein, Yasmin H. H.; Soliman, Al-Zahraa M.
Abstract: BACKGROUND: The coronavirus disease 2019 (COVID-19) lockdown had a significant effect on people’s lifestyles and dietary habits resulting in a possible negative health impact, particularly for patients with type-2 diabetes mellitus (T2DM). The objective of the study was to assess the changes in dietary habits and lifestyle and how these relate to glycemic control in patients with type 2 diabetes (T2D), who attended Zagazig Diabetes Clinic, Sharkia Governorate, Egypt, during the COVID-19 pandemic. MATERIALS AND METHODS: A total of 402 patients with T2D were included in this cross-sectional study. A semistructured questionnaire was used to collect information on socioeconomic status, dietary habits, lifestyle changes, and previous medical history. Weight and height were also measured, and hemoglobin A1C levels before and after lockdown were compared. Data analysis was performed using the SPSS. To determine statistical significance, Chi-square test was used for categorical variables whereas, paired t-test or McN-Nemar test, as appropriate, was used to compare change in HbA1c before and after lockdown. Ordinal logistic regression was used to determine factors associated with weight change, whereas binary logistic regression was used to determine factors related with glycemic control. RESULTS: During the COVID-19 pandemic, 43.8% of the studied groups consumed more than their usual diet with an increase in fruits, vegetables, and immunity-boosting food; 57% depended on home-cooked food, 48.3% did not practice exercise. About 57% reported to have gained weight, 70.9% suffered from mental stress, and 66.7% reported inadequate sleep. Collectively, there was a statistically significant decrease in the percentage of good glycemic control in the studied groups (28.1% vs. 15.9%) before and after the COVID-19 lockdown, respectively (P < 0.001). Weight gain, physical inactivity, mental stress, and inadequate sleep were significantly associated with poor glycemic control. CONCLUSION: COVID-19 pandemic has had a negative impact on the lifestyle and dietary habits of the studied groups. Therefore, it is very important to ensure better diabetes management in this critical period.
Emergency versus elective cholecystectomy: Experience at a university hospital in the Eastern Province, Saudi Arabia
(2023) Amer, Nasser M.; Alarfaj, Mosab A.; Othman, Sharifah A.; Alshammary, Shadi; Alshammari, Eiman M.
Abstract: BACKGROUND: Laparoscopic cholecystectomy (LC), the procedure of choice for treating most gallbladder pathology, has become the most trusted elective procedure for treating gallstone disease because of its effectiveness and safety. While the timing is an important factor in those cases, our aim in this study was to compare emergency and elective LC, determine the differences in postoperative complications, and assess the conversion rate to open cholecystectomy. MATERIALS AND METHODS: This study included a total of 627 patients who had undergone laparoscopic cholecystectomy during 2017-2019 at King Fahd Hospital of the University (KFHU). Records of both emergency and elective cases were reviewed from Quadra-med (software package). All demographic data of the patients, presenting complaint, laboratory and inflammatory marker, type of the operation, intraoperative complications, procedure time, conversion rate from laparoscopic to open cholecystectomy, postoperative period, length of hospital stay, and pathological diagnosis were entered into an Excel sheet. The data was analyzed using SPSS 23.0. Qualitative variables were described as frequencies and percentages, and continuous variables were summarized with mean and standard deviation (SD). Chi-square test, t-test, and the Mann–Whitney U-test were applied to test for statistical significance at P ≤ 0.05. RESULTS: The mean age for patients undergoing elective LC was 39.94 years (SD=13.56) whereas, mean age of patients undergoing emergency LC was 40.64 years (SD=13.02). About 71% of cases in elective LC group were females compared to 55% in the emergency LC group. There was a significant difference in C-reactive protein (CRP) in relation to the type of surgery where P < 0.05. Twelve (1.9%) patients had subtotal cholecystectomy and two cases converted from LC to open. There was a significant association between postoperative complication and the type of surgery. The length of hospital stay (LOS) was also found to be significantly more in patients having emergency LC (6.0 vs. 4.5 d; P < 0.05). CONCLUSION: The relation between conversion to an open procedure and type of surgery (elective or emergency) in our study was nonsignificant. There was a significant association between preoperative CRP, postoperative complication, length of hospital stay, and type of surgery. Further multicenter studies are required for further investigation.
A rare invasive male breast cancer of nonspecific type presenting at a primary care clinic: Importance of early diagnosis and management
(2023) Mansoor, Nurulhana S.; Arifin, Farnaza; Kornain, Noor K.M.; Razalli, Mazuin M.
Abstract: Male breast cancer is a rare disease with an incidence rate of <1% of all breast cancer cases, and only 1% of all male malignancies. Men tend to present at an older age and with more advanced stages compared to women. We report a case of a 74-year-old man who presented at a primary care clinic with a right subareolar painless breast mass. A mammogram and core biopsy were performed. A diagnosis of right invasive breast carcinoma was rendered. The patient underwent a right total mastectomy with ipsilateral axillary lymph node dissection, which revealed an invasive ductal carcinoma of no special type (NST). Chemotherapy, radiotherapy, and hormonal therapy were included in the adjuvant treatment plan. In this report, we discuss the important role of the primary care physician (PCP) in early diagnosis and referral for definitive management. The PCP also plays an essential role in the holistic care of male breast cancer patients, including the management of physical, psychological, social, and underlying chronic diseases.
Prevalence of anemia in primary care patients with Type 2 diabetes mellitus and chronic kidney disease in Oman
(2023) Alsalmani, Asma A.; Alalawi, Nouf M.; Alsumri, Hana; Aljabri, Maha K.; Alharami, Ghassan; Alweshahi, Ruqaiya; Alhabsi, Aziza
Abstract: BACKGROUND: Previous research has highlighted potential associations between anemia, diabetes, and worsening kidney disease. The aim of this study, therefore, was to determine the prevalence of anemia in patients with both chronic kidney disease (CKD) and Type 2 diabetes mellitus (T2DM) at a primary care center in Oman. MATERIALS AND METHODS: A cross-sectional study was conducted at the Primary Care Clinic of Sultan Qaboos University Hospital, Muscat, Oman. All patients with established diagnoses of CKD and T2DM who attended appointments at the clinic in 2020 and 2021 were included. Data concerning the patients’ sociodemographic characteristics, medical history, clinical findings, and laboratory results during past six months were retrieved from the hospital’s information system. Patients were contacted via telephone for clarification in the event of any missing data. SPSS version 23 was used for Statistical analyses of the data. Frequencies and percentages were used to present categorical variables. Chi-squared tests were used to determine association between anemia and demographic and clinical variables. RESULTS: A total of 300 patients with T2DM and CKD were included in the study; 52% were male, 54.3% were 51–65 years of age, and majority (88%) were either overweight or obese. The majority of patients (62.7%) had Stage 1 CKD followed by Stage 2 (34.3%) and Stage 3 (3%). The total prevalence of anemia was 29.3%, with 31.4%, 24.3%, and 44.4% of Stage 1, Stage 2, and Stage 3 CKD patients being anemic, respectively. The frequency of anemia was significantly higher in female than male patients (41.7% vs. 17.9%; P < 0.001). No associations were observed between anemia status and other sociodemographic or clinical characteristics. CONCLUSION: The prevalence of anemia in CKD and T2DM primary care patients in Oman was 29.3%, with gender as the only factor significantly associated with anemia status. Routine screening of anemia in diabetic nephropathy patients is highly recommended.
Trends, characteristics, and impact of global scientific production on mental health of health workers in the context of coronavirus disease 2019 (COVID-19)
(2023) Puchuri-Lopez, Javier; Galvez-Sandoval, Manuel; Guerrero, Maria E.; Munive-Degregori, Arnaldo; Mauricio-Vilchez, Cesar; Barja-Ore, John; Mayta-Tovalino, Frank
Abstract: BACKGROUND: Healthcare workers are under significant constant stress as a result of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study, therefore, was to analyze bibliometrically the impact, trend, and characteristics of scientific production related to the mental health of health professionals during the COVID-19 pandemic. MATERIALS AND METHODS: A bibliometric analysis of the scientific production on the mental health of health professionals and COVID-19 in Scopus from December 2019 to December 2021 was performed. An advanced search was designed using Boolean operators in Scopus and applied in April 2022. The metadata was entered into Microsoft Excel for the elaboration of the tables, SciVal to obtain the bibliometric indicators, and VosViewer to plot collaborative networks. RESULTS: A total of 1393 manuscripts, 1007 of which met the eligibility criteria, were found on the mental health of health workers and COVID-19.The country with the highest academic production was the United States and Harvard University with 27 manuscripts as the most productive institution. The scientific journal with the highest scientific production was the International Journal of Environmental Research and Public Health with 138 manuscripts and 1580 citations, and the author with the most citations per publication was Carnnasi Claudia with 69.8. CONCLUSION: The countries with the highest economic income occupy the first places in scientific production on the mental health of health workers during the COVID-19 pandemic, with the United States as the leader. There is a gap in the scientific knowledge on the mental health of healthcare workers during the COVID-19 pandemic in middle- and low-income countries.

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