VOL.30 2023 Issue 4 (October-December)
Permanent URI for this collectionhttps://repository.iau.edu.sa/handle/123456789/1025
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Item Spinal cord compression secondary to intraspinal extramedullary hematopoiesis(2023) AlShamrani, Foziah J.; AlMohish, Noor M.; AlDawsari, Fahad A.; AlObaid, Jaafer J.; AlGhanimi, Ibrahim A.; AlNahdi, Abdullah A.Extramedullary hematopoiesis (EMH) is a rare cause of spinal cord compression (SCC) occurring in various hematological illnesses such as myeloproliferative disorders, thalassemias, and various types of anemia. EMH represents the growth of blood cells outside the bone marrow. Common EMH locations include the spleen, liver, lymph nodes, and paravertebral regions. When this occurs in the spinal cord, the mass effect can compress the spinal cord and cause different neurological symptoms depending on the area of the spinal cord affected. This report describes a 27-year-old female with a known case of beta-thalassemia major, who presented with mid-thoracic back pain, weakness, and paresthesia at the T10 level. In addition, this report illustrates the importance of considering EMH in the differential diagnosis of SCC in patients with thalassemia.Item Frequency and risk factors for headache disability: A population-based cross-sectional study in Egypt(2023) Elsary, Asmaa Y.; El-Sherbiny, Naglaa A.; Eldessouki, RandaBACKGROUND: A headache is a very common condition that can have a significant impact on one’s quality of life. It is one of the leading causes of years lived with disability worldwide. The objective of the study was to determine the prevalence of primary headache disability, its characteristics, risk factors and its impact on daily life. MATERIALS AND METHODS: A cross-sectional study was conducted in Fayoum governorate. The sample size was 1909 participants. A multistage random sample technique was used to select adults aged above 18 years. A self-structured questionnaire solicited information on sociodemographic characteristics, headache characteristics, and the headache disability index. SPSS v 22.0 was used for data analysis. RESULTS: Headaches caused complete disability in 19.5% of the study group, and 76.8% developed severe disability. Participants who reported that they had a headache more than once a week were; 44.5% had moderate pain and 40.2% had more intense pain. About 55% complained of attacks rather than continuous headache and were more likely to have a degree of complete disability, (P = 0.001). A statistically significant association was found between living in urban areas, working in professional occupations, complaining of severe headache in the form of an attack and seeking medical advice, with high scores of headache disability. CONCLUSION: Headache is a condition that affects the entire population in a way that causes high levels of disability. Good management is necessary for the reduction of the adverse effects of headaches on the health of the population. This should focus on raising public awareness by means of education and on the provision of basic healthcare.Item Risk factors associated with fatal thrombosis in hospitalized coronavirus disease 2019 (COVID-19) patients on anticoagulant therapy(2023) Kaliyeva, Sholpan; Yukhnevich, Yekaterina; Myasnikova, Zhanna; Simokhina, Natalya; Dyussembaeva, Nailya; Bikbatyrova, Yuliya; Drobchenko, Yelena; Sagadatova, Torgin; Semenikhina, PolinaBACKGROUND: The purpose of this study was to determine the factors that increase the risk of fatal thrombotic events in hospitalized coronavirus disease 2019 (COVID-19) patients receiving standard therapy according to the National Clinical Practice Guidelines (National Guidelines). MATERIALS AND METHODS: In this case–control study, cases included 83 adults with COVID-19 who had died from thrombosis and controls comprised 83 COVID-19 patients with comparable criteria who survived. Data was abstracted by reviewing the medical records of selected patients and analyzed using Statistica. Parametric and non-parametric tests, as appropriate, were used to compare continuos variables between cases and controls, whereas Chi-square test was employed to compare categorical variables. Odds ratio (OR) was also calculated to measure the strength of association of case status and various independent variables. RESULTS: Fatal outcomes were higher in patients with chronic tubulointerstitial nephritis, (OR = 2.4, 95% CI 1.2–4.9); obesity, (OR = 2.1, 95% CI 0.5–8.6); and coronary heart disease (OR = 1.6, 95% CI 0.8–3.2). In the group with a D-dimer level from 250 to 1000 ng/ml, a statistically significant moderate positive correlation was found between the day of death and D-dimer level (P = 0.026). The lack of use of the PADUA Prediction Score for the risk of venous thromboembolism scale (PADUA Scale) and control of laboratory parameters (APTT and D-dimer) were associated with increased risk of fatal outcome. Overall, 19.2% cases and 8.4% of controls had no coagulation control; (OR = 2.6, 95% CI 1–6.7). CONCLUSION: Chronic tubulointerstitial nephritis, obesity, and coronary heart disease were associatied with fatal thrombosis. A slight elevation of D-dimer level, lack of the PADUA Scale and laboratory monitoring in the management of hospitalized patients with COVID-19. was associated with an increased risk of thromboembolism.Item Impact of sodium-glucose cotransporter-2 inhibitors on kidney outcomes in type 2 diabetes: A tertiary center experience(2023) Tawhari, Mohammed H.; Aldahash, Raed A.; Almutairi, Faisal M.; Albogami, Mahdi S.; Rokon, Ahmad E.; Alsomali, Faisal A.; Alanazi, Khaled H.; Alshehri, Abdulrahman A.; Almutairi, Talal H.; Alharbi, Abdulrahman D.; Alghamdi, Rayan M.; Tawhari, Ibrahim H.; Salih, Salih A. BinBACKGROUND: Diabetic nephropathy (DN) is a complication of chronic hyperglycemia associated with diabetes mellitus (DM). Several studies have demonstrated the positive impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on kidney outcomes. The objective of the study was to evaluate the effects of dapagliflozin, an SGLT2 inhibitor, on kidney outcomes in Saudi patients with type 2 DM. MATERIALS AND METHODS: Study included all Saudi patients with type 2 DM who visited our center from August 1, 2021, to July 31, 2022, and had been on dapagliflozin for at least 3 months. Data was abstracted through chart review for all patients included in the study. Paired t-test or Wilcoxon signed-rank test were used to compare the results before and after treatment for continuous variables and the McNemar test was used to compare the results for categorical data. RESULTS: Study included 184 Saudi patients with type 2 diabetes with a mean age of 61.32 years (SD=9.37). Dapagliflozin 10 mg/day significantly reduced hemoglobin A1C (HbA1C) from a mean (SD) of 9.00 to 8.40 (P < 0.001). Among a subgroup of patients with significant proteinuria (n = 83), dapagliflozin significantly reduced ACR from a median of 93.1 to 64.9 mg/g (P = 0.001). Following treatment, the estimated glomerular filtration rate improved from a mean of 69.83 to 71.68 mL/min and the mean arterial pressure (MAP) fell from 90.03 to 89.06 mmHg, both were not statistically significant. Despite a statistically insignificant increase in the episodes of urinary tract infections (UTIs), the hospitalization rate declined. No episodes of amputations or ketoacidosis occurred during the study period. CONCLUSION: SGLT2 inhibitors had beneficial effects among Saudi patients with type 2 diabetes by improving diabetic control and lowering proteinuria. Dapagliflozin did not result in significant harm, including UTIs, amputations, and ketoacidosis.Item Health-related quality of life and its association with the symptom score and the thyroid function status of patients with primary hypothyroidism on replacement therapy(2023) Martin, Merina; Subramaniyan, Rani; Naik, Dhukhabandu; Ramamoorthy, Lakshmi; Lalthanthuami, Hmar T.BACKGROUND: A number of patients with primary hypothyroidism have reduced health-related quality of life (HR-QoL), even with optimum thyroid hormone replacement therapy. This study aimed to assess the HR-QoL of patients with hypothyroidism under replacement therapy and identify its relationship with the symptom score and thyroid function status. MATERIALS AND METHODS: Using a cross-sectional study design, 175 hypothyroid patients under replacement therapy who visited the Endocrinology Outpatient Department of a tertiary care center were selected by convenient sampling technique. Data was collected using a structured data collection tool comprising, HR-QoL Short Form-36 questionnaire, and Zulewski’s clinical score. Inferential statistical analyses were performed using Mann–Whitney U, Kruskal–Wallis, and Karl–Pearson Correlation tests. RESULTS: The overall mean quality of life score was 44.22 ± 12.14, with a substantial decline in role functioning because of physical health. A significant negative correlation (P < 0.05) was found between HR-QoL and hypothyroidism symptom score. A significant association was observed between participants’ HR-QoL and their dosage of thyroxine supplement (P < 0.05,) but no association was found with thyroid function status. CONCLUSION: There was a substantial reduction in the quality of life of the patients despite being on thyroid replacement therapy and achieving euthyroid status. This underlines the importance of symptom reduction and hormone optimization to enhance the quality of life.Item Attention-deficit hyperactivity disorder in Egyptian medical students and how it relates to their academic performance(2023) Shebl, Eman M.; Abu Bakr Elsaid, Noha M.; Hassan, Hend A.; Kamal, Doaa; Araby, EmanBACKGROUND: The neurobehavioral disorder, known as attention-deficit hyperactivity disorder (ADHD), is characterized by impulsivity, hyperactivity, and a lack of focus. In addition, it is connected to poor academic performance. The purpose of this study was to determine the prevalence of ADHD and its effect on their academic performance among medical students. MATERIALS AND METHODS: This web-based cross-sectional study was conducted among medical students of four medical colleges during December 2021 and April 2022. Data was collected using a self-administered questionnaire comprising Wender Utah Rating Scale and adult ADHD Self-Report Scale [ASRS]. The link to Google Form survey was distributed to students through academic emails and WhatsApp. Data analyzed using SPSS; Chisquare test or Fisher’s exact test as appropriate, were used to determine statistical significance. RESULTS: A total of 990 students filled online questionnaire; 54.7% were females.. The estimated prevalence of ADHD in Egyptian medical students was 11%. Students who had childhood ADHD were significantly linked with the present ADHD (r = 0.54, P < 0.001). There was a negative correlation between the ASRS score for ADHD and students’ GPA (r = 0.2, P < 0.001). No statistically significant association was observed between ADHD and sex, type of university, and academic level. of the students. CONCLUSION: ADHD is prevalent among medical students. Since most of our students with adult ADHD also had preexisting childhood ADHD, it is crucial that the primary care services, especially school health services, have appropriate standards for the early identification and management of ADHD. Health authorities should conduct a comprehensive health education campaign to raise public awareness of ADHD and its risk factors, the clinical picture, and the burden.Item Prevalence of long-lasting loss of smell and taste after coronavirus disease 2019 infection in Saudi Arabia(2023) Allhaiby, Nada M.; Allihybi, Sultan M.; Almhmadi, Amir H.; Alkot, Mohammad M.BACKGROUND: People with coronavirus disease 2019 (COVID-19) who experience symptoms for more than 35 weeks are said to have long COVID. Anosmia can occur on its own or in combination with other COVID-19 symptoms. Anosmia may be a significant differential presentation for the suspicion and diagnosis of COVID-19 in patients with asymptomatic-to-mild COVID-19 disease and may disappear in 3 weeks. This study sought to determine the prevalence of persistent loss of taste and smell following COVID-19 in Saudi Arabia. MATERIALS AND METHODS: A population-based cross-sectional study was conducted among Saudi citizens who had been diagnosed with COVID-19 for more than 2 weeks and had experienced a loss of taste and smell. Data was collected using a questionnaire having questions about demographics, long-lasting loss of taste and smell, whether this related to COVID-19 infection, and whether respondents had received the COVID-19 vaccine. SPSS was used for data analysis; statistical significance was determined using Chi-square test. RESULTS: A total of 383 Saudis who had a history of COVID-19 participated in the study. About 43.3% study participants had experienced persistent loss of taste and smell after COVID-19 infection. A significant association was found between loss of smell and the region, Northern region having highest proportion of study participants who had loss of smell and Western region having the lowest prevalence (34%). CONCLUSION: There were permanent changes in the sense of taste or smell in 34.3% of participants. This might add to the growing weight of long COVID.Item Association between fitness tracker use, physical activity, and general health of adolescents in Eastern Province of Saudi Arabia(2023) AlSayegh, Layla A.; Al-Mustafa, Maria S.; Alali, Ali H.; Farhan, Manal F.; AlShamlan, Nouf A.; AlOmar, Reem S.BACKGROUND: Physical inactivity is a major problem of adolescents worldwide. Fitness trackers are widely used technologies that assess physical activity and allow self-monitoring of daily activities. Thirty-five percent of the Saudi population is made up of adolescents, which makes them an important target population. Few studies have evaluated the association of fitness trackers with physical activity levels of adolescents. This study aimed to evaluate physical activity among adolescents and its relationship to their use of fitness trackers and overall health. MATERIALS AND METHODS: A cross-sectional study was carried out among adolescents in middle and high schools in the Eastern Province. Data was collected using a structured questionnaire and physical activity was assessed using International Physical Activity Questionnaire for Adolescents. Chi-square test and ANOVA were performed to test for statistical significance. Unadjusted and adjusted odds ratios (ORs) were obtained through ordered logistic regression models. Model diagnostics were run as post hoc analyses. RESULTS: Majority of participants (82.6%) had low physical activity levels, 12.2% had moderate and 5.2% had vigorous activity level. The model revealed that as participants’ ages increased, the odds of having higher levels of physical activity decreased (OR = 0.92; 95% confidence interval [CI]: 0.85–0.99). Moreover, participants who did not go to a gym regularly or own a fitness tracker were less likely to have higher physical activity levels (OR = 0.43; 95% CI:0.30–0.61, and OR = 0.44; 95% CI: 0.33–0.59, respectively). Motivation for using fitness trackers was mostly “no specific reason” for females. However, “luxury and esthetics” were mostly reported by males. CONCLUSION: Physical activity tends to be higher in younger adolescents who use fitness trackers, or go to the gym regularly, with no significant difference between males and females. However, the motivation behind adolescents’ use of fitness trackers varied by gender.Item Arabic Abstracts(2023)Item Violence against healthcare workers in the emergency departments of Al-Madinah hospitals, Saudi Arabia(2023) Al-Sayaghi, Khaled M.BACKGROUND: Workplace violence (WPV) directed against healthcare workers (HCWs) in healthcare facilities has always been neglected. These occupational hazards have been investigated in recent times and received greater attention from decision-makers. This study aimed to assess the WPV committed against HCWs in the emergency departments (EDs). MATERIALS AND METHODS: All the emergency department (ED) healthcare workers (HCW) in the hospitals of Al-Madinah Province, Saudi Arabia, were invited to participate in this cross-sectional study by completing an online questionnaire during May 15 to August 15, 2020. Information sought included characteristics of the participant and workplace, violence, the participants’ responses and emotions, the consequences of the WPV incident, and the level of satisfaction with the management of the WPV incident. Data was analyzed using SPSS; Chi-square test was used to assess the association between WPV and various participant and workplace characteristics. Binary logistic regression analysis performed to identify independent predictors of work place violence. RESULTS: A total of 250 HCW filled the questionnaire. One-third of the participants were victims of at least one violent event, mostly nonphysical. The perpetrators were primarily the patient’s companions, and a heavy workload/understaffing or an overcrowded environment was the main cause of the violence. The most frequent reaction was to call the hospital security. The emotions the participants experienced were disappointment, low self-esteem, and sadness. Most victims did not report the WPV incident because they believed that reporting was useless, insignificant, or they were fearful of adverse consequences. CONCLUSION: The rate of violence in EDs in Al-Madinah hospitals was lower than expected, and only 33.3% of HCWs had experienced a violent incident in the last year. However, there is a substantial margin for interventions to improve the situation and protect the HCWs in the EDs.Item Accuracy of body mass index compared to whole-body dual energy X-ray absorptiometry in diagnosing obesity in adults in the Eastern Province of Saudi Arabia: A cross-sectional study(2023) Alqarni, Amani M.; Aljabr, Abdullah S.; Abdelwahab, Moataza M.; Alhallafi, Ahmed H.; Alessa, Mustafa T.; Alreedy, Abdullah H.; Elmaki, Sara A.; Alamer, Naheel A.; Darwish, Magdy A.BACKGROUND: Obesity is a major health concern that requires accurate diagnosis and management. Body mass index (BMI) commonly used to diagnose obesity, has limitations in accurately assessing body fat. Body fat percentage (BF%) from whole-body dual energy X-ray absorptiometry (DEXA) scans is gaining popularity as a more accurate method in diagnosing obesity. MATERIALS AND METHODS: This cross-sectional study included 319 adult patients who underwent whole-body DEXA scans in the Eastern Province of Saudi Arabia from May 2016 to December 2021 were recruited from three medical centers, where data for whole-body DEXA were available. Body fat percent was obtained from the whole-body DEXA scan reports and were compared to BMI to evaluate prevalence of obesity. Data was extracted by reviewing patients’ records using a structured data collection tool. BMI was defined using WHO criteria, and diagnostic performance was assessed by estimating specificity, sensitivity, likelihood ratios, and predictive values, and by constructing receiver operating characteristic (ROC) curves for BMI to detect obesity by age group. RESULTS: The gender-specific BF% cutoff points revealed a higher prevalence of obesity than BMI cutoff points. BMI misclassified 40.6% of participants, and optimal cutoff points yielding highest area under the curve were 24 kg/m2 and 24.3 kg/m2 for males and females, respectively. CONCLUSION: The study underscores the importance of using accurate and comprehensive diagnostic tools such as whole-body DEXA scans to assess obesity.