Maintenance Dose of Vitamin D: How Much Is Enough?

BACKGROUND: It is still unclear the ideal vitamin D dosage once the deficiency and insufficiency is treated. Once deficiency was corrected we prospectively treated patients with 2,000 IU of vitamin D3 to check whether this dosage is enough to keep them above the 30 ng/mL of 25-hydroxy-vitamin D (25[OH]D). METHODS: One hundred and thirty-five Saudi Arabian men and women treatment naïve for the vitamin D deficiency and insufficiency were part of this study. History and clinical examination were done to rule out any metabolic bone disease. Weight and height was taken to calculate the body mass index (BMI). Patients who were vitamin D deficient (≥30 ng/mL), a standard treatment of 50,000 IU of vitamin D3 weekly for 3 months, a blood test for the vitamin D levels at the end of 3 months, maintenance dose of 2,000 IU of vitamin D3 for 3 months and a third blood sample after 3 months. RESULTS: The data for 128 patients was available for analysis. The average age was 44.95±12.97 years with the mean BMI of 29.60±2.59 kg/m2. The baseline 25(OH)D level was 13.16±3.30 ng/mL. The increase in the level of 25(OH)D on 50,000 IU weekly was significant from 13.16±3.3 ng/mL to 36.97±4.67 ng/mL (P < 0.001) and then 2,000 IU daily for next 3 months, the level of 25(OH)D dropped top 20.38±5.42 ng/mL (P < 0.001). CONCLUSIONS: Our study indicates that the maintenance dose of 2,000 IU of vitamin D is not enough for patients to keep the 25(OH)D levels above 30 ng/mL.

Awareness, attitudes and background information about the surgical options in the treatment of obesity among the general adult population in Riyadh City, Saudi Arabia

Objectives: To assess the awareness, attitudes and background information about the surgical options in the treatment of obesity among the general adult population in Riyadh city, Saudi Arabia

Methods: In this cross-sectional study 420 adult residents from Riyadh from both genders were interviewed and given specifically designed questionnaire to assess their awareness about weight loss surgery and the attitude toward it as a method used in the treatment of obesity. Data were collected between September 2017 and December 2017. The questions highlighted 3 health status scales; 4 aspects including subject's demographics characteristic, personal weight, height and BMI, and their understanding about obesity and its causes and beliefs about weight loss surgery. Scores were analysed using SPSS

Results: More than 90% of the participant in this research identified at least three risk factors of obesity, and more than 90% of the participants had good knowledge about the lifestyle modification to prevent or reduce obesity, regarding the knowledge about bariatric surgery. Although [79%] of them knew the effectiveness of bariatric surgery as a method of reduction of weight; only [37.6%] thought that it will reduce mortality among obese people, [21.4%] knew that weight loss surgeries can result in complications but on the other hand [42.9%] of subjects thought that bariatric surgery can result in death The overall beliefs among the participants regarding the use of bariatric surgery as a method in the treatment of obesity was poor and only 38% had favourable beliefs about the surgery

Conclusion: the knowledge of subjects about obesity and its preventive measures were high but the favourable perceptions about Bariatric surgeries were low. These results indicated that efficient educational programs about obesity and bariatric surgeries are needed for control of obesity and its complications as well as increasing the availability of weight loss surgeries

Characteristics of Saudi patients with congestive heart failure and adherence to management guidelines in a tertiary hospital in Riyadh

There is limited data available on the characteristics of local Saudi patients diagnosed with congestive heart failure [CHF] and on their adherence to guidelines for managing the disease. This study aimed to fill this gap. Retrospective study of patients treated at King Abdulaziz Medical City from 20022008. The records were reviewed of subjects admitted secondary to heart failure [defined as systolic heart failure [ejection fraction < 55%] and/or heart failure with preserved ejection fraction diagnosed either clinically and/or by echocardiogram and/or cardiac catheterization] or who visited the outpatient department for the same complaint. Of 392 CHF cases, the mean age was 67.8 [12.8] years and the majority were males [53.1%]. Hypertension was the predominant comorbid illness, accounting for 84.9% of cases, followed by diabetes mellitus type 2 and hyperlipidemia. Almost three-fourths [73.7%] of the subjects had mild to severe left ventricular dysfunction, with 68.5% of the cases having right ischemic cardiomyopathy. Spironolactone, exercise and vaccination were the the least least adhered to recommendations [30.0%, 20.5% and 15.2%, respectively]. The study highlights the need for proper education of patients and caregivers to increase compliance to medications. Physicians are also encouraged to undergo continuing medical education and training courses to properly implement current recommendations in the management of heart failure. Further studies are needed on a larger scale in order to formulate an effective management scheme that will address the current challenges faced by both clinicians and CHF patients.