Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia

To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis [DKA]. In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 [Phase 1]. From the case files, we obtained information related to patients' age, gender, weight, presenting complaints, serum biochemical profile, and management. This study included 373 DKA admissions with a median age of 11 years [interquartile range [IQR]: 8-13]. The patients in the subgroup of age more than 10 years old had the highest proportion of admissions [n=250, 67%, p<0.000]. The median duration of diagnosis of diabetes mellitus [DM] was 3 years [IQR: 2-6]. New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours. The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies

Influence of pediatric disease severity on parental report of children admitted in a tertiary care center PICU

The objective of this study was to assess influence of the severity of diseases on parental assessment of their child's health care issues. A cross-sectional study. Pediatric ward [PW]/ Pediatric Intensive Care Unit [PICU] at a 1000 plus bed University affiliated hospital. During the study period of 45 days, we offered the parents/guardians of all children who had been hospitalized for 5 to 10 days to participate and provide responses to 37 items that were divided in five categories. The participants [n=99] comprised of two groups: PICU [n=35] and PW [n=64]. Responses were analyzed using SPSS statistical software; differences were considered significant at P

Evaluation of off-service rotations at National Guard Health Affairs: results from a perception survey of off-service residents

"Off-service" clinical rotations are part of the necessary requirements for many residency training programs. Because these rotations are off-service, little attention is given to their structure and quality of training. This often leads to suboptimal educational experience for the residents on these rotations. The aim of this study was to assess medical residents' perceptions, opinions, and levels of satisfaction with their "off-service" rotations at a major residency training site in Saudi Arabia. It was also to evaluate the reliability and validity of a questionnaire used for quality assurance in these rotations. Improved reliability and validity of this questionnaire may help to improve the educational experience of residents in their "off-service" rotations. A close-ended questionnaire was developed, Pilot tested and distributed to 110 off-service residents in training programs of different specializations at King Fahad Naitonal Guard Hospital and King Abdulziz Medical City, Riyadh, Saudi Arabia, between September 2011 and December 2011. A total of 80 out of 110 residents completed and returned the questionnaire. Only 33% of these residents had a clear set of goals and educational learning objectives before the beginning of their off-service rotations to direct their training. Surgical specializations had low satisfaction mean scores of 57.2 [11.9] compared to emergency medicine, which had 70.7 [16.2], P value [0.03]. The reliability of the questionnaire was Cronbach's alpha 0.57. The factor analysis yielded a 4-factor solution [educational environment, educational balance, educational goals and objectives, and learning ability]; thus, accounting for 51% variance in the data. Our data suggest that there were significant weaknesses in the curriculum for off-service clinical rotations in KAMC and that residents were not completely satisfied with their training

Risk factors assessment for hypertension in a squatter settlement of Karachi

To assess the risk factors for hypertension in adults [age more than 15 years] in a squatter settlement of Karachi. Cross-sectional survey of adults more than 15 years old in a squatter settlement of Karachi through random sampling method. A total of 327 adults were approached, 165 [50.5%] were males and 162 [49.5%] females. Blood pressure was measured in 63 [38%] males and 135 [83%] females. Out of which, 11 [17.5%] males and 19 [14%] females were screened hypertensive. Hypertensives were older as compared to normotensives [p<0.001]. The mean BMI of hypertensives [25.6 + 4.5 kg/m2] was significantly higher [p=0.008] than normotensives [22.9 + 5.0 kg/m2]. Hypertensives were 9.7 times more likely to be diabetic as compared to normotensives in this study [p<0.001]. On analyzing the relationship of hypertension with other variables, no significant difference was noticed for education [p=0.68], smoking status [p=0.46], family history [p=0.31] and occupation [p=0.27]. Prevention and control of hypertension is essential as the life expectancy is increasing in developing countries as well. The main emphasis according to this study, should be on controlling the BMI through weight reduction and regular exercise. Awareness about the risk factors for hypertension among the population is required to decrease the double burden on the society

Relation of body mass index with lipid profile and blood pressure in young healthy students at Ziauddin medical university

This study was conducted to assess serum lipids in healthy young subjects in relation with their BMI. Students of Ziauddin Medical University were assessed for anthropometric measures, blood pressure and lipid profile at the time of their admission for MBBS program. Out of 426 students all parameters were available for 301 students and they were selected for analysis in this study. Mean serum cholesterol in 301students was 149.3 +/- 31.3 mg/dl, mean LDL-C was 91.3 mg/dl +/- 27.7, mean HDL-C was 40.0 mg/dl +/- 42.2, mean triglycerides were 89.9 mg/dl +/- 42.2, mean systolic blood pressure was 113.1 mmHg +/- 13.5 and mean diastolic blood pressure was 74.0 mmHg +/- 8.1. The mean BMI of students was 21.6 Kg/m2 +/- 4.2. Among 301 students, 88 were underweight, 175 were normal and 38 were overweight according to their BMI. We found no significant difference in mean serum cholesterol and LDL-C while there were significant difference in mean serum HDL-C, triglycerides, systolic and diastolic blood pressure among the three BMI groups. In our study, there are high numbers of at-risk individuals. Therefore, strategies should be designed for weight reduction in children and adults to prevent cardiovascular disease