Prevalence of depression among adults with sickle cell disease in the Southern Region of Saudi Arabia

Objectives: Sickle Cell Disease [SCD] as other chronic medical conditions is commonly complicated by psychiatric symptoms. Saudi SCD patients are usually originally from Eastern and Southwestern Provinces. The main objective of our study was to evaluate the prevalence of depression among adults with SCD in southern region of Saudi Arabia. We also studied the sociodemographic profiles for these individuals

Methods: We conducted a cross-sectional study among subjects [n=78] in Armed Forces Hospital, Southern Saudi Arabia using an Arabic version of a Hamilton Rating Scale for Depression HAM-D that has received widespread use and have undergone reliability and validity testing. The data were analyzed by SPSS 22 package program. Pearson's chi-squared test is used to examine the association between the categorical outcome variables A p-value less than 0.05 was considered statistically significant

Results: Most of the participants were young adults [26.4 +/- 9.2 years], single females not working who are originally from Jizan and Mahayel Aseer, Southern Saudi Arabia. The prevalence of depressive symptoms was 85.9%. When the association between depression in SCD patients and different demographic characters was tested, no significant relation between depression and any factors was discovered

Conclusion: This study confirms that depression is common in adult patients with SCD as confirmed by previous studies. On the other hand, socio-demographic factors were not significant predictors of depression in SCD patients. Further research is needed to explore the magnitude and impact of this problem at the national level

Expression of clusterin in colorectal carcinoma in relation to clinicopathological criteria

Background/Aim: Colorectal carcinoma (CRC) carries a high incidence of morbidity and mortality.Prognosis is related to nodal metastasis and stage. Clusterin is a widely distributed glycoproteinwith not yet fully understood functions. Clusterin may be overexpressed in some tumours or underexpressed in other tumours. The aim behind this study is to examine the relation of clusterincytoplasmic immunostaining to tumour characteristics, disease relapse, and survival in CRC. Materialsand Methods: Paraffin blocks of 133 CRCs were retrieved from the Department of Pathology,King Abdulaziz University, Jeddah, Saudi Arabia. Immunostaining was done using antibody toclusterin. Staining expression in 10% of malignant cells was used as a cut-off to determine lowimmunostaining and high immunostaining. Statistical tests were used to evaluate the association ofclusterin immunostaining with clinicopathological parameters. Results: Immunohistochemical resultsshowed clusterin low immunostaining in CRC and nodal metastases. No association was foundbetween clusterin immunostaining and tumour grade, age, tumour invasiveness, distant metastases,vascular invasion, nodal metastases, relapse, and survival. Conclusion: Our study showed low clusterinimmunostaining in CRC with lack of association with prognostic indicators in CRC. These resultsraise the controversy of understanding the role of clusterin in CRC. Further molecular studies arerequired to explore more about possible mechanisms of clusterin association with tumorigenicity,apoptosis, tumour growth progression, local and vascular invasion, and metastasis of CRC.

Perceived stress and its associated sociodemographic factors among physicians working in Aseer region of Saudi Arabia

Introduction: It is well acknowledged that health workers experience higher level of stress and stress related health problems than other occupational groups. Thus, measuring physician stress and understanding its related factors is a topic of importance with public health implications

Objectives: To measure the level of stress and to identify the socio-demographic and practice factors associated with stress among physicians in Aseer region

Study Design: Cross sectional study

Study Setting: Physicians in government health service, Aseer region, Saudi Arabia

Methodology: A self administered questionnaire based on Perceived Stress Scale [PSS] was used in the study. Study included 375 participants across three levels [resident, specialist, consultant] and six broad specialties [Surgical, Medical, Obstetrics / Gynaecology, Paediatrics, Dermatology, Emergency and ICU]; selected following a two stage sampling procedure

Results: A total of 303 physicians returned completely filled questionnaires. A high mean stress score was reported [18.07+/-5.1]. Though highest mean stress scores were found for dermatologists [21.00], no significant differences in stress was found based upon nationality, smoking status, presence of any chronic illness and specialty. Significantly more stress was found in females [df =301, t=3.68, p<0.001]; and singles as compared to married physicians [df=301, t=4.52, p<0.001]. ANOVA across multiple groups revealed significant difference in stress scores between younger age groups with F [2,300] =9.402; p=<0.001, ?[²]=0.05; mean=[19.10+/-4.91] and other age groups, and also between residents, F[2,300]=9.76; p<0.001; ?[²]=0.06, mean=19.34+/-4.81 as compared to specialists [17.04+/-5.30] and consultants [16.56+/-5.11]

Conclusion: Physicians in Aseer region experience high level of stress. Gender, age, marital status and position are significantly related to stress

Sleep Patterns and Predictors of Poor Sleep Quality among Medical Students in King Khalid University, Saudi Arabia

Background: Sleep problems and poor sleep quality are important issues for medical students. This study aimed to investigate the sleep patterns, measure the prevalence of poor sleep quality, and identify the predictors of poor sleep among medical students in King Khalid University (KKU), Saudi Arabia. Methods: This cross-sectional study enrolled 318 medical students during October– November, 2015. Participants were selected by convenience sampling and data were collected using self-administered questionnaires to obtain information regarding socio-demographic variables and indicators of sleep quality. Results: The overall mean sleep quality score was 6.79 with a standard deviation of 3.06. Poor sleep quality was reported by 74.2% students. Significantly high mean sleep quality scores (Pittsburgh Sleep Quality Index) were observed for students with very poor subjective sleep quality (mean = 10.50, SD = 2.58), least sleep efficiency (mean = 11.21, SD = 2.23), shorter sleep duration (mean = 7.83, SD = 2.88), sleep onset latency more than 30 minutes (mean = 7.82, SD = 2.53), sleeping after midnight (mean = 7.53, SD = 2.95), and use of sleep aiding medication (mean = 8.78, SD = 3.5). Significant differences were observed between good sleepers and poor sleepers regarding these sleep characteristics. Poor sleep was predicted by sleep behaviours such as going to sleep after midnight (AOR = 2.18, 95% CI: 1.20, 3.94) and sleep duration of less than seven hours (AOR = 7.49, 95% CI: 4.24, 13.22). Conclusion: Medical students of KKU have poor sleep quality. Longer sleep latency, going to sleep after midnight, and shorter sleep duration are important problems in this group.

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.

Hepatic vasculitis mimicking liver abscesses in a patient with systemic lupus erythematosus

Clinical and radiological liver diseases are uncommon in patients with systemic lupus erythematosus [SLE]. We report a 29-year-old female with SLE who presented with right upper quadrant abdominal pain, thrombocytopenia, elevated liver enzymes and multiple hypodense lesions in the liver on a computed tomography [CT] study that mimicked multiple liver abscesses. A liver biopsy showed mild chronic inflammation. Culture results were negative. With steroid therapy the patient improved clinically, the platelet count returned to the normal range and the multiple liver lesions disappeared radiologicaly. This patient represents a rare case of SLE that had hepatic vasculitis mimicking multiple liver abscesses