Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia.

We sought to define the type and antibiotic sensitivity response of pathogens isolated from diabetic foot ulcers based on ulcer location and Wagner classification. This retrospective analysis was done among 126 patients between 40 and 70 years of age at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, using the swab culture method for microbiological assessment. Data on demographic variables, ulcer sites (location), and depth of ulcer (Wagner classification) were also collected. A total of 134 pathogens were isolated from 126 patients. The most common gram-negative pathogen identified was Pseudomonas aeruginosa (15.6%), followed by Klebsiella spp (6.7%). The most common gram-positive pathogen was Staphylococcus aureus (35%), followed by Streptococcus (8.9%). The most widely accepted antibiotic to which the gram-negative bacteria were sensitive was gentamycin (20.1%), followed by ciprofloxacin (19%). The most routinely used antibiotic in the treatment of the gram-positive bacteria was erythromycin (16%), with trimethoprim-sulfamethoxazole (14.1%) being the next most effective. In conclusion, Pseudomonas aeruginosa, Klebsiella spp, Staphylococcus aureus, and Streptococcus were the most common causes of diabetic foot infections. However, the frequency of encountered pathogens and respective sensitivity to antibiotic therapy may be influenced by the location site and severity of the ulceration.

Diabetes Mellitus in Saudi Arabia: A Review of the Recent Literature.

The World Health Organization (WHO) has reported that Saudi Arabia ranks the second highest in the Middle East, and is seventh in the world for the rate of diabetes. It is estimated that around 7 million of the population are diabetic and almost around 3 million have pre-diabetes. Even more worrying perhaps, is the increasing pattern of diabetes noted in Saudi Arabia in the recent past. In fact, diabetes has approximately registered a ten-fold increase in the past three eras in Saudi Arabia. Diabetes mellitus (DM) has been found to be related to high mortality, morbidity and vascular complications, accompanied by poor general health and lower quality of life. In Saudi Arabia, DM is quickly reaching disturbing proportions and becoming a significant cause of medical complications and even death. However, when compared with the developed countries, the research work conducted, focusing particularly on the incidence, prevalence and socio-demographic properties of DM is woefully inadequate. The health burden due to DM in Saudi Arabia is predicted to rise to catastrophic levels, unless a wide-ranging epidemic control program is incorporated, with great emphasis laid on advocating a healthy diet, including exercise and active lifestyles, and weight control. To properly manage the DM in Saudi Arabia, a multidisciplinary approach is required. In this review we discuss all the aspects of DM in Saudi Arabia drawing from the published literature currently available.

Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt.

PURPOSE: To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. METHODS: Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA ≤ 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. RESULTS: This study included 1047 boys and 1023 girls, mean age 10.7 ± 3.1 years. Visual impairment (uncorrected VA ≤ 6/9) was detected in 29.4% of children, while 2.0% had moderate-severe visual impairment (uncorrected VA ≤ 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p < 0.05), with the highest prevalence in Abu Redis. Prevalence of visual impairment was significantly higher among girls (p < 0.05) and those with positive consanguinity (p < 0.05). Bedouin children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p < 0.0001). Ophthalmic examination revealed other disorders, e.g. dry eye (4.74%), squint (2.37%), exophthalmos (1.58%) and ptosis (0.79%). VA significantly improved in children who received spectacles (p < 0.001). CONCLUSION: A total of 29.4% of South Sinai children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.