Risk Factors of Microvascular Complications Among Type 2 Diabetic Patients Using Cox Proportional Hazards Models: A Cohort Study in Tabuk Saudi Arabia.

Purpose: The burden of type 2 diabetes (T2D) is high in Saudi Arabia, but data related to its complications are limited. This study aimed to determine the incidence of microvascular complications caused by T2D and evaluate the impact of the associated risk factors. Patients and Methods: This retrospective cohort study was conducted at two military hospitals in Tabuk, Saudi Arabia. Data on the socio-demographics, glycaemic profile, blood lipid indices, duration of T2D, and associated microvascular complications were collected from electronic health records and medical files. Descriptive statistics and Cox proportional hazards models were used for data analysis. Results: This study included 1563 T2D patients. The incidence of microvascular complications was 34.3% (95% confidence interval [CI], 32.0-36.6). Retinopathy was the most common complication (incidence=20.0%; 95% CI, 18.0-22.0%), while nephropathy was the least common complication (incidence=12.2%; 95% CI, 10.6-13.8%). Advanced age (≥65 years) showed the highest risk of retinopathy (Hazard ratios [HR], 2.86; 95% CI, 2.56-3.21), neuropathy (HR, 2.70; 95% CI, 2.40-3.05), and nephropathy (HR, 2.37; 95% CI, 2.12-2.64) compared with their counterparts. After adjusting for potential confounders, the study found that the significant risk factors for microvascular complications were longer duration (≥10 years) of T2D (HR, 5.3; 95% CI, 5.1-5.6), uncontrolled hypertension (HR, 3.9; 95% CI, 3.3-4.2), poor glycaemic control (HR, 4.6; 95% CI, 4.3-5.1), obesity (HR, 2.3; 95% CI, 2.2-2.6), and dyslipidaemia (HR, 1.6; 95% CI, 1.2-2.0). Conclusion: Given the high burden of microvascular complications in military healthcare facilities in Tabuk, Saudi Arabia, a context-specific accessible public health program focusing on the promotion of a healthy lifestyle, physical activity, and consumption of a healthy diet, as well as the early diagnosis and management of diabetes, needs to be developed and implemented.

Investigating the incidence and risk factors of hypertension: A multicentre retrospective cohort study in Tabuk, Saudi Arabia.

BACKGROUND: Hypertension is a major global health concern affecting approximately 1.13 billion people worldwide, with most of them residing in developing countries. The aim of this study was to determine the incidence of different stages of hypertension and its associated modifiable and non-modifiable risk factors among patients in military-setting hospitals in Tabuk, Saudi Arabia. METHODS: This retrospective cohort study was conducted at two hospitals in Tabuk, Saudi Arabia. The data were collected from hospital electronic records from 1 January 2019 to 31 December 2019. The blood pressure levels of patients from the last three separate medical visits were recorded. Descriptive statistics and multinomial logistic regression were used for the data analysis. RESULTS: The study included 884 hypertensive patients. The incidences of stage of elevated BP, stage 1, stage 2, and hypertension crisis were 60.0, 29.5, 7.0, and 3.5 cases per 1000 persons. Multivariate analysis indicated that progression from the stage of elevated blood pressure to hypertension crisis was significantly associated with advanced age (odds ratio [OR] = 3.62, 95% confidence interval [CI] = 1.99-8.42), male sex (OR = 2.84, 95% CI: 0.57-5.92), and a positive family history of hypertension (OR = 1.95, 95% CI: 1.23-3.09). Other key determinants of the development of stage of elevated blood pressure to hypertension crisis were current smoking status (OR = 1.74, 95% CI: 1.23-4.76), and physical inactivity (OR = 6.48, 95% CI: 2.46-9.14). CONCLUSION: The incidence stage of elevated blood pressure was high among the patients investigated at armed forces hospitals in Tabuk, Saudi Arabia. The logistic regression model proposed in the present study can be used to predict the development of different stages of hypertension. Age, sex, marital status, family history, smoking status, and physical activity play an important role in the development of hypertension. Better strategies to improve awareness, screening, treatment, and management of hypertension are required in Saudi Arabia.

Road Traffic Injuries and Related Safety Measures: A Multicentre Analysis at Military Hospitals in Tabuk, Saudi Arabia.

BACKGROUND: Road traffic injuries are one of the major public safety issues around the world, as they put a great burden on countries' economies. Saudi Arabia has a good road transportation system, but still, road-related fatalities are higher in this country. The main purpose of this study was to determine the association between the severity of injuries caused by road traffic collision and safety measures taken by the drivers admitted to the emergency departments at two military hospitals in Tabuk, a city in Saudi Arabia. METHODS: A total of 342 male drivers who had injuries due to road traffic collision took part in this multicentre, cross-sectional study. The research sites were King Salman Armed Forces Hospital and King Khalid Armed Forces Hospital in Tabuk, Saudi Arabia. The data were collected using a common protocol and a self-reported questionnaire with the help of convenience sampling approach. Descriptive statistics and logistic regression analysis were done using IBM SPSS version 23. RESULTS: Nearly 62.0% of the male drivers were aged less than 36 years. About 90% of the drivers were from low- and middle-income groups. Logistic regression analysis indicated that drivers who had road traffic collision and used mobile phones while driving were four times more likely to have severe injuries (OR = 3.89; 95% CI (2.53, 5.95)), those who drove the vehicle at an excessive speed limit were three times more likely to have severe injuries (OR = 2.71; 95% CI (1.01, 4.97)), and those who attempted to overtake another vehicle were two times more likely to have severe injuries (OR = 1.85; 95% CI (1.24, 3.77)). CONCLUSION: Based on the results of the present study, the most important safety measures which contributed the most to road traffic collision were use of mobile phones while driving the vehicle, driving at an excessive speed limit, irregularity in maintaining the vehicle, attempt to pass other vehicles, and not following the traffic rules. All the safety measures are protective, but if care is not taken, they will risk the life. There is an urgent need to spread traffic safety awareness in this region.

Antibiotic resistance: a hospital-based multicenter study in Tabuk city, Kingdom of Saudi Arabia.

Background: During the 21st century, antimicrobial resistance (AMR) has emerged as one of the greatest public health challenges worldwide. In the coming 20 years, health care systems may be unable to treat bacterial diseases efficiently due to this phenomenon. Objective: To determine the level of knowledge regarding AMR among patients attending two hospitals in Tabuk city in northeast Kingdom of Saudi Arabia (KSA). Materials and Methods: This cross-sectional study was conducted at King Salman Armed Forces Hospital and King Khalid Armed Forces Hospital in Tabuk city. The study participants were selected from different outpatient departments using a simple random sampling technique. Data collection was performed using a self-reported questionnaire. All of the questions were closed-ended to facilitate study participation and were translated into Arabic. The data were entered into SPSS version 22 for Windows, cleaned and managed before analysis. Results: Our results showed that 26.85% of the respondents had knowledge regarding antibiotic resistance. Knowledge regarding the use of antibiotics for treating bacterial infection was good among participants (60%), but responses related to viral infection indicated confusion (23.06%), and misconceptions were observed. Several factors were significantly associated with knowledge regarding AMR among participants: 1) the use of antibiotics in the last year (OR: 2.102, CI: 0.654-6.754); 2) the discontinued use of antibiotics when feeling better (OR: 8.285, CI: 3.918-17.523); 3) giving antibiotics to friends or family members to treat the same illness ([False]: OR: 108.96, CI: 29.98-395.93) and 4) asking doctors to prescribe antibiotics that had been previously administered for the same symptoms (OR: 9.314, CI: 3.684-23.550). Conclusion: Our results revealed a very high unawareness of AMR and its contributing factors among the study participants. Thus, health education and awareness are highly and urgently recommended to address AMR in the Tabuk area.

Quality of life of women with breast cancer undergoing treatment and follow-up at King Salman Armed Forces Hospital in Tabuk, Saudi Arabia.

Background: Assessment of quality of life can significantly impact the diagnosis and treatment course of breast cancer, resulting in a better prognosis among patients. However, very limited data are available regarding quality of life among breast cancer patients in Saudi Arabia. Objective: To determine the quality of life of women with breast cancer referred to the Surgery Department of King Salman Armed Forces Hospital for treatment and follow-up. Materials and methods: This cross-sectional study used a questionnaire to assess the quality of life of 96 adult Saudi female patients diagnosed with breast cancer from January 2016 to September 2017. Results: One-third of the surveyed patients (31.3%) were >48 years of age, and 29.2% were in the 18- to 27-year age group. Regarding marital status, 35.4% of the women were married and 8.3% were single. The highest score was observed for the physical well-being subscale (7.65±071), followed by the spiritual well-being subscale (7.19±0.66), psychological well-being scale (7.09±0.30) and social concerns subscale (7.02±0.41). Age, marital status and cancer stage differed remarkably (P=0.00) for the physical well-being subscale scores. Meanwhile, employed women differed significantly (P=0.01) in terms of psychological well-being compared to those who were not employed. The social well-being subscale score of single and married women was significantly higher than that of widowed and divorced women. Women who underwent radiation and immunotherapy had significantly higher scores for the spiritual well-being subscale. Conclusions: Scores were determined for the physical, spiritual, psychological and social well-being scales. Age, marital status and cancer stage significantly influenced the physical well-being scale; the occupation status of the patients significantly impacted the psychological well-being scale. Social well-being can be predicted by marital status, and chemotherapy and radiation significantly impacted the spiritual well-being scale.

A Germline Mutation in the BRCA1 3'UTR Variant Predicts Susceptibility to Breast Cancer in a Saudi Arabian Population

Purpose: The impact of the BRCA1-3'UTR-variant on BRCA1 gene expression and altered responses to external stimuli was previously tested in vitro using a luciferase reporter assay. Its ability to predict breast cancer risk in women was also assessed but the conclusions were inconsistent. The present study concerns the relationship between the BRCA1-3'UTR germline variant rs8176318G>T and susceptibility to Breast cancer in an ethnic population of Saudi Arabia. Methodology: The study included 100 breast cancer patients and 100 sex matched healthy controls from the northwestern region (Tabuk) and Dammam of Saudi Arabia were investigated for the BRCA1-3'UTR germline variant rs8176318G>T using an allele specific PCR technique. Genotype distributions were then compared. Results: The frequencies of the three genotypes GG, TT and GT in our Saudi Arabian patients were 26%, 8% and 66% and in healthy controls were 45%, 5% and 50%, respectively (p=0.03). Risk of developing breast cancer was found to be significantly associated with the GT variant (OR 2.28, 1.24-4.191; RR 1.47, 1.11-1.93; P=0.007), GT+TT (OR, 2.32, 1.28-4.22; RR 1.48, 1.13-1.94; P=0.005) and the T allele (OR 1.62 , 1.072- 2.45; RR 1.28, 1.02-1.60: P=0.020). There were 2.76 and 2.28 fold increase risks of developing breast cancer associated with the TT and GT genotypes in our cases. A significant correlation was also found between the BRCA1 3'UTR variants with the stage of the disease and distant metastasis but not with age, grade, and ER, PR and her2/neu status. Conclusion : The rs8176318G/T in the 3'untranslated region (UTR) of the BRCA1 gene was found to be associatedwith increased susceptibility to breast cancer in our study population, increased risk being noted with the GT and TT genotypes. Further association studies are needed to confirm this finding in other regions of Saudi Arabia.