Inter-relation between diabetes mellitus and hypertension in terms of incidence and prediction in Saudi Arabia: a retrospective cohort study.

BACKGROUND: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are interconnected metabolic disorders with escalating global incidence and prevalence. However, no longitudinal studies have specifically examined the incidence of HTN and T2DM in the same study population. This study aimed to elucidate the association between HTN and T2DM and ascertain their respective roles in the development of each other. METHODS: This retrospective cohort study encompassed 809 Saudi patients from primary healthcare centers in Al Madinah Al Munawarah, Saudi Arabia. The sample was stratified into three cohorts: 226 patients with HTN but without T2DM, 274 patients with T2DM but without HTN, and 309 patients devoid of both T2DM and HTN. Over a retrospective follow-up period of approximately 5 years, incidence density rates (IDR) were computed for HTN in the T2DM cohort, T2DM in the HTN cohort, and both HTN and T2DM in the control cohort. Multiple logistic regression analysis was employed to identify predictors of HTN and T2DM. RESULTS: The IDR of T2DM among patients with HTN stood at 73.9 (95% confidence interval [CI] 56, 92) per 1000 person-years, in contrast to 33.9 (95% CI 24, 44) per 1000 person-years in the control cohort (adjusted odds ratio [OR] = 7.1, 95%CI 3.55, 14.13). Conversely, the IDR of HTN among patients with type-2 T2DM was 55.9 (95% CI 42, 70) per 1000 person-years, while in the control cohort, it was 20.8 (95% CI 13, 28) per 1000 person-years (adjusted OR = 5.8, 95% CI 3.11, 11.09). Significant predictors of HTN in the logistic regression model encompassed age, smoking status, family history of HTN, T2DM status, and body mass index (BMI). Similarly, significant predictors of T2DM in the logistic regression model included age, sex, family history of T2DM, HTN, and BMI. CONCLUSION: This study unveils HTN and T2DM as mutually significant risk factors. The IDR of each condition in the presence of the other significantly exceeded that among individuals devoid of HTN or T2DM.

Association of Protein Tyrosine Phosphatase Receptor Type D and Serine Racemase Genetic Variants with Type 2 Diabetes in Malaysian Indians.

Introduction: Type 2 diabetes (T2D) candidate genes, protein tyrosine phosphatase receptor type D (PTPRD), and serine racemase (SRR) were suggested by a genome-wide association study (GWAS) in the Chinese population. Association studies have been replicated among East Asian populations. The association of PTPRD and SRR genetic variants with T2D in Southeast Asian populations still needs to be studied. This study aimed to investigate the association of PTPRD and SSR genetic variants with T2D in Malaysian Indian subjects. Methods: The single nucleotide polymorphisms (SNPs) of PTPRD (rs649891 and rs17584499) and SRR (rs4523957, rs391300, and rs8081273) were genotyped in 397 T2D and 285 normal Malaysian Indian subjects. Results: The homozygous dominant genotype of rs17584499 is frequent in diabetic patients (56.5%) compared to normal subjects (47.3%). In contrast, the homozygous recessive genotype of rs8081273 is more frequent among normal subjects (12.5%) than diabetic patients (5.6%). The dominant genetic model showed that PTPRD rs17584499 (CC) is a risk factor for T2D (OR = 1.42, P = 0.029), whereas the recessive genetic model showed that SRS SNP rs8081273 was protective for T2D (OR = 0.42, P = 0.003). Conclusion: This study confirmed the association of PTPRD rs17584499 genetic variations with T2D in Malaysian Indians. While the SRR rs8081273 (TT) genotype showed protection against T2D, more investigation in different populations is required to confirm this protection.

Outcomes of Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.

Chronic rhinosinusitis (CRS) is a prevalent health problem that affects many people around the world and can require surgical intervention if conservative therapy fails. Functional endoscopic sinus surgery (FESS) is a minimally invasive surgical procedure commonly used to manage CRS. The success of FESS depends on various factors, and larger studies are necessary to determine its efficacy in managing CRS in this population. This systematic review and meta-analysis of the available literature aims to provide a comprehensive assessment of the effectiveness of FESS in the Middle East. We followed the standards outlined by PRISMA and the Cochrane Handbook for systematic reviews. The primary outcome of interest was the quality of life (QOL), and the secondary outcome was the recurrence of CRS. This systematic review and meta-analysis was conducted, and sensitivity analysis was performed to examine the robustness of the results. Six studies were included. The review found that the QOL significantly improved (p < 0.001). Two studies reported recurrence of CRS after FESS, and data showed that the recurrence of CRS after surgery was 6%. FESS is an effective intervention for CRS, but further research is needed on recurrence rates.

Functional Outcome of Subvastus versus Medial Parapatellar Approaches for Total Knee Replacement in Patients with Knee Osteoarthritis: A Prospective Cohort Study.

Background: Subvastus approach and medial parapatellar approach are two major approaches for total knee replacement (TKR). There is no global consensus on the superiority of either approach in terms of functional outcomes. Objective: The present study aimed to evaluate the functional outcome of TKR through subvastus approach and medial parapatellar approach by using patient-reported scores at 3-, 6-, and 12-month post-operative follow-ups. Methods: This prospective cohort follow-up study included patients with knee osteoarthritis who underwent elective primary TKR either through the subvastus or medial parapatellar approaches at King Abdullah Medical City, Makkah city, Kingdom of Saudi Arabia, from January 2019 to December 2022. Scores from the self-reported Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared in the two groups of patients at 3-, 6-, and 12-month post-operative follow-ups. Results: A total of 98 patients were included, of which 37 underwent TKR through the subvastus approach and 61 through the medial parapatellar approach. There was an overall significant change over time in both WOMAC and OKS scores (P < 0.001). Patients who underwent the subvastus approach had significantly higher mean of WOMAC and OKS than patients with the medial parapatellar approach at the 3- and 6-month follow-ups (P < 0.05), but not at the 12-month follow-up. Conclusions: For TKR, the medial parapatellar approach results in better functional outcomes at the 3- and 6- month follow-up periods compared with the subvastus approach.

An evaluation of the efficacy and the safety of home blood pressure monitoring in the control of hypertensive disorders of pregnancy in both pre and postpartum periods: a systematic review and meta-analysis.

BACKGROUND: Hypertensive disorders of pregnancy (HDP) can significantly impact maternal, neonatal, and fetal health. For controlling these disorders, frequent blood pressure measurements are required. Home blood pressure monitoring (HBPM) is a suggested alternative to conventional office monitoring that requires frequent visits. This systematic review was conducted to evaluate the efficacy and safety of HBPM in the control of HDP. METHODS: We systematically conducted databases search for relevant studies in June 2022. The relevant studies were identified, and qualitative synthesis was performed. An inverse variance quantitative synthesis was conducted using RevMan software. Continuous outcome data were pooled as means differences, whereas dichotomous ones were summarized as risk ratios. The 95% confidence interval was the measure of variance. RESULTS: Fifteen studies were included in our review (n = 5335). Our analysis revealed a superiority of HBPM in reducing the risk of induction of labor, and postpartum readmission (P = 0.02, and 0.01 respectively). Moreover, the comparison of birth weights showed a significant variation in favor of HBPM (P = 0.02). In the analysis of other outcomes, HBPM was equally effective as office monitoring. Furthermore, HBPM did not result in an elevated risk of maternal, neonatal, and fetal adverse outcomes. CONCLUSION: Home monitoring of blood pressure showed superiority over office monitoring in some outcomes and equal efficacy in other outcomes.

The Association Between Physical Activity and Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Multicenter Study From Saudi Arabia.

Background Peripheral diabetic neuropathy (PDN) is a serious consequence of diabetes mellitus (DM) that can impair quality of life and result in physical disability. This study aimed to investigate the relationship between physical activity and the severity of PDN among a sample of Saudi diabetic patients in Medina city, Saudi Arabia. Methodology A total of 204 diabetic patients participated in this multicenter, cross-sectional study. A validated self-administered questionnaire was distributed electronically to patients on-site during follow-up. Physical activity and diabetic neuropathy (DN) were assessed using the validated International Physical Activity Questionnaire (IPAQ) and the validated Diabetic Neuropathy Score (DNS), respectively. Results The mean (SD) age of the participants was 56.9 (14.8) years. The majority of the participants reported low physical activity (65.7%). The prevalence of PDN was 37.2%. There was a significant correlation between the severity of DN and the duration of the disease (p = 0.047). Higher neuropathy score was noticed in those with hemoglobin A1C (HbA1c) level ≥7 compared to those with lower HBA1c (p = 0.045). Overweight and obese participants had higher scores compared to normal-weight participants (p = 0.041). The severity of neuropathy decreased significantly when the level of physical activity increased (p = 0.039). Conclusions There is a significant association between neuropathy and physical activity, body mass index, duration of diabetes mellitus, and HbA1c level.

The degree of nicotine dependence among users of different tobacco and nicotine products in Madinah City, Saudi Arabia.

BACKGROUND: Nicotine addiction has many consequences. The World Health Organization has classified nicotine dependence as a disorder of substance use. This study aimed to assess the dependence in users of different tobacco and/or nicotine-containing products (TNPs). MATERIALS AND METHODS: This analytical, cross-sectional study involved 211 TNP users in Madinah, Saudi Arabia. The data was collected using a self-administered questionnaire that consisted of two main sections. The first section included sociodemographic domain, TNP status domain, and the Stages of Change model domain. The second section of the instrument included the ABOUT dependence construct comprising 12 items. Independent t-test, analysis of variance, and correlation analysis were used to assess the relationship between the study variables. RESULTS: Most users of TNPs exclusively used tobacco cigarettes (53.1%). Total dependence score was significantly associated with gender, marital status, age group, monthly income, nicotine concentration in electronic cigarettes (e-cigarettes) liquid, and the number of cigarettes smoked per day (P < 0.05). Total dependence score was correlated with the duration of TNP usage (r = 0.24, P < 0.001), Switching attempts to another TNP (r = 0.16, P = 0.020), attempts of quitting TNPs (r = 0.25, P < 0.001), and willingness to quit (r = -0.37, P < 0.001). CONCLUSION: Dependence was associated with gender, marital status, age group, monthly income, nicotine concentration in e-cigarette liquid, and the number of cigarettes smoked per day. It was also associated with duration of TNP usage, Switching attempts to another TNP, attempts of quitting TNPs and the willingness to quit.

Perception of Antibiotic Prescribing and Resistance Among Hospital Physicians in Medina City, Saudi Arabia.

Background Overuse or misuse of broad-spectrum antibiotics appeared to be a major cause of increased antibiotic resistance. This study aimed to explore awareness and knowledge of antibiotic prescribing and resistance among hospital physicians in Medina, Saudi Arabia. Methodology A cross-sectional study was conducted among 223 physicians in seven public hospitals in Medina, Saudi Arabia. A validated self-administered questionnaire was used, including questions on sociodemographics, awareness about the current scope of antibiotic resistance, knowledge and frequency of antibiotic prescribing, confidence and input seeking, factors influencing antibiotic prescribing, and attitude toward antibiotic use. t-Test and analysis of variance (ANOVA) tests were used to compare total knowledge scores across the sociodemographic variables. The level of significance was set at 0.05. Results Most participants were aware that antibiotic resistance is a problem in Saudi Arabia (87.4%) and worldwide (93.3%). The majority of physicians (77.6%) were classified as having moderate knowledge, the mean knowledge score on antibiotics was 4.41, and 26.5% of the respondents prescribed antibiotics more than once daily. Most physicians (91.4%) were confident in antibiotic prescribing, and 94.1% of them consulted (at least sometimes) colleagues before prescribing. Factors associated with knowledge were age (P = 0.001), educational level (P = 0.002), working years (P = 0.004), current position (P = 0.003), specialty (P = 0.023), duration since graduation from medical school (P = 0.002), and duration since the last qualification (P = 0.022). Conclusions The majority of physicians had a moderate knowledge level of antibiotics, and most of them were prescribing antibiotics more than two times per week. Most respondents agreed that antimicrobial resistance is a worldwide concern and that it is a problem in Saudi Arabia. This study recommends training and courses on the fact that appropriate antibiotic prescribing should be ensured to have the best practice in antibiotic prescription among physicians.

Stigmatization and discrimination against people living with HIV/AIDS: Knowledge, attitudes, and practices of healthcare workers in the primary healthcare centers in Madinah, Saudi Arabia, 2022.

BACKGROUND: There are very few studies in Saudi Arabia on stigmatization and discrimination against people living with HIV/AIDS (PLWHA), a critical step for the prevention and control of HIV. The aim of this study was to assess the level of stigmatization and discrimination against PLWHA by healthcare workers (HCWs) as well as their knowledge, attitude, and practices (KAP). MATERIALS AND METHODS: This cross-sectional study included 182 HCWs at primary healthcare centers in Medina, Saudi Arabia. The validated short version of the Healthcare Provider HIV/AIDS Stigma Scale and the AIDS Attitude Scale were used in this research. Student's t-test and analysis of variance (ANOVA) were used to assess the differences in the mean knowledge, attitudes, and practices KAP scores by various sociodemographic factors. Multiple linear regression analysis was used to determine factors associated with KAP scores. RESULTS: Most participants were males (58.2%) and aged more than 30 years (60.4%). The tendency to stigmatizing behavior was present in 24.2%-68.17% of the participants, and discriminatory practice was present in 11.5%-50% of the participants. In multiple linear regression analysis, factors that independently predicted the knowledge score were being a doctor compared to nurses (P < 0.001), receiving in-service training for PLWHA (P < 0.001), and male gender (P = 0.002). Attitude was predicted by being female (P = 0.008) and a doctor (P = 0.005). Practice was predicted by the knowledge score (P < 0.001) and being married (P = 0.035). CONCLUSION: This study found that stigmatization and discrimination were less prevalent in HCWs who had good HIV-related knowledge and had received in-service training for PLWHA. The results highlight the significance of continuing education and training opportunities for HCWs to provide effective and appropriate treatment to PLWHA.

Prevalence and Associated Factors of Burnout Among Saudi Resident Doctors: A Multicenter Cross-Sectional Study.

Background: Burnout is a prevalent psychological state among resident doctors. This study aimed at assessing the prevalence and associated factors of burnout among resident medical doctors in Medina, Saudi Arabia. Methods: This cross-sectional study was conducted among 426 resident doctors in Medina city, Saudi Arabia. We used the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) to measure this phenomenon. Results: Of the participants, 81.22% scored high on at least one subscale of burnout and 18.31% scored high on all the subscales of burnout. Burnout was related to lack of physical exercise (P < .001), level of training (P < .001), number of on-call shifts per month (P = .020), number of weekends on-call per month (P < .050), number of patients seen per day (P = .002), number of clinics per week (P < .001), satisfaction with work-life balance (P < .001), and sources of stress in the workplace (P < .050). Conclusion: Burnout is present among resident doctors at a relatively high rate. Numerous factors associated with burnout were evident, particularly work-related factors and sources of stress in the workplace. Therefore, the Saudi Commission for Health Specialties and the residency program directors should act to improve working conditions and work-life balance, and minimize the impact of stressors in the workplace, to minimize the consequences of burnout among resident doctors. Provisions could be enacted to implement early comprehensive assessments of burnout syndrome among medical residents for early detection to curb the burnout phenomenon within healthcare systems.

Comparison between Modified Bone-splitting Technique and Distraction Osteogenesis in Horizontal Alveolar Ridge Expansion: Randomized Clinical Study.

AIM: This study aimed to compare modified ridge splitting (RS) and distraction osteogenesis (DO) for horizontal ridge expansion clinically (bone width, pain, and soft tissue healing) and radiographically (bone width). MATERIAL AND METHODS: This randomized clinical trial was conducted on fourteen patients who had a partial edentulous narrow mandibular posterior alveolar ridge (not less than 4-mm width and 12-mm height). All patients were divided randomly into two equal groups: Group I was treated with a modified bone-splitting technique, and group II was treated with DO technique by the fabricated device as AlveoWider®, and without any graft material for both groups. All patients were followed up clinically to evaluate the increase of bone width at preoperative measurement (T0) and 6 months postoperative (T6), and radiographically by cone-beam computed tomography (CBCT) at T0, 3 months postoperative (T3), and T6. Descriptive and bivariate statistics were computed using the SPSS version (SPSS, IBM Inc., Chicago, IL, USA), and p ≤ 0.05 was considered an indicator of statistical significance. RESULTS: All patients were female. Patients' ages ranged from 18 to 45 years, with a mean age of 32.07 ± 5.87 years. Radiographically, there is no significant statistical difference in comparing between two groups for the creation of a horizontal alveolar bone; however, there was a highly significant statistical difference (p < 0.001) in each group between different interval periods (T0, T3, and T6) with mean start 5.27 ± 0.53, and 5.19 ± 0.72 at T0 reaching to 7.60 ± 0.89 and 7.09 ± 0.96 at T3, and slightly decreases to 7.52 ± 0.79 and 7.02 ± 0.79 in T6 with radiographic evaluation, and it represented clinically in each group with mean 3.57 ± 0.313 and 4.0 ± 0.58 at T0 increase to 6.55 ± 0.395 and 6.52 ± 0.45 at T6 for both groups, respectively. There is a statistically significant difference in soft tissue healing with the average mean of 4.57 ± 0.24 and 3.57 ± 0.509 and pain with an average mean of 1.66 ± 0.22 and 4.74 ± 0.55 with p = 0.001 and p < 0.001 when comparing between both groups, respectively, that is, p = 0.001 is considered to be statistically significant. CONCLUSION: Both techniques seem to be useful as augmentation techniques for dental implant placement in a narrow alveolar ridge. Techniques are sensitive and need good experience. The modified splitting technique has fewer complications, less pain, and better soft tissue healing when compared with the DO technique. CLINICAL SIGNIFICANCE: Both techniques are alternative methods for the treatment of the atrophic alveolar ridge with uneventful healing except for minor complications that do not interfere with dental implant placement.

Prevalence and associated factors of stress among primary health care nurses in Saudi Arabia, a multi-center study.

BACKGROUND: Nursing practice has been identified as one of the most stressful professions within the healthcare systems. The current study aimed to determine the prevalence of stress and its associated factors among primary healthcare nurses. MATERIALS AND METHODS: This analytical cross-sectional study was conducted among 200 Saudi nurses in the government primary health care centers in Medina city, Saudi Arabia. Stress was measured by the stress subscale of the 21-Item Depression, Anxiety and Stress Scale. Sources of stress were assessed by 15 items. RESULTS: The majority were females (68.0%) and aged less than 40 years (72.5%). Thirty percent had severe or very severe stress. Stress was associated significantly with the presence of chronic diseases (P = 0.037) and with working in night shifts (P = 0.042). All sources of stress in the workplace were associated significantly and positively with stress (P < 0.01). CONCLUSION: About one-third of the participants had stress. Improving work conditions and minimizing stress in the workplace should be a priority in the primary health care setting.

Workplace Violence Among Healthcare Workers in a Tertiary Medical City in Riyadh: A Cross-Sectional Study.

Introduction Workplace violence is a common problem that is encountered by healthcare workers worldwide; however, it is still under-studied in Saudi Arabia. This study aims to determine the prevalence of workplace violence and to explore reasons for not reporting it among healthcare workers in a tertiary medical city in Riyadh. Methods This cross-sectional study was conducted among 404 healthcare workers who had direct contact with patients or their relatives in a tertiary care medical city in Riyadh, Saudi Arabia. Data were analyzed using Statistical Analysis Software Package (SPSS; IBM, Armonk, NY, USA). Results Most participants (81.4%) had experienced verbal, physical, academic, or sexual violence. Approximately 39.6% of those who experienced workplace violence did not report the incident, and the most common reason for not reporting was identified as "reporting would not accomplish anything" (49.4%). About 27.5% of violence victims did not know how to report the incidents. Patients or their relatives were the main sources of violence across all violence categories except academic violence, in which consultant physicians were the main source. Conclusions The prevalence of workplace violence in the population studied was higher than anticipated compared to similar studies both in Saudi Arabia and globally. Almost half of those who were subjected to violence did not report the incident, believing that reporting would not change anything. There is arguably an urgent need to develop strategies that reduce workplace violence and facilitate reporting it in hospitals. Moreover, awareness programs regarding the negative impacts of violence against healthcare workers on the quality of care are necessary.

Burnout among nurses working in the primary health care centers in Saudi Arabia, a multicenter study.

BACKGROUND: Burnout is a common psychosocial phenomenon among nursing. It has been attributed to prolonged exposure to stress in the work place. This study aimed to determine the prevalence and associated factors of burnout among nurses in the primary health care centers in Saudi Arabia. METHODS: This cross-sectional study was conducted among 200 nurses by using a self-administered questionnaire. Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to measure burnout. RESULTS: Most participants were females (73.0%) and aged ≤35 years (52.0%). About 39% had high emotional exhaustion, 38% had high depersonalization and 85.5% had low personal accomplishment. About 89% (178) scored high at least on one subscale of burnout. Burnout was associated with age, educational level and sources of stress in the workplace. CONCLUSION: Level of burnout among nurses was high and was associated mainly with stressors in the workplace. Improving work environment and management of stress in the workplace should be a priority to minimize burnout among nurses.

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia. A cross-sectional study.

OBJECTIVES: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with pre-hospital delay. METHODS: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, and multivariate analysis were used to examine factors associated with pre-hospital delay. RESULTS: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). CONCLUSION: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the bene ts of availing an ambulance service.

Relationship of metabolic syndrome defined by IDF or revised NCEP ATP III with glycemic control among Malaysians with Type 2 Diabetes.

BACKGROUND: The chronic complications of Type 2 Diabetes (T2D) such as macrovascular disease is amplified with the increase in the number of metabolic syndrome (MetS) risk factors. This research aims to study the relationship of MetS, diagnosed by the International Diabetes Federation (IDF) or revised National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria, with glycemic control, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), C-peptide, and insulin resistance in T2D patients. METHODS: The study is a cross-sectional observational study which, involved 485 T2D patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. The MetS among the T2D patients was diagnosed based on IDF and revised NCEP ATP III criteria. C-peptide and HbA1c levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography, respectively. The MetS factors; FBG, triglyceride, and high-density lipoprotein cholesterol were measured by spectrophotometer. RESULTS: Application of the IDF and revised NCEP ATP III criteria respectively resulted in 73% and 85% of the T2D subjects being diagnosed with MetS. The concordance of these criteria in diagnosing MetS among T2D patients was low (κ = 0.33, P < 0.001). Both IDF and revised NCEP ATP III criteria indicated that T2D patients with 5 MetS factors had higher insulin resistance (P = 2.1 × 10-13; 1.4 × 10-11), C-peptide (P = 1.21 × 10-13; 4.1 × 10-11), FBG (P = 0.01; 0.021), and HbA1c (P = 0.039; 0.018) than those T2D patients without MetS, respectively. CONCLUSION: Although there is a low concordance between IDF and revised NCEP ATP III criteria in the diagnosis of MetS among T2D patients, both criteria showed that T2D patients with 5 MetS factors had higher insulin resistance, C-peptide, FBG, and HbA1c.

Knowledge and attitude of basic life support skills among female school teacher in Al-Madinah, Saudi Arabia.

BACKGROUND AND OBJECTIVES: Basic life support (BLS) is the care provided by first responders in case of cardiac or respiratory arrest in order to save someone's life. This study aimed to assess the knowledge and attitude of BLS skills among female school teachers in Al-Madinah. MATERIALS AND METHODS: This cross-sectional study was conducted among 302 female teachers in 24 governmental school Al-Madinah city in 2019 by using a self-administrated questionnaire. T-test and ANOVA test were used to compare mean knowledge scale across variables. RESULTS: The majority aged 41-50 years (46%). Only 30.5% had completed cardiopulmonary resuscitation (CPR) training and 73.9% had trained more than 2 years ago. Most of them (94.7%) wanted more training in CPR. The main reason to attend CPR training was to avoid unnecessary death (48.7%). The mean knowledge scale was (5.63 ± 1.49). There was a significant difference in the knowledge score between those who had observed CPR and those who had not observed CPR (P = 0.045). CONCLUSION: The knowledge and skills of BLS were low among female school teachers. Teachers' attitude toward CPR training was positive.

Gender and side distribution of urinary calculi using ultrasound imaging.

INTRODUCTION: Urinary calculi constitute a significant medical problem worldwide. Due to lack of previous studies on gender and side distribution of urinary calculi, the current study was conducted. PATIENTS AND METHODS: This retrospective study involved 590 urinary calculi from the electronic reports of 266 patients. Gender and side distribution were compared using Chi-square test. Relationship between gender and side of urinary calculi was analyzed using cross tabulation test. RESULTS: This study involved 590 urinary calculi reported in 266 patients. Among 590 calculi; 565 (95.8%) were in adults, and 25 (4.2%) were in children. Urinary calculi were in male in 397 (67.3%) and in female in 193 (32.7%). Calculi were 304 (51.5%) in right side, and 286 (48.5%) in left side. Exactly 507 (85.9%) of calculi were in the kidneys, and 83 (14.1%) in the ureters. No significant relationship between gender and side of the calculi (P = 0.238), (Odds ratio 0.869, 95% Confidence interval 0.615-1.226). CONCLUSION: Urinary calculi affect male more than female and adults more than children. No significant relationship between calculi and right or left side of the body.

Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes and is responsible for morbidity and disability among diabetic patients. OBJECTIVES: The aim of this study was to assess the prevalence of painful DPN and its associated risk factors in patients with diabetes mellitus. MATERIALS AND METHODS: A cross-sectional study was conducted among 430 diabetic patients attending primary healthcare centres (PHC) in AL Madinah city, Saudi Arabia. The validated Douleur Neuropathique-4 (DN4) questionnaire was used to identify the presence of painful DPN. RESULTS: The majority were female (54.7%) and had type 2 diabetes mellitus (74.9%). The prevalence of DPN was 30.1% in type 2 diabetic patients and 25.9% in type 1 diabetic patients with an overall prevalence of 29.1%. DPN was associated significantly with age, duration of diabetes milieus, uncontrolled A1c, and positive family history of diabetes mellitus (P < 0.05). All the investigated comorbidities were also associated significantly with DPN (P < 0.05). CONCLUSIONS: The prevalence of DPN was 25.9% and was associated with age duration of DM and uncontrolled HbA1c. PHC physicians treating diabetes should be more aware of the importance of screening for DPN and the treatment plan.

Risk factors associated with anorectal malformations development. A case-control study.

OBJECTIVES: To determine the risk factors for the development of anorectal malformations (ARM). Methods: This case-control study was conducted in the Maternity and Children Hospital (MCH), Al Madinah Al Munnawarah, Saudi Arabia. The sample was taken from the ARM cases admitted at MCH between January 2013 and December 2017. The controls were selected from well-baby clinics in primary health care centers. Parents of the cases and the controls were interviewed based on a questionnaire. Descriptive, univariate, and multivariate logistic regression were used in the analysis. Results: The study included 48 cases and 96 controls with 31 (64.6%) cases of isolated ARM and 17 (35.4%) cases of associated ARM. Among the ARM cases, 27 (56.3%) were males and 21 (43.8%) were females. In multivariate analysis, we found consanguinity to be associated with an increased risk of developing ARM with odds ratio (OR): 2.43, 95% CI: 1.12-5, and p=0.025, in addition to maternal obesity, with OR: 4.36, 95% CI: 1.2-15.8, and p=0.025. Conclusion: Consanguinity and maternal obesity (body mass index more than 30) were found to be risk factors for ARM development.