Reactivation of Herpes Zoster in a Young Patient With Multiple Sclerosis Under Dimethyl Fumarate Treatment and Normal Lymphocyte Subsets Count: A Case Report.

Herpes zoster (HZ) infection results from the reactivation of the varicella-zoster virus (VZV), which remains dormant in the dorsal root ganglia after an initial chickenpox infection. Although HZ appears more common in people with multiple sclerosis (MS) than expected in the general population, few studies have investigated this association, particularly with a normal absolute lymphocyte count (ALC). Additionally, no reported cases have discussed the clinical presentation of such patients. This report describes the case of a 26-year-old female with a known history of relapsing-remitting MS on dimethyl fumarate (DMF) treatment. She presented with a history of painful erythematous blisters, diagnosed as acute HZ infection with a normal ALC. This case provides evidence that warrants further research and attention to the management of patients with MS receiving DMF, particularly regarding infectious risks. It highlights the importance of pharmacovigilance and the potential benefits of VZV and HZ immunization in DMF recipients.

Patient Trust in Primary Care Physicians: A Mixed Methods Study of Persons with Diabetes at University- Based Clinics in the Eastern Province of Saudi Arabia.

Background: The establishment of patient trust in physicians is becoming increasingly valuable. Trust can be fundamental to successful patient care, favorable patient outcomes and improved financial savings for healthcare organizations. This study aims to explore patients' perceptions of trust in physicians, determine factors that play a role in this relationship, and to identify ways to improve patient trust. Methods: The study was conducted via a mixed-method design using semi-structured in-depth interviews until data saturation was reached (n=24), followed by a cross sectional survey of consecutive sampling until the number of participants (n=256) exceeded the required sample size. Adult patients with diabetes, aged 18-65, attending internal medicine (IM) or family medicine (FM) clinics of King Fahd Hospital of the University, Saudi Arabia were included in the interviews and surveys. Patients' interview transcripts were analyzed into trust dimensions resulting in a 51-item scale. Quality function deployment (QFD) was used to define the highest priority patient requirements. Overall satisfaction was calculated as a satisfaction percent, and factors related to satisfaction were tested using independent samples t-test and ANOVA. Results: Significant domains for establishing patient trust in physicians were the perceived physician's competency level, comprehensiveness of care, morals, personal traits, and establishing continuity of care. The trust score ranged from 42.0% to 100% with an average of 90.4%. There was no difference between the FM and IM setting, nor between the sociodemographic factors and the patients' satisfaction level. No statistically significant results were found between diabetes type, years of diagnoses, achieving the target HbA1c with patients' satisfaction level and trust. Patients reporting hypo or hyperglycemic symptoms had lower levels of satisfaction than those who did not. Conclusion: Persons with diabetes were more trustful of primary care physicians if they displayed satisfactory communication skills, experience, and a caring attitude.

Prevalence of Obesity and Cardiovascular Risk Factors Among Type 2 Diabetes Mellitus Patients in Al-Khobar, Saudi Arabia.

BACKGROUND: The prevalence of obesity has grown significantly worldwide. It is considered a major cardiovascular risk factor among type II diabetes mellitus (T2DM) patients. OBJECTIVES: The main objective of this study is to determine the prevalence of obesity in patients with T2DM at King Fahd University Hospital (KFUH), Al-Khobar, and to assess the relationship between T2DM and cardiovascular risk factors with body mass index (BMI) and waist to hip ratio (WHR). METHODS: A retrospective, cross-sectional study, included T2DM patients from the Internal Medicine department at KFHU. The investigators recorded patient demographics (age and gender), weight (kg), height (cm), body mass index (Kg/m2), waist and hip circumference (cm), smoking status, physical activity, blood pressure measurements (mmHg) and laboratory results of fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and lipid profile. RESULTS: Among 346 patients, the prevalence of obesity and overweight was 62.4% and 27.2%, respectively. The relationship between BMI and demographic data including age and gender was statistically significant (P<0.05). The correlation between the BMI with cardiovascular risk factors including smoking, physical activity and WHR found to be statistically significant (P<0.05). CONCLUSION: Our study showed that obesity and overweight affect 89.6% of patients with T2DM. Therefore, it is important to take into consideration weight control strategies to effectively manage diabetic patients.

"Webside" healthcare from medical interns' perspective: Telemedicine implementation and need for training.

BACKGROUND: Telemedicine involves the use of electronic communication and technology to remotely deliver clinical services to patients. With the increase in the adoption of telemedicine in healthcare delivery, "webside healthcare" is becoming the virtual analog of bedside care. The Ministry of Health in Saudi Arabia has recently established the use of telemedicine, including social media (SM) and medical applications (Apps) to enhance the quality and accessibility of healthcare services to patients and healthcare providers. In the present study, we evaluated medical interns' perception of the use of telemedicine, SM, and medical Apps in patient care, their awareness of related guidelines to find out if targeted training is needed. MATERIALS AND METHODS: A qualitative study recruited and interviewed, through semi-structured key informant (KI) interviews and focus group discussions (FGD), a total of 24 male and female medical interns. The Interns were purposefully sampled from all Saudi Arabia's 5 main geographical regions until data saturation was observed. The transcripts of five KI interviews and 6 FGDs done were thematically analyzed and are presented as themes and subthemes. RESULTS: Medical interns discussed the advantages and disadvantages related to telemedicine, SM, and medical Apps in healthcare services. Overall, interviewees appreciated the role telemedicine, SM, and medical Apps play in the healthcare and for such particular specialties as family medicine and (tele-) psychiatry. However, the interns believed that training on the technical operational aspects of different telemedicine modalities with an emphasis on targeted education for related ethical and legal regulating guidelines was vital. CONCLUSION: Most interviewed medical interns had a positive perception of telemedicine and were willing to use it in their daily clinical practice. However, there were some challenges to its successful implementation such as prompt training on its proper use and clear ethical and legal guidance.

Prevalence of color vision deficiency in medical students at a Saudi University.

BACKGROUND: Color vision deficiency (CVD) affects approximately one in 12 men and one in 200 women in the world. It is considered a problem in the medical field since the color is often used as a sign in the practice of medicine, in observational assessment, diagnosis, and follow-up. These conditions make the appreciation of color essential in doctors' lives, thus we aimed at finding the prevalence and predictors of CVD in medical students. MATERIALS AND METHODS: This cross-sectional study included 1115 medical students. A pretested questionnaire consisting of personal data, history of vision problems, familial color vision defect, eye surgery, bad trauma on the head or eyes, drugs taken or chemicals exposed to, other health problems, and whether sufficient amount of Vitamin A is taken was used. This was followed by the screening of the participants for CVD using the Ishihara 15-plates test. RESULTS: A total of 1115 students participated in the study; 52.2% were females and the mean age of the participants was 21.7 years (±1.4). The prevalence of definitive CVD was found to be 2.1%; all of which comprised males. Eighty-seven percent of the affected participants were not aware of their color vision problem. A highly statistically significant association was found between history of vision problems and CVD status (P < 0.008). No association were found for nationality, marital status, family history of CVD, history of eye surgery, and eye trauma. CONCLUSION: The percentage of CVD in the present study is lower than that reported by previous studies done in other countries. Many medical students with CVD remain unaware of their condition. Therefore, we recommend early screening of all school-age children, and proper counseling of medical students with definite CVD to take care of their own health and wellbeing.