Knowledge and practices of fundoscopy among general practitioners in Qassim Province, Saudi Arabia, for the management of diabetic retinopathy and diabetic macular edema: A cross-sectional study.

OBJECTIVES: Blindness is one of the most widespread final pathways of diabetic retinopathy and its associated diabetic macular edema. The general practitioners are the first to encounter these diabetic patients. Fundoscopy is now considered as an ideal way for the diagnosis of patients with diabetic retinopathy. Therefore, this study was undertaken to know the ability and skills of general practitioners for the diagnosis and management of patients with diabetic retinopathy and diabetic macular edema. METHODS: This study was conducted in all major cities in Qassim province of Saudi Arabia during January to May 2017. A validated questionnaire was used to assess the general practitioners' knowledge and practice for the management of diabetic retinopathy and diabetic macular edema. Questions related to referrals, diagnosis, and treatment options to diabetic retinopathy and diabetic macular edema were asked to the general practitioners. RESULTS: Of 96 general practitioners, 76 returned the questionnaire with a response rate of 79.2%. Only 26.3% general practitioners referred patients with type 1 diabetes to ophthalmologists as per guidelines set by the American Academy of Ophthalmology, whereas 74% of general practitioners showed good knowledge for referring patients with type 2 diabetes to ophthalmology clinics. Lack of knowledge was also noticed for the treatment of diabetic retinopathy, as only 36.8% of general practitioners replied positive for dilated fundus examination option, whereas 78.9% of general practitioners chose laser photocoagulation as a treatment option. Similar response from them was observed for patients with diabetic macular edema. Furthermore, data also showed years in practice of general practitioners was well correlated with their knowledge for the management of diabetic retinopathy and diabetic macular edema. CONCLUSION: The general practitioners included in this study showed lack of knowledge in handling patients with diabetic retinopathy and diabetic macular edema. Therefore, refresher courses are needed that highlight the acquisition of their skills in fundoscopy.

Dupilumab side effect in a patient with atopic dermatitis: a case report study.

Atopic dermatitis (eczema) is a common chronic disease that is described as severe itching associated with recurrent eczematous lesions. In 2017 the US Food and Drug Administration approved dupilumab for treatment of adults with moderate to severe atopic dermatitis not well controlled with topical therapies or when other therapies are inadvisable. Dupilumab is a monoclonal antibody that inhibits interleukin-4 (IL-4) and IL-13 signaling by specifically binding to the IL-4R-alpha subunit shared by the IL-4 and IL-13 receptor complexes. There are many adverse effects reported after dupilumab therapy; commonly reported adverse effects include local injection site reactions, conjunctivitis, headache, and nasopharyngitis. Some adverse effects are rare, eg, alopecia areata and cicatricial extropion. We report a new case of a 28-year-old female who experienced face and neck rash after dupilumab injection.

Perception of primary health care providers of plastic surgery and its influence on referral.

OBJECTIVES: The aim of this study is to understand the level of knowledge and awareness of plastic surgery among primary health care (PHC) providers in Qassim region, Kingdom of Saudi Arabia. METHODS: This is a cross-sectional study conducted from February 2018 to March 2018 among health care providers in PHC in Qassim region, Saudi Arabia. Overall, 82 health care providers were recruited using simple random sampling. Filling the questionnaire was considered as approval to join the study. The study included general practitioners and family medicine specialists. Other specialties working in PHC were excluded from the study. RESULTS: In total, 82 physicians were enrolled in this study. Physicians considered that out of 28 listed disorders 16 of them have chosen a plastic surgeon as the best surgeon to perform the necessary surgery. The selection of plastic surgeon as the best doctor for a specific disorder was as follows: Burn deformities (93%), liposuction (87.7%), breast reduction/enhancement (86.8%), skin grating (84.4%), surgery for facial wrinkles (79.2%), electrical burns (71.6%), Botox (64.4%), cuts over the face (63.5%), abdominoplasty (62.9%), burns (59.4%), congenital anomalies of ear and nose (51.5%), deformities of leprosy (51.4%), sex change surgery (49.2%), non-healing wound over legs (47.1%), cleft lip and palate (41.7%), and totally, amputee thumb, finger, or hand (36.1%). The selection of other disorders was distributed almost similarly. CONCLUSION: General practitioners need more orientation for plastic surgery discipline. In this study, the majority of the study physicians do not have enough knowledge about the meaning of plastic surgery. As a PHC physician, knowledge about this topic is very essential because the patient is very likely to ask about the best surgeon for referral and the potential positive and negative effect of the reconstructive procedure.

Gender-specific differences in the awareness and intake of Vitamin D among adult population in Qassim Region.

BACKGROUND: Despite the abundance of sunshine throughout the year, Vitamin D deficiency is highly prevalent among different Saudi populations. The objective of the current study was to evaluate the awareness and intake of Vitamin D and their association among adults of both genders. MATERIALS AND METHODS: A cross-sectional study was done between June and August 2016 among adult patients and their family members (>18 years) presenting at 6 Primary Care Centers in the Qassim region, Saudi Arabia. RESULTS: A total of 500 study participants were included in the study; 54.6% of the participants were males and mostly aged most between 26-50 years. The majority of the participants had heard of Vitamin D (91.4%), believed in its importance for health (92.8%), were aware of the symptoms of Vitamin D deficiency (72.6%), and were able to identify exposure to sunlight (81.4%) and diet (70.4%) as sources. The sources of Vitamin D used by the participants were exposure to the sun (57.2%), Vitamin D-rich foods (51.2%) and supplements (18.8%). There was a significant association between overall awareness of Vitamin D and intake of at least 2 sources of Vitamin D in males (P < 0.001) but not females (P = 0.920). Although females had better awareness than males, exposure to the sun was much lower in females than males. CONCLUSION: As supplementation was very low in both genders, and since cultural factors that limit females' exposure to the sun are not easily modifiable, the current findings further underline the critical importance of Vitamin D supplementation, particularly in females in Saudi Arabia.