Herpetic Whitlow Associated With an Eating Disorder: A Case Report.

Herpetic whitlow is a localized cutaneous viral infection primarily affecting the fingers, caused by herpes simplex virus types 1 (HSV-1) or 2 (HSV-2). It can be recurrent due to behavioral factors associated with eating disorders, such as bulimia nervosa. We would like to introduce "Jehany Sign," suggesting the term for the association of bulimia nervosa with HSV infections. Here, we present the case of a 50-year-old pre-diabetic female with recurrent herpetic whitlow on her left index finger associated with self-induced vomiting and extreme concern about her weight and body shape. Skin examination showed an eroded group of vesicles on an erythematous base on her left finger. The diagnosis was established through history and clinical examination. Upon follow-up, the patient showed complete resolution in one week after receiving topical and systemic acyclovir, which led to a subsequent referral to a psychiatrist for further management regarding bulimia nervosa. This case highlights the importance of a multidisciplinary approach and the complicated connections between eating disorders and dermatological diseases. Recognizing these allows healthcare providers to deliver more comprehensive care, improve patient outcomes, and further study in this area.

Internal jugular vein phlebectasia: A systematic review of therapeutic approaches in Pediatrics.

OBJECTIVES: Internal jugular vein phlebectasia (IJVP) is a rare type of vascular abnormality that causes dilatation of internal jugular vein in the neck. There is presently no consensus on the most effective method of treatment for this condition, that is commonly seen in children. We conducted a systematic review of the literature reported till date to comprehend the key features of IJVP and its most effective therapeutic modalities. METHODS: Five databases were searched until October 10, 2022 for articles of any design (including case reports) reporting IJVP in pediatric subjects. Individual patient data on demographics, clinical features of this entity and the differential diagnosis, methods of imaging, management, and outcome of illness were recorded. The quality assessment was performed using the Joanna Briggs Institute's Critical Appraisal Checklist for studies. RESULTS: A total of 51 articles including 169 cases were retrieved and included in the analysis. Of the 169 patients, most of them were male children, and in 77% of cases right internal Juglar vein was involved. All patients had some symptoms suggestive of IJVP with most common ones being neck swelling or tenderness, and difficulty in breathing. In 90% of cases, it was observed that the neck swelling typically increases in size with Valsalva maneuver. Once jugular vein phlebectasia was clinically suspected, ultrasonography, CECT, or color Doppler flow imaging were used to confirm the diagnosis. The management of most of the cases was either conservative or surgical, and in surgery mostly ligation was performed. There have not been any cases of serious complications, therefore, according to included studies, a conservative approach is recommended with continuous monitoring. Out of the 51 studies included, most of them had low risk of bias. CONCLUSION: Internal jugular vein phlebectasia, a rare benign condition, is most commonly found in children, and affects predominantly the right internal jugular vein. Although most patients did well with merely conservative treatment, still management of this vascular anomaly has to be on a case-by-case basis.

The Associations among Dental Anxiety, Self-Esteem, and Oral Health-Related Quality of Life in Children: A Cross-Sectional Study.

BACKGROUND: The current evidence on the relationships among child oral health-related quality of life, dental anxiety, and self-esteem indicates that we need to investigate these relationships to improve our understanding of the associations. Therefore, the current research aimed to enhance this evidence and provide an overview of the participating children's oral-health-related quality of life (as measured by the CPQ8-10), self-esteem (as measured by the Coopersmith SEI-SF), and dental anxiety (as measured by the CFSS_DS) and how these child-related outcome measures interacted and were related to one another. METHOD: A cross-sectional survey was conducted on a random sample of school children (n = 1900) aged 8 to 10 years. The questionnaire was collected through validated self-report measures: dental anxiety, COHRQoL, and self-esteem. Structural equation modelling (SEM) was used to test the strength of the association of our model to explore the relationships among these three psychological constructs. The moderating effects of age, gender, location, and the educational board were analysed for their possible influence on these relationships. RESULTS: Significant relationships between COHRQoL and child dental anxiety and between COHRQoL and SE were detected. The relationship subscale between COHRQoL and child dental anxiety was 0.24, (p < 0.001). A stronger correlation between COHRQoL, and SE was found, with B = -0.77, (p < 0.001). Although the association between CDA and SE was small, it was statistically significant (p = 0.03). These findings provide some important background information for designing effective educational programs for children.

Association between proton pump inhibitors and rhabdomyolysis risk: a post-marketing surveillance using FDA adverse event reporting system (FAERS) database.

Background: This research aims to explore and compare the signals of rhabdomyolysis from the use of Proton pump inhibitors (PPIs) using the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Rhabdomyolysis and related terms submitted between 2013 and 2021 were retrieved from the FAERS database. The data were analyzed using the reporting odds ratio (ROR), proportional reporting ratio (PRR), Empirical Bayes Geometric Mean (EBGM) and the information component (IC). The signals of rhabdomyolysis associated with PPIs use were detected in both 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) utilizers and non-utilizers. Results: A total of 7,963,090 reports were retrieved and analyzed. Fifty-seven reports linked PPIs to rhabdomyolysis out of 3670 reports from other drugs (non-statin included). The association of rhabdomyolysis and PPIs was significant in both statins included, and non-statin-included reports, although with varying degrees of association. The ROR was 2.5 (95% confidence interval [CI] 1.9-3.2) for PPIs in non-statin-included reports and 2 (95% CI: 1.5-2.6) for PPIs in statin-included reports. Conclusion: Significant signals of rhabdomyolysis were associated with PPIs. However, its signals were higher in non-statin-included reports compared to statin-included reports. Plain Language Summary: Plain language summaryProton Pump Inhibitors and rhabdomyolysis risk Background: The FDA created the FDA Adverse Event Reporting System (FAERS) database to support post-marketing surveillance programs. The FAERS is a computerized database with more than nine million adverse event reports, including all reports from 1969 to the present. This research aims to explore and compare the signals of rhabdomyolysis from the use of proton pump inhibitors (PPIs) using the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database.Research design and methods: We retrieved rhabdomyolysis and related terms submitted between 2013 and 2021 from the FAERS database. Then, we analyzed the data that we found. We detected the signals of rhabdomyolysis associated with PPIs use in both statins utilizers and non-utilizers.Results: We retrieved and analyzed a total of 7,963,090 reports. We found 57 reports linked PPIs to rhabdomyolysis out of 3670 reports from other drugs (non-statin included). The association of rhabdomyolysis and PPIs was significant in both statins included, and non-statin-included reports, although with varying degrees of association.Conclusion: Significant signals of rhabdomyolysis were associated with PPIs. However, its signals were higher in non-statin-included reports than in statin-included reports.

Exploring the Needs of Patients Undergoing Hemodialysis: A Qualitative Study.

BACKGROUND:  Many studies have focused on patients' experiences living with hemodialysis therapy; however, there is little research exploring their needs. Therefore, the purpose of this study was to explore hemodialysis patients' needs in Saudi Arabia. METHODS: A qualitative research design with semi-structured interviews was used. Data were collected from Aghrass Medical Center, Jeddah, Saudi Arabia. Data were analyzed using thematic analysis. RESULTS: A total of 16 hemodialysis patients underwent in-depth interviews. The mean age of the participants was 49 ± 14.93 years of age. More than half of the participants were male (56.25%), and most of them were married (75%). Regarding the clinical characteristics, all patients had three sessions in a week, and the average duration was four hours per session. The mean number of years on dialysis therapy was 3.80 ± 2.8. Using thematic analysis, four themes emerged. These were the impact of fatigue and need for fatigue self-management, need for family and social support, psychological and emotional support from healthcare professionals, and changes in the patients' role performance and their need for adaptation.  Conclusions: This study highlights the aspects of needs among hemodialysis patients from their own perspective. Four themes of needs emerged from this study. Consequently, healthcare professionals should assess patients' needs frequently to ensure high-quality care.

Efficacy and Safety of Luspatercept in the Treatment of ß-Thalassemia: A Systematic Review.

ß-thalassemia is characterized by the faulty generation of hemoglobin resulting in an elevated α/ß globin ratio; this led to several patients needing red blood cell (RBC) transfusions for the rest of their lives. Luspatercept is an erythroid maturation test for treating various types of anemia, including ß-thalassemia. It inhibits the Smad2/3 cascade and treats ß-thalassemia by downregulating the transforming growth factor-beta (TGF-ß) pathway. Luspatercept was evaluated in randomized controlled trials (RCTs). However, there is still limited data. Therefore, the study aims to review the current literature to assess the efficacy of luspatercept in cure ß-thalassemia and its safety. From 2015 to 2022, searches were undertaken in PubMed, Google Scholar, and Cochrane. Only RCTs published in English were eligible for inclusion. The Cochrane Collaboration tool for bias assessment was used to analyze the quality of the publications. Our search strategy revealed 94 publications, of which 12 full-text papers were read and five were chosen for this review.All five trials included 1161 participants. Of whom, 153 (13.18%) entered phase 2, and 1008 (86.82%) entered phase 3. Two articles included 153 participants, of whom 70 (45.75%) were transfusion-dependent beta-thalassemia (TD) and 83 (54.25%) were non-transfusion-dependent beta-thalassemia (NTD) of phase 2. Three articles included 1008 participants, of whom 672 (66.67%) were given luspatercept and 336 (33.33%) were given a placebo. All participants in RCTs were 18 years of age or older. In phase 2, 0.2 to 1.25 mg/kg of luspatercept was given, and in phase 3, 1.0 to 1.25 mg/kg of luspatercept was given once every three weeks. In beta-thalassemia patients, luspatercept was more effective than a placebo and well tolerated. The high dose has shown promising results in the erythroid response, measured by a drop in blood transfusions or an average rise in hemoglobin levels. Luspatercept might make patients less likely to need RBC transfusions, improve their clinical results, and improve their quality of life. Adverse events were hyperuricemia, arthralgia, dizziness, influenza hypertension, and bone pain, but they were manageable.

Post-CD19 Chimeric Antigen Receptor T-Cell Therapy Cytomegalovirus Retinitis.

The purpose of this case report was to present a case of cytomegalovirus (CMV) retinitis in a patient with diffuse large B-cell lymphoma (DLBCL) post-CD19 chimeric antigen receptor (CAR) T-cell therapy. A 43-year-old female patient who was complaining of metamorphopsia and sudden blurring in the vision of her left eye was referred to the ophthalmology department. The patient had DLBCL and was started on systemic chemotherapy, which showed no response to therapy and disease progression. Therefore, she was diagnosed with primary refractory DLBCL and treated with CAR T-cell therapy. The visual acuity of the left eye was 20/25 in the left eye on the Snellen visual acuity chart. The dilated fundus examination of the left eye demonstrated a diffuse yellowish retinal infiltration radiating from the optic disc involving the inferior macula and inferotemporal arcade. A color fundus image of the left eye showed a creamy infiltrate involving the inferior half of the macula sparing the fovea with subtle small white lesions in the midperiphery. Horizontal cross-section optical coherence tomography (OCT) of the macula of the left eye showed islands of destruction of all the retinal layers, which are replaced with moderately hyperreflective material; these infiltrates spare the fovea but with subfoveal fluid. Further systemic evaluation indicated CMV viremia reactivation and an absolute CD4+ cells count of 13 cells/mcL. Thus, she was diagnosed with CMV retinitis. After three days of the initial presentation, she received the first intravitreal ganciclovir injection; 17 days after presentation, she received five intravitreal ganciclovir injections. The patient responded well to intravitreal ganciclovir therapy. She regained very good vision, and the visual acuity was 20/20 in both eyes. Early recognition and initiation of proper treatment are crucial. Thus, any visual complaints in patients with immunodeficiency should be taken seriously and should be further assessed. As the right eye had retinal scaring indicating previous retinitis, prophylactic treatment with ganciclovir could have been used to reduce the risk of retinitis development in the left eye.

The pragmatic functions of emojis in Arabic tweets.

Emojis have been used on different platforms and in different languages to express feelings and emotions in online communication, which has led to their widespread familiarity among social media users worldwide. The current study is concerned with the pragmatic functions (speaker and contextual meanings) of emojis in Arabic tweets. The study used mixed methods to analyze the use of emojis and emoji position to identify their functions and possible gender similarities and differences. The dataset of this study consists of 421 Arabic tweets by Arab users at the beginning of 2022 (149 by male users and 272 by females). This study addressed three questions: (1) What are the common emojis used in Arabic tweets and their position in the tweet? (2) What are the pragmatic functions of these emojis? (3) What are the possible differences and similarities between male and female users in the use of emojis? The findings revealed that Loudly Crying Face, Red Heart, Face with Tears of Joy, Broken Heart, Smiling Face with Heart-Eyes, Pleading Face, Slightly Smiling Face, Pensive Face, and Weary Face were preponderant in Arabic tweets. Also, this study found seven pragmatic functions ranging from the most to the least frequent: Multiple functions, Reaction, Action, Decoration, Physical action, Softening, and Tone modification. Regarding the role of gender, there were both similarities and differences in terms of the frequency of emoji use, emoji position, and function. Moreover, the findings showed the importance of context to interpreting the functions of emojis. Finally, the findings have implications for emoji designers and Natural Language Processing (NLP).

Pneumocephalus resulting from chest infection complicated by pleural-subarachnoid fistula.

Pleural-subarachnoid fistula is a rare type of Cerebrospinal fluid fistula with less than 60 cases reported in the literature. Here we present a case of 55-year-old female patient, known case of acute myeloid leukemia on chemotherapy, who developed pleural-subarachnoid fistula due to invasive atypical apical lung fungal infection. All of the reported cases in the literature were secondary to trauma or post-surgery. To our knowledge, this is the first reported case of pleural-subarachnoid fistula developed as sequela of fungal infection.

Prevalence of colorectal cancer biomarkers and their impact on clinical outcomes in Riyadh, Saudi Arabia.

OBJECTIVES: KRAS, NRAS, and BRAF mutations are commonly present in colorectal cancer (CRC). We estimated the frequency of KRAS, NRAS, and BRAF mutations and assessed their impact on survival and other clinical variables among Saudi patients. DESIGN: Retrospective cohort study design. SETTINGS: Oncology department of a tertiary hospital in Riyadh, Saudi Arabia. We gathered information from 2016 to 2018. PARTICIPANTS: Cohort of 248 CRC patients to assess the demographic data, pathological tumour features, response to treatment modalities, disease progression, and metastasis. STATISTICAL ANALYSIS USED: Correlation analysis using the chi-square test. Survival analysis using a Kaplan Meier method. Cox regression analysis to calculate the hazard ratios. RESULTS: Demographic data revealed that 84% of patients were diagnosed with CRC above the age of 50 years. Only 27% of patients presented with distant metastasis. KRAS mutations were the most prevalent (49.6%), followed by NRAS mutations (2%) and BRAF mutations (0.4%). Wild type tumours were found among 44.4% of patients. KRAS mutation showed no significant correlation with the site, type, pathological grade, and stage of the tumour. The mean survival time was shorter among patients with KRAS mutations than among patients with wild type KRAS tumours (54.46 vs. 58.02 months). Adjusted analysis showed that the survival time was significantly affected by patients' age at diagnosis (P = 0.04). Male patients had an increased risk of mortality by 77% (hazard ratio: 1.77). CONCLUSIONS: Saudi CRC patients had a high frequency of KRAS mutations and a low frequency of BRAF mutations. The KRAS mutation status did not affect the patients' survival.

Detection of Giardia lamblia by Microscopic Examination, Rapid Chromatographic Immunoassay Test, and Molecular Technique.

Background Giardia lamblia is a pathogenic intestinal flagellate transmitted by the ingestion of contaminated water or food with the cyst stage of the parasite. Giardiasis can cause severe acute diarrhea and malabsorption or may persist as a chronic infection. Effective treatment and control measures depend on proper laboratory diagnosis using diagnostic methods with high sensitivity and specificity. Objective To compare the sensitivity and specificity of direct smear, Ritchie sedimentation technique, two brands of rapid chromatographic immunoassay test, and real-time polymerase chain reaction (PCR) for the detection of G. lamblia in clinical human fecal samples. Materials and methods Unpreserved 100 stool specimens were collected in clean plastic containers and labeled with the patient's information and examined through light microscopy, immunochromatographic test (ICTs), and real-time PCR. Results Out of 100 fresh stool samples obtained from workers analyzed, real-time PCR targeting the SSU rRNA gene was able to detect Giardia deoxyribonucleic acid (DNA) in (42) samples followed by ImmunoCard STAT! (31) samples (Meridian Bioscience, Germany), direct smear (23) samples, CerTest (19) samples (Biotec, Zaragoza, Spain), and Ritchie technique (17) samples. Real-time PCR was the most sensitive for the diagnosis of G. lamblia in comparison to the other techniques. Conclusions All the techniques investigated were sensitive for the detection of G. lamblia in stool samples. Further studies are recommended using multiplex real-time PCR assay in order to increase the possibility of the presence or absence of the infection.

Long-term outcomes of the Ahmed glaucoma valve surgery in childhood glaucoma.

PURPOSE: To report the rates of success of Ahmed glaucoma valve (AGV) surgery in early childhood glaucoma and factors associated with success. METHODS: Children with primary congenital or early childhood secondary glaucoma who underwent AGV surgery over a 10-year period (one eye per child) at a single institution were identified. Surgical failure was defined as having one or more of the following: intraocular pressure of >21 mm Hg 3 months postoperatively, reoperation for glaucoma, and vision loss to no light perception. RESULTS: A total of 178 patients were identified (median age, 5.8 ± 5.5 years): 125 with primary congenital and 53 with secondary childhood glaucoma. The success rate at 1 year was 92% (95% CI, 88%-96%); at 5 years, 64% (95% CI, 55%-73%); and at 10 years, 36% (95% CI, 25%-52%). Younger age at baseline (P = 0.003) and secondary childhood glaucoma (P = 0.045) were associated with lower success. CONCLUSIONS: The AGV is associated with high short-term success in children with primary congenital glaucoma, but the 10-year success rates are poor. Younger age and secondary childhood glaucoma may be associated with a more refractory outcome.

Awareness of head and neck cancers in Saudi Arabia. A questionnaire based study.

OBJECTIVES: To address the gap in knowledge by providing data and analyses of the status of awareness among Saudi adults. METHODS: This cross-sectional questionnaire-based study was carried out in Saudi Arabia from August 2018 to August 2019 through social media platforms using SurveyMonkey. The domains of the questionnaire included demographic information, knowledge of types and symptoms of head and neck cancers (HNCs), and the relation of HNCs to human papillomavirus (HPV) and its vaccine. RESULTS: A total of 3171 respondents completed the questionnaire. The analysis revealed that many of the study respondents (49.3%) were not knowledgeable about HNCs. Almost two-thirds (61.2%) of the study population incorrectly believed that brain cancer was included in HNCs. Over half (57.8%) did not recognize headaches as a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable about HPV infection (p less than 0.05). CONCLUSION: This study revealed that there is a lack of knowledge and awareness of the clinical features of and risk factors for HNCs among the Saudi population.

Knowledge, attitude and current practices of pregnant women towards group B streptococcus screening: cross-sectional study, Al-Madinah, Saudi Arabia.

AIMS: Group B streptococcus (GBS) is one of the most frequent bacterial pathogens causing invasive infections in neonates. It can be transmitted from colonised mother to neonates around delivery. Screening strategies for GBS during pregnancy include either universal culture-based or risk-based screening. The present study aimed to assess the knowledge, attitude and current practices of pregnant women towards GBS screening in Al-Madinah City, Saudi Arabia. METHODS: A hospital-based cross-sectional study was conducted at Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia, from May to July 2018. Participants were recruited from postnatal wards. Participants were interviewed using a previously published validated survey that was divided into the following domains: demographic data, knowledge, experience and attitude towards different GBS screening strategies. RESULTS: A total of 377 out of 450 women (response rate 83.7%) were enrolled. The results showed that the overall mean knowledge score of the pregnant women towards GBS screening was 59.8%. Majority of the women (66.8%) were not aware of the GBS bacterium, while 86.5% of them had never been informed of GBS risk assessment during their pregnancies. The mean knowledge score among women who were aware of GBS (62.8%) was significantly higher than that among women who were not (58.4%) (p=0.015). However, majority of the pregnant women (61.8%) showed preference for universal culture-based GBS screening strategy over risk-based strategy. CONCLUSION: The study results have concluded that the level of awareness and knowledge about GBS among pregnant women were relatively poor; however, majority of the pregnant women prefer universal culture-based screening.

Attitude and levels of awareness toward organ donation and transplantation among healthcare providers: A cross-sectional study.

End-stage organ damage is the major cause of death worldwide. The number of donors is low, and one of the challenging phases in organ donation is the availability of organ donors. There are many studies that suggest a strong correlation between knowledge and beliefs toward organ donation. A study conducted among Health-Care Providers in the Intensive Care Units at a Tertiary Center at Riyadh reported that only 57% of the health-care providers in the Intensive Care Unit were willing to donate their organs. The objective of our study was to evaluate the knowledge, attitude, and awareness of organ donation and transplantation among health-care providers at different hospitals around the Kingdom of Saudi Arabia. The data of this cross-sectional descriptive study were collected between February and July 2018 in different hospitals all around the Kingdom of Saudi Arabia. The investigators formulated a questionnaire based on several published studies. Ethical approval was obtained from the Unit of Biomedical Ethics, Research Committee at King Abdul Aziz University. Of the 241 participants, 130 (53.9%) were female. In addition, 110 (45.6%) of them were medical residents. Moreover, 224 (92.9%) participants were aware of the concept of organ donation. The overall level of knowledge is good (55.2%).The study showed 62.2% have participated in the organ donation program for their close relatives only. In conclusion, the level of perception and knowledge about organ donation among health-care providers was inadequate, although they showed positive attitudes toward this issue.

Research education in an undergraduate curriculum: Students perspective.

OBJECTIVE: This study aims to investigate the attitude and practice toward undergraduate research studies among medical students at Qassim University in Buraydah, Saudi Arabia. METHODS: An online cross-sectional survey developed based on previous studies. It was announced to all registered medical students who have active college's email (n = 448) at Qassim University in Buraydah, Saudi Arabia during the academic year of 2016. RESULTS: The response rate was 56.6% (n = 252). Less than half of the students have started their research projects (41.6%). Students complained about the lack of free time and the unavailability of a university hospital: 92.4% and 97.1%, respectively. One-third of students participated in extra-curriculum research, and female students were more involved. Only 15.2% have published their research and 26.7% have presented it in conferences. Male students have more journal publication in compared to their female collages while the females have presented their projects more often in conferences. To improve their curriculum vitae, 95.2% stated they are going to participate in extra-curriculum research in the future. CONCLUSIONS: Students believe in the importance of research for improving their future work life. The main reason for not participating in research, beyond deficiency of research activities, is lack of free time. Students are unsatisfied with research skills gained through academic life, although their interest toward research increases and they plan on participating in future research.

The psychometric properties of the CFSS-DS for schoolchildren in Saudi Arabia: A confirmatory factor analytic approach.

AIM: To test the psychometric properties of an Arabic version of the Child Fear Survey Schedule-Dental Subscale (CFSS-DS) a using confirmatory factor analysis. METHODS: Two convenience samples were obtained: Sample [1]: 600 boys (33%) and girls attending 4 public schools in Onizah and Sample [2] 800 girls attending 8 public schools in Buridah. The questionnaire asked the participant's age, gender, and completion of the CFSS-DS. The data were subjected to exploratory factor analysis (EFA), parallel factor analysis, Cronbach's alpha, confirmatory factor analysis (CFA), and goodness of fit statistics. RESULTS: A total of 513 children in Sample [1] and 503 children in Sample [2] participated giving a valid response rate of 86% and 67%, respectively. From the EFA, 3 factors were identified and confirmed statistically using parallel factor analysis. The internal consistency of the 3 factors, Dental Fear Subscale (0.86), Hospital Fear Subscale (0.77), and Stranger Fear Subscale (0.71), was good. The CFA showed that the current EFA model was an equivalent fit to the El Housseiny et al (BMC Oral Health 2016;16:49). model; however, the solution using El Housseiny et al's structure was distorted. CONCLUSIONS: A 3-factor structure with acceptable reliability exists for this Arabic version of the CFSS-DS, confirmed by a CFA using an additional data set.

Atrial fibrillation among adult Saudi patients with chronic heart failure: Tertiary center experience.

OBJECTIVE: To estimate the rate of atrial fibrillation (AF) among adult patients with chronic heart failure (HF) from Saudi Arabia, and to identify the clinical and the demographic characteristics. METHODS: This study was performed using all medical records of patients registered in Prince Sultan Cardiac Center in Qassim, Saudi Arabia, and diagnosed with HF during the period from January 1, 2010 to June 30, 2014. The review process included patients diagnosed with chronic HF who were registered for follow-up during the study period. The rate of AF was calculated, and the associated risk factors were determined. RESULTS: The rate of AF among chronic HF (n = 70) patients was 14.9%. The rate of AF was higher among males (15.7%) than females (12.5%). In both genders, the rate of AF rose with advancing age, and in each age stratum, it was higher in males than females. The rate of AF was higher if chronic HF was associated with chronic diseases, such as diabetes mellitus (DM, 14.3%), hypertension (HTN, 20%), and none of the patients had a history of chronic kidney disease. CONCLUSION: The rate of AF with chronic HF is high among Saudi Arabia patients. It is higher among male patients and HTN and DM patients.