Review of the spectrum of tuberous sclerosis complex: The Saudi Arabian Experience.

OBJECTIVES: To determine the prevalence of tuberous sclerosis complex (TSC) in the paediatric Saudi population and to characterise the range of clinical symptoms, neurocutaneous findings, neuroimaging results, and complications of the disease. METHODS: A total of 61 genetically confirmed TSC patients from the National Guard Health Affairs (NGHA) in Saudi Arabia were the subject of this retrospective descriptive analysis. The data were presented using descriptive measures. RESULTS: The mean age at diagnosis was found to be 4.9 years. Subependymal nodules (86.9%), numerous cortical tubers and/or radial migration lines (63.9%), and hypomelanotic macules (63.9%) were the 3 most common significant criteria. The vast majority (86.9%) of those diagnosed had epilepsy, of which 50% were considered medically intractable. Nearly half of our subjects underwent genetic testing, which revealed that TSC2 predominated over TSC1. Symptoms of Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders (TAND) were present in 66.7% of TSC1 patients and 73.9% of TSC2 patients. CONCLUSION: The findings of this study demonstrate that the clinical spectrum of TSC among Saudi children is consistent with the body of existing literature. The TSC2 was more prevalent than TSC1. The most frequent signs were cutaneous and neurological. Monitoring TSC patients regularly is crucial to identify any issues as soon as possible.

Knowledge, Attitude, and Practice (KAP) of COVID-19 Vaccine Among Saudi Mothers.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) vaccine is a novel vaccine that was created during the midst of the COVID-19 pandemic in 2020 to combat the highly contagious COVID-19 infection. Since the initiation of vaccine administration campaigns globally, lots of research was simultaneously being done to study the vaccine's side effects and possible complications, especially in vulnerable groups such as pregnant women and children. Saudi Arabia is one of the leading countries in administering the COVID-19 vaccine to its population. However, due to the exchange of a lot of incorrect information through social media platforms about the vaccine's safety, people, particularly women expecting a child, breastfeeding, or having younger children, started to display some vaccine hesitancy. This study aims to assess the knowledge, attitude, and practice (KAP) of the COVID-19 vaccine among Saudi mothers and to recognize how certain individual characteristics affect it. METHODS:  This is an observational cross-sectional study that was carried out among 293 Saudi mothers attending primary healthcare clinics at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia from April 2022 to July 2022. The participants completed a pre-validated self-administered questionnaire that was composed of 39 closed-response questions divided into four sections: participant characteristics, knowledge, attitude, and practice towards the COVID-19 vaccine. The English questionnaire was translated to Arabic, retranslated back to English, and then compared to the first English version by a different translator to ensure translation accuracy. A pilot study was conducted on 20 participants before the survey was distributed for data collection. Statistical analysis was done using SPSS version 23.0 (IBM Corp., Armonk, NY). The association between the four sections of the questionnaire was assessed using Chi-square test of proportion.  Results: The study found that 64% of the participants were below the age of 40. The majority (56%) have earned a bachelor's or a higher degree. According to 41%, "Ministry of Health official channels" was the most important source of COVID-19 vaccine-related information. Almost half of the respondents (45%) showed to have an excellent knowledge of the COVID-19 vaccine and 62% showed to have a positive attitude towards it. Around 40% of the participants reported that they delayed taking the COVID-19 vaccine until it was mandatory. For those who have children aged between 12 and 18 years, 78% stated that their children took the COVID-19 vaccine. Mothers aged below 40 years showed to have significantly better vaccine knowledge compared to the older group. Mothers who received the influenza vaccine over the past three years were less likely to delay taking the COVID-19 vaccine until it became mandatory compared to those who did not receive it.  Conclusion: Younger age, higher educational level, flu vaccine administration in the previous three years, and adherence to child immunization schedules were all factors that had a significant impact on the KAP towards the COVID-19 vaccine. Correcting misunderstandings about vaccine safety through educational campaigns and providing timely information through the Ministry of Health channels can all contribute to achieving better practice related to vaccine uptake in this group.

Associations between Body Mass Index in Hemodialysis Patients and Comorbidity, Dialysis Adequacy, Blood Pressure Control, Vascular Access Type, and Hospital Admission Rate.

Higher body mass index (BMI) is associated with various comorbidities. In hemodialysis (HD) patients, BMI affects dialysis adequacy and blood pressure (BP) control and is associated with serious comorbidities. This is a cross-sectional observational study that took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia. A total of 262 adult patients on HD for at least six months were recruited to this study. Chart review was used to retrospectively collect patients' data. Categorical variables were compared using Chi-square test of proportions, whereas analysis of variance was used between categorical and continuous variables. P <0.05 was considered statistically significant. Only 17 (6.5%) patients were underweight, 90 (34.4%) had normal weight, 65 (24.8%) were overweight, and 90 (34.4%) were obese. Diabetes mellitus was the most common cause of chronic kidney disease. A significant relationship was found between BMI and dialysis adequacy (P = 0.004) with 54 (60%) obese patients having inadequate dialysis. The mean postdialysis systolic BP was the lowest in the obese BMI category (129.71 ± 18.38 mmHg, P = 0.037). The obese category scored least on the Charlson Comorbidity Index (CCI) reflecting lower risk of mortality than the other three BMI categories. Despite having the lowest overall rate of hospitalization in the previous 12 months, obese patients had higher rates of hospitalization from sepsis compared to the other three groups (P = 0.048). Despite having reduced dialysis adequacy, obese HD patients scored less on CCI, had better postdialysis BP, and had fewer hospital admissions in the previous 12 months compared to the other BMI groups. These findings distinctly contrast with what is seen among obese persons in the general population.