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1.
J Stroke Cerebrovasc Dis ; 33(4): 107552, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38277959

ABSTRACT

PURPOSE: This study aimed to investigate the outcomes of endovascular thrombectomy-treated patients in King Fahad Medical City, Riyadh, Saudi Arabia. METHODS: A retrospective cohort study of acute ischemic stroke patients treated with endovascular thrombectomy. Patients were included in the study between January 2015 and December 2022. Good outcomes were defined as a modified Rankin Scale (mRS) of 0-2 at 90 days. Multivariate logistic regression analysis was performed to identify the independent factors associated with good outcomes. RESULTS: During the study period, 369 patients with acute ischemic stroke (mean ± SD age, 61/- 15.1 yrs; 55.4 % male) underwent mechanical thrombectomy. Median National Institute of Health Stroke Scale (NIHSS) 15. Intravenous thrombolysis was administered to 34.5 % of the patients. Successful recanalization in the anterior circulation was achieved in 84.8 % of patients. Data from mRS performed after 90 days in the anterior circulation were available for 71.2 % of the patients. Of these, 41 % showed a good outcome, and the mortality rate was 22.4 %. The significant factors associated with good outcomes were age, NIHSS score, Alberta Stroke Program Early Computed Tomography Score (ASPECTS), and short arterial puncture to recanalization. CONCLUSION: The number of patients who underwent endovascular thrombectomy has increased over time. The treatment outcomes and mortality were comparable with those of previous endovascular thrombectomy registries despite the high prevalence of DM, lower ASPECT score, and prolonged onset-to-recanalization time.


Subject(s)
Brain Ischemia , Endovascular Procedures , Ischemic Stroke , Stroke , Humans , Male , Female , Ischemic Stroke/diagnostic imaging , Ischemic Stroke/therapy , Retrospective Studies , Saudi Arabia , Stroke/diagnostic imaging , Stroke/therapy , Thrombectomy/adverse effects , Thrombectomy/methods , Treatment Outcome , Endovascular Procedures/adverse effects , Brain Ischemia/diagnostic imaging , Brain Ischemia/therapy
2.
J Voice ; 2023 Jul 09.
Article in English | MEDLINE | ID: mdl-37433707

ABSTRACT

BACKGROUND: The Reflux Symptom Score (RSS) is a patient-related outcomes measure (PROM) that was developed to diagnose Laryngopharyngeal reflux (LPR), by assessing the severity and frequency of specific symptoms and their respective impact on quality of life (QoL). OBJECTIVE: To develop the Arabic version of RSS-12 (Ar-RSS-12), and to assess its validity and reliability. METHOD: The RSS-12 was translated from French into Arabic using the forward-backward translation method, and the translated version underwent transcultural validation. A case-control study was conducted at the otolaryngology clinics of a referral hospital, during the period November to December 2022. It included 61 patients with LPR-related symptoms and a Reflux Symptom Index (RSI) score >13, and 61 control without LPR-related symptoms and negative RSI scores ≤13. The internal consistency, internal and external validity, and Test-Retest reliability of Ar-RSS-12 were analyzed. RESULT: Patients had significantly higher scores than controls in all 12 items and total Ar-RSS and QoL impact scores, with high Z score values. Item scores showed variable correlation levels with total Ar-RSS score, with ear-nose-throat items showing the strongest correlation (Spearman's rho 0.592-0.866). The QoL scores were more strongly correlated to the symptoms' severity than frequency. The internal consistency was high, with Cronbach's alpha = 0.878. Regarding external validity, correlations with RSI score showed high Spearman's rho values for total Ar-RSS (0.905) and QoL total score (0.903). No statistically significant difference was observed between Test and Retest results in any of the 12 items' score or the total score and QoL, indicating the reproducibility of the test. CONCLUSION: The Ar-RSS is a valid and reproducible tool for the screening, assessment, and monitoring of LPR in Arabic speaking patients. The inclusion of symptoms severity and frequency, as well as their individual effects on patient's QoL, support the superior clinical applications of RSS compared to other existing PROMs.

3.
Cureus ; 15(6): e40253, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37440798

ABSTRACT

INTRODUCTION: Physical activity (PA) significantly impacts mental health. However, studies addressing the influence of PA on the mental health and academic performance of medical students are scarce. MATERIALS AND METHODS: A cross-sectional study was carried out among 2,819 students pursuing their medical degrees in Saudi Arabia. PA was measured using the Global Physical Activity Questionnaire, and the state of their mental health was recorded using the Hospital Anxiety and Depression Scale. A multi-logistic regression was performed to predict the risk factor of poor academic performance. RESULTS: The prevalence of abnormal anxiety and depression levels were found to be 45.3% and 31.6%, respectively, which were comparatively more prevalent among students of younger age (p < 0.001). Students with abnormal anxiety levels had significantly lower grade point average (GPA) levels than others (p < 0.001). Those who were aged < 21 years, female gender, with chronic disease presence, low PA levels, and abnormal anxiety levels were independently associated with lower GPA levels (p < 0.05). CONCLUSION: Low PA and high anxiety and depression levels were found to affect the academic performance of medical students in Saudi Arabia. Hence, health education about the importance of PA should be directed to those students.

4.
Healthcare (Basel) ; 9(7)2021 Jun 25.
Article in English | MEDLINE | ID: mdl-34202109

ABSTRACT

The aim of this retrospective chart review study was to examine the cost effectiveness of angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); and dihydropyridine calcium channel blockers (CCBs) such as amlodipine, monotherapies in the management of essential hypertension among adult patients (≥18 years) without cancer, cardiovascular disease, and chronic kidney disease in the primary care clinics of a university-affiliated tertiary care hospital. Patients were followed up for at least 12 months from the initiation of therapy. Propensity score bin bootstrapping with 10,000 replications was conducted to generate the 95% confidence intervals (CI) for both treatment outcome (e.g., reduction of the systolic (SBP) and diastolic blood pressures (DBP) in mmHG) and the cost (e.g., costs of drugs, clinic visits, and labs in Saudi riyals (SAR)). Among the 153 included patients who met the inclusion criteria, 111 patients were on ACEIs/ARBs, while 44 patients were on amlodipine. On the basis of the bootstrap distribution, we found that the use of ACEIs/ARBs was associated with an incremental reduction of SBP of up to 4.46 mmHg but with an incremental cost of up to SAR 116.39 (USD 31.04), which results in an incremental cost effectiveness ratio (ICER) of SAR 26.09 (USD 6.95) per 1 mmHg reduction with 55.26% level of confidence. With regard to DBP, ACEIs/ARBs were associated with an incremental reduction of DBP of up to 5.35 mmHg and an incremental cost of up to SAR 144.96 (USD 38.66), which results in an ICER of SAR 27.09 (USD 7.23) per 1 mmHg reduction with 68.10% level of confidence. However, ACEIs/ARBs were less effective and costlier than amlodipine in reducing SBP and DBP with 44.74% and 31.89% levels of confidence, respectively. The findings of this study indicate that the use of ACEI or ARB as a monotherapy seems to be more effective than amlodipine monotherapy in the management of essential hypertension in primary care settings with minimal incremental cost.

5.
PeerJ ; 9: e10949, 2021.
Article in English | MEDLINE | ID: mdl-33777522

ABSTRACT

OBJECTIVE: In consideration of the current nursing shortage in Saudi Arabia, we aimed to investigate the association among perceptions of work environment, communication satisfaction, and intentions to quit nursing profession among nurses. In addition, we aimed to investigate the mediating effect of communication satisfaction on the association between nurses' perception of work environment and their intentions to quit nursing profession. METHODS: This predictive correlational study was conducted at one of the major hospitals in Saudi Arabia from January 2020 to March 2020. It included a convenience sample of 367 full-time registered nurses who completed three types of close-ended questionnaires. We used IBM SPSS version 24.0 to analyze the collected data. Regression analyses were used to test the study's hypotheses. All regression assumptions were assessed and confirmed. Significance for all tests was set at p ≤ .05. RESULTS: The findings indicated an affirmative association between work environment perception and communication satisfaction (b = .764, p < .05) among nurses. In addition, findings showed that work environment perception (b = -.187, p < .05) and communication satisfaction (b = -.226, p < .05) have negative impacts on the nurses' intentions to quit; indicating that as work environment perception or communication satisfaction increases, the intention to quit decreases among nurses. Further, a mediation effect of communication satisfaction on the relationship between work environment perception and intention to quit was confirmed. CONCLUSION: This study presents a novel conceptual framework developed based on the literature about the predisposing factors for nurses' intentions to quit nursing profession. Our results suggest that work environment perception and communication satisfaction among the most contributing factors for nurses resignation. Effective communication was established as a crucial factor for establishing attractive and healthy working environment. Nursing managers can benefit by applying these findings to develop appropriate strategies to inhibit the shortage of nurses in Saudi Arabia.

6.
Int J Afr Nurs Sci ; 13: 100256, 2020.
Article in English | MEDLINE | ID: mdl-33072514

ABSTRACT

The Saudi government is currently facing multiple challenges in achieving "The Gold Standard" in nursing practice. This is not limited to educational challenges, staffing shortage, paucity of international and national benchmark evidence, absence of clear and defined scope of nursing practice, and lack of appropriate policies and regulations. This study presented a comprehensive plan for developing a policy based on current challenges, recognition of policy goals, assessment of potential options and alternatives, identification of stakeholders, proposition of recommended solutions, and implementation of the framework to transform nursing standards and link these changes with the Saudi Vision 2030. However, amendments are required in the present strategic plan for the better management of the nursing profession. It is doubtful that the current nursing profession status quo is capable of meeting the golden standards for health care. Thus, the transformation of the nursing profession in Saudi Arabia is necessary.

7.
Saudi Med J ; 41(6): 614-621, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32518928

ABSTRACT

OBJECTIVES: To determine the prevalence and types of complementary and alternative medicine (CAM) being utilized and the possible factors that prompted the use of CAM in patients with brain tumors. Methods: The study conducted was a questionnaire-based, cross-sectional study of patients diagnosed with brain tumors at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2011 to May 2018. Patients with primary and secondary brain tumors, were included. Our questionnaire was conducted via phone interviews after obtaining patient consent.  Results: A total of 72 patients were included. The mean age of the participants was 45.89 (±16.52) years. We found that education level significantly affected the use of CAM. Fewer users of CAM held bachelor's degree and patients with lower degrees used CAM more frequently (p=0.027). The most frequent types of CAM were Zamzam (holy water) and Ruqya (Quran reading). Family members were the most frequent source of information about the use of CAM (81.6%).  Conclusion: Education level has a significant effect on CAM use. Gender plays a role in the type of CAM used. Future research should focus on the adverse effects of some CAM therapies, how effective CAM therapies are, and the effect CAM may play in delaying patients from seeking medical advice.


Subject(s)
Brain Neoplasms/therapy , Complementary Therapies/methods , Complementary Therapies/statistics & numerical data , Educational Status , Hospitals, University/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Complementary Therapies/adverse effects , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Saudi Arabia/epidemiology , Sex Factors , Surveys and Questionnaires , Time-to-Treatment , Young Adult
8.
Cost Eff Resour Alloc ; 17: 25, 2019.
Article in English | MEDLINE | ID: mdl-31827409

ABSTRACT

BACKGROUND: There has been an increase in incidence and prevalence of inflammatory bowel disease (IBD) outside the western countries. Treatment costs are an essential component for healthcare planning and priority setting. The utilization patterns and annual administration and cost of IBD medications are largely unknown in countries with an increasing incidence of disease, Saudi Arabia being an example. AIM: To evaluate the use of non-biologic and biologic agents and their associated annual administration costs in a sample of patients with Crohn's disease (CD) and ulcerative colitis (UC) in Saudi Arabia. METHODS: Single-center retrospective chart review was performed to determine the use of biologic and non-biologic medications among IBD patients in a tertiary care hospital in Riyadh, Saudi Arabia. Daily and the annual acquisition cost of different IBD therapeutic agents was calculated. The utilization rates and cost of each type of medication by CD and UC patients were compared. RESULTS: Data of 258 CD patients and 249 UC patients were analyzed. Infliximab and adalimumab were the most commonly prescribed biologics among the study sample, however, their utilization rates were significantly higher among CD than UC patients (36.82% vs. 11.24%, and 20.54% vs. 9.64%, respectively, P < 0. 01). Azathioprine utilization rate was also higher among CD patients compared to their UC counterparts (71.71% vs. 40.16%, respectively, P < 0.01). However, the utilization rate of mesalazine in the UC patients was significantly higher than their CD counterparts (85.53% vs. 14.34% for CD, P < 0.01). The annual cost of biologics (including administration and lab test cost) ranged from 5572 USD for ustekinumab to 18,424 USD for vedolizumab. On the other hand, the annual cost of non-biologics ranged from 16 USD for prednisone to 527 USD for methotrexate. CONCLUSION: Biologics are extensively used in the management of IBD, particularly CD, and their utilization costs are significantly higher than non-biologics. Future studies should examine the cost effectiveness of IBD medications especially in countries with increasing incidence such as Saudi Arabia.

9.
Sensors (Basel) ; 19(5)2019 Feb 28.
Article in English | MEDLINE | ID: mdl-30823415

ABSTRACT

Human injuries and casualties at entertaining, religious, or political crowd events often occur due to the lack of proper crowd safety management. For instance, for a large scale moving crowd, a minor accident can create a panic for the people to start stampede. Although many smart video surveillance tools, inspired by the recent advanced artificial intelligence (AI) technology and machine learning (ML) algorithms, enable object detection and identification, it is still challenging to predict the crowd mobility in real-time for preventing potential disasters. In this paper, we propose an intelligent crowd engineering platform using mobility characterization and analytics named ICE-MoCha. ICE-MoCha is to assist safety management for mobile crowd events by predicting and thus helping to prevent potential disasters through real-time radio frequency (RF) data characterization and analysis. The existing video surveillance based approaches lack scalability thus have limitations in its capability for wide open areas of crowd events. Via effectively integrating RF signal analysis, our approach can enhance safety management for mobile crowd. We particularly tackle the problems of identification, speed, and direction detection for the mobile group, among various crowd mobility characteristics. We then apply those group semantics to track the crowd status and predict any potential accidents and disasters. Taking the advantages of power-efficiency, cost-effectiveness, and ubiquitous availability, we specifically use and analyze a Bluetooth low energy (BLE) signal. We have conducted experiments of ICE-MoCha in a real crowd event as well as controlled indoor and outdoor lab environments. The results show the feasibility of ICE-MoCha detecting the mobile crowd characteristics in real-time, indicating it can effectively help the crowd management tasks to avoid potential crowd movement related incidents.

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