Translation, cultural adaptation, and evaluation of the psychometric properties of the Arabic Gastroesophageal Reflux Disease Questionnaire (Ar-GerdQ).

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common chronic digestive disease that affects people in different communities at different rates. Because of the absence of a validated Arabic tool to assess GERD symptoms, this study aimed to validate and culturally adapt the GERD questionnaire (GerdQ) tool to Arabic speakers. METHODS: Patients referred for pH testing with symptoms suggestive of GERD were recruited. A cross-sectional study was conducted from March 2023 to April 2023 by administering the Arabic GERD questionnaire (Ar-GerdQ) tool on two different occasions and comparing it with the short-form leeds dyspepsia questionnaire and the Reflux Symptom Index to establish reliability and construct validity. RESULTS: A total of 52 participants were included in the study. The results of the internal consistency analysis of the Ar-GerdQ indicate that the test has good reliability, with a Cronbach's alpha coefficient of 0.86 (95% CI: 0.75-0.91). Significant positive correlations with the short form leeds dyspepsia questionnaire (r = 0.59, P < 0.001, 95% CI: 0.29-0.78) and the reflux symptom index (r = 0.47, P = 0.01, 95% CI: 0.13-0.71) were demonstrated. Moreover, the intraclass correlation coefficient value was 0.60 (P < 0.001, 95% CI: 0.28-0.77), indicating a substantial level of agreement between the measurements. CONCLUSIONS: Our findings indicate that the Ar-GerdQ is useful for assessing reflux disease symptoms among Arabic speakers. Effective utilization of Ar-GerdQ will reduce unnecessary endoscopic requests in primary care settings.

Obesity in Saudi Medical Students and Alignment with Eating Disorders: A Stratified Random Cross-Sectional Investigation.

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants' mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218-3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287-0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students.

Physicians' perceptions and beliefs on the current dyslipidemia management practices within Saudi Arabia.

Background: Limited reports addressing physicians' understanding of the various low-density lipoprotein cholesterol (LDL-C) targets/statin intensity required for treating the various dyslipidemia patient populations in Saudi Arabia are available. Therefore, the current study assessed the perceptions and beliefs of practicing clinicians in Saudi Arabia regarding the current practice for management of dyslipidemia and potential perceived barriers to adherence to lipid guidelines encountered in their regular clinical practice. Knowledge of different clinical practices and beliefs could have a positive impact on improving the quality of future care provided by physicians. Methods: A survey questionnaire was designed to assess physicians' familiarity, usage, and adherence to seven different international guidelines and used to evaluate the management of dyslipidemia, practice of patient treatment, and perceived obstacles to adhering to lipid guidelines related to specific patients, doctors, and practice issues. Results: A total of 467 physicians were recruited for the study: (1) 57.2% were primary care physicians (PCPs) and (2) 42.8% were specialists. About 90.8% of them followed lipid guidelines of which the most common set were based on those by the American College of Cardiology/American Heart Association. The most utilized risk assessment tool was the atherosclerotic cardiovascular disease (ASCVD) risk calculator. About 60% of the physicians set an LDL-C target for their patients based on a combination of patients' risk factors and lipid profiles. In all, 42.1% of the physicians chose not to change existing therapy among patients with dyslipidemia to attain a non-high-density lipoprotein goal with controlled LDL-C level. Atorvastatin accounted for the greatest percentage of primary and secondary prevention choices (71.9% and 69.6%, respectively). Rosuvastatin was mostly preferred by physicians for patients with familial hypercholesterolemia. About two-thirds of the physicians (77.9%) prescribed statins to diabetic patients aged 40-75 years. Statin intolerance was encountered by 62.9% of the physicians in ≤ 10% of patients by 62.9%. Therapeutic strategies included switching to an alternative statin (40.1%) followed by reducing the statin dose (35.3%). Ezetimibe was prescribed by most physicians (77.9%) as an add-on to statin if the LDL-C target was not achieved. Fibrate was most preferred by physicians (62.7%) for hypertriglyceremia treatment followed by statins (28.7% of the physicians). Sixty-six percent reported not using proprotein convertase subtilisin/kexin type 9 serine protease inhibitors in their clinical practice due to unavailability at their institute (51.8%), high costs (26.3%), and/or lack of knowledge (20.6%). Perceived barriers to guideline adherence identified by physicians were lack of familiarity and knowledge of the guidelines, patient non-adherence, medication costs, and lack of timely follow-up appointments and educational tools. Multiple similarities and differences were observed after comparisons were made between specialists and PCPs in terms of guideline preference, clinical practice, and perceived barriers. Conclusion: Different perceptions and attitudes among physicians in Saudi Arabia were found due to variable recommendations by international lipid guidelines. Perceived barriers that included the patient, physician, and practice were identified by physicians at multiple levels. Multiple challenges and different action gaps were observed when comparing specialists to PCPs. It is recommended that standardized practices be followed by clinicians in Saudi Arabia, and actions to address the outlined barriers are essential for optimizing health outcomes and ASCVD prevention.

Is There an Association between Increased Stress and Smartphone Addiction? Insights from a Study on Medical Students from Saudi Arabia during the COVID-19 Pandemic.

Purpose: Smartphone addiction is prevalent among medical students, and there is a concern that the coronavirus disease 2019 (COVID-19) pandemic fueled a rise in smartphone addiction. Earlier studies suggest a link between excessive smartphone usage and negative outcomes such as depression, stress, and reduced academic achievement. However, there is a dearth of both local studies in Saudi Arabia and studies conducted during the COVID-19 pandemic exploring the prevalence of smartphone addiction and its association with academic performance, depression, and perceived stress, which is the purpose of the current study. Methods: In 2021, a cross-sectional research project took place among medical students at King Saud University and the Vision Colleges located in Riyadh, Saudi Arabia. An online self-administered questionnaire consisting of demographic variables, grade point average (GPA), the Patient Health Questionnaire-9 (PHQ-9), the Perceived Stress Scale-4 (PSS-4), and the Smartphone Addiction Scale-Short Version (SAS-SV) was deployed. Results: Three hundred and fifteen students participated. Around 47.9% of students reported smartphone addiction, and the mean SAS-SV score was 32.31 ± 12.01 points. Both PHQ-9 and PSS-4 scores showed a significant positive correlation with the SAS-SV score (r = 0.216, p < 0.001 and r = 247, p < 0.001, respectively), while GPA did not (r = -0.027, p = 0.639). An adjusted analysis showed that the PSS-4 score was positively associated with the SAS-SV score (odds ratio (OR) = 1.206, p < 0.001), while the PHQ-9 score was not (OR = 102, p = 0.285). Conclusions: Smartphone addiction is prevalent among medical students and associated with perceived stress. Additional research is required to gain a deeper comprehension of this issue and to assess the success of intervention initiatives aimed at encouraging healthy smartphone usage, particularly in times of crisis like the COVID-19 pandemic.

Experiences with telemedicine among family medicine residents at king saud university medical city during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: The healthcare system experienced various challenges during the coronavirus disease 2019 (COVID-19) pandemic, and a wide range of safety measures were implemented, including limiting the number of patients allowed to visit primary care clinics and follow-up through telemedicine clinics. These changes have accelerated the growth of telemedicine in medical education and affected the training of family medicine residents throughout Saudi Arabia. Therefore, this study aimed to evaluate the experiences of family medicine residents with telemedicine clinics as a part of their clinical training during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted with 60 family medicine residents at King Saud University Medical City, Riyadh, Saudi Arabia. An anonymous 20-item survey was administered between March and April 2022. RESULTS: The participants included 30 junior and 30 senior residents, with a 100% response rate. The results revealed that most (71.7%) participants preferred in-person visits during residency training, and only 10% preferred telemedicine. In addition, 76.7% of the residents accepted the inclusion of telemedicine clinics in training if such clinics constituted not more than 25% of the training program. Moreover, most participants reported receiving less clinical experience, less supervision, and less discussion time with the attending supervisor when training in telemedicine clinics compared with in-person visits. However, most (68.3%) participants gained communication skills through telemedicine. CONCLUSIONS: Implementing telemedicine in residency training can create various challenges in education and influence clinical training through less experience and less clinical interaction with patients if it is not structured well. With the growth of digital healthcare, further structuring and testing of a paradigm that involves using telemedicine in residents' training programs prior to implementation should be considered for better training and patient care.

Assessment of food labeling knowledge and associated reading barriers among patients with diabetes.

Background: The most challenging part of diabetes management for a patient with diabetes is selecting a healthy diet. The purpose of this study is to evaluate participants' knowledge of food labels, to find out the relationship between the type of diabetes mellitus (DM) and knowledge score of food labels, and to explore the barriers that prevent patients from reading food labels. Methodology: This observational study was conducted on patients with type 1 or type 2 diabetes using a validated self-administered questionnaire. The study was conducted at diabetes clinics at King Khalid University Hospital and King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, from November 2019 to February 2020. Data were analyzed using SPSS. Results: A total of 310 participants were enrolled in this study, of which 50.3% had type 1 DM, and more than half of them were female (51.6%). Patients with type 1 DM had higher mean declarative and applied knowledge scores than those with type 2 DM, regardless of whether they were taking pre meals insulin or not. The highest proportion (39.9%) had difficulty in understanding the content of the nutrition labels, and some of them (37.2%) did not receive any educational session about it. Only 9.5% of the participants did not have any difficulties in reading food labels. Conclusion: Patients with both types of diabetes tended to have poor total knowledge about food labels and faced difficulties in reading them. Provided educational sessions by primary health care and specialized physician and DM educator about food labels are recommended to help them to choose food properly.

Exploring Determinants of COVID-19 Vaccine Acceptance, Uptake, and Hesitancy in the Pediatric Population: A Study of Parents and Caregivers in Saudi Arabia during the Initial Vaccination Phase.

OBJECTIVES: This study aims to assess COVID-19 vaccine acceptance, uptake, and hesitancy among parents and caregivers of children in Saudi Arabia during the initial rollout of pediatric COVID-19 vaccination. METHODS: An electronic survey was used to collect data from participants who visited a COVID-19 vaccine center. The survey included demographic data, COVID-19 vaccine status among participants and their children, and reasons for vaccine acceptance or rejection. The Vaccine Hesitancy Scale (VHS) tool was also employed to assess vaccine hesitancy and attitudes toward the COVID-19 vaccine and routine childhood vaccination. Multivariate binary regression analysis was used to identify predictors of actual COVID-19 vaccine uptake among children. RESULTS: Of the 873 respondents included in the analysis, 61.5% were parents and 38.5% were other caregivers. Of the participants, 96.9% had received the COVID-19 vaccine. Six hundred and ninety-four participants accepted the vaccine for their children, with the main reasons being an endorsement by the Saudi Ministry of Health (60%) and the importance of going back to school (55%). One hundred and seventy-nine participants would not vaccinate their children, with the most common reasons being fear of adverse effects (49%) and inadequate data about vaccine safety (48%). Factors such as age, COVID-19 vaccination status, self-rated family commitment level, attitudes toward routine children's vaccines, and participants' generalized anxiety disorder (GAD7) score did not significantly correlate with children's COVID-19 vaccination status. Parents were less likely to vaccinate their children compared to other caregivers, and participants with a higher socioeconomic status were more likely to vaccinate their children. CONCLUSION: Vaccine acceptance and uptake were high during the initial pediatric COVID-19 vaccination rollout in Saudi Arabia. Still, the ongoing endorsement of the Ministry of Health and healthcare authorities should continue to advocate for better vaccine uptake in children.

Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review.

This review seeks to establish, through the recent available literature, the prevalence of therapeutic intensification delay and its sequences in poorly controlled Type 2 Diabetes Mellitus (T2DM) patients. The strategy identified studies exploring the clinical inertia and its associated factors in the treatment of patients with T2DM. A total of 25 studies meeting the pre-established quality criteria were included in this review. These studies were conducted between 2004 and 2021 and represented 575,067 patients diagnosed with T2DM. Trusted electronic bibliographic databases, including Medline, Embase, and the Cochrane Central Register of Controlled Trials, were used to collect studies by utilizing a comprehensive set of search terms to identify Medical Subject Headings (MeSH) terms. Most o the studies included in this review showed clinical inertia rates over 50% of T2DM patients. In the USA, clinical inertia ranged from 35.4% to 85.8%. In the UK, clinical inertia ranged from 22.1% to 69.1%. In Spain, clinical inertia ranged from 18.1% to 60%. In Canada, Brazil, and Thailand, clinical inertia was reported as 65.8%, 68%, and 68.4%, respectively. The highest clinical inertia was reported in the USA (85.8%). A significant number of patients with T2DM suffered from poor glycemic control for quite a long time before treatment intensification with oral antidiabetic drugs (OADs) or insulin. Barriers to treatment intensification exist at the provider, patient, and system levels. There are deficiencies pointed out by this review at specialized centers in terms of clinical inertia in the management of T2DM including in developed countries. This review shows that the earlier intensification in the T2DM treatment is appropriate to address issues around therapeutic inertia.

Relationship between Medical Students' Perceived Stress and Gaming Behavior at King Saud University.

Gaming addiction has gradually developed among medical students and has been a contentious topic for nearly a decade. This study is aimed at estimating the prevalence of gaming addiction among medical students at King Saud University and examining the relationship between perceived stress levels and gaming addiction. We conducted a cross-sectional study among 370 students from 2019 to 2020 using a self-reporting questionnaire consisting of two validated test scales: the Gaming Disorder Test and the Perceived Stress Scale. The questionnaire was sent to all students through an email. Descriptive analyses and t-test statistical tests were used in this study. The prevalence rate of gaming addiction was found to be 4.6%, while the prevalence of perceived stress was confirmed at 95.9%. Students with excellent GPAs and high family income were associated (p < 0.001). Younger groups, females, and students with high family incomes showed higher levels of perceived stress than others. According to Pearson's correlation, gaming addiction was not significantly correlated with stress among medical students (p > 0.05). According to chi-square test also, no significant association was found between gaming disorder and perceived stress (χ 2 = 4.412; p = 0.353). In conclusion, gaming addiction among medical students has scored low prevalence, indicating gaming is not a factor contributing to stress among this group. The high level of perceived stress among medical students should draw attention to the provision of regular psychological care.

Nondisclosure of Medical Related Information by Persons with Type 1 and Type 2 Diabetes Mellitus to Their Healthcare Providers: Do Different Patterns Exist?

Purpose: The doctor-patient relationship is often challenged by complex communication issues and nondisclosure of important related medical information, especially in diabetes management. Very little information is known about diabetic patient nondisclosure to their doctors. The present study evaluated the prevalence of nondisclosure of information by persons with type 1 and type 2 diabetes mellitus to healthcare providers and its associated factors among the Saudi population, as well as the differences between persons with type 1 and type 2 diabetes mellitus. Methods: A cross-sectional study targeting persons with type 1 and type 2 diabetes mellitus was conducted at King Saud University Medical City, Saudi Arabia, Riyadh. An online self-administered questionnaire was used to collect data. Results: A total of 285 participants were included in the study (155 [54.4%] and 130 [45.6%] type 1 and 2 diabetic patients, respectively). Having an unhealthy diet (25.3%, n = 72), not regularly exercising (23.5%, n = 67), hiding some glucose readings (23.2%, n = 65), and not following instructions for weight loss (22.8%, n = 44) were the most common types of nondisclosed information among diabetic patients. The nondisclosure of information was significantly higher among type 2 patients (29.2%) than type 1 diabetic patients (18.7%) in terms of not participating in regular exercise (p = 0.018). Similarly, the nondisclosure of information was significantly higher among persons with type 1 diabetes compared to persons with type 2 diabetes in terms of hiding some glucose readings (p < 0.001) and not disclosing hyperglycemia (p = 0.011). Conclusion: Nondisclosure of important related medical information among diabetic patients to their healthcare providers is prevalent among the Saudi population. Furthermore, the types and causes of nondisclosed information differ among persons with type 1 and type 2 diabetes mellitus.

Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress.

Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.

Hand Grip Strength as an Index of Health Does Not Associate With Insomnia: A Cross-Sectional Study.

Introduction Insomnia is one of the most prevalent diseases globally, with many adults around the world suffering from at least one of its symptoms. It has a significant effect on the body's normal physiology and may lead to the development of chronic diseases that impair the main functional domains of health and cognition if left untreated. Handgrip strength (HGS) has previously been linked to several diseases that occur in tandem with insomnia. Thus, this study aimed to investigate the association between HGS and insomnia. Materials and methods This is a cross-sectional study in which the involved participants were approached in different locations. The participants were surveyed using the Insomnia Severity Index (ISI) to evaluate the presence of insomnia. A hydraulic hand dynamometer was used to measure the HGS of the participants' right and left hands. Results A total of 494 questionnaires were collected, including 365 (74%) males and 129 females (26%). About 16% of females had insomnia, compared to 15% of males. There was no significant association between gender and insomnia (P=0.873). The difference between the mean HGS for the right and left hands among males and females was not statistically significant (P>0.05). The correlation coefficients of the right and left HGS scores with insomnia were r=0.019 and r=0.018, respectively, which showed no statistically significant association (P>0.05). Conclusions The study found no significant association between HGS and insomnia. The study recommends conducting further large-scale studies focusing on specific groups in the population to understand the relationship between HGS and chronic sleep disturbance.

Psychological Wellbeing of Diabetic Individuals, Prediabetics, and Non-diabetics: A Population-Based Study in Saudi Arabia.

Background: The increased burden of diabetes affects the quality of life, including psychosocial problems. The study aims to compare the psychological well-being of individuals who are prediabetic, diabetic, or non-diabetic. Methods: A cross-sectional exploratory study was conducted from January to June 2016 (n = 1,019) in Al Kharj, Saudi Arabia. After consent and questionnaires were filled out, trained staff took blood samples followed by anthropometry. Chi-squared tests, one-way ANOVA, and multiple linear regression analyses were conducted to examine the association between diabetes classes defined by HbA1c cut-off levels set by the American Diabetes Association (three categories), individual items, and total score in general health questionnaire (GHQ). An ROC curve was plotted for the total GHQ-12 score against HbA1c. Findings: The mean GHQ score for psychological distress was significantly higher (F = 6.569, P = 0.038) in the diabetics (mean = 14.7) and the prediabetics (12.4) than in the non-diabetics (10.71). Four out of six positive GHQ items and three out of six negative GHQ items significantly differed among the three classes of diabetes. The adjusted multivariate analysis revealed that people with diabetes were most likely to report psychological distress compared to non-diabetics (unstandardized beta = 2.414; P = 0.037). The AUC examining the relationship between HBA1c and GHQ scores showed a moderate but statistically insignificant sensitivity/specificity of 0.643 (P = 0.23). Conclusion: This study demonstrates that psychological wellbeing is substantially poorer among diabetic or prediabetic individuals than non-diabetic individuals. Future longitudinal studies are required to examine a plausible causal relationship between diabetes/prediabetes and psychological distress.

Adequacy of physician clinical rounds and nursing care elements for non-COVID-19 infected patients admitted during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic created many challenges for healthcare systems. Frontline workers and especially healthcare professionals were the most severely affected through increased working hours, burnout and major psychological distress. OBJECTIVES: To evaluate the changes in standard care elements which occurred during the COVID-19 pandemic, specifically the physician clinical rounds and nursing care provided to non-COVID-19 infected patients. DESIGN: Observational retrospective study. SETTINGS: The study was conducted at King Abdulaziz Medical City, Riyadh Saudi Arabia. KAMC is a 1200 bed tertiary care referral academic medical center. PATIENTS (MATERIALS) AND METHODS: We compared the physician clinical rounds and nursing care elements in all admissions due to non-COVID-19 pneumonia and ST elevation myocardial infarction during the lockdown period with similar admissions in a baseline period in the same weeks in the previous pre-lockdown. MAIN OUTCOME MEASURES: To evaluates the changes occurring during the COVID-19 pandemic in terms of the standard care elements, such as the physician rounds and nursing care. SAMPLE SIZE: Total of 113 patients records were analyzed. RESULTS: During the lock down period, a total of 113 patients were admitted to the medical and cardiology wards, (95 patients with pneumonia and 18 patients with ST segment elevation myocardial infarction (STEMI)) compared to 89 patients in the pre lockdown period (74 patients with pneumonia and 15 patients with STEMI). Both groups were similar in age, gender, disposition, length of stay, goal of care planning and outcome. Chronic respiratory disease and Diabetes were more present in patients admitted on the pre lockdown time. Azithromycin was more frequently used as part of the initial antibiotic regimen for pneumonia during the pre-lockdown while doxycycline was significantly more during the lockdown. For the 95 patients admitted in the medical wards during the lockdown, there were a total of 820 physicians' clinical rounds opportunities for senior and junior physicians each. The residents missed 133 (16.2%) and consultant missed 252 (30.7%) of those clinical rounds opportunities. Missed clinical rounds opportunities during the pre-lock down period was higher for residents and consultants at 19.3% (P = 0.429 ) and 36.3% respectively (P = 0.027 ). Similarly, missed clinical rounds opportunities was less during the lockdown period from 35.2% to 25% (p 0.022) and from 38.8% to 30.6% (p = 1 ) for junior staff and consultant cardiology respectively compared to pre lockdown period. For nursing care elements, there was a decrease in missed opportunities in vital signs measurement (p 0.47 and p 0.226), pain assessment (p 0.088 and p 0,366) and skin care (p 0.249 and p 0.576) for patients admitted during the lockdown period in medical and cardiology wards. CONCLUSIONS: Caring for patients admitted for non COVID 19 infection reasons, physicians' clinical rounds did marginally increase compared to pre lockdown period while nurses monitoring for those patients was significantly higher. No difference in mortality was observed for patients admitted pre and during lockdown. The number of missed opportunities to do clinical rounds by physicians remains high during both periods and measures to improve adherence of physicians to performed clinical rounds are needed.

The Influence of Diet, Water Intake, Exercise, Education Level, and Income on the Quality of Sleep in the Saudi Population: A Cross-Sectional Study.

BACKGROUND: Sleep quality is known to affect and be affected by multiple factors in one's life through physiological and psychological manners. The study aimed to assess the influence of diet, water intake, exercise, level of education, and income on the quality of sleep of the Saudi population. MATERIALS AND METHODS: The study was a cross-sectional design that used a validated standardized fact-based questionnaire developed based on the Insomnia Severity Index. The data collection continued for three months, during which subjects were approached and interviewed in many locations, ensuring the Saudi population's best representation. RESULTS: The study included 496 subjects, of whom 74% were men. Most of the participants (51.4%) were aged between 18 and 25 years old and were unmarried (64.2%). The education level of participants was between high school and bachelor's level (45-43%), respectively. Around 53% believed that they were following an unhealthy diet, although 42% of the total had a normal BMI. About 44% of participants consumed about 1-2 L of water daily, and 42% never exercised. The majority (39%) earned an income of >5000 Saudi Riyals. Forty-two percent of the participants reported subthreshold insomnia. The data analysis showed that social status and diet were significantly related to sleeping quality (P = 0.051, P = 0.027). Additionally, the level of education was found to be an important confounding factor. CONCLUSION: Diet and social status were significantly related to insomnia, and educational level served as a significant confounding factor. Neither water intake, exercise, BMI category, age, nor gender were associated with insomnia.

Dyslipidemia Among Patients With Type 1 Diabetes and Its Associated Factors in Saudi Arabia: An Analytical Cross-Sectional Study.

Objectives The present study was conducted to determine the prevalence of dyslipidemia among patients with type 1 diabetes mellitus (T1DM) and its associated factors in Saudi Arabia. Methods An analytical cross-sectional study was conducted to examine patients with T1DM at a tertiary care hospital in Riyadh, Saudi Arabia. The hospital's electronic medical records (EMRs) and a telephone survey were used to collect data after obtaining institutional approval and informed consent from every patient. The inclusion criteria included age >18 years, T1DM, and follow-up at the tertiary care hospital. The data collected included age, gender, hypertension, glycosylated hemoglobin (HbA1c), body mass index (BMI), diabetes duration, total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Results A total of 234 patients with T1DM were included in the study, which comprised 44.4% men and 55.6% women with an average age of 30.9 ± 9.7 years. Total cholesterol, TG, LDL-C, and HDL-C were 4.6 ± 1.04 mmol/L, 1.1 ± 0.60 mmol/L, 2.6 ± 0.89 mmol/L, and 1.5 ± 0.43 mmol/L, respectively. About 18.4% were hypertensive, and about 51.9% and 50% men and women had dyslipidemia, respectively. Males and HbA1c ≥ 7% showed significant associations with dyslipidemia. Conclusion Dyslipidemia is prevalent in patients with T1DM in Saudi Arabia, which warrants the use of solid preventive strategies to limit the risk of cardiovascular disease.

Prevalence, Reasons and Determinants of Patients' Nondisclosure to Their Doctors in Saudi Arabia: A Community-Based Study.

INTRODUCTION: Patient-doctor communication is a fundamental component of patients' care. Withholding important information to the doctor can negatively affect the patients' health and patient-doctor communication. AIM: This study aimed to explore the fundamental types of information that patients hide from doctors, eg, the use of medication, health-related lifestyle, or disagreement with the doctor's plan. In addition, this study examines the prevalence and reasons for this nondisclosure and factors associated with it. METHODOLOGY: An online survey was conducted using a self-designed questionnaire, which was distributed to social media, targeting the residents of Saudi Arabia from February 1, 2021 to February 28, 2021. Respondents under 18 years of age and those who provided incomplete/incorrect data were excluded from the study. Types of nondisclosed information and their reasons were evaluated. RESULTS: A total of 2725 participants completed the questionnaire, and 1392 (51.1%) were males. About 43.2% of the participants were 18-29 years. Most (82%) responded "yes" to the question "Have you ever withheld any information from your doctor?" Nondisclosed information commonly involved disagreements with the recommendation (44.7%), not taking prescription medication as instructed (40.6%), and not understanding the instructions (37.4%). The most frequent reasons (68.7%) for nondisclosure were that the participants wanted to undergo further tests, did not like the doctor's attitude (48.7%) and felt it did not matter to the doctor (43.2%). Those under 40 were more apt to withhold information (70.4%) than older participants (29.6%) p value = 0.0034. Other factors like gender, education level, and marital status were not associated with nondisclosure. CONCLUSION: The prevalence of nondisclosure to doctors is high. Effective communication skills and sound doctor-patient relationships may reduce this risk and improve the care delivered to the patients.

Training medical students in physical examination and point-of-care ultrasound: An assessment of the needs and barriers to acquiring skills in point-of-care ultrasound.

BACKGROUND: With growth of the use of point of care ultrasound (PoCUS) around the world, some medical schools have incorporated this skill into their undergraduate curricula. However, because of epidemiology of disease and regional differences in approaches to patient care, global application of PoCUS might not be possible. Before creating a PoCUS teaching course, it is critical to perform a needs analysis and recognize the training obstacles. MATERIALS AND METHODS: A validated online questionnaire was given to final-year medical students at our institution to evaluate their perceptions of the applicability of specific clinical findings, and their own capability to detect these signs clinically and with PoCUS. The skill insufficiency was assessed by deducting the self-reported clinical and ultrasound skill level from the perceived usefulness of each clinical finding. RESULTS: The levels of expertise and knowledge in the 229 students who participated were not up to the expected standard. The applicability of detection of abdominal aortic aneurysm (AAA) (3.9 ± standard deviation [SD] 1.4) was the highest. However, detection of interstitial syndrome (3.0 ± SD 1.1) was perceived as the least applicable. The deficit was highest in the detection of AAA (mean 0.95 ± SD 2.4) and lowest for hepatomegaly (mean 0.57 ± SD 2.3). Although the majority agreed that training of preclinical and clinical medical students would be beneficial, 52 (22.7%) showed no interest, and 60% (n = 136) reported that they did not have the time to develop the skill. CONCLUSION: Although medical students in Saudi Arabia claim that PoCUS is an important skill, there are significant gaps in their skill, indicating the need for PoCUS training. However, a number of obstacles must be overcome in the process.

Prevalence and characteristics of multivitamin-multimineral (MVMM) use among Saudi populations in Riyadh, Saudi Arabia: A cross-sectional study.

ABSTRACT: Use of multivitamin multimineral (MVMM) preparations is prevalent and growing worldwide, contributing to major health expenditure. Minimal literature on prevalence and characteristics of MVMM use is available from Saudi Arabia.The study was conducted to determine the prevalence and characteristics of MVMM use among Saudi population in Riyadh, Saudi Arabia.A cross-sectional study was conducted at 6 shopping malls located in the different regions of Riyadh city for 6 months from February 01, 2019, to July 31, 2019. A well-structured English questionnaire was developed, translated into Arabic language, and validated by the experts. A pertinent inclusion and exclusion criteria were established. After having informed consent to be included in the study, the printed copies of the questionnaire were distributed among the participants using a convenient sampling technique. The data were collected and analyzed using SPSS version 24. Descriptive statistics were presented as numbers, percentages, means, and standard deviations. A P value of ≤.05 and 95% confidence intervals were used to report the statistical significance.Out of 1200 surveys distributed, 1105 were returned by the participants (response rate 92%). Prevalence of MVMM supplements use turned out to be 47%. The study revealed statistically significant association between MVMM use and gender, marital status, education, regular exercise, smoking, following special diet, and eating fruits and vegetables (P ≤ .05). Majority of the participants used MVMM on daily basis (57.9%), and hospital prescriptions (57.9%) were the most common reason of MVMM use. Majority of the participants used MVMM for diet supplements (32.2%), health promotion (29.4%), and treatment of disease (16%).The MVMM use is prevalent in Saudi population, warranting sound regulatory policies for their judicial use and increase awareness about the benefits and side effects of dietary supplements.

Ramadan and gestational diabetes: maternal and neonatal outcomes.

AIMS: The impact of Ramadan exposure to Gestational Diabetes Mellitus (GDM) pregnancies is not known. We therefore aimed to assess the association of Ramadan with maternal and neonatal outcomes among pregnant women with GDM. METHODS: Retrospective cohort study of 345 Muslim women with singleton pregnancies who attended a major Sydney teaching hospital during the period 1989-2010, was undertaken. Exposure to Ramadan was stratified by the: (1) total pregnancy days exposed to Ramadan, (2) duration (hours) of daily fasting and (3) trimester of exposure. Maternal and neonatal outcomes were examined by exposure status, and never exposed pregnancies were comparator in all three analyses. Fasting status was not recorded. RESULTS: We found no significant effect of Ramadan exposure on mean birthweight, macrosomia and maternal outcomes. However, we found a significant trend for increased neonatal hyperbilirubinemia with increasing Ramadan days exposure and later trimester exposure (ptrend ≤ 0.02 for both), with adjusted OR 3.9 (p=0.03) for those with ≥ 21 days exposure to Ramadan and adjusted OR 4.3 (p=0.04) for third trimester exposure. Conversely longer Ramadan exposure and late trimester exposure were independently associated with a lower prevalence of neonatal hypoglycaemia (adjusted OR 0.4 and 0.3 for ≥ 21 days and third trimester exposure, respectively). Furthermore, neonatal hypoglycaemia decreased for the fasting period of > 15 h group (adjusted OR 0.2, p = 0.01). CONCLUSIONS: Ramadan exposure is associated with reduced neonatal hypoglycaemia, with no effect on birthweight, implying more favourable glycaemic control. However, the fourfold excess of neonatal hyperbilirubinemia indicates a need for further study of Ramadan and GDM.