ABSTRACT
Background: Few studies have been conducted on unintended pregnancies and peripartum depression in Saudi Arabia. This study aimed to evaluate the relationship between unplanned pregnancies and peripartum depression among pregnant women in Jeddah, Saudi Arabia. Methods: This prospective cohort study included pregnant women attending an antenatal care clinic in 2021. The London Measure of Unplanned Pregnancy was used to assess the prevalence of unplanned pregnancy, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal and postnatal depression. Results: A total of 236 participants were included, of which 25.8% had unplanned pregnancies, 36.0% had ambivalent pregnancies, and 38.1% had planned pregnancies. EPDS results revealed that 77.5% and 73.35% of the females were negative for antenatal and postnatal depression, respectively. A history of stressful events (P=0.001), husband (P=0.020), and family support (P=0.007) was significantly associated with antenatal EPDS score, whereas age (P=0.005), type of delivery (P=0.019), and family support (P=0.031) were significantly associated with the postnatal score. Conclusion: Unplanned pregnancies may affect the perinatal mental health of women. We demonstrated the importance of family or husbands' support for women with perinatal depression. In addition, our research showed that pregnancy at an early age is a risk factor for postnatal depression. Therefore, these women should be closely monitored not only during their pregnancy but also during the first postpartum year.
ABSTRACT
Background Understanding palliative care (PC) can hinder access to it. To address this, further research into the factors influencing knowledge and awareness of PC is required to develop effective public health campaigns. This study aimed to estimate the knowledge and awareness of PC among primary family caregivers of patients present to the palliative department at King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia (KSA), in 2023, and to determine the factors affecting the family caregiver's awareness about PC. Materials and methods This cross-sectional study was conducted in 2023 among patients' family caregivers in the palliative department of King Abdullah Medical City, Makkah, KSA. The patient was evaluated by palliative service as an inpatient or outpatient presentation. A score, namely "caregivers' general knowledge of palliative care," was used as a study variable. Each of the questions was converted to points and calculated using a simple additive method. The total score was converted to a categorical variable. To discard the null hypothesis, a conventional p-value <0.05 was used. Results The 378 family primary caregivers completed the self-administered questionnaire. The majority (73.8%) were unaware of PC until their family member was admitted to the hospital. The mean score of caregivers' general knowledge is 2.75+0.9, indicating that they have limited knowledge about PC. Age, employment status, relation to the patient, and duration of receiving PC are significantly associated with their knowledge. No associations were found on gender, level of education, and tumor site. Participants aged 26-35 years old (p<0.001), those who are students (p=0.002), who are brother/sister of the patient (p<0.001), and less than one year of PC (p<0.001) significantly related to caregivers' knowledge. Conclusion A low knowledge mean score was found in this study. This indicated that participants had limited knowledge of PC. This study suggested that effective PC education programs and increasing specialized facilities be developed to raise the awareness of both caregivers and patients.
ABSTRACT
Background COVID-19 pandemic represents a significant risk factor for developing, relapsing, or exacerbating pre-existing mental health conditions. This negative impact on mental health results in increasing demand for psychiatric services. This study aimed to explore the effects of COVID-19 pandemic lockdown on the utilization of mental health services in three periods - prior, during, and after the lockdown - compared to the matched weeks in the previous years 2018 and 2019. Materials and Method In this retrospective cohort, quantitative, single-center study, data were collected from electronic medical records, including all patients with referrals\consultations to the psychiatric section prior, during, and after COVID-19 lockdown. Results In total, 2,454 patients were either referred to psychiatric outpatient clinics or needed consultation as inpatients during the study periods. Only 2,326 patients were included in our study. The total number of inpatient consultations was 1,410, with a statistically significant increase during the lockdown (p-value<0.001) and post-lockdown (p<0.016) in comparison to previous years. A significant reduction in outpatient referrals was observed during the lockdown (p=0.005) and post-lockdown period. Psychiatric disorders were identified in most patients (N=1,599), representing 65%, 54%, and 74% of patients in pre-lockdown, lockdown, and post-lockdown periods compared to 71%, 71%, and 76%, respectively, in the previous years. A total of 821 patients manifested symptoms of depression, constituting the largest proportion among all reasons for referral\consultations. The number of patients referred for substance/alcohol use disorders during the lockdown increased compared to patients in the same period in 2019. Suicidal behavior was identified in 70 patients across all study periods, with the lowest number observed in 2020. Conclusion Our findings indicate that during the COVID-19 lockdown, a significant increase in inpatient psychiatric services utilization was observed. Outpatient psychiatric service utilizations were significantly reduced. Implementation of evidence-based policy and protocol to guide mental health challenges in future health emergencies is needed.
ABSTRACT
We need to be aware of rare causes of persistent thrombocytopenia as Bernard-Soulier syndrome (BSS). When BSS is suspected based on family history and giant platelets, genetic test for mutations of GPIbIXV is necessary. Management varies once you recognize the cause. Platelets transfusion and antifibrinolytics are the mainstay of therapy.
