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Background Plantar fasciitis is characterized by heel pain and is often associated with extended periods of walking or standing, improper footwear, and biomechanical imbalances. This condition primarily affects the bottom of the foot, particularly the area where the heel meets the arch. Despite its prevalence, the potential systemic effects, especially the relationship with cardiovascular disease (CVD) risk factors, require further illumination. This study explores the association between chronic plantar fasciitis and elevated C-reactive protein (CRP) levels in individuals with cardiovascular risk factors. Methods A cross-sectional study of 400 patients with foot or ankle pain was initially assessed clinically and with ultrasound or MRI scans. After excluding those with confounding factors for elevated CRP, 295 patients with concurrent diabetes, hypertension, or dyslipidemia were analyzed. We investigated the correlation between plantar fasciitis and elevated CRP levels, defined as >1 mg/L, in the context of cardiovascular risk assessment. Results The study indicated that nearly half of the patients suffering from foot or ankle pain were diagnosed with plantar fasciitis, accounting for 47.8% of cases. A statistically significant association was observed between plantar fasciitis and elevated CRP levels (p=0.035). Furthermore, a substantial correlation was found between high BMI and plantar fasciitis, but no gender-specific disparity was noted. Elevated CRP levels were significantly associated with diabetes, hypertension, and dyslipidemia. Discussion A definitive cause-and-effect relationship between plantar fasciitis and systemic inflammation has not been established; our study suggests that chronic plantar fasciitis may be more than a localized condition and could be indicative of systemic inflammation, which is known to be a factor in atherosclerosis and CVD. The observed correlation between increased CRP levels and plantar fasciitis suggests that plantar fasciitis might be a clinical indicator of systemic inflammation and could improve the assessment of CVD risk. Conclusions Elevated levels of CRP, associated with chronic plantar fasciitis, suggest a link to systemic inflammation, which could elevate the risk of CVD. Identifying plantar fasciitis as a marker for systemic inflammation in patients with CVD risk factors, including diabetes, hypertension, and dyslipidemia, underscores the importance of thorough cardiovascular evaluations in individuals with persistent heel pain. Further longitudinal and interventional research is essential to substantiate these preliminary findings and understand their impact on CVD risk management and treatment.
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Background Cardiovascular diseases are the leading cause of death in Saudi Arabia, and cardiac risk-stratification scoring methods are critical in the primary healthcare setting to predict and potentially prevent the fatal outcomes of CVD. Therefore, this study aimed to examine the prognostic value of coronary artery calcium scoring (CACS) and other cardiac risk-stratification scores: arteriosclerotic cardiovascular disease (ASCVD) risk estimator, cardiovascular risk score (QRISK2), and triglyceride glucose index (TyG) in primary healthcare facilities in Riyadh, Saudi Arabia. Methods A retrospective cohort study was conducted at Family Medicine Clinics, and data on patient's demographics, medical records, and chronic illnesses obtained from the Integrated Clinical Information System (ICIS) database that were recorded between 2010 and 2019 were analyzed. We performed descriptive statistics, student's t-test, analysis of variance (ANOVA), Pearson correlation, Cohen's Kappa, and regression analyses. Results QRISK (p<0.001) and ASCVD (p<0.05) risk estimators positively correlated with the CACS score in predicting fatal and non-fatal cardiac outcomes while the TyG score had the lowest prediction ability among all the other risk estimators. CACS (OR = 1.003; 95% CI: 1.005 -1.002) (p<0.001), ASCVD (OR = 18.177; 95%CI: 214.578 - 1.540) (p=0.021), and QRISK2 (OR=154.796; 95%CI: 4137.356 - 5.792) (p=0.003) significantly predict stenosis unlike the TyG score's statistically insignificant prediction (p>0.05). Conclusion These findings show that ASCVD and QRISK2 are consistent with CACS and are effective risk indicators that could be used to predict cardiac-associated fatal and non-fatal cardiac events among primary care patients. This indicates that the integration of multiple risk scores, as necessary, can all contribute to more effective risk assessment and prevention of coronary artery diseases and related cardiovascular events.
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BACKGROUND: This study aims to compare the effectiveness of using the checklist and global rating scores to evaluate the clinical competency of medical students in Objective Structured Clinical Examinations (OSCEs). Additionally, the study assesses the appropriateness of using the borderline regression method to set standards for small-scale OSCE exams and determines if the estimated passing marks differ significantly from the university's prefixed passing score of 70%. The study also examines whether the university should utilize the borderline regression method to determine passing scores for each OSCE exam instead of a set passing score. METHODS: The study analyzed medical students' grades in 11 OSCE exams in the 2022-2023 academic year at Alfaisal University, Riyadh, Saudi Arabia. Students received family medicine clerkship rotations, and after each rotation, they took an OSCE exam consisting of three stations that family medicine consultants graded. The exam included a checklist of 30 tasks and a five-level global rank scale. The study collected all the checklist marks and global rank grades and analyzed them using IBM® Statistical Package for Social Sciences (SPSS® Statistics) software. The statistical tests used were descriptive statistics, the T-test, chi-square tests, Fisher's exact test, and Pearson correlation. RESULTS: The study showed that students were more likely to pass when using the global rating system than the checklist scoring system. Additionally, students had a significantly lower passing rate when using the higher cut-off passing score estimated using the borderline regression method compared to the pre-set passing score of 70% established by the university (with a p-value of 0.00). CONCLUSION: Each scoring system has advantages and disadvantages, but they complement each other. Combining scoring systems can produce a more comprehensive and precise evaluation of a candidate's performance. The study also emphasizes the importance of carefully selecting and validating cut-off points in OSCE exams to ensure fairness and consistency in assessment.
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BACKGROUND: Obesity is a significant risk factor for multiple diseases such as diabetes mellitus and cardiovascular diseases. Many healthcare organizations worldwide have identified a high prevalence of obesity among their employees. In this study, we are looking at the prevalence of obesity among the employees of our healthcare organization and its impact on the employees' productivity and if its current prevalence is costly to the employer. METHODS: This is a non-interventional cross-sectional study conducted at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. Data on the current employees were obtained from medical records. We investigated a random sample of employees who worked in the hospital for at least one year between January 1, 2021 and January 1, 2022. We explored the prevalence of obesity among hospital employees at the beginning of their employment and its current prevalence. In addition, we aimed to investigate the effect of having employees suffering from obesity on their productivity and their utilization of healthcare during their employment period. RESULTS: We identified that our hospital has relatively younger healthcare workers and more employees who are suffering from obesity than in different other countries. The percentage of obese male and female employees was comparable. We had a relatively high increase in the prevalence of obesity among our employees during the last few years. We found a higher number of obesity-related medical problems, more office visits, more sick leaves, and more medications prescribed for overweight and employees who are suffering from obesity compared to those with normal weight. CONCLUSION: Healthcare workers suffering from obesity had lower productivity and they had higher utilization of healthcare. Therefore, employers should investigate the prevalence of obesity in their organization and implement diverse strategies to prevent and manage this issue to help their employees have better health and, at the same time, be more productive and lower their utilization of healthcare.
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Background Frequent sick leaves in any healthcare organization is a critical problem that can undermine the patients' care through increasing the workload on other co-workers and costing the organization a lot of money. Methods This is a quantitative cross-sectional study looking at the frequency of sick leaves among employees of a large, tertiary healthcare facility in Riyadh. We randomly selected 474 employees, who were seen in family medicine clinics during a one-year period. We collected all the data retrospectively from their electronic medical records. Then we reviewed and analyzed all the data using SPSS software version 26.0 (IBM Corp., Armonk, NY). Results There was no difference in the sick leaves rate between males and females (p-value = 0.8618), but we saw a higher rate among younger employees (40 years old or less) compared to those 41 years or older (p-value <0.0001). We also investigated those who took four sick leaves or more during the period of the study, and we found that majority of them were nursing staff (31.71%), hospital assistances (24.39%) and housekeepers (14.63%). The commonest cause for taking sick leave in our study was viral upper respiratory tract infection (VURTI). Therefore, we studied the effect of influenza vaccine on the frequency of sick leaves and we found that those who took the vaccine were less likely to take a leave because of flu (p-value <0.0001, odds ratio 0.4067 with 95% CI: 0.2739-0.608). Conclusion Younger employees, nurses, hospital assistants and housekeepers are more likely to take sick leaves. Flu is the leading cause of sick leaves and influenza vaccine seemed to reduce its rate. In this study, we also discussed different methods that can be used by any healthcare organization to reduce the absence rate. Further studies are required to better manage the issue of excessive sick leaves.
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OBJECTIVES: To review the evidence of the benefits and harms of infant male circumcision, and the legal and ethical perspectives of infant male circumcision. METHODS: We conducted a systematic search of the literature using PubMed, EMBASE, and the Cochrane library up to June 2015. We searched the medical law literature using the Westlaw and Lexis Library law literature resources up to June 2015. RESULTS: Male circumcision significantly reduced the risk of urinary tract infections by 87%. It also significantly reduced transmission of human immunodeficiency virus among circumcised men by 70%. Childhood and adolescent circumcision is associated with a 66% reduction in the risk of penile cancer. Circumcision was associated with 43% reduction of human papilloma virus infection, and 58% reduction in the risk of cervical cancer among women with circumcised partners compared with women with uncircumcised partners. Male infant circumcision reduced the risk of foreskin inflammation by 68%. CONCLUSION: Infant male circumcision should continue to be allowed all over the world, as long as it is approved by both parents, and performed in facilities that can provide appropriate sterilization, wound care, and anesthesia. Under these conditions, the benefits of infant male circumcision outweigh the rare and generally minor potential harms of the procedure.
