A Rare Case of Gastric Phytobezoar (Diospyrobezoar) in a Healthy Adult.

Phytobezoars are solid masses of indigestible plant material and are a common type of gastrointestinal bezoar, with varying incidences globally. These bezoars typically form from the ingestion of high-fiber fruits and vegetables and are associated with factors such as decreased gastric acid production and delayed gastric emptying. We present a case of a 35-year-old healthy man with recurrent upper abdominal pain, nausea, a rolling ball sensation in the abdominal region, and a history of consuming unripe persimmons. Imaging revealed the presence of phytobezoars in the stomach, leading to unsuccessful endoscopic attempts at removal. Laparoscopic extraction was eventually performed successfully after failed conservative management. The case highlights the rarity of diospyrobezoars, a subtype of phytobezoars formed from persimmon ingestion, and the challenges in their management. Surgical intervention, particularly laparoscopic extraction, can be effective but carries risks such as surgical site infections. Comprehensive care involving diagnostic imaging, non-surgical interventions, and surgical techniques is crucial for the successful management of phytobezoars. Phytobezoars, though relatively common, present unique diagnostic and management challenges, especially when formed from specific dietary factors such as persimmons. Understanding their epidemiology, clinical manifestations, and treatment options, including the role of laparoscopic surgery, is essential for optimizing patient outcomes and minimizing complications such as surgical site infections.

Public Awareness Regarding the Differences Between Ophthalmologists and Optometrists Among Adults Living in Makkah Province, Saudi Arabia.

Background Patients' knowledge of the differences between ophthalmologists and optometrists has been identified as a crucial factor influencing the choice of eye care services. This study aimed to assess the level of understanding of the differences between ophthalmologists and optometrists among the population in the Makkah province. Methods This cross-sectional study utilized an online questionnaire distributed to adults via social media platforms in the Makkah province, Saudi Arabia, from January to April 2023. The total number of respondents was 1,404. Results This study revealed that 464 (33.3%), 690 (49.5%), and 241 (17.3%) of the participants demonstrated a low, fair, and good understanding, respectively of the distinction between an optometrist and an ophthalmologist. Overall, 936 (66.7%) exhibited good knowledge. The high level of knowledge is directly correlated with a history of previous eye examinations and the use of eyeglasses. The variables of age (specifically the 18-30-year cohort) and higher educational attainment (at or above university level) emerged as statistically independent predictors of sufficient knowledge acquisition. The odds ratios for younger age and a higher educational level were (confidence interval of 95%) 1.45 (1.11-1.88) and 1.42 (1.19-1.68), respectively. Conclusion This study revealed a fair public knowledge of the distinctions between optometrists and ophthalmologists. Additionally, we recommend the Ministry of Health encourage and sustain ongoing initiatives to enhance public awareness.

Probable Causative Agents and Demographic Patterns of Encephalitis, Meningitis, and Meningoencephalitis in a Single Tertiary Care Center.

Introduction Encephalitis, meningitis, and meningoencephalitis present significant challenges in clinical management owing to their diverse etiologies and potential complications. A high suspicion index is critical for guiding treatment strategies and improving patient outcomes. Understanding the demographic characteristics and frequency of causes of these conditions is essential to deliver optimized care. Objective This study aimed to investigate epidemiological causes and relative outcomes, including mortality, based on cultures, laboratory investigations, and demographic factors among patients with encephalitis, meningitis, and meningoencephalitis in a Saudi Arabian tertiary care center. Methods A retrospective cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected from patients admitted between April 2016 and December 2022 who met the specified inclusion criteria. Results Among 233 patients, meningitis was the most prevalent diagnosis (65.77%), with bacterial agents being the predominant causative agents (79.74%). Higher mortality was significant with pediatrics <5 years and adults >60 years. Conclusion This study provides valuable insights into the epidemiology and clinical outcomes of central neurological infections based on a Saudi Arabian cohort. These findings underscore the importance of an accurate diagnosis and tailored management strategies. Further studies are warranted to enhance our understanding and to inform more predictable characteristics targeted in optimizing healthcare delivery for patients with such conditions.

TMEM38B Gene Mutation Associated With Osteogenesis Imperfecta.

Osteogenesis imperfecta is a genetic disorder characterized by decreased bone density, bone deformities, and fractures. It results from mutations in different genes, including all steps of collagen 1 synthesis and modifications. In addition, the gene is involved in the homeostasis of intracellular calcium. TMEM38B is a gene involved in the formation of a cation channel responsible for calcium entry intracellularly. Mutations in this gene are associated with osteogenesis imperfecta. However, this mutation has not been frequently discussed in the literature. In our study, we report a case of TMEM38B-associated autosomal recessive osteogenesis imperfecta in a child of a consanguineous family presented with a history of multiple prenatal and postnatal fractures. No other associated complications are present in our case.

Biomedical Waste Management Knowledge among Dental Students and Private Dental Practitioners of Alkharj, Saudi Arabia.

Introduction: Improper handling of biomedical waste causes health hazards. Dental practitioners and students as health care professionals should know about biomedical waste management from its generation to disposal. This will prevent associated risk and cross-infection. Objectives: To assess the awareness, attitude, and practice of dental students and dental practitioners at Alkharj, Saudi Arabia. Methodology: Total of 100 dental students from a teaching institute and 100 private dental practitioners participated in the study. A closed-ended questionnaire was used containing 20 questions related to awareness, attitude, and practice of biomedical waste. Participation was voluntary. Results: 98% of dental practitioners and 95% of dental students are aware that biomedical waste causes health hazards. 25% of dental students and 36% of dental practitioners are aware of guidelines laid by the government of Saudi Arabia for BMW. On average, 74% of dental students and 87% of dental practitioners correctly answered practice-related questions. Conclusion: The knowledge hof dental practitioners about biomedical waste management in the Alkharj region is good compared to dental students. Dental students must be given training related to handling and management of biomedical waste.

Burnout and resilience among physical therapy students: a cross-sectional study.

BACKGROUND: This study aimed to examine the prevalence of burnout, determine burnout-related factors, investigate resilience levels, and assess the relationship between burnout and resilience among physical therapy (PT) students at King Saud University (KSU) in Saudi Arabia. MATERIAL AND METHODS: This cross-sectional study involved 153 PT students studying at KSU between January and March 2023. The participants completed an online questionnaire, a Maslach Burnout Inventory, and a Brief Resilience Scale. RESULTS: Low-to-moderate levels of Emotional Exhaustion (EE) were observed in 85% of the participants and high Depersonalization (DP) levels were reported by 34.2%. Female participants reported higher levels of EE and DP, whereas males had a greater prevalence of low Personal Achievement (PA) levels. Approximately 6.5% of the study participants reported high burnout levels (a combination of high DP, high EE, and low PA). Academic stress, followed by sleeping difficulties and changes in the academic year structure, were the most important factors contributing to higher levels of burnout (75.2%, 56.9%, and 43.8%, respectively). Most study participants around (66.0%) reported normal resilience levels. A significant correlation was detected between resilience and 2 domains of burnout (DP and PA), with the correlation being negative and weak for DP and positive and moderate for PA. CONCLUSIONS: Overall, low-to-moderate levels of burnout were observed among the PT students who took part. Related factors that contributed to burnout were academic stress, sleeping difficulties, and academic year structure. A normal level of resilience was found to be significantly related to DP and PA but not to EE on the burnout subscales. Higher levels of resilience can be considered to play a protective role against burnout among PT students. Med Pr Work Health Saf. 2024;75(4):343-354.

The Impact of Bariatric Surgery on Weight Reduction and the Resolution of Comorbidities in Older Geriatric Populations of Saudi Arabia: A Retrospective Study.

Background Obesity is a significant health concern among older adults, leading to various comorbidities and reduced quality of life. Bariatric surgery (BS) has emerged as a potential intervention, but its efficacy in geriatric populations, particularly in Saudi Arabia, is not well-established. Aims This retrospective study aims to evaluate the impact of BS on weight reduction and comorbidity resolution in Saudi Arabian geriatric populations. Methods A retrospective cohort study was conducted at King Khalid Hospital, Saudi Arabia, involving geriatric patients aged 60 and above who underwent BS between January 2018 and December 2022. Data were collected from medical records and analyzed using descriptive statistics, chi-square tests, t-tests, and multivariate regression analysis. Results The study included a total of 26 patients with a mean age of 64 years. Of these, 18 (69.3%) were females, while eight (30.7%) were males, and 23 (87%) underwent sleeve gastrectomy (SG), while three (13%) had Roux-en-Y gastric bypass (RYGB). Preoperative comorbidities majorly included diabetes (17, 35.42%), hypertension (11, 22.92%), and anemia (four, 8.33%). The average body mass index (BMI) of the patients decreased significantly from 45.12 to 37.29 at three months and further to 31.36 at six months post surgery. Total weight loss (TWL) was 19.92% at three months and 35.15% at six months, while the percentage of excess weight loss (%EWL) was 33.42% at three months and 57.85% at six months. Results also showed a significant reduction in the number of comorbidities postoperatively. A significant association with gender, preoperative weight, and preoperative height at three and six months and a significant association with preoperative BMI and comorbidity status at six months were recorded. Conclusion The study suggests that bariatric surgery is effective in achieving significant weight loss and improving comorbidities in geriatric patients. Few demographic and clinical features affect the outcome of the weight loss.

Essential oils as capsule disruptors: enhancing antibiotic efficacy against multidrug-resistant Klebsiella pneumoniae.

Background: Multidrug-resistant Klebsiella pneumoniae (MDR-KP) poses a significant global health threat due to its involvement in severe infections and high mortality rates. The emergence of MDR strains necessitates the exploration of alternative therapeutic strategies. Methods: K. pneumoniae isolates were obtained from human and animal sources. Antibacterial susceptibility testing was performed, followed by the evaluation of essential oil activity through inhibition zone, MIC, and MBC determinations. Checkerboard assays were conducted to assess synergistic effects with amikacin. Gene expression analysis and transmission electron microscopy were employed to elucidate the mechanisms of action. Molecular docking studies were performed to identify potential binding targets of bioactive compounds. Results: Klebsiella pneumoniae was isolated from 25 of the100 samples examined, representing a prevalence rate of 25%. All isolates were found to be multidrug-resistant. Tea tree and thyme essential oils exhibited potent antibacterial activity and synergistic effects with amikacin. Notably, these combinations significantly downregulated the expression of key capsule virulence genes (wcaG, rmpA, magA, uge, and wabG), suggesting a novel mechanism for enhancing amikacin efficacy. Transmission electron microscopy revealed disrupted cell integrity in MDR-KP cells treated with the combinations. Molecular docking analysis identified Terpinen-4-ol, Farnesol, 1,4-Dihydroxy-p-menth-2-ene, and 7-Oxabicyclo [4.1.0] heptane as potential bioactive compounds responsible for the observed effects. Conclusion: By effectively combating MDR-KP, this research holds promise for reducing antibiotic resistance, improving treatment outcomes, and ultimately enhancing potential care.

Prevalence and Associated Risk Factors of Insomnia Among Adults in Riyadh, Saudi Arabia.

Background Insomnia is a common sleep disorder with significant effects on physical and mental health. This study aimed to document the prevalence of insomnia and its associated risk factors among adults in Riyadh, Saudi Arabia. Materials and methods A cross-sectional study was conducted in Riyadh using the Sleep Condition Indicator Questionnaire (SCIQ). Data were collected from 548 participants. The inclusion criteria encompassed adults aged 18 and above living in Riyadh, Saudi Arabia. Information on sociodemographic characteristics, medical history, and sleep patterns was gathered through a translated eight-item SCIQ (score ≤16=insomnia). Statistical analysis involved descriptive and inferential statistics using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States). Results The findings revealed a significant prevalence of insomnia, affecting 219 individuals (40%). Insomnia was significantly associated with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, including difficulty initiating or maintaining sleep, frequency of sleep disturbances, significant distress, and duration of sleep disturbances (p<0.001 for each). The highest prevalence of insomnia was observed in the 40-60-year age group (n=91, 45.7%, p=0.014), among smokers (n=27, 60%, p=0.0063), and among obese individuals (n=20, 54.1%, p=0.035). Additionally, insomnia was strongly associated with anxiety (n=49, 66.2%, p<0.001), depression (n=27, 54%, p=0.033), and hypertension (n=24, 58.5%, p=0.011). Conclusion This study highlighted the high prevalence of insomnia among adults in Riyadh, particularly among older adults, smokers, and those with chronic health conditions. These findings underscore the need for targeted interventions to address insomnia and its associated risk factors. Future research should focus on longitudinal studies to establish causal relationships and explore the impacts of lifestyle and genetic factors on insomnia.

Health Education Resources Favored by Out-Patients Attending King Saud Medical City, Riyadh.

Background Health education, primarily through printed materials, is crucial for promoting preventive healthcare. It is essential to understand patients' preferences and ensure patient engagement in healthcare decisions. Health literacy challenges persist, and web-based platforms are expanding access. Tailoring materials to target populations, considering content, layout, and cultural appropriateness, maximizes effectiveness. This study aimed to determine the preferred health education resources for patients visiting King Saud Medical City, Riyadh. Methodology A cross-sectional study was conducted at King Saud Medical City, Riyadh, targeting adults in outpatient and staff clinic waiting areas. Data were collected using a validated questionnaire and analyzed with IBM SPSS Statistics for Windows, Version 29.0 (Released 2023; IBM Corp., Armonk, New York, United States). Results The study included 210 participants and revealed key preferences in health education. Notably, 57.6% preferred social media platforms, while 49.1% favored a doctor as their primary source. Participants prioritized pictures/photos (27.8%) and labels (56.2%) for printed materials. Most participants (91.4%) chose formats based on the comprehensive content provided. Participants sought general health guidance (26%) and preferences were significantly associated with education levels (p=0.010) and different sources (p<0.001). Additionally, students showed a significant association with receiving health education (p=0.046).  Conclusion The current study revealed diverse preferences for health education resources among patients at King Saud Medical City. The most favored method was social media platforms (57.6%, n=121), with participants ranking it as their first preference. Understanding these preferences is crucial for tailored and effective health education strategies.

Assessment of the services provided at the family medicine staff clinics in King Saud Medical City, Riyadh.

Background: Patient satisfaction is the subjective evaluation of a patient's cognitive and emotional responses. This reflects their expectations regarding the ideal healthcare to be provided. This study aims to assess the satisfaction level of the attendees to the family medicine staff clinics at King Saud Medical City, Riyadh. Materials and Methods: A descriptive cross-sectional study recruited 378 participants. An adapted and piloted questionnaire was used to gather the data. The questionnaire enquires about the communication skills of the receptionist, the triage nurse, and the assigned physician. It included questions regarding the structure of the clinics. Results: Females represent the majority of about 255 (67.5%). About 2/3 of the respondents were within the age group of 18-34 years, 245 (64.8%). A high level of satisfaction was reported by the participants regarding the professionalism, kindness, interest of the staff member, and waiting time. Gender, marital status, and age group have no significant effect on the satisfaction level; the P value was uniformly more than 0.05. Conclusion: The result of this study identified high satisfaction responses regarding the communication skills of the receptionist, triage nurse, and physicians. The overall evaluation of the experience during staff clinic visits was satisfactory. Periodic evaluation of these attributes and other indicators that promote patient-centered care should be undertaken to improve the overall quality of care.

Safety and Effectiveness of Direct Oral Anticoagulants Versus Warfarin in Patients with Venous Thromboembolism using Real-World Data: A Systematic Review and Meta-Analysis.

BACKGROUND: Direct oral anticoagulants (DOACs) have shown comparable efficacy and a superior safety profile in clinical trials for patients with venous thromboembolism (VTE). However, further study is needed to assess DOACs' effectiveness and safety compared to warfarin in a real-world context. Thus, this meta-analysis compares the effectiveness and safety of warfarin and DOACs in patients with VTE. METHOD: A systematic review of the literature using PubMed and EMBASE was conducted from inception until June 2024. We examined observational studies that compared safety and effectiveness between DOACs and warfarin when used in treating VTE and reported adjusted hazard ratios (HRs) and/or odds ratios (ORs) for recurrent VTE, major bleeding, clinically relevant non-major bleeding, gastrointestinal bleeding, intracranial hemorrhage, and death from any cause. We then estimated the pooled effect using the random-effects model for meta-analysis. RESULTS: A total of 25 studies were included in the current meta-analysis. DOAC therapy was associated with significantly lower risks of recurrent VTE (HR 0.76, 95% confidence interval [CI] 0.69-0.85), major bleeding (HR 0.77, 95% CI 0.72-0.83), clinically relevant non-major bleeding (HR 0.82, 95% CI 0.77-0.88), and gastrointestinal bleeding (HR 0.75, 95% CI 0.68-0.83) compared to warfarin. However, no statistically significant difference was observed in all-cause mortality between the two groups (HR 0.96, 95% CI 0.83-1.10). CONCLUSION: This meta-analysis found that DOACs are associated with a significant reduction in VTE recurrence in addition to the known favorable safety profile when compared to warfarin.

Exploring Patient Preferences for Information About CT Radiation Exposure: Bridging the Gap Between Patient Preference and Physician Practice.

Background: CT scan utilizes ionizing radiation poses a danger to the patient's health. Thus, telling the patient about ionizing radiation would be critical in promoting shared decision-making and improving patient-doctor communication. However, few studies have examined this topic broadly. Objective: The study was conducted to identify the frequency of physicians informing patients about the radiation risk before ordering a CT scan, as well as to examine the association between patients' demographic characteristics and their awareness of the radiation risks associated with CT scans. Methods: A cross-sectional study was conducted among 387 patients who had undergone CT scans at a tertiary hospital in Riyadh, Saudi Arabia. Data were collected via phone interviews using a structured questionnaire. Chi-squared tests were employed to assess associations between patients' demographic characteristics and their awareness of CT scan radiation risks. Results: When examining knowledge, 58% of patients knew that CT involves harmful radiation. This knowledge was significantly associated with higher education level and previous experience with CT scans. Regarding doctors' practice of providing information to patients about the scan, 344 (88.9%) patients indicated that their doctor had explained to them why they needed the scan. Only 28 (7.2%) patients stated that their doctor had mentioned the amount of radiation, and 74 (19.1%) patients indicated that doctors mentioned the risks associated with the radiation of the scan. Almost all patients (96.9%) preferred to be told about why they needed a CT scan. Conclusion: The vast majority of patients who underwent CT scans did not receive enough information about the harm of the scans. However, most of them preferred to know about this harm.

Rapid Improvement in Guillain-Barré Syndrome With Demyelinating and Secondary Axonal Involvement: A Case Report.

Guillain-Barré syndrome (GBS) is a major cause of acute neuropathy worldwide. The accurate classification of GBS subtypes is essential for diagnosis and prognosis, with acute inflammatory demyelinating polyneuropathy generally linked to more favorable outcomes. This case report examines a 65-year-old Sudanese man who experienced a six-day progression of symmetrical lower limb weakness and numbness, which rapidly escalated to significant motor impairment. Clinical evaluations and diagnostic tests identified primary demyelinating polyradiculoneuropathy with secondary axonal damage. Despite severe initial weakness and hypoxia, the patient showed significant recovery. Follow-up assessments confirmed full motor recovery and independent mobility. This case report aims to fill the gap in local data and provide valuable insights into the clinical features and outcomes of GBS in the Saudi Arabian context.

Patient Contentment Regarding Health Education Services at King Saud Medical City in Riyadh, Saudi Arabia.

BACKGROUND: Health education enhances healthcare outcomes and patient satisfaction, and with digitalized methods, it is gaining popularity in high-income nations. Effective education promotes behavioral change, treatment adherence, and overall satisfaction while maintaining interpersonal communication. Despite the strides made in medical advancements for diagnosis and treatment, interpersonal communication remains the primary conduit for information exchange, particularly manifested through health education dialogues between medical practitioners and patients. METHODOLOGY: A cross-sectional study was conducted at King Saud Medical City (KSMC), Riyadh, Saudi Arabia, to assess patient satisfaction with health education services. Data were collected through a structured questionnaire. Data were analyzed by IBM SPSS Statistics for Windows, Version 29 (Released 2021; IBM Corp., Armonk, New York, United States). RESULTS: This study on patient satisfaction with health education at KSMC in Riyadh included 225 participants, predominantly females (67.6% (n=152), mean age 38.5 years). Diabetes was the most prevalent (21.3%, n=48) among participants. Doctors were the primary source of health advice (46.2%, n=104). Structural aspects received high satisfaction (mean score of 31.8), surpassing healthcare provider delivery (mean score of 24.9) and print materials (mean score of 22.7). Demographically, occupation significantly impacted contentment (p-value=0.002), with students exhibiting the highest scores. Logistic regression highlighted patients' occupation (aOR=1.498) and patients' level of education (aOR=0.420) as predictors of contentment. CONCLUSION: This study highlighted high satisfaction with structural aspects of health education. Occupation, particularly among students, significantly impacts contentment. Tailoring education strategies based on occupation and education levels is crucial for improved patient satisfaction.

The Pathological Pattern of Breast Cancer in the Najran Region of Saudi Arabia: A Retrospective Study.

Background Breast cancer (BC) is the most widespread cancer on a global scale, and its prevalence is likewise significant in the Kingdom of Saudi Arabia. Nevertheless, the data accessible regarding the epidemiology and histopathological characteristics of BC in clinical practice is restricted and primarily confined to research endeavors. Aim This study aims to investigate the histopathological profile of women diagnosed with BC seeking treatment at King Khalid Hospital in the Najran region of the Kingdom of Saudi Arabia. Methods In this retrospective study, BC biopsies performed on Saudi patients at King Khalid Hospital between January 2018 and December 2022 were examined. All records of breast biopsies from this timeframe were extracted from the hospital's histopathology laboratory computer database after written permission from the head of the laboratory department. For all neoplastic lesions, the World Health Organization's 2012 categorization of breast tumors was applied. Results A total of 61 women with BC were included. Women's age ranged from 30 to 89 years, with a mean age of 49.6 ± 12.3 years. The most reported BC was invasive ductal carcinoma (IDC; 70.5%). Other types reported included invasive papillary carcinoma (8.2%), ductal carcinoma in situ (4.9%), and invasive lobular carcinoma (3.3%). A total of 14 (23%) of the study women had multifocal cancer. Ki-67 was high in 19 cases (31.1%); six (9.8%) had BRCA1 mutations, and six (9.8%) had BRCA2 mutations. Conclusion The current study revealed that BC was frequent among young females, mainly IDC, which was reported on both sides at different sizes and grades. Breast lump was the most commonly presented symptom and had a high representation in women with hormonal receptors, mainly estrogen receptors, but positive genetic testing was infrequent.

Genetic and Epigenetic Biomarkers Associated with Early Relapse in Pediatric Acute Lymphoblastic Leukemia: A Focused Bioinformatics Study on DNA-Repair Genes.

Genomic instability is one of the main drivers of tumorigenesis and the development of hematological malignancies. Cancer cells can remedy chemotherapeutic-induced DNA damage by upregulating DNA-repair genes and ultimately inducing therapy resistance. Nevertheless, the association between the DNA-repair genes, drug resistance, and disease relapse has not been well characterized in acute lymphoblastic leukemia (ALL). This study aimed to explore the role of the DNA-repair machinery and the molecular mechanisms by which it is regulated in early- and late-relapsing pediatric ALL patients. We performed secondary data analysis on the Therapeutically Applicable Research to Generate Effective Treatments (TARGET)-ALL expansion phase II trial of 198 relapsed pediatric precursor B-cell ALL. Comprehensive genetic and epigenetic investigations of 147 DNA-repair genes were conducted in the study. Gene expression was assessed using Microarray and RNA-sequencing platforms. Genomic alternations, methylation status, and miRNA transcriptome were investigated for the candidate DNA-repair genes. We identified three DNA-repair genes, ALKBH3, NHEJ1, and PARP1, that were upregulated in early relapsers compared to late relapsers (p < 0.05). Such upregulation at diagnosis was significantly associated with disease-free survival and overall survival in precursor-B-ALL (p < 0.05). Moreover, PARP1 upregulation accompanied a significant downregulation of its targeting miRNA, miR-1301-3p (p = 0.0152), which was strongly linked with poorer disease-free and overall survivals. Upregulation of DNA-repair genes, PARP1 in particular, increases the likelihood of early relapse of precursor-B-ALL in children. The observation that PARP1 was upregulated in early relapsers relative to late relapsers might serve as a valid rationale for proposing alternative treatment approaches, such as using PARP inhibitors with chemotherapy.

Evaluating diabetic foot care knowledge and practices at education level.

Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.

The Prevalence, Awareness, and Associated Risk Factors of Inguinal Hernia Among the Adult Population in Saudi Arabia.

PURPOSE: Inguinal hernias lead to several potentially fatal complications such as strangulation. Assessing the prevalence, risk factors, and beliefs of a population is essential to develop appropriate preventive strategies. This study investigated the prevalence, risk factors, and awareness of inguinal hernia in the adult population of Saudi Arabia. METHODS: This cross-sectional study enrolled 461 adults aged between 18 and 60 years after excluding those aged <18 and >60 years. This study was conducted in five regions of Saudi Arabia (north, west, central, south, and east). A pre-tested questionnaire was used to collect data on the prevalence, perception, and awareness of the participants. Multivariate regression analysis was used to identify risk factors for inguinal hernia. RESULTS: The study revealed that most participants were men n=262 (56.8%), aged between 18 and 25 years n=241 (52.3%), were single n=278 (60.3%), had a bachelor's degree n=225 (48.8%) and earned less than 50,000 Saudi Riyals annually n=285 (61.8%). Most participants resided in urban areas n=366 (79.4%) with their parents n=230 (49.9%). The prevalence of inguinal hernias in adults was low (5.2%). Our results indicated a significant association between family history of inguinal hernia, chronic cough, bronchial asthma, smoking, and inguinal hernia (p < 0.001). Young adults and undergraduates displayed significantly low awareness of inguinal hernias (p < 0.001). CONCLUSION: Family history of inguinal hernia, chronic cough, bronchial asthma, and smoking were factors associated with inguinal hernia. Low awareness levels were observed among young undergraduates, with a moderate overall level of awareness.

The Predictive Accuracy of Anogenital Distance and Genital Tubercle Angle for First-Trimester Fetal Sex Determination.

BACKGROUND: Early identification of fetal gender is crucial for managing gender-linked genetic disorders. This study aimed to evaluate the predictive performance of anogenital distance (AGD) and genital tubercle angle (GTA) for fetal sex determination during the first trimester. METHODS: A multicenter retrospective cohort study was conducted on 312 fetal cases between 11 and 13 + 6 weeks of gestation from two tertiary hospitals. AGD and GTA measurements were taken from midsagittal plane images using ultrasound, with intra- and inter-reader reproducibility assessed. Binomial logistic regression and ROC curve analysis were employed to determine the diagnostic performance and optimal cutoff points. RESULTS: AGD had a mean of 7.16 mm in male fetuses and 4.42 mm in female fetuses, with a sensitivity of 88.8%, specificity of 94.4%, and an area under the ROC curve (AUC) of 0.931 (95% CI: 0.899-0.962) using 5.74 mm as a cutoff point. For GTA, the mean was 35.90 degrees in males and 21.57 degrees in females, with a sensitivity of 92%, specificity of 84.7%, and an AUC of 0.932 (95% CI: 0.904-0.961) using 28.32 degrees as a cutoff point. The reproducibility results were excellent for AGD (intra-operator ICC = 0.938, inter-operator ICC = 0.871) and moderate for GTA (intra-operator ICC = 0.895, inter-operator ICC = 0.695). CONCLUSIONS: The findings suggest that AGD and GTA are reliable markers for early fetal sex determination, with AGD showing higher reproducibility. The findings highlight the feasibility and accuracy of these non-invasive sonographic markers and their potential usefulness in guiding timely interventions and enhancing the management of gender-linked genetic conditions.