Incidence of ocular manifestations in patients with graft versus host disease after allogeneic stem cell transplant in Riyadh, Saudi Arabia.

AIM: To evaluate the incidence and severity of ocular graft versus host disease (oGVHD) in patients who underwent allogeneic stem cell transplant (SCT) in King Abdul-Aziz Medical City, Saudi Arabia. METHODS: This is a retrospective cohort study conducted in King Abdul Aziz Medical City on patients who underwent allogeneic hematopoietic cell transplant (allo-HCT) from 2010 to 2017. The ocular examination findings including visual acuity, meibomian gland dysfunction, corneal and conjunctival staining with severity, corneal scarring, tear film meniscus and breakup time, anterior and posterior segment examination findings, intraocular pressure, treatment given, punctual plugs used or not, and follow up response were collected. RESULTS: The five years cumulative incidence of oGVHD among post-transplant patients was 56.98% (95%CI 38.6%-71.7%). The potential risk factors assessed for developing ocular manifestation were age, gender, donor's age, donor gender mismatch CD3 and CD34 infusion, while none of the correlates were identified as statistically significant risk factors of developing ocular manifestation. However, the incidence was statistically significantly different between patients diagnosed with acute myelocytic leukemia and acute lymphocytic leukemia (P=0.038). The mean latent period to develop ocular symptoms was 20.5mo. All patients had variable degree of dry eyes. None of the patients developed any posterior segment complication. CONCLUSION: The incidence of oGVHD is low in King Abdul-Aziz Medical City. This can be attributed to the preconditioning and immunosuppressive regime.

Quality of life in living kidney donors: A single-center experience at the king abdulaziz medical city.

Chronic kidney disease (CKD) results in irreversible decline in renal function, which ultimately progresses to end-stage renal disease (ESRD). Transplantation is the treatment of choice for ESRD, and this is possible only if donor kidneys are available. Several doubts can appear in the minds of donors and among general public regarding the quality of life (QOL) after donation which can affect the willingness to donate. Therefore, we aimed to assess the QOL in living kidney donors in King Abdulaziz Medical City, Riyadh, Saudi Arabia using the kidney disease QOL instrument short form (KDQOL-SF). This was a cross-sectional survey of living kidney donors between 18 and 65 years of age who donated their kidneys between 2008 and 2014 and was conducted in the hepatobiliary and transplantation department of our hospital. The study measured 17 domains in KDQOL-SF. Each domain score is up to 100; the higher the score in each domain, the better the QOL. Data will be entered and analyzed using Statistical Package for the Social Sciences version 21.0. The descriptive statistics will be presented as frequency and percentage for the categorical variables (e.g., gender and income) and the mean ± SD for numerical variables (e.g., QOL score). The study included 60 donors who donated during the study period between 2008 and 2014. Males were 49 (82%) with the age (mean ± standard deviation) as 32 ± 6.5 years. The donors reported an "overall-mean-score" of 86.7 ± 14.6. Four domains had lower scores between 60 and 80: "sleep" (61.8 ± 13.8), "emotional-well-being" (71.6 ± 11.1), "quality-of-social-interaction," and "energy/fatigue." The other 13 domains had scores >80. The two highest domains: "role-physical" (97.9 ± 13.3) and "effect-of-kidney-disease" (97.4 ± 8). Comparing males and females scores, work status was higher in males with P = 0.03. Our findings suggest that donors have a good QOL which may result in more donations. It is important to improve the standard of care for donors to enable them to live their life to the fullest.

Development of type 2 diabetes mellitus after gestational diabetes in a cohort in KSA: Prevalence and risk factors.

OBJECTIVES: KSA has the highest prevalence of diabetes mellitus among Middle Eastern countries with a prevalence range of 21%-24%. Gestational diabetes (GDM) is a well-known risk factor for type 2 diabetes mellitus (T2DM). GDM is associated with a 7-fold increased risk of T2DM. Thus, this research assessed the prevalence and risk factors associated with the development T2DM in a cohort of patients with GDM in KSA. METHODS: The medical records of patients with GDM who visited the outpatient clinics of a tertiary care hospital from 2011 to 2014 were included in this study. Patients with a prior diagnosis of diabetes mellitus before pregnancy and those with GDM who did not have postpartum diabetes screening were excluded. RESULTS: A total of 123 women with GDM and underwent postpartum diabetes screening, 82 (67%) developed T2DM based on follow-up records. Approximately 45% (37/82) of patients who developed T2DM were screened ≤6 months after delivery, whereas 55%(45/82) were screened >6 months after delivery. Older patients, patients who had a higher number of pregnancies (gravidity and parity), and patients with previous GDM were more likely to develop T2DM. CONCLUSION: In KSA, women who developed GDM, particularly those who are older, multigravid, and multiparous and who have a prior history of GDM, are at an increased risk of developing T2DM. Postpartum diabetes screening of patients with GDM within the recommended period need to be improved.