Patterns and Characteristics of Diabetic Ketoacidosis in Children With Type I Diabetes in Saudi Arabia.

BACKGROUND: Type 1 diabetes mellitus (T1DM) in children, a significant public health concern, often leads to diabetic ketoacidosis (DKA). The prevalence of T1DM is increasing globally, with Saudi Arabia recording high rates of DKA at T1DM onset. This study aimed to evaluate the characteristics and risk factors of pediatric T1DM patients presenting with DKA in the emergency room in Saudi Arabia and quantify intensive care unit (ICU) admission incidences reflecting DKA severity. METHODS: This retrospective chart review, conducted at Medina Maternity and Children's Hospital, Saudi Arabia, analyzed data from 2017 to 2022. The study included children and adolescents under 18 presenting with DKA, using non-probability consecutive sampling. Patient medical records provided demographic, medical, and laboratory data, and the analysis employed SPSS for statistical assessment. RESULTS: The study enrolled 70 participants, predominantly female (n = 42, 60%) and Saudi nationals (n = 63, 90%). The average age at diabetes mellitus (DM) onset was 6.9 years, with a mean hospital stay of 3.31 days. About 18.57% (n = 13) were newly diagnosed with DM, and 81.43% (n = 57) were known cases of DM. Most participants (n = 59, 86.8%) had no comorbidities, while 7.4% (n = 5) had celiac disease. The recovery rate was high (n = 67, 95.7%), with 80% (n = 56) experiencing no complications. Notably, 44.3% (n = 31) were admitted to a ward, and 12.9% (n = 9) required ICU admission. Weight was found to be a significant predictor of ICU admission (OR = 1.26, 95% CI: 1.05 to 1.5; p = 0.011). CONCLUSIONS: This study highlights the importance of personalized insulin therapy and weight management in pediatric T1DM patients presenting with DKA. It suggests that early and effective management in emergency settings can significantly improve patient outcomes. The study also calls for further research into long-term management strategies and the impact of targeted educational programs.

Over-the-Counter Bronchodilators Use Among Asthmatic Patients in Al-Medina Al-Monawwara.

Asthma is a prevalent chronic disease that affects a significant number of individuals worldwide. Proper diagnosis and assessment of asthma patients are crucial before determining the appropriate inhaler for them. Many asthmatic patients self-medicate with over-the-counter (OTC) inhaled and orally taken bronchodilators, leading to overuse and serious adverse effects. This study aims to identify the extent of OTC bronchodilator usage in the Al-Medina Al-Monawwara region. and urge health authorities to address the issue and prevent potential side effects arising from the overuse of bronchodilators. This cross-sectional observational study was conducted among individuals with asthma residing in the Al-Medina Al-Monawwara region of Saudi Arabia. The study encompassed multiple hospitals. It was carried out between September 2021 and February 2023, utilizing a convenience sampling method. A total of 419 participants were included in the study; the majority of them, 362 (86.4%), reported being prescribed asthma inhalers at least once in their lives, while 57 (13.6%) always used asthma inhalers without a prescription. However, most of our participants reported having a prescription for their short-acting bronchodilators, with 46.3% always obtaining them with a prescription and the remaining obtaining them over the counter. The current study indicates that the use of OTC Bronchodilators increases the risk of significant ER visits; this observation is quite concerning as the increasing use of short-acting beta-agonists (SABA) might indicate less asthma control and more SABA overuse; further research is needed to address the issue of short-acting bronchodilators overuse.

Role of Metformin in Polycystic Ovary Syndrome (PCOS)-Related Infertility.

Polycystic ovarian syndrome (PCOS) is considered the most prevalent endocrinological disorder, which affects some women and it is characterized by anovulation and hyperandrogenism, with morphologic changes in the ovary, inappropriate gonadotropin secretion, and insulin resistance (IR) with accompanying compensatory hyperinsulinemia. PCOS was associated with some degree of IR which probably contributes to hyperandrogenism. Many studies showed that metformin, when used to treat PCOS, significantly reduced serum androgen levels, improved insulin sensitivity, restored menstrual cyclicity, and was successful in triggering ovulation. As a result, metformin may be useful in treating PCOS-related infertility. The aim of this review was to clarify PCOS, its prevalence, particularly in Saudi Arabia, its pathogenesis, its impact on the patient's health, and to explain the uses of metformin, its mechanism of action, and its role in the treatment of PCOS-related infertility.