Association of ABO Blood Groups and Obesity in Patients With Diabetes Mellitus in King Abdulaziz University Hospital.

BACKGROUND: Differences in the blood, resulting from the presence or absence of antigens corresponding to specific blood types, have indirect implications for susceptibility to diseases. The aim of this study was to examine the association between the ABO type and obesity in patients with diabetes mellitus. METHODS: This is a cross-sectional observational study that was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Data were collected using a simple random method through hospital records during the period between August and September 2022. Patients with type 1 diabetes mellitus (T1DM) and T2DM were included in this study. Binary logistic regression analysis was used to identify the association between blood group and obesity. RESULTS: A total of 411 patients were involved in this study. More than half of the patients (54.3%; n= 223) are diagnosed with T1DM. O-positive was the most common blood group type among the patients, accounting for 38.6% (n= 161). Only 23.6% (n= 97) of the patients were classified as having normal weight. Around 32.6% (n= 134) of the patients were classified as having the pre-obesity stage. More than one-third of the patients (35.1%; n= 145) were classified as being obese. There was no statistically significant difference between the patients in terms of their blood type group and its association with obesity (p>0.05). CONCLUSION: Many diabetics are overweight or obese, according to this study. This shows the importance of weight management for diabetes treatment. Many patients were overweight, emphasizing the importance of obesity prevention and diabetes care. Most patients were O-positive, according to blood type tests. Previous research suggests that blood types may be linked to diabetes. However, this study found no significant relationships. More research is needed to understand the complex link between blood types, weight, and diabetes.

Prehospital Fibrinolysis Therapy in Acute Myocardial Infarction: A Narrative Review.

Acute myocardial infarction is a fatal condition. Acute myocardial infarction requires appropriate timely reperfusion therapy to improve the outcomes. Fibrinolysis and percutaneous coronary intervention are the cornerstone strategies for managing such cases. In this review, our objective is to summarize the available evidence concerning the administration of prehospital fibrinolysis and its impact on patient outcomes in patients with acute myocardial infarction. We conducted a comprehensive literature search across PubMed, Cochrane Library, Scopus, and Web of Science databases. Our search strategy included the following terms: "Prehospital," "EMS," "Emergency Medical Services," "ambulance," "Fibrinolytic Therapy," "alteplase," "streptokinase," "reteplase," "tenecteplase," "Acute Myocardial Infarction," and "patient outcomes." We found prehospital administration of fibrinolysis may improve the outcomes and decrease the mortality rate. We found that some recommendations were to use prehospital fibrinolysis only if the percutaneous coronary intervention was not accessible within two hours. Additionally, we discussed recommendations to use newer prehospital fibrinolysis as they have better efficacy and safety outcomes. In conclusion, prehospital fibrinolysis decreases the total ischemic time and improves outcomes in acute myocardial infarction patients when timely percutaneous coronary intervention is not available. The guidelines strongly recommend it when the anticipated time for percutaneous coronary intervention exceeds two hours. Ongoing research optimizes patient selection, treatment tools, and prehospital systems of care.

User Perceptions and Use of Decision Support Medical Apps Among Medical Students: Cross-Sectional Study.

We aimed to assess medical students' use of decision-support medical apps and evaluate their perception of app use. A cross-sectional multi-center observational study was conducted among medical students with and without a medical informatics course as part of their undergraduate medical curriculum. We assessed trust, perceptions, patient impression, reliability, and comfort using an online survey. A total of 439 responses were received. There were significant differences between the two groups when indicating which apps, they trust. Students agreed that using apps enhanced knowledge (91%), saved time (88%), improved patient care (85%), and increased diagnostic accuracy (82%). Students indicated that patients would think that students didn't know what they were doing (63%) or students were fresh out of training (53%) when using apps in the presence of patients. Incorporating medical app usage as part of learning may increase trust and comfort with using medical apps in medical practice.

Smartphone use and its association with body image distortion and weight loss behaviours among adolescents in Saudi Arabia.

BACKGROUND: Concerns about the harmful effects of smartphone use on teenage development have been raised as the use of cell phones among adolescents has risen. OBJECTIVE: This study aimed to examine the associations of smartphone usage patterns with Body Image Distortion (BID) and weight loss behaviors among adolescent smartphone users in Saudi Arabia. METHODS: This population-based, cross-sectional study was conducted from July to October 2022. We assessed the mean daily length of smartphone use and classified it into quartiles using data from a self-reported survey and data on weekday and weekend use. Self-reported body weight and height were collected via an online survey. Out of the 11384 adolescents, the majority was females (65.7%) and was secondary school students (68.9%). RESULTS: The prolonged smartphone use (301 min/d) was found in 36.4% of adolescents, 181-300 min/d in 27.6% of respondents, 121-180 min/d in 22.4% of respondents, while the modest smartphone use (1-120 min/d) was found only in 13.6% of participants. The duration of smartphone use was significantly associated with BID (P= 0.000); students with middle perceived stress levels (51.4%) and no depressive symptoms (68.9%) used smartphones 121-180 min/d sparingly. However, prolonged smartphone use was significantly associated with the presence of depressive symptoms (42.6%) and high perceived stress levels (21.5%). Weight loss behaviors were significantly associated with smartphone use duration. Modest smartphone use was significantly found in students with normal weight (P= 0.00, 71.9%); however, aerobic physical activity weight loss strategy (P= 0.00, 30.9%) was correlated with prolonged smartphone use. CONCLUSION: Adequate parental advice is required to assist teenagers in developing healthy smartphone usage practices. Digital platform companies may increase their social responsibility for the information generated and delivered on their networks, boosting its beneficial effect.

Insight of the Biopharmaceutical Implication of Sleeve Gastrectomy on Levothyroxine Absorption in Hypothyroidism Patients.

PURPOSE: The growing rate of obesity led to an increased number of bariatric surgeries (BS) as a treatment option for obesity. The gastrointestinal tract (GIT) changes following BS can impact many drugs' absorption. Levothyroxine (LT4) is a synthetic thyroxine (T4) replacement used commonly as tablets to manage hypothyroidism disorder, which is more prevalent among patients with obesity. This study aims to examine the LT4 oral tablet form therapy after sleeve gastrectomy. MATERIALS AND METHODS: A retrospective cohort study was conducted in multi-center. The LT4 doses and TSH and T4 levels were compared before and after BS. The post-surgery readings were categorized into three periods: (one to three months), (four to six months), and (> six ) months after surgery. ANOVA test was used for analysis. RESULTS: A total of 14374 patients who underwent BS from (1/2019 to 3/2022) were screened for eligibility, and n = 101 participants matched the inclusion criteria. The TSH and T4 were not statistically significant differences before and after surgery (P-values of 0.4864 and 0.5970, respectively). However, the doses significantly differed before and after surgery in all the follow-up time point periods (P < 0.002). CONCLUSION: The LT4 required doses significantly reduced after sleeve gastrectomy, which can be related to the improved endogenous thyroid production in patients with obesity. However, the abnormality of the GIT induced by the sleeve gastrectomy may affect the exogenous LT4 absorption. Using liquid forms of LT4 while monitoring the thyroid function parameters can optimize the treatment after the procedure.

Real-world effectiveness of the inactivated COVID-19 vaccines against variant of concerns: meta-analysis.

BACKGROUND: COVID-19 has killed over 6 million people worldwide, making it the worst global health disaster since the 1918 influenza pandemic. Experts have worked to establish the source, track and analyse the disease, and produce treatment and preventative guidelines. Inactivated vaccines have little evidence of efficacy compared to mRNA and adenoviral vector vaccines; however, three doses of both mRNA and inactivated vaccines appear to provide significant and lasting protection against severe disease and mortality. This study examines inactivated vaccine effectiveness data by disease status, age, gender, primary immunisation, booster doses, and SARS-CoV2 virus types. METHODS: We conducted a quantitative epidemiological meta-analysis study to assess the vaccine effectiveness of inactivated COVID-19 vaccines. Data extraction was performed on the selected studies, and data analysis was conducted using a random-effects model to determine consolidated assessments of vaccine effectiveness. Subgroup analyses were conducted for gender, age, disease level, and vaccine status, and sensitivity analyses were conducted to assess the robustness of the results. RESULTS: The overall effect size of inactivated COVID-19 vaccinations was statistically significant (p-value<0.05), suggesting that complete vaccination should be the primary method of vaccination. Partial vaccination was associated with lower levels of vaccine effectiveness (70.18 95% CI 57.33-83.02) than complete vaccination (79.52 95% CI 67.88-91.71)) and booster vaccination (84.22 95% CI 74.34-94.10), suggesting that it is essential to finish the recommended vaccine series and receive booster doses. Fig.-3: Partially vaccinated individuals showed a vaccine effect size of 70.18 (95% CI 57.33-83.02), indicating that the vaccine was moderately effective in preventing COVID-19 among this group. Fully vaccinated individuals showed a vaccine effect size of 79.52 (95% CI 67.88-91.71), indicating a higher level of vaccine effectiveness. Finally, booster-vaccinated individuals showed a vaccine effect size of 84.22 (95% CI 74.34-94.10), indicating the highest level of vaccine effectiveness. CONCLUSION: Inactivated COVID-19 vaccines are highly effective in preventing COVID-19, and complete vaccination and booster vaccination are associated with higher levels of vaccine effectiveness compared to partial vaccination. These findings highlight the importance of completing the recommended vaccine series and receiving booster doses to provide greater protection against COVID-19.

The Impact of Recombinant Human Erythropoietin Administration in Critically ill COVID-19 Patients: A Multicenter Cohort Study.

The use of erythropoietin-stimulating agents (ESAs) as adjunctive therapy in critically ill patients with COVID-19 may have a potential benefit. This study aims to evaluate the effect of ESAs on the clinical outcomes of critically ill COVID-19 patients. A multicenter, retrospective cohort study was conducted from 01-03-2020 to 31-07-2021. We included adult patients who were ≥ 18 years old with a confirmed diagnosis of COVID-19 infection and admitted to intensive care units (ICUs). Patients were categorized depending on ESAs administration during their ICU stay. The primary endpoint was the length of stay; other endpoints were considered secondary. After propensity score matching (1:3), the overall included patients were 120. Among those, 30 patients received ESAs. A longer duration of ICU and hospital stay was observed in the ESA group (beta coefficient: 0.64; 95% CI: 0.31-0.97; P = < .01, beta coefficient: 0.41; 95% CI: 0.12-0.69; P = < .01, respectively). In addition, the ESA group's ventilator-free days (VFDs) were significantly shorter than the control group. Moreover, patients who received ESAs have higher odds of liver injury and infections during ICU stay than the control group. The use of ESAs in COVID-19 critically ill patients was associated with longer hospital and ICU stays, with no survival benefits but linked with lower VFDs.

Keloid Scar Resistance to Intralesional Steroid Injections: Should We Look for Foreign Bodies? A Case Report.

Keloid is a challenging pathological condition characterized by abnormal scarring that extends beyond the boundaries of the original wound. Despite the available treatment options, keloid scars remain difficult to manage. This case report discusses a 10-year-old boy with a keloid scar on his neck following branchial anomaly repair surgery. The patient underwent multiple treatments, including triamcinolone injections, cryotherapy, and a pulsed dye laser session, with limited improvement. Subsequently, an X-ray and ultrasound were performed revealing the presence of metallic clips over the surgical site. To our knowledge, the effect of the presence of foreign bodies within the keloid scar on its response to treatment is not well understood yet. The findings of this case encourage performing imaging studies on post-surgical keloid scars resistant to treatment to rule out the presence of any foreign material. However, more trials to investigate the effect of the presence of foreign bodies on the treatment of keloid scar are required before it can be set as a mandatory investigation.

The Association Between Glycated Hemoglobin (HbA1c) Level and Vitamin D Level in Diabetes Mellitus Patients: A Cross-Sectional Study.

BACKGROUND: Prior research has established noteworthy correlations between inadequate glycemic management and a multitude of problems in individuals diagnosed with diabetes mellitus (DM). METHODS: This is a cross-sectional retrospective study that was conducted at the Jeddah Center for the Care of Diabetes and Blood Pressure Patients, Jeddah, Kingdom of Saudi Arabia. The medical records of patients diagnosed with DM between 2015 and 2022 were identified and reviewed for the purpose of this study. Pearson correlation coefficient was used to examine the correlation between glycated haemoglobin (HbA1c) and vitamin D levels. Multiple linear regression analysis was applied to identify the association between HbA1c and vitamin D levels. RESULTS: A total of 152 patients were included in this study. The mean HbA1c level for the patients in this study was 8.2% (SD: 1.7). The median vitamin D level for the patients was 20.9 ng/ml (interquartile range (IQR): 13-30.4). More than half of the patients (n= 92; 60.5%) were found to have vitamin D insufficiency. Pearson correlation coefficient identified that there is an inverse correlation between the level of HbA1c and vitamin D level (r= -0.21 (95%CI -0.36 to -0.06; p-value= 0.007). Multiple linear regression analysis (adjusting for age and type of DM) identified that poor glycaemic control has a negative association with vitamin D level (regression coefficient (B) = -0.027; 95%CI -0.053 to - 0.001; p-value= 0.039). CONCLUSION: Poor glycaemic control is associated with vitamin D deficiency in DM patients. It is recommended that patients with DM adhere to their medications and maintain a healthy lifestyle in order to manage their condition. This will improve their overall health, specifically their vitamin D status.

The Knowledge, Attitudes, and Associated Factors Regarding First Aid Among the General Public in Saudi Arabia.

BACKGROUND: Accidents may occur at any time and in any location. Unintentional accidents may have life-threatening consequences. Anyone with basic first aid knowledge can assess the situation and intervene to provide proper care. This research aims to assess public knowledge and attitudes toward first aid and its related aspects in Saudi Arabia. METHODS: A cross-sectional online survey was conducted between April and May 2023 to investigate first aid knowledge, attitude, and associated factors among the general public of Saudi Arabia. This study's population consisted of Saudi Arabians aged at least 18 who are part of the general community. This research adapted and used a previously developed questionnaire to evaluate the general public's knowledge, attitudes, and other characteristics about first aid in Saudi Arabia. A binary logistic regression analysis was utilized to determine the variables that influence their knowledge and attitude. RESULTS: A total of 1135 participants were involved in this study. Almost one-third of the study participants (36.0%) reported that they had received training in first aid. The vast majority of the study participants (94.5%) reported that they had heard of first aid before. The media was the most commonly reported source of information on first aid (37.6%). Choking (63.2%), breathing difficulty (61.7%), and fainting (56.7%) were the most commonly reported indications (injuries or accidents) that need first aid. The mean knowledge score for the study participants was 4.4 (SD: 2.8) out of 8 (55.0%), which represents a moderate level of knowledge of first aid. The mean attitude score for the study participants was 22.5 (SD: 2.7) out of 28 (80.4%), which reflects a positive attitude toward first aid. Binary logistic regression analysis identified that women, those who have a higher education level, medical students, those with a high monthly income (7500 Saudi Arabian rials (SAR) and above), and those who work in the healthcare sector were more likely to be knowledgeable about first aid (p<0.05). Participants aged 31 to 40 years and university students were more likely to have a positive attitude toward first aid (p<0.05). CONCLUSION: This research highlights the need to educate the public about first aid and emergency treatment. Even though one-third of participants have received first aid training, ongoing training is necessary. First aid information, especially on social media, is often unreliable. Choking, difficulty breathing, and syncope are typical first aid conditions, and awareness of dealing with choking is needed. Gender, socioeconomic status, and education influenced first aid knowledge and attitudes. Women, medical students, and healthcare workers knew more about first aid. Most participants supported first aid provision. This research strongly suggests improving awareness, providing inexpensive first-aid training, and targeting specific populations to improve first-aid knowledge and attitudes.

Public awareness of online pharmacies, consumers' motivating factors, experience and satisfaction with online pharmacy services, and current barriers and motivators for non-consumers: The case of Saudi Arabia.

Purpose: Online pharmacies (OPs) represent a growing field that plays a major role in providing pharmaceutical services in Saudi Arabia (SA). Thus, investigating public awareness of this option and assessing consumers' experiences and satisfaction, as well as opportunities and barriers for OPs, were the main aims of this study. Participants and methods: In this cross-sectional study, adult participants (≥18 years) in SA completed a three-part, custom-designed online questionnaire. The first section collected information on participants' demographic characteristics, their awareness of the existence of OPs, and history of OP purchases. The second section explores customer satisfaction levels and motivating factors. Finally, the third section investigated non-consumers' reasons for not purchasing from OPs and sought information about services that could motivate them to make future purchase decisions. Results: In total, 487 participants completed the questionnaire; they were mostly female (65.7%) and younger than 40 years (57.1%). Among all the respondents, 89.3% were aware of the existence of OPs, and 60.2% purchased from OPs in the past. Most were satisfied with the product quality (92.7%), completeness of order delivery (91.2%), and condition of the product and packaging (89.3%). Furthermore, 99.2% of respondents indicated that they would continue to purchase from OPs. Customers' main motivational factors included saving time (85.5%), offers and discounts (83.6%), and variety of products (82.1%). Among non-consumers, the main reasons for not purchasing from OPs included a personal preference to visit a community pharmacy (87.2%), the ability to talk to pharmacists directly (83.6%), and the vicinity of a pharmacy (80.0%). Conclusions: These findings confirm the increasing level of awareness regarding the existence of OPs in SA. Overall, OP customers expressed satisfaction with the services provided. Nevertheless, various areas of improvement have emerged, such as improved delivery time and providing medical consultation services. Increasing public awareness of OP services provided is essential considering their significant role in reforming the healthcare system in SA.

Public Knowledge of Inflammatory Bowel Diseases in Saudi Arabia: A Cross-Sectional Survey Study.

BACKGROUND: Lack of public understanding and perception may lead to a general downplaying of inflammatory bowel disorder (IBD) symptoms as they affect a less socially acceptable area of the body, which may be a significant component in the everyday struggles of an individual with IBD. AIM: The aim is to assess the public knowledge of Crohn's disease and ulcerative colitis in Saudi Arabia. METHOD: This was an online survey study that examined public knowledge of IBD in Saudi Arabia for the duration between February and March 2023. Participants were invited to participate in this study using social media websites. The questionnaire tool comprised three sections: a sociodemographic characteristics section (seven questions), an awareness section (two questions), and a knowledge section (24 questions). A binary logistic regression analysis was utilized to identify the factors that influenced the participants' knowledge of Crohn's disease and ulcerative colitis. RESULTS: A total of 630 individuals participated in this study. Around 28% of the participants reported that they had never heard of, read about, or dealt with Crohn's disease. Around 16% of them reported that they had never heard of, read about, or dealt with ulcerative colitis. The mean overall knowledge score of the study participants was 8.3 (standard deviation: 2.4) out of 24, which is equal to 34.6% and represents a weak level of knowledge of IBD. The participants showed a weak level of knowledge for all sub-scales of knowledge related to IBD general knowledge, diet, treatments, and complications. The knowledge sub-scale level ranged between 30% and 36.7%. Females, the participants in the moderate and high-income category, those who lived in urban areas, those with a higher level of education, and those who reported having osteoarthritis were more likely to be knowledgeable about IBD compared to others (p≤0.001). CONCLUSION: In Saudi Arabia, a low level of IBD awareness was identified among the general population, supporting findings from other countries. Future research should aim to identify effective educational interventions to increase public awareness of this group of diseases, which would ultimately facilitate early diagnosis and improve patient outcomes.

Interoceptive Awareness Among the General Public in Saudi Arabia: A Cross-Sectional Study.

Background Interoception refers to the cognitive process of perceiving internal bodily states. This encompasses various physiological indicators, including heart rate fluctuations, stomach distention, internal temperature, hydration levels, sensory input from free nerve terminals in the fascia and muscles, as well as hormonal, stretch, and pain receptors. This study aimed to examine the interoceptive awareness among the general public in Saudi Arabia. Methods A cross-sectional online survey was undertaken in Saudi Arabia to investigate the level of interoceptive awareness within the overall population of the country in October 2023. This research used a previously developed questionnaire named the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2). In a binary logistic regression analysis, the mean interoceptive awareness score of the participants was utilized as the dummy variable to determine the variables that influence interoceptive awareness. Results A total of 814 participants were involved in this study. Overall, the study participants demonstrated a marginal level of interoceptive awareness with a mean score of 94.3 (standard deviation (SD): 29.3) out of 185 (representing 51.0% of the maximum attainable score). The mean interoceptive score was not consistent across different subscales and ranged between 37.7% and 63.3%. The highest mean interoceptive score was observed for the Trusting subscale (9.5 (SD: 4.5) out of 15) (representing 63.3% of the maximum attainable score for this subscale). The lowest mean interoceptive score was observed for the Not-Distracting subscale (11.3 (SD: 6.9) out of 30) (representing 37.7% of the maximum attainable score for this subscale). Binary logistic regression analysis did not identify any statistically significant difference in the likelihood of having a higher level of interoceptive awareness among the participants based on their demographic characteristics (p>0.05). Conclusion The participants in our research demonstrated a modest degree of interoceptive awareness. The study's results suggest that the participants demonstrated a heightened inclination towards internal experiences rather than being attentive to their bodily sensations. Further investigation is required to examine interoceptive awareness across various cohorts.

Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia.

Background Family medicine is a specialty that provides care for family members' physical, social, and psychological aspects regardless of age, gender, and health conditions. A family physician can manage a wide range of health conditions and prevent various diseases. However, there are scarce data on the awareness and perceptions of the Saudi population regarding family medicine; therefore, we aim to determine the awareness and perception of family medicine and family physicians in the population of Jeddah, Saudi Arabia. Methodology This cross-sectional study was conducted in Jeddah and randomly enrolled 519 participants aged 18 years and older through an online self-administered survey. Microsoft Excel and SPSS were employed for the data entry and analysis. Result The analysis indicated that 86.7% of the participants had heard about family physicians, 55.1% recognized the family physician's role, 61.7% had never visited one, and 57.2% were unfamiliar with the locations of family medicine clinics. Conclusion The results of this study demonstrated that the general population of Jeddah has moderate positive responses toward the role of a family physician as a vital element in the healthcare system. However, the majority of the participants had never previously visited a family physician and were unfamiliar with the locations of family medicine clinics.