Knowledge, Attitude, and Practice of Foot Care and the Risk of Foot Ulcers in Diabetic Patients in Jeddah, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVE: Diabetic patients in Saudi Arabia are often underinformed about proper diabetic foot care. This study aims to determine the knowledge, attitude, and practice of the risk factors of diabetic foot ulcers among diabetic patients in the Jeddah region of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was done on 210 diabetic patients attending the international diabetic center in Jeddah, Saudi Arabia, during the study period. A validated questionnaire was used to collect data about participants' demographics and knowledge, attitudes, and practices of diabetic foot care. RESULTS: Of the participants, 77 (36.7%) were aged 51-60 years; 161 (76.7%) were male; 153 (72.9%) had a university education; and approximately 138 (65%) had type 2 DM. A majority, 190 (90.5%), acknowledged that DM patients might have reduced foot sensation; 204 (97.1%) agreed that diabetics could develop gangrene; 188 (89.5%) concurred that poor foot sensation increases the risk of foot ulcers; and 193 (91.9%) agreed that poor blood flow to the feet heightens this risk. Among them, 152 (72.4%) demonstrated good knowledge about foot care and the risk of foot ulcers; eight (3.8%) exhibited a positive attitude; and 95 (45.2%) showed a good level of practice. Good knowledge was significantly higher among married patients, and good practice was notably higher among older patients (>50 years). A significant positive correlation was found between knowledge scores and both attitude and practice scores. CONCLUSION: The study revealed adequate knowledge and practice of foot care and the risk of foot ulcers among diabetic patients. However, a high percentage of negative attitudes toward these issues were observed.

Conventional surgery versus botulinum toxin injections for partially accommodative esotropia.

PURPOSE: To compare the effect of botulinum toxin injection (BTX) to bilateral medial rectus recession (BMR) in partially accommodative esotropia (PAET). METHODS: The medical records of children 1-14 years of age treated for PAET with BMR or BTX between 2010 and 2020 at a single institution were reviewed retrospectively. PAET was defined as residual esotropia of at least 14Δ after 6 weeks of continuous wear of full cycloplegic refraction (> +2.5 D). Success was defined as esotropia of 0Δ-10Δ after a single surgery or ≥1 BTX injections. RESULTS: Of 224 patients, 121 received BTX and 103 underwent BMR. BMR showed a higher success rate than BTX (70.9% vs 53.7% [P = 0.006]). BMR was more successful in males, in patients >5 years of age, and when spherical equivalent was ≤ +5.00 D (79.2%, 74.3%, and 67.5%, resp. [P < 0.05]). Mean follow-up was shorter in the BMR group than in the BTX group (16.7 ± 14.7 vs 31.4 ± 29.5 months [P = 0.0001]). Mean duration of surgery was significantly shorter in the BTX group (5.2 ± 4.3 vs 70.5 ± 31.4 min [P = 0.0001]). Postoperative inferior oblique overaction was more common in the BTX group (7.4%; P = 0.02 [Fisher exact test]), and persistent ptosis was only seen in the BTX group (0.8%); consecutive exotropia was only seen in the BMR group (2%). CONCLUSIONS: In our study cohort, BMR had a higher success rate than BTX. Conventional surgery allowed for shorter follow-up and fewer complications than BTX in the treatment of PAET.

Curcumin mouthwashes versus chlorhexidine in controlling plaque and gingivitis: A systematic review and meta-analysis.

OBJECTIVES: The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and gingivitis. METHODS: A comprehensive online search of multiple databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed to identify all relevant studies published up to August 2020, using the following keywords: curcumin, turmeric, gingivitis, periodontal health, and plaque control. All clinical trials that compared the efficacy of curcumin mouthwash with chlorhexidine in controlling dental plaque and gingivitis were included. Data were analysed using Review Manager (RevMan) 5.3 software. The risk of bias was evaluated by two independent reviewers using the Cochrane assessment tool. RESULTS: Six randomized clinical trials (comprising 320 subjects) fulfilled the eligibility criteria. Five studies showed a high risk of bias and only one study showed a low risk of bias. The pooled data of the six included studies revealed comparable efficacy of curcumin and chlorhexidine in reducing dental plaque (I2  = 91%; standardized mean difference [SMD]: 0.27, 95% CI: -0.53, 1.07, p = 0. 51) and gingival inflammation (I2  = 40%; SMD: -0.13, 95% CI: -0.35, 0.09, p = 0.24), with no statistically significant differences between the two groups. CONCLUSION: The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.

Methicillin-Resistant Staphylococcus Aureus Bacteremia: Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes in a Tertiary Care Center in Riyadh, Saudi Arabia.

Background Methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly common in hospitals worldwide. In an era of pandemics, it is important to understand all types of infectious diseases in order to control its outcome and reduce mortality rates related to it. This study aims to identify the epidemiology of MRSA bloodstream infection, risk factors, and mortality in King Abdulaziz Medical City in Riyadh. Methods This is a retrospective chart review study from January 2013 to June 2017. All patients with positive blood culture for MRSA at King Abdulaziz Medical City (KAMC), which is a tertiary care center in Riyadh, Saudi Arabia, were included. Data were extracted from electronic and paper medical records for patients who had a positive blood culture for MRSA. Data collected included demographics, microbiological details, risk factors, and 30-day mortality. Results From 2013 through June 2017, 633 Staphylococcus aureus bacteremia were reported in KAMC, of which 184 (29.1%) were MRSA with a mean age of 60±19 years. Almost all of our isolates were susceptible to vancomycin, linezolid, and tigecycline. The most common infectious syndrome these patients presented with was an endovascular infection which accounts for 30.4% while 19.9% presented as a case of pneumonia. The mortality within 30 days of collection of the positive blood culture was 20.65%. Male gender (OR = 2.33; 95% CI = 1.34-4.05; P-value = 0.003) and patients with history of recent hospital (OR = 2.34; 95% CI = 1.27-4.34; P-value = 0.007) or ICU (OR = 1.66; 95% CI = 1.09-2.52; P-value = 0.018) admissions were more likely to acquire MRSA. Conclusions The incidence of MRSA bacteremia at King Abdulaziz Medical City is high and increasing in conjunction with incidence rate posing a significantly high rate of mortality. Recent history of hospital admission, ICU admission and males were found to be significantly associated with higher rates of MRSA infection. Some modifiable risk factors that could be used to facilitate the reduction of MRSA acquisition rates is to avoid unnecessary hospital and ICU admissions.