Characteristics and Outcomes of Failure to Thrive in Pediatric Patients Referred to the King Abdulaziz Medical City Pediatric Clinic.

BACKGROUND: Failure to thrive (FTT) in pediatric populations is a diagnostic challenge with implications for growth and development. Despite its prevalence, detailed epidemiological data, especially concerning organic versus non-organic etiologies, are sparse. This study examines the prevalence, characteristics, and outcomes of organic and non-organic FTT in a pediatric outpatient setting at King Abdulaziz Medical City, Jeddah. METHODS: This retrospective chart review included pediatric patients aged three months to 14 years diagnosed with FTT at KAMC from 2016 to 2023. FTT was defined by weights below the 3rd percentile or a decline across two major growth percentiles. Patients were stratified into organic and non-organic FTT groups based on predefined criteria. Prevalence rates, clinical characteristics, and outcomes were compared to draw distinctions between the two categories. RESULTS: Out of 349 evaluated patients, organic FTT was present in 160 patients (45.8%), with gastrointestinal conditions and endocrine disorders being the most common etiologies. Non-organic FTT, accounting for 189 (54.2%) of cases, was primarily associated with inadequate nutritional intake and behavioral factors. Notably, the non-organic FTT group exhibited a significantly higher rate of condition resolution (45.0%) compared to their organic counterparts (32.5%). Furthermore, significant laboratory parameter differences were noted, indicating a higher white blood cell count in organic cases, among other findings. CONCLUSIONS: Non-organic FTT was more prevalent and demonstrated higher resolution rates, suggesting better outcomes with timely intervention and appropriate care strategies. The study advocates for increased educational efforts for caregivers and healthcare providers and calls for further research to explore effective management protocols for FTT.

A Comparison of Magnesium Levels in Obese Versus Normal-Weight Children.

Introduction One of the world's most pressing problems right now is childhood obesity. After potassium, magnesium (Mg) is the second most prevalent intracellular cation and the fourth most prevalent mineral in the human body. Numerous symptoms of magnesium insufficiency can include hypocalcemia, hypokalemia, as well as cardiac and neurological symptoms. Additionally, chronically low Mg levels have been associated with a number of chronic diseases such as diabetes, hypertension, coronary heart disease, and osteoporosis. Objectives This study aimed to compare the magnesium (Mg) level between normal-weight and obese children in a tertiary center in Saudi Arabia over the past seven years and evaluate the vitamin D and phosphorus between the two groups as a secondary objective. Methods This is a single-center, case-control study conducted on patients followed up in our center from January 2016 to December 2022. All pediatric patients were between two and 14 years of age. They were divided into two groups: one with children whose body mass index (BMI) was over the 85th percentile and the other with children whose BMI was between the 3rd and 85th percentiles. Results Mean serum Mg levels showed no significant correlation between the obese group (0.82 mg/dl) and the normal-weight group (0.83 mg/dl). However, vitamin D and phosphorus demonstrate a significant difference between the two groups. The obese group revealed a vitamin D of 1.6±0.24 and phosphorus of 4.2±0.46. On the other hand, the normal group had a vitamin D of 44.0±28.2 and phosphorus of 1.5±0.26. Conclusion There was a negative correlation between Mg levels and weight in pediatric patients. However, a positive relationship was observed between the Mg intake and Mg levels. Moreover, sodium, phosphorus, and vitamin D levels showed significant differences.

Male Sexual Dysfunction-Related Medical Comorbidities in a Tertiary Care Center, Western Region, Saudi Arabia.

INTRODUCTION: Sexual functionality is considered a vital component of human life and quality of life. Issues with sexual functionality can be a source of distress, lower self-esteem, and lower quality of life. Early detection of medical comorbidities can significantly lower the effect on sexual function. In Saudi Arabia, studies investigating the association between medical comorbidities and male sexual dysfunction (MSD) are limited. Therefore, our goal was to fill this knowledge gap. AIM: This study aimed to analyze and elaborate on all cases of MSD at a tertiary hospital, in Jeddah, Saudi Arabia from 2016 to 2021. METHOD: This is a cross-sectional retrospective study. The medical records of 321 patients diagnosed with MSD from 2016 to 2021 were reviewed retrospectively. The age, sex, type of sexual dysfunction, comorbidities, and lipids profile were some of the factors obtained from the patient's computerized medical records. RESULTS: The study population included 321 men with MSD and a mean age of approximately 53 years (SD=11.5). Among the sexual dysfunction pattern, only erectile dysfunction (ED) was found in 279 (86.9%) patients. ED duration lasted one to five years in 169 (52.8%) patients. Most of the patients (196, 61.1%) had mild ED severity. Medical causes were seen in 278 (80.4%) patients. The most frequent comorbidities were diabetes mellitus (DM) in 179 (55.8%) patients, hypertension (HTN) in 155 (48.2%) patients, and dyslipidemia in 113 (35.2%) patients. Smoking was not a risk factor for ED. The risk of having a severe form of ED was associated with idiopathic causes, HTN, DM, and ischemic heart disease (IHD). The risk of having a long duration of ED was related to idiopathic causes of ED and high serum creatinine levels. CONCLUSION:  In conclusion, patients diagnosed with DM, HTN, and IHD are at greater risk to experience a severe form of ED. It is crucial to keep erection function in mind for patients with DM, HTN, and IHD as this is associated with severe ED.

The Recurrence of Symptoms After Anterior Cervical Discectomy and Fusion.

Objectives This study aimed to evaluate the recurrence symptoms rate after anterior cervical discectomy and fusion (ACDF) for one year and seek the common cervical vertebral disk affected in a tertiary center in Saudi Arabia over the past five years. Methods This is a single-center, cross-sectional study conducted on patients followed in our center from January 2016 to December 2022. All patients who were older than 18 and underwent ACDF were included. Results Out of 77 patients, 43 (55.8%) have experienced a recurrence of symptoms after the ACDF operation. The highest rate of recurrent symptoms was neck pain 22 (28.6%), left upper limb numbness 20 (26%), and right upper limb numbness 16 (20.8%). It was found that shoulder pain recurred after one level of ACDF in six patients out of 10 (60%), and only one (10%) patient experienced shoulder pain after two-level ACDF. Conclusion ACDF has a high rate of recurrence of symptoms, and the most common type of ACDF was two levels. Most symptoms were neck pain and upper limb radicular pain. However, there is a lack of studies. We recommend conducting more studies on the secondary management of recurrent symptoms post-ACDF.

The effect of different types of anemia on HbA1c levels in non-diabetics.

BACKGROUND: Diabetes mellitus is one of the most common diseases worldwide with significant morbidity and mortality. HbA1c remains one of the most important methods for diagnosis and monitoring of the disease. Since HbA1c is a reflection of the glucose attached to red blood cells, factors affecting hemoglobin and red blood cells' half-life can influence HbA1c measurements. OBJECTIVE: This study aims to evaluate the effect of different types of anemia including iron deficiency anemia, sickle cell anemia, ß -thalassemia trait, and megaloblastic anemia on HbA1c levels in a tertiary hospital over the past 6 years (2016-2022). METHOD: This is a retrospective chart review study of 324 patients including those with one of the four types of anemia mentioned above and a control group. The control group were healthy adults with normal HbA1c and hemoglobin, who were not known to have diabetes or anemia. Patients with diabetes or prediabetes based on self-reporting or elevated fasting, random blood sugar, or 2 hours post-prandial blood glucose were excluded. RESULTS: The mean HbA1c levels were significantly higher in sickle cell anemia at 5.83% (95% CI = 5.39-6.28) and in iron deficiency anemia at 5.75% (95% CI = 5.68-5.82) when compared to the control group at 5.32% (95% CI = 5.22-5.41). However, the mean HbA1c levels in megaloblastic anemia were 5.38% (95% CI = 5.26-5.5) and 5.45% (95% CI = 5.21-5.69) in beta thalassemia trait, which were not significantly different when compared to the control group. HbA1c significantly decreased from 5.75 to 5.44% after treatment in the iron-deficient group with a p-value of < 0.001. Moreover, lower hemoglobin and higher red cell distribution width correlated with higher HbA1c levels in patients with sickle cell anemia. CONCLUSION: This study found a significant increase in HbA1c levels in iron deficiency anemia and sickle cell disease in patients not known to have diabetes. However, there was no significant effect in those patients with ß-thalassemia trait and megaloblastic anemia. Treatment of iron deficiency anemia significantly decreased the HbA1c level, bringing it back to normal.

Infective Endocarditis Outcomes in Jeddah City, Saudi Arabia.

OBJECTIVES: This study aimed to analyze all the reported cases of definitive infective endocarditis, based on the modified Duke criteria in a tertiary hospital over the past five years, focusing on the causative organism/s, predisposing factors, and outcomes. METHODS: This is a cross-sectional retrospective study. Patients with a confirmed diagnosis of infective endocarditis using modified Duke criteria were included. The demographic data, predisposing factors, the causative microorganisms, laboratory and echocardiography results, and treatment were collected. RESULTS: In total, 37 patients were identified, 22 were male, and the median age was 59 years. Native valve endocarditis was found in 29 (78.3%) patients. The most frequently involved valves were the mitral valve in eight (42.1%) and aortic valve in six (31.6%) patients. Fever occurred in 22 patients (59.5%). The most frequent organisms were Staphylococcus aureus in 14 (37.4%) patients, coagulase-negative staphylococci in seven (18.9%) patients, and streptococci in seven (18.9%) patients. The majority (n=27) of the patients (72.97%) were treated medically, with 10 (27.02%) requiring in-hospital surgical intervention. The in-hospital mortality rate was 24.3%. Late presentation, reluctance to undergo surgery, and the past history of rheumatic fever were the contributing factors. CONCLUSION: Native valve endocarditis is the major type of infective endocarditis. The most frequent organisms were Staphylococcus aureus, Streptococcus, and coagulase-negative staphylococci. In our study, infective endocarditis was more common among males, surgical intervention was low, and a high in-hospital mortality rate was noted in our series.