The Prevalence and Impact of Urinary Incontinence on Multiple Sclerosis Patients in Taif City, Saudi Arabia.

Introduction Multiple sclerosis (MS) is a chronic inflammatory disease that results in demyelination and progressive loss of nerve cells within the central nervous system. Multiple sclerosis, as well as other neurological diseases that impact brain structures and spinal pathways involved in sphincter control, may cause lower urinary tract symptoms (LUTS) Our aims are to determine the prevalence, severity, and impact on the quality of life of urinary incontinence among MS patients in Taif, Saudi Arabia, as well as its potential association with demographics and clinical features. Method A cross-sectional study included 150 of MS patients aged 18 years and older who completed the validated Arabic versions of both the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). In addition, other clinical parameters were collected from the medical records of patients. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26 (IBM Inc., Armonk, New York). Qualitative data were expressed as numbers and percentages, and the Chi-squared test (χ2) was employed. Quantitative data were expressed as means with standard deviation (mean ± SD). Result 67.3% of the participants were female; the mean ICIQ UI and ICIQ OAB scores in these MS patients were found to be 6.30 ± 6.26 and 5.32 ± 3.76, respectively. They were significantly higher in progressive MS patients compared to relapsing-remitting MS patients (p<0.05). There was a high positive correlation obtained between ICIQ UI and ICIQ OAB scores (rho=0.801, p<0.001). Conclusion The findings of this study showed that urinary incontinence was a common and distressing symptom experienced by individuals with MS. The severity of UI symptoms was significantly more in progressive multiple sclerosis compared to relapsing-remitting multiple sclerosis.

Association Between Smartphone Usage and Primary Headaches in Taif, Saudi Arabia: A Hospital-Based Study.

Background Integrating smartphones into human life has transformed various daily activities. Numerous symptoms, including headaches, have been linked to smartphone use. The excessive use of these devices raises significant health concerns. This study aimed to investigate the relationship between smartphone use and the progression, type, and severity of primary headaches, as well as the necessity for both abortive and prophylactic medications in treating such conditions. Materials and methods In this study, we utilized a cross-sectional survey involving 403 participants aged 14 years and older, all experiencing primary headaches and seeking care at three governmental hospitals in Taif, Saudi Arabia. The participants were divided into two groups based on their smartphone usage: high and low smartphone users. Data were collected through a hospital-based questionnaire administered across the three centers. Descriptive analysis and Pearson chi-square tests were conducted using IBM SPSS Statistics for Windows, Version 21 (released 2012; IBM Corp., Armonk, New York, United States). Results Of the participants, 128 (31.8%) were classified as low users, while 275 (68.2%) were identified as high users. The most frequently reported type of headache was undiagnosed headache, among 109 (27%), followed by migraine, at 86 (21.3%). Headaches were severe in 112 (40.9%) of cases and moderate in 134 (48.9%) of users. Around 62 (72.1%) of participants diagnosed with migraine reported a severe impact on their daily lives. In terms of medication usage, 166 (60.6%) of participants reported consuming zero to five pills monthly, while 52 (19%) reported taking more than 10 pills monthly. Additionally, 58 (21.2%) of participants utilized prophylactic medications. Conclusion No significant association was observed between smartphone use and the impact of headaches. Notably, pain severity was higher among low smartphone users who reported a high intake of medications. Migraine was the most severe and intense headache type. On average, the participants consumed fewer than five pills per month.

Prevalence of stroke among patients with chronic kidney disease, Taif, Saudi Arabia.

OBJECTIVES: To evaluate the prevalence of stroke among chronic kidney disease (CKD) patients in Taif, Saudi Arabia. METHODS: A multicentric retrospective study was carried out from May 2021 to August 2022 on 4 dialysis centers in Taif, Saudi Arabia. With a total of 1857 CKD patients (aged ≥18 years old) participated in this study. Data were collected by reviewing patients' files. RESULTS: Approximately 98.3% of the participants had severely decreased glomerular filtration rate. Approximately 49.1% of them were on dialysis; the majority of them (87.2%) underwent hemodialysis. The prevalence of stroke in these CKD patients was 8.3%. Ischemic stroke was the most frequently reported issue (81.2%). Ischemic stroke was comparatively more frequently observed in peritoneal dialysis patients (12.1%); whereas hemorrhagic stroke was more on hemodialysis patients with statistically significant association (p=0.029). However, there was no significant association between the prevalence of stroke and stages of CKD. CONCLUSION: The prevalence of stroke in our cohort was 8.3%, and the majority of cases were ischemic strokes. Furthermore, ischemic strokes were more frequent in peritoneal dialysis patients, whereas hemorrhagic strokes occurred more frequently in hemodialysis patients with a statistically significant association.

Awareness Level of Diabetic Neuropathy and Its Complications Among Taif City Population in Saudi Arabia.

Background: Diabetes mellitus (DM) has become one of the most prevalent medical conditions worldwide. Despite the fact that DM affects a substantial proportion of the Saudi population over the age of 30, the general level of awareness of diabetic neuropathy has been reported to be poor in Saudi Arabia. Objective: To determine the level of awareness of diabetic neuropathy and its complications among the population of Taif City. Methods: This cross-sectional study evaluated the level of awareness of diabetic neuropathy among the population of Taif City using an online pre-designed self-administered questionnaire. Results: Of 486 participants enrolled in the study, 57.2% were females and 42.8% were males. In addition, 88.1% of the participants were Saudis. Our study showed that awareness of diabetic neuropathy and its complications among the population of Taif was almost non-existent, with 83.9% of the participants having never heard of diabetic neuropathy in their life. The level of awareness of this disorder was scored as 7.65 1.01 out of a total of 18, even though the educational level of the participants was excellent, and 61.3% of them had a university degree and above. Conclusion: This is the first report demonstrating the knowledge of diabetic neuropathy among residents of Taif City. Regardless of educational level, the knowledge of diabetic neuropathy was poor, necessitating greater efforts to increase public awareness using different approaches and campaigns. This will help in the early detection of such complications and impact the response to different treatment modalities.

Galcanezumab-Induced Myasthenia Gravis-Like Symptoms.

Fluctuating weakness affecting the ocular, bulbar, and/or appendicular muscles is characteristic of myasthenia gravis. Autoimmune components and certain drugs have been implicated in the pathophysiology of this disease. I report a case of chronic migraine in which the patient developed symptoms of myasthenia gravis after using galcanezumab, the recently approved anti-calcitonin gene-related peptide (anti-CGRP). This case shows that anti-CGRP medications could affect the neuromuscular junction and cause such symptoms. Moreover, this case illustrates the clinical approach and management of such a presentation.

COVID-19 Associated Neurological Manifestation.

BACKGROUND: At the end of 2019, COVID-19 was first detected in Wuhan. In March 2020, COVID-19 became a pandemic globally. Saudi Arabia registered the first case of COVID-19 on March 2, 2020. This research aimed to identify the prevalence of different neurological manifestations of COVID-19 and to assess the relation of the severity, vaccination state, and continuity of symptoms to the occurrence of these symptoms. METHODS: Cross-sectional retrospective study was done in Saudi Arabia. The study was conducted on previously diagnosed COVID-19 patients by random selection using a predesigned online questionnaire to collect data. Data was entered through Excel and analyzed through SPSS version 23. RESULTS: The study showed that the most common neurological manifestations in COVID-19 patients are headache (75.8%), changes in sense of smell and taste (74.1%), muscle pain (66.2%), and mood disturbance (depression, anxiety) (49.7%). Whereas other neurological manifestations such as weakness of the limbs, loss of consciousness, seizure, confusion, and vision changes are significantly associated with older individuals, this may lead to increased mortality and morbidity in these patients. CONCLUSION: COVID-19 is associated with many neurological manifestations in the population of Saudi Arabia. The prevalence of neurological manifestations is similar to many previous studies, where acute neurological manifestations such as loss of consciousness and convulsions are seen more in older individuals which may lead to increased mortality and worse outcomes. Other self-limited symptoms such as headache and change in smell function i.e., anosmia or hyposmia were more pronounced in those <40 years. This mandates more attention to elderly patients with COVID-19, to early detect common neurological manifestations associated with it, and to apply preventive measures known to improve the outcome of these symptoms.

Epidemiological determinants for the spread of COVID-19 in Riyadh Province of Saudi Arabia.

BACKGROUND AND OBJECTIVE: Coronavirus Disease 2019 (COVID-19) has affected millions of individuals all over the world. In addition to the patients' compelling indications, various sociodemographic characteristics were identified to influence infection complications. The purpose of this study was to assess the impact of the aforementioned parameters on the dissemination of COVID-19 among residents of Saudi Arabia's Riyadh region. MATERIALS AND METHODS: In the Saudi Arabian province of Riyadh, a cross-sectional retrospective analysis of COVID-19 incidences, recoveries, and case-fatality ratio (CFR) was undertaken. The study was carried out by gathering daily COVID-19 records from the ministry of health's official websites between October 2020 and September 2021. The influencing factors were obtained from the statistical authority. Using the SPSS IBM 25 software, the data was examined. The association between demographic factors as well as the presence of comorbidity on the COVID-19 outcome was determined using Spearman's correlation and regression tests. P < 0.05 was considered to indicate the significance of the results. RESULTS: The data from the study indicated that the highest number of COVID-19 cases were recorded in June 2021, and peak recovery was observed in July 2021. The CFR declined progressively from October 2020 to just over 1, even when the cases peaked. A significant (p < 0.05) correlation between diabetes and COVID-19 incidences was observed. The recovery rate had a significant (p < 0.05) association with the literacy rate and those aged 14-49 years old. Presences of co-morbidities such as Dyslipidemia, hypertension, diabetes, asthma, stroke and heart failure have negatively affected the recovery from COVID-19 in the population. The CFR is significantly (p < 0.05) associated with people over 60, hypertensive patients, and asthma patients. Regression analysis suggested that the risk of complications due to COVID-19 infection is more in males, people above 60 years age and those suffering from co-morbidities. CONCLUSIONS: The findings of the study indicate an association between several of the characteristics studied, such as gender, age, and comorbidity, and the spread of infection, recovery, and mortality. To restrict the spread of COVID-19 and prevent its complications, effective measures are required to control the modifiable risk factors.

Public knowledge and awareness of stroke among adult population in Taif city, Saudi Arabia.

OBJECTIVES: To evaluate the knowledge and awareness of stroke in adult population in Taif, Kingdom of Saudi Arabia and to address the association between several sociodemographic variables of participants and their knowledge regarding stroke. METHODS: A cross-sectional study was conducted among adult residents in Taif, Kingdom of Saudi Arabia, during the period of December, 2020 to February, 2021 using an online questionnaire. RESULTS: Our study included 3456 participants (43.6% males, 56.4% females). Analysis showed that 61.7% of the participants were aware of stroke. Participants who were 15-39 years-old had good knowledge. Male participants had better knowledge than females. The most identified risk factor was 'unhealthy lifestyle' (84.5%) and the least identified one was 'epilepsy' (34.8%). The most identified symptom was 'slurred speech' (57.5%), and the least identified one was 'dizziness' (36.2%). Approximately 86.6% of the participants agreed that stroke was a medical emergency. A total of 41.5% of the participants agreed that stroke was treatable and 42.6% agreed that stroke was a preventable disease. CONCLUSION: Although the participants recognize that stroke is a medical emergency and that early intervention is crucial, the obtained results show that there is a large gap in the knowledge of the warning signs and symptoms of stroke. Increasing community awareness about these warnings may affect how quickly the patient is treated.

Prevalence of depression among epileptic patients in Taif City, Saudi Arabia.

OBJECTIVES: To assess depression and its relation with different factors among people with epilepsy in wider range of ages. METHODS: A cross-sectional study was conducted in Taif city. The sample size was 150; the inclusion criteria were ≥18-year-old patients diagnosed with epilepsy. The data were collected by interviewing patients following up from rural and urban areas of Taif in neurology clinics at King Faisal Medical Complex (KFMC) and King Abdul-Aziz Specialist Hospital (KAASH). The PHQ-9 score was used to screen for depression. RESULTS: Our study showed that approximately 76.7% (n=115) of the patients had some form of depression. A severe form of depression was identified in 8.7% (n=13) of the patients, and a moderately severe form was observed in 13.3% (n=20) of the patients. There was no significant association between depression and gender, duration of epilepsy, type of epilepsy, and medications for epilepsy, while there was a statistical association between depression and age, stress level, and employment status (p<0.044, p<0.001, p<0.008, respectively). CONCLUSION: Depression is common in people with epilepsy. Regular screening for depression is recommended in people with epilepsy for early detection and treatment.

Nemaline Myopathy: A Case Report.

Generalized weakness in the pediatric and adolescent population is caused by many disorders that affect the neuromuscular axis. As next-generation sequencing (NGS) is becoming of high yield in replacing more invasive procedures, that is, muscle and nerve biopsy, more previously undiagnosed diseases of the muscles are now labeled with specific pathogenicity. A 16-year-old-girl diagnosed with nemaline myopathy but previously was misdiagnosed with congenital myasthenia and put-on unnecessary medications. Clinicians should be aware of congenital diseases that affect the muscles and know the importance of the NGS in reaching the correct diagnosis more so when there is a history of consanguinity.

Prevalence of anosmia among COVID-19 patients in Taif City, Kingdom of Saudi Arabia.

OBJECTIVES: To assess the prevalence of anosmia in coronavirus-19 (COVID-19) patients. Coronavirus-19-related anosmia and hyposmia is a new emerging concept in the medical literature. METHODS: A retrospective study on COVID-19 patients with anosmia and hyposmia was performed during the period between May-July, 2020. The inclusion criteria were all clinically stable COVID-19 patients less than 15 years old with positive reverse transcription-polymerase chain reaction (RT-PCR). Patients who refused to participate or leave incomplete questions were excluded. In this study, we investigated 1022 patients who met our criteria. RESULTS: Olfactory dysfunction (OD) was reported by 53% of our COVID-19 patients, of which 32.7% were anosmic and 20.3% were hyposmic. Other neurological symptoms included ageusia (51.4%), fatigue (63%), myalgia (59.2%), and headache (50.9%), all of which showed significant association with OD. In addition, anosmia had a significant association with young age and female gender. However, there was no association between OD and pre-existing neurological disease. CONCLUSION: Half of our COVID-19 patients presented OD (anosmia/hyposmia), which often associated with ageusia and many neurological symptoms.

Advantages and disadvantages of telemedicine during the COVID-19 pandemic era among physicians in Taif, Saudi Arabia.

OBJECTIVES: To evaluate the advantages and disadvantages of telemedicine among physicians during the COVID-19 pandemic. To assess the awareness about telemedicine among physicians and determine their opinions about telemedicine in the post-pandemic era. METHODS: A cross-sectional study was conducted at government hospitals (King Faisal Medical Complex [KFMC]-King Abdulaziz Specialist Hospital [KASH]) in Taif, Kingdom of Saudi Arabia (KSA), from May-August 2020. Taif is a small city in the western region of KSA with a population of 689,000 and 2 main hospitals (KFMC & KASH) which also serve rural areas close to Taif city. A total of 36 physicians practiced telemedicine, only 25 physicians accepted to participate in this study. RESULTS: Thirty-six percent of the responders believed that telemedicine could improve the effectiveness of therapeutic intervention and 44% believed that the quality of care was enhanced using telemedicine. Difficulty in reaching the correct diagnosis due to the lack of physical examination was one of the disadvantages that faced the participants. CONCLUSION: Telemedicine should be part of medical services but should not completely replace physicians' personal interaction. Telemedicine could be continued for stable remotely residing patients even after the COVID-19 pandemic.

The Prevalence of Peritonitis among Pediatric Peritoneal Dialysis Patients at Large Saudi Center.

Peritonitis is a common and serious complication of peritoneal dialysis (PD) and it is a direct or major contributing cause of death in around 16% of PD patients. Severe or prolonged peritonitis leads to structural and functional alterations of the peritoneal membrane, eventually leading to membrane failure, PD technique failure, and conversion to long-term hemodialysis (HD). This is cross-sectional record-based study in which the records of all children aged <14 years with end-stage renal disease on PD either on coiled or straight PD catheter had been reviewed at pediatric nephrology department in a tertiary care hospital, Riyadh, over the period of three years from 2017 to 2019. All information was collected using a structured data collection form. Our study had 30 patients on automated PD with 10 females (33.3%) and 20 males (66.7%) during the study period. The age ranged from 11 months to 14 years with a median 5.5 years, all of them were new to dialysis. A total of 11 out of 30 patients had multiple episodes of PD-associated peritonitis and the prevalence of peritonitis among the 30 patients was 37%. Peritoneal fluid cultures were positive in 100% episodes. Gram-positive, Gram-negative, and fungal organisms were identified in 72.7%, 18.1%, and 9.0% episodes, respectively. The analysis showed the exit-site infection (ESI) to be a risk factor to develop peritonitis, where 21 patients out of 30 had at least one ESI, 52% end by peritonitis in coiled catheter group. No mortality among our cohort of patients was noted, even removal of or changing PD catheter and transfer to HD. Our data showed that the prevalence of peritonitis secondary to ESI with Gram-positive organisms was significantly high, especially in coiled catheter group.