Adult Saudi Patients Research Articles

Assessment of Choroidal Thickness in Keratoconus Patients Using Optical Coherence Tomography Among Adult Saudi Patients

Assessment of Choroidal Thickness in Keratoconus Patients Using Optical Coherence Tomography Among Adult Saudi Patients

Patterns of Complementary and Alternative Medicine Use Among Adult Patients with Multiple Sclerosis: A Cross-Sectional Study

Multiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination of the central nervous system. No treatment has shown to be completely effective, thus, the tendency for patients with MS to use non-conventional therapies like Complementary and Alternative Medicine (CAM) might increase. The study aims to explore the pattern of CAM use among patients with MS at a tertiary health care center in Saudi Arabia. This is a questionnaire-based observational cross-sectional study that targeted adult patients diagnosed with MS at a tertiary care center, Riyadh, Saudi Arabia. The study sample size was 176 patients, and consecutive non-probability sampling technique was used to approach them during their appointments. An Arabic validated questionnaire was used to evaluate patients’ use of CAM. The mean age was 34.6 ± 10.9 years, and the majority of patients were females. Eighty-nine percent of the participants reported using CAM at least once. Praying was the most frequent modality (60%), followed by supplication (59%), Ruqia (52%), and vitamins (44%). Symptomatic improvement was reported by 49 (27.8%) of complementary medicine users and 81 (46%) of alternative medicine users. The study found a high prevalence of CAM utilization among Saudi adult patients with MS exceeding internationally reported rates. Although some patients described some improvement in their symptoms, further research is needed to evaluate the effectiveness of CAM.

Factors affecting the distribution of glomerulonephropathies among adult Saudi patients: A single-center, biopsy-based clinico-pathological study

Introduction: Glomerulonephropathies (GNs) have high burden of morbidity and mortality worldwide. The distribution GNs varies significantly due to several factors. Materials and Methods: This retrospective clinico-pathological study estimates the biopsy-proven distribution of primary and secondary GNs and detect s the predominant patterns among adult patients who underwent renal biopsy at Nephrology Centre, King Abdul-Aziz Specialist Hospital, Taif City, Kingdom of Saudi Arabia (KSA) from 2008 to 2013 with comparing data to other KSA studies and to other countries. Analysis of possible contributing factors for variation is provided. Relevant patients’ data were collected from hospital records. Renal biopsies stained with H&E, Periodic Acid Schiff (PAS), Gomori Methenamine Silver (GMS), Masson Trichrome (MT) and immunofluorescence (IF) were examined and categorized according to the World Health Organization (WHO) classification of glomerular diseases. Comparisons to other studies were set. Results: Primary and secondary GNs comprised 59.4% and 40.6%. Focal segmental glomerulosclerosis (FSGS) was the commonest primary GN (29.3%), followed by minimal change disease (MCD, 22%) then membranous glomerulonephropathy (MGN, 19.5%). IgA nephropathy was the least frequent (IgAN, 2.4%). Lupus nephritis (LN) was the commonest secondary GN (75%), followed by diabetic and vascular nephropathies (DN, 17.9% ; VN, 7.1%). Spatial and temporal variations in GNs distribution existed locally and worldwide. Conclusion: Factors including selection criteria; biopsy rate and indications; local facilities; demographic distribution; racial, ethnic and genetic differences; and prevalence of etiological factors contribute to the variations of GNs distribution. National renal biopsy registry is recommended for obtaining correct distribution of GNs leading to proper prevention and treatment. Keywords: Distribution, Glomerulonephropathy, Renal biopsy, FSGS, Lupus nephritis.

Exploring the outcome of multiple sclerosis among Saudi adult patients. A single-centered cross-sectional study at King Abdulaziz Medical City in Riyadh, Saudi Arabia.

Objectives:To assess the outcome and impact of multiple sclerosis (MS) using validated Arabic versions of the Barthel index (BI) multiple sclerosis impact scale (MSIS-29), the modified Rankin scale (mRS), and the expanded disability status scale (EDSS).Methods:A cross-sectional study conducted at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia, during July-November 2017. All Saudi adult patients diagnosed with MS between 2000-2016 (269 patients) were included. Patients were contacted via phone calls and were assessed using a newly developed and validated multi-component questionnaire that included demographic data, disease course, and Arabic versions of the scales.Results:Out of 269 patients, 210 (78.2%) responded. The average patient age was 37.44±10.3 years. The majority were females (69.5%). Only, 51 (24.3%) patients reported worsening conditions. Annually, the average relapse rate was 2.28±1.91. In regard to patient outcomes, 120 (57.1%) showed no significant disability in mRS, 146 (69.5%) were ambulatory without aid in EDSS, and 185 (89.4%) were independent in BI scores. The average MSIS-29-PHYS score was 33.6±27.6 and MSIS-29-PSYCH score was 38.2±25.8. Modified Rankin scale and EDSS were significantly associated with the current use of disease-modifying therapy (DMT). Modified Rankin scale was negatively associated with delayed diagnosis. Barthel index showed significant association with medication compliance and the absence of attacks.Conclusion:Majority of patients had a favorable outcome that was linked with the use of DMT, compliance, early diagnosis, and absence of attacks.

The association of health literacy with glycemic control in Saudi patients with type 2 diabetes.

Objectives:To identify the prevalence of health literacy among adult Saudi with type 2 diabetes mellitus (T2DM) patients and determine the clinical factors that are associated with health literacy scores including glycemic control.Method:A cross-sectional study that included 249 adult Saudi patients with T2DM (99 males and 150 females) who visited the Diabetes Clinic of the Endocrine Center at King Fahad Medical City, Riyadh, Saudi Arabia between September 2017 and January 2018. The short test of Functional Health Literacy in Adults (Arabic version) was used to classify patients into 3 levels of functional health literacy: inadequate, marginal, and adequate. Demographic characteristics were noted and glycosylated hemoglobin was assessed routinely. Regression analysis was carried out to determine whether health literacy is associated with glycemic control.Results:Majority of the participants had adequate literacy rate (68.7%). The adequate group is significantly younger (48.4±12.8) than the marginal (54.2±13.3) and inadequate group (54.1±9.1). Females in the adequate group were significantly lesser (54.6%) than the marginal (66.7%) and inadequate (81.8%) groups. Being female has a lesser odds of having an adequate health literacy level (odds ratio [OR] -1.24, confidence interval [CI] -1.97-0.50; p=0.001). Body mass index was positively associated with adequate health literacy level, but the significance was modest (OR 0.04; CI 0.003-0.09; p=0.045).Conclusion:Health literacy is high among Saudi T2DM patients and is not associated with glycemic control.

Estimation of apparent clearance of valproic acid in adult Saudi patients.

Background Valproic acid is one of several antiepileptic medications requiring therapeutic drug monitoring due to its complex and wide pharmacokinetic interindividual variability. Objective The objective of this study was to determine the population pharmacokinetics of valproic acid in adult Saudi patients and to identify factors that explain its pharmacokinetic variability. Setting Tertiary referral teaching hospital, Riyadh, Saudi Arabia. Method A retrospective chart review was performed at King Saud University Medical City of patients who received oral valproic acid. The population pharmacokinetic models were developed using Monolix 4.4. After development of the base model, we investigated several covariates including age, sex, weight, total daily dose, and cotherapy with carbamazepine and phenytoin. Main outcome measures the pharmacokinetic parameters of valproic acid and the variables that contributing towards its inter-individual variability. Results The analysis included a total of 54 valproic acid plasma concentrations from 54 patients (42.5% male). The data were sufficiently described by a one-compartment model with linear absorption and elimination processes. Average parameter estimates for valproic acid apparent clearance (CL/F) and apparent volume of distribution (V/F) were 0.14 L/h and 37.7 L (fixed), respectively. The inter-individual variability (coefficients of variation) in CL/F was 12%. The most significant covariates for valproic acid CL/F were age, body weight, total daily dose, and cotherapy with carbamazepine and phenytoin. Conclusion This model showed significant inter-individual variability between subjects. Our findings showed that patient age, body weight, total daily dose, and cotherapy with carbamazepine and phenytoin are the most significant covariates of valproic acid clearance. Collectively, healthcare providers should take these factors in consideration for optimal valproic acid dosage regimen.

HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN TYPE 2 DIABETES PATIENTS WITH PAINFUL NEUROPATHY BEFORE AND AFTER 6 WEEKS PREGABALIN THERAPY.

Painful Diabetic Neuropathy (PDN) is associated with a significant reduction in health-related quality of life (HRQOL). Glycemic control and improving HRQoL are now recognized as the main goals of patientcentered diabetes care. This pre-post quasi study aimed to assess HRQoL in type 2 diabetic patients with PDN before and after pregabalin therapy from October 2017 to April 2018. Adult Saudis outpatients (N=103) with PDN, under no specific therapy, were selected from three private hospitals in Jeddah, Saudi Arabia. Neuropathy Symptom Score, Numeric Rating Scale (NRS-11), neurological examination, 10 gm monofilament, and Ewing's reflex tests were used for assessment. All enrolled patients received pregabalin 75 mg once for 1 week followed by twice daily; then higher doses were used based on response (median dose 150 mg for 6 weeks). Weekly follow up was performed for patient’s severity using NRS-11 and for drug side effects. HRQOL was assessed before and 6 weeks after pregabalin therapy using the Arabic version of The RAND 36-item Health Survey. Patients had severe PDN (median of 7), poor metabolic control (median A1C of 9.1) and disabling both mental (36.71) and physical summary scores (32.50) of HRQoL (both below 50). Higher baseline A1C was significantly associated with higher pain severity (r=0.467, p=0.000) and lower pain score-QoL (r=-0.267, p=0.006). After 6 weeks of therapy, significant improvements were detected in pain severity, metabolic control and all subparameters of HRQoL (p=0.000 for all). The major side effect was dose-dependent somnolence (18%). Uncontrolled type 2 adult Saudi patients with severe PDN have disabling HRQoL. Six weeks of pregabalin therapy was safe and effective and was associated with the improvement of physical and mental parameters of HRQoL. Given its recent restrictions in Saudi Arabia, risk of misuse and dependency, other therapeutic modalities for these patients should be similarly investigated.

Sociodemographic Characteristics of Adult Saudi Patients with Mood Disorder Subtypes.

Background:The demographic profile and clinical manifestations of mood disorder subtypes can differ across regions; however, there is a lack of studies from Saudi Arabia on the sociodemographic characteristics of adult Saudi patients with mood disorder subtypes.Objective:The study aims to explore the sociodemographic profile of adult Saudi patients with different types of mood disorders.Methods:This retrospective study analyzed the data of all adult Saudi patients (aged ≥18 years) who were diagnosed with a mood disorder and attended the psychiatric outpatient clinic at King Fahd Hospital of the University (KFHU), Al Khobar, Saudi Arabia, between 1982 and 2011. Patients with psychiatric comorbidity were not included in the analyses. Major depressive disorder (depression), bipolar disorder, adjustment disorder and dysthymia were the four subtypes of mood disorder identified in the sample, and all eligible patients were categorized accordingly.Results:A total of 340 patients were included in this study. Slightly less than half (42.4%) the study population were aged 18–30 years. Further, 58% of the patients were females, 67.6% were married and 58.8% were unemployed. Depression was the most common mood disorder (~73%). Of the patients with bipolar disorder (n = 38), more than half were male and aged 18–30 years (~58% each); these percentages were higher than that observed in other subtypes.Conclusion:This study found that among patients at KFHU, depression is the most common mood disorder and that most patients are females. In contrast, bipolar disorder is more common among males. Further in-depth studies in a larger sample size may provide better patient profiling, which can be used for developing effective screening programs.

Awareness and Knowledge of Adult Saudi Patients with Visual Impairment about Cataract

AbstractBackground: Cataract is the leading cause for visual impairment among people of developing and underdeveloped countries.Aim of Study: This study aimed to identify the common patterns of eye diseases among patients with visual impairment and to assess their awareness and knowledge regarding cataract.Patients and Methods: A cross-sectional study was con-ducted in Abha City, Saudi Arabia from October 2017 till December 2017. A total of 300 Saudi adult patients were included. A study questionnaire was used for data collection that evaluates participants' knowledge and awareness about cataract.Results: Among participants, 77% heard about cataract and 66.3% knew that it is clouding of normally clear lens while 70% perceived cataract, as an age-related disease. Hypertension (48%), diabetes (67.3%) and corticosteroids usage (49.7%) were considered as the main precipitating factors for development of cataract. A vast majority (82%) believed that cataract causes decreased visual acuity. Surgery as treatment of cataract was identified by only 61.3% of participants. Only 54% knew that cataract can lead to loss of vision.Conclusions: There is lack of awareness and knowledge among Saudi adult eye patients in Abha City regarding cataract. Hence, health education of the public regarding cataract risk factors, prevention and treatment should be undertaken to encourage efforts for prevention and seeking early detection and to avoidance of complications of cataract.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

Objectives:To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA).Methods:Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index>15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p<0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion.Results:A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA.Conclusion:The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Outcome of Chronic Myeloid Leukemia-Chronic Phase Patients Treated With Imatinib: A Local Experience

BackgroundImatinib was the first tyrosine kinase inhibitor that has revolutionized the therapy of chronic myeloid leukemia. It binds breakpoint cluster region–Abelson kinase domain inducing apoptosis of the leukemic cells. In this study, we assessed the efficacy and toxicity of imatinib therapy in patients with chronic myeloid leukemia in chronic phase (CML-CP) in our hospital. Patients and MethodsWe retrospectively analyzed the outcome of 17 patients with CML-CP treated with imatinib. ResultsThe median age at the time of presentation was 35 years with male preponderance. The most common presenting clinical features were fatigue, abdominal distention, and discomfort. Forty-seven percent of patients had fever at presentation whereas 35.29% were referred to our hospital because of incidental findings of high blood cell counts. With a median follow-up of 8 years (range, 2-16 years) the overall survival is 100% and progression-free survival 85%. Two patients had acceptable adverse effects. ConclusionAfter a median follow-up of 8 years, imatinib was found to induce long survival with manageable side effect in adult Saudi patients with CML-CP.

Mental Illnesses Stigma and Its Association with Quality of Life in Adult Saudi Patients

Background: Mental health patients with self-stigma often loss their self-esteem. The objectives: This study was conducted to determine the prevalence rate of mental illnesses stigma and its association with quality of life in adult Saudi patients attending the out patient’s in psychiatry department in King Fahad University Hospital at Al Khobar, KSA. Methods: This is a cross sectional study. A demographic data including age, sex, marital status and occupation were collected in addition to a 32 question-based questionnaire with different variables divided into three parts; To gain further perspective on discrimination experienced by persons with mental illness. To study rejection experienced by mentally ill patients. To evaluate the patients coping ways to stigma which characterized by secrecy, avoidance and withdrawal, and advocacy and confrontation. Results: There were 71 (34.6%) women, 112 (54.6%) men. About third (36.6%) of respondent agrees that people think of mentally ill patients as untrustworthy. Almost half of them (44.9%) disagree that people find them dangerous. The same percent (44.9%) agree that people take them less seriously.41.5% of them feel that people avoid them. More than half of them 51.2% disagree that someone will not take them as close friend. But 54.6% didn’t feel any avoidance from relative, neighbors or colleagues (missing data 11.2%). 67.8% also, didn’t feel any avoidance from family members. More than half (55.1 %) tries to hide the fact that they are mentally ill and 72.2% will not avoid getting married or starting a family because of their mental illness history. Conclusion: Our study indicated that most of mental health patients in our community have experienced moderate to severe level of stigma. Future researches are needed to study the prevalence of stigma and rejection in mental health patients allover Saudi Arabia. Community awareness campaigns to raise the knowledge that mental illness is a disease like other body diseases and there is no shame of being mental health patient.

Evaluation of skeletal variations and establishment of Cephalometric Norms in Saudi Sub Population using Bjork Jarabak's analysis.

Objective:To evaluate the skeletal variations amongst individuals and to compare the measurements with the standardized linear and angular values of Bjork Jarabak’s analysis.Methods:This study was conducted at POS Department, King Khalid University on 100 adult Saudi patients recruited through convenience sampling. It was conducted between April to September 2017, had inclusion criteria of patients between the age group 17 to 22 years showing normal occlusion. After history and examinations, lateral cephalographs were taken, scanned and traced using Dolphin Imaging Software and Cephalometric points were recognized. Linear and angular dimensions were calculated according to Bjork-Jarabak’s method.Results:Analysis and assessment of Saudi male and female values revealed considerable variation in the anterior and posterior cranial base lengths (p<0.05), anterior and posterior face height, ramus height, and mandibular length. Male measurements in contrast to Jarabak’s values showed noteworthy variances in articular angle, anterior and posterior cranial base, ramus height, length of mandible, anterior face height and Jarabak’s ratio. Female dimensions in relation to Jarabak’s norms showed considerable variances in articular angle, anterior cranial base, posterior facial height with less significant values in Saudi females while compared with Jarabak’s norms apart from mandibular body length which is more in Saudi females.Conclusion:Skeletal variations amongst Saudi males and females were significant and comparison with standardized linear and angular values of Bjork Jarabak’s analysis was also significant.

Influenza is more common than Middle East Respiratory Syndrome Coronavirus (MERS-CoV) among hospitalized adult Saudi patients.

BackgroundSince the initial description of Middle East Respiratory Syndrome Coronavirus (MERS-CoV), we adopted a systematic process of screening patients admitted with community acquired pneumonia. Here, we report the result of the surveillance activity in a general hospital in Saudi Arabia over a four year period.Materials and methodsAll admitted patients with community acquired pneumonia from 2012 to 2016 were tested for MERS-CoV. In addition, testing for influenza viruses was carried out starting April 2015.ResultsDuring the study period, a total of 2657 patients were screened for MERS-CoV and only 20 (0.74%) tested positive. From January 2015 to December 2016, a total of 1644 patients were tested for both MERS-CoV and influenza. None of the patients tested positive for MERS-CoV and 271 (16.4%) were positive for influenza. The detected influenza viruses were Influenza A (107, 6.5%), pandemic 2009 H1N1 (n = 120, 7.3%), and Influenza B (n = 44, 2.7%). Pandemic H1N1 was the most common influenza in 2015 with a peak in peaked October to December and influenza A other than H1N1 was more common in 2016 with a peak in August and then October to December.ConclusionsMERS-CoV was a rare cause of community acquired pneumonia and other viral causes including influenza were much more common. Thus, admitted patients are potentially manageable with Oseltamivir or Zanamivir therapy.

HAEMOGLOBIN A1C;

Objectives: Our aim was to determine the prevalence of controlled diabeteson the basis of HbA1c test (Hb ≤ 7 ) in registered diabetic population in three Primary HealthCenters of Ministry of Health Makkah al Mukarrahma. Study Design: Retrospective review ofmedical records of registered adult Saudi patients with type 2 diabetes. Setting: Three PrimaryHealth Centers of Ministry of Health Makkah al Mukarrahma. Period: 20 June 2015 to 31December 2015. Methods: The sample size calculated was 354 patients with confidence levelof 95% and confidence interval of 5. The cut of values adjusted for all diabetes mellitus patientswas, haemogloblin A1c (HBA1c) ≤ 7. Three last readings were recorded and to be declared ascontrolled diabetic case (valid control), last two readings were required to be within this normallimit. Data was processed on Microsoft Excel and SPSS-23 software. Results: Overall the agerange was 21–79 (58) years and a mean of +/- SD of 56.67 +/- 11.97. Male were 206 and female148 in number. Hb A1c test entries recorded in 292. On the basis of set HbA1c criteria no validcontrol entry was found in one PHC while in other two, there were 15 (4.23% prevalence) validcontrol entries. Valid control results were found significant (P &lt; 0.05). Conclusion: Very lowPrevalence of controlled diabetes on bases of HbA1c test in Primary Health Centers indicatenoncompliance of this test in our study group. Guidelines of the Ministry of Health regardingcare of diabetic patients in Primary Health Care should be followed to achieve the recommendedoutcome.

Medication adherence among diabetic and hypertensive patients in Al-Qassim region of Saudi Arabia

Non-adherence to medication is often an unrecognized risk factor that contributes to failure of the therapeutic plan. The purpose of the study was to identify factors related to high, medium and low medication adherence among adult Saudi patients with hypertension and diabetes mellitus. This study is designed as a descriptive cross sectional survey and was conducted in three tertiary care hospitals of Al-Qassim province of Saudi Arabia. The data was collected using the 8-item Morisky Medication Adherence Scale (MMAS-8) and analyzed by SPSS. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high). Of the 396 patients interviewed, 52% reported low adherence to prescribed medication. Multinomial logistic regression analysis was conducted. Gender, age, literacy level, duration of illness and type of chronic disease were negatively associated with medication adherence. The study shows very high proportion of low and medium adherence on long term medication, which may be responsible for the failure of achieving therapeutic outcome. Further investigation is required to evaluate the applicability of MMAS-8 as a tool of measuring medication adherence among Saudi patients with chronic diseases. Adherence enhancing strategies should also be evaluated in separate patients group.

23. Epidemiological aspects and clinical outcomes of mitral valve prolapse in Saudi adults over a 10 year period

Mitral valve prolapse (MVP) is a well recognized clinical entity that is associated with significant morbidity. Epidemiology, echocardiographic (echo) characteristics and clinical outcome of MVP in Saudi Arabia have not been studied. To determine the prevalence, echo features and clinical outcome of MVP among the adult Saudi patients who underwent echo evaluation over a 10-year period.Retrospective review of consecutive cases of MVP or any of its components as diagnose by echocardiogram. Study was conducted in King Abdulaziz Cardiac Center, Riyadh and included 121,419 adult echo studies done between January 2003 and December 2012. Study population consisted of 77,176 patients after removing duplicate studies. Echo parameters for all Saudi nationals ⩾14 y of age were collected from the Xcelera database. Mitral valve disease due to non-myxomatous prolapse were excluded. Among the study population ( n = 77,176) 600 patients were labled as having MVP or any of its echo features (0.7%). Mean age was 64 years and 62% were males. Majority of patients (54.4%) had mild MVP, while moderate and severe prolapse were present in 21.1% and 24.5% respectively. Severe mitral regurgitation was present in 16.5% and chordal rupture was noted in 9%. Left ventricular size was moderately dilated in 7.6% and severely dilated in 1.3%.Prevalence of MVP in Saudi nationals at a referral cardiac center is less than the reported international figure of 1-3%. In contrary to published literature MVP in Saudi population seems to be more common in males and seems to be diagnosed at a later age.

Knowledge, Attitudes and Perceptions of Saudis towards Participating in Clinical Trials.

AimTo assess the knowledge, attitudes, and perceptions of Saudis towards participating in clinical trials (CTs).MethodsA cross-sectional study was conducted on 232 Saudi adult patients and their companions visiting adult outpatient clinics at King Fahad Medical City, Riyadh, Saudi Arabia. Data were collected using a self-administered questionnaire based on information obtained from the literature. The questionnaire was divided into four sections, one covering the respondents’ demographics, and the other three assessing knowledge, attitudes, and perceptions towards participating in CTs.ResultsA total of 148 (63.8%) respondents were males, and 52 (22.4%) participants had been invited to participate in a CT previously. Of those, 39 (75%) participated. Knowledge about the essential elements of informed consent ranged from 55.7% (number of participants needed) to 85.7% (confidentiality of personal information). The majority (163, 73.8%) of respondents was willing to participate in a CT after consulting their family physician and 130 (58.0%) respondents would be motivated to participate in a CT if they were healthy. Only 36.8% of the respondents believed that patients who participated in a CT received the best care. Moreover, 110 (48.7%) respondents believed that research was conducted in a responsible and ethical manner.ConclusionsThe present study assessed the current understanding of CTs among Saudi participants. Although the majority of participants had an acceptable level of knowledge about CTs, they exhibited conditional attitudes and misperceptions towards participating in a CT. Increased patient awareness may improve patients’ attitudes towards ethical conduct of CTs.

The Role and Prevalence of Polyol Pathway and Oxidative Stress Markers as Risk Factors for Diabetic Cataract in Adult Type-I Diabetic and Diabetic Cataract Saudi Patients

Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia and its prevalence is rising globally. Prolonged exposure to uncontrolled chronic hyperglycemia can lead to various complications in the eye including cataract. Cataract is characterized by cloudiness or opacification of the eye lens which is the leading cause of sight loss and visual disability. It has been reported that diabetes mellitus is a major problem in the management of blindness and cataract surgery.

9. Prevalence and impact of carotid disease in adult Saudi patients undergoing isolated coronary artery bypass surgery on early post-operative outcome

Assess the prevalence of carotid disease in our Saudi population undergoing coronary artery bypass surgery and determine its impact on stroke and early post-operative outcome. 3197 consecutive adult patients underwent major cardiac surgery in our center between January 2002 and December 2012. 3150 of these had preoperative duplex scanning, and out of these, 210 patients (6.6%) had significant carotid artery disease defined as ⩾75% stenosis (Group A), while 2940 (94.4%) were free from carotid artery disease (Group B). Both groups were compared for presence of pre-operative risk factors and for occurrence of adverse events in the immediate post-operative period. In uni-variant analysis, pre-operative risk factors for the presence of carotid artery stenosis were diabetes mellitus (p < 0.0001); hypertension (p < 0.0001); past cerebrovascular accident (p < 0.0001) and peripheral vascular disease (p < 0.0001). All-cause in hospital mortality was high in group A in comparison to group B (3.8% vs 1.56%; p = 0.004). The Morbidity was also high in group A compared to group B in terms of stroke (4.3% vs 1.6%; p = 0.0014), nosocomial pneumonia (16.4% vs 8.9%; p = 0.0015), leg wound infection (14.2% vs 6%; p = 0.0001), septicemia (9.3% vs 4.8%; p = 0.013), acute limb ischemia (1.1% vs 0.4%; p = 0.034), new-onset atrial fibrillation (26.8% vs 16.3%; p = 0.0005), ventricular fibrillation (4.9% vs 1.5%; p = 0.0035) and renal dysfunction (11% vs 4.9%; p = 0.0017). The Presence of carotid artery disease in Saudi patients undergoing cardiac surgery is associated with increased prevalence of diabetes, hypertension, cerebro-vascular accidents and peripheral vascular disease. It is also a major determinant of adverse outcome after coronary surgery.