Arabian Experience Research Articles

Review of the spectrum of tuberous sclerosis complex: The Saudi Arabian Experience.

To determine the prevalence of tuberous sclerosis complex (TSC) in the paediatric Saudi population and to characterise the range of clinical symptoms, neurocutaneous findings, neuroimaging results, and complications of the disease. A total of 61 genetically confirmed TSC patients from the National Guard Health Affairs (NGHA) in Saudi Arabia were the subject of this retrospective descriptive analysis. The data were presented using descriptive measures. The mean age at diagnosis was found to be 4.9 years. Subependymal nodules (86.9%), numerous cortical tubers and/or radial migration lines (63.9%), and hypomelanotic macules (63.9%) were the 3 most common significant criteria. The vast majority (86.9%) of those diagnosed had epilepsy, of which 50% were considered medically intractable. Nearly half of our subjects underwent genetic testing, which revealed that TSC2 predominated over TSC1. Symptoms of Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders (TAND) were present in 66.7% of TSC1 patients and 73.9% of TSC2 patients. The findings of this study demonstrate that the clinical spectrum of TSC among Saudi children is consistent with the body of existing literature. The TSC2 was more prevalent than TSC1. The most frequent signs were cutaneous and neurological. Monitoring TSC patients regularly is crucial to identify any issues as soon as possible.

Connecting worlds: Filipino and Indonesian sojourns to Saudi Arabia

This article is a comparative study of Filipino and Indonesian migrant workers in the Kingdom of Saudi Arabia. It investigates how these two different transnational communities envisage their lives in the Kingdom. It examines (1) the historical dynamics and contemporary developments of Filipinos and Indonesians in Saudi Arabia, (2) the underlying motives, purposes and rationales of their sojourn and employment in the Kingdom, and (3) their perceptions and insights about their Saudi Arabian experiences. Interviews were conducted with 17 Filipinos and 16 Indonesians living and working in Saudi Arabia. This study suggests that many factors affect these two groups’ perceptions and experiences such as religiosity, employer/employee relations, and/or cultural factors.

Total quality management as a key step to healthcare transformation; the Saudi experience

Total quality management (TQM) is a comprehensive approach to healthcare management that emphasizes continuous improvement in service quality through stakeholder engagement. In Saudi Arabia, a new model of care (MoC) was introduced aimed at elevating healthcare quality across different care levels. This MoC comprises six care systems and service layers, integrating clinical governance to ensure ongoing improvements in service quality. The integrated clinical care pathway (ICCP) functions as a customizable disease management pathway tailored to the unique needs of each health cluster. Within the ICCP, a robust quality management program has been implemented, covering quality planning, control, and improvement practices. This program fosters a culture of knowledge exchange and continuous learning, ensuring that changes within the healthcare system are grounded in scientific principles and subject to ongoing assessment. To ensure the success of ICCPs and fulfill their objectives, the Health Holding Company (Health Co.) partnered with the Institute of Healthcare Improvement (IHI). This collaboration aims to enhance the capacity and capabilities of quality improvement teams within ICCPs, driving MoC transformation, inspiring an innovation and improvement culture, and facilitating knowledge and expertise exchange. The primary goal of the quality improvement program is to enhance population health by addressing prevalent risk factors for chronic diseases improving the quality of life through enhancing all healthcare pathways. It seeks to bridge the gap between current healthcare practices and best practices, utilizing improvement coaches (ICs) and advisors to promote effective teamwork. Initially implemented in Saudi Arabia's Al-Hasa region, the TQM program within ICCPs underwent a feedback-gathering workshop. This collaborative effort involved input from ICs and cluster leadership, focusing on various program aspects. The collected feedback aims to further refine and enhance the program for widespread implementation throughout the Kingdom. This review focuses on TQM as a critical step in healthcare transformation, highlighting the Saudi Arabian experience.

Healthcare workers awareness and perception to COVID-19 measures and their attitude toward the vaccine rollout: A Saudi Arabian experience

Healthcare workers awareness and perception to COVID-19 measures and their attitude toward the vaccine rollout: A Saudi Arabian experience

Quality of life post total knee arthroplasty: Saudi Arabian experience

Background and Objective:Osteoarthritis of knee is quite common in Saudi Arabian population. Total knee arthroplasty (TKA) was reluctantly accepted in Saudi Arabia about 2 decades ago but there are few small number reports on quality of life (QOL) postsurgery. The objective of this study was to investigate the QOL and overall satisfaction postTKA.Methods:We retrospectively studied 200 patients’ consecutive patients who underwent primary TKA at King Fahd Hospital of the University, AlKhobar, Saudi Arabia. Patient's age, sex, weight, height, body mass index, and range of movements at the time of surgery were extracted from the QuadraMED patients Database. The minimum follow-up was 24 months. At the last visit of 24 months, patients were evaluated using modified Western Ontario and McMaster Universities Osteoarthritis Index (MWOMAC), QOL using Short Form-36 Health Survey (SF-36), and patient satisfaction was assessed.Results:Among the 212 TKAs performed, 52 were male and 148 were female. One hundred and twenty two were right side and 90 were left side and 22 were bilateral. The mean age was 62.7 ± 5.1 years. There were no intraoperative complications. Nearly 95% resulted in patient satisfaction. SF-36 and all the parameters assessed significantly improved (P < 0.001). MWOMAC scores of the patients, which show all functions, had statistically significantly improved to (P < 0.001) except prayers before and after surgery did not change which was expected. The overall level of satisfaction was observed 95% of patients.Conclusions:Our study shows that TKA has a positive effect on pain, mobility, QOL, and ultimate satisfaction.

Corrigendum

Corrigendum

Dental students' perception about using videos in teaching professionalism: A Saudi Arabian experience.

To describe the development and evaluation of using videos (watched and student-generated) for teaching stronger interpersonal communication skills to dental students. We used the Experiential Learning Theory to develop a professionalism course for third-year dental students. Videos were used as the core method of teaching communication skills. Students were guided to produce videos that addressed an array of communication scenarios. Quantitative data was collected using a Likert-scale questionnaire to assess students' perceptions about watching and generating videos. The questionnaire was divided into 3 parts: the first part assessed students' perceptions and skills gained when producing videos. The second part assessed students' perceptions about watching videos to gain knowledge. The last part assessed their perceptions about their overall learning experience. A total of 110 students, 50 males and 60 females, were enrolled in the course. Developing team skills and a better understanding of professional communication with patients were acknowledged by 85% and 80% of students respectively during video production. Improved problem-solving skills were reported by 77% students while involved in video production. While watching motivational interviewing strategies and interpersonal skills videos, 86% stated that watching the videos improved their understanding of professional behavior with colleagues. Only 33% felt that they had enough time to prepare videos and only 38% were willing to prepare videos in the future. Using videos in teaching communication skills was found effective. Producing videos had more benefits than simply watching videos. Caution should be given when allocating time for such activities.

Pandemic preparedness of dentists against coronavirus disease: A Saudi Arabian experience.

BackgroundDental offices are among the highest risk for transmission of the COVID-19, having the potential to transmit the virus via routine dental procedures. This cross-sectional study assessed the preparedness and perception of infection control measures against the COVID-19 pandemic by dentists in Saudi Arabia.Materials and methodsThis online survey addressed the impact and perception of the COVID-19 pandemic on dental practice in Saudi Arabia. The questionnaire comprised 26 closed-ended questions. Descriptive statistics included frequency distributions with percentages. In addition, the significance between the different demographic variables and questions about dentists’ perception of the COVID-19 pandemic was tested using the Chi-square test.ResultsCOVID-19 management in dental clinics varied in terms of adherence to the Ministry of Health (MOH) guidelines. Dental clinics’ screening questionnaire for patients showed good adherence (67%), while the lowest agreement was detected with the question on the existence of an airborne infection in the isolation room (15%). Almost two-thirds of the respondents agreed that the dental reception area adopted the proper COVID-19 preventive measures. Greatest accord was observed in their answers on questions about dentists’ perception of the COVID-19 pandemic, ranging from 64%–89%. In addition, there were statistically significant differences in questions about the perception of dentists towards the COVID-19 pandemic by different demographic variables such as age and years of work experience (p < 0.05).ConclusionThe response of most dentists regarding the preparedness and perception of infection control measures against the COVID-19 pandemic was positive. Dental clinics need to adhere more to the MOH recommendations in preparedness of their facilities or by educating their dentists and staff.

Impact of Cardiopulmonary Bypass and Aorta Cross Clamp Time on the Length of Mechanical Ventilation after Cardiac Surgery among Children: A Saudi Arabian Experience.

AimSeveral factors determine the perioperative outcome besides the nature of the congenital heart defect. Prolonged mechanical ventilation (PMV) is a major factor that determines mortality, length of stay (LOS), residual disability, and other functional outcomes. We aim to determine the clinical variables predicting PMV and LOS in hospital, and specifically the impact from the duration of cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC).MethodWe conducted a retrospective review of the medical records of 413 children consecutively admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in one year at a single center. We collected demographic information (e.g., age, gender, and weight), perioperative variables, clinical outcomes, length of mechanical ventilation, high-frequency ventilator use, and mortality. We used logistic regression to analyze the data. PMV was defined as mechanical ventilation for longer than seven days.ResultsA total of 410 records were included in our study. We found no statistically significant association between CPB time and mechanical ventilation days. Forty-seven children had PMV, 362 did not have PMV. We found no statistically significant association between CPB time and mechanical ventilation days after adjusting for covariates. Reanalyzing the data with PMV defined as longer than four days produced the same results. Using a regression model to assess the variables via the least absolute shrinkage and selection operator for feature selection, we found no statistically significant association between ACC time and mechanical ventilation days after adjusting for covariates.ConclusionAccording to our results, CPB and ACC time are not associated with PMV or prolonged hospital LOS.

How foreign investors influence stock markets? The Saudi Arabian experience

ABSTRACTThis paper investigates the impact of foreign institutional investors on valuation, liquidity and volatility in the Saudi stock exchange for the post-liberalization period. Saudi regulators allowed the foreign investment community to invest in the Tadawul All Share Index (TASI) in June 2015. Firstly, the paper finds a positive change in abnormal returns in the three-year post-liberalization period compared to the three-year non-liberalization period (pre-period), suggesting that the entry of qualified foreign institutional investors (QFIIs) benefited security valuation. Further, the higher valuation result is consistent with the prediction of standard international asset pricing models, that stock market liberalization may reduce the liberalizing country’s cost of equity capital by allowing for risk sharing between domestic and foreign agents. Secondly, contrary to the regulators/policymakers’ intention and empirical evidence, the liquidity proxies document mixed evidence. Lastly, this study finds mixed evidence in the price volatility measures. However, the volatility and liquidity finding suggests that the presence of foreign institutional investors is not the source of excess volatility or high turnover on local bourses. Overall, the evidence, on average, shows some signs of improvement for different market efficiency measures during the post-liberalization period compared to the pre-liberalization period. The less than expected improvement in Tadawul during the post-period implies that the Saudi financial regulator’s incentive of opening the TASI for QFIIs coincides with economic vulnerabilities for the Kingdom, stringent QFIIs regulation and weak investor protection laws.

Achieving smart sustainable cities with GeoICT support: The Saudi evolving smart cities

Geoinformation and Communication Technology (GeoICT) is being increasingly adopted to foster urban sustainability and smart cities. Despite the burgeoning utilization of GeoICT, the development of frameworks of components and guidelines is still at the infancy. This is due to the fact that GeoICT implementations are guided by contextual factors and there is no one size fits all approach. This paper focuses on the topic of leveraging GeoICT for smart sustainable cities by examining the Saudi Arabian experience using information from the literature, government websites, official documents, newspaper articles and personal interviews. This study reviews the definitions, typologies, and frameworks of implementing GeoICT and smart cities. It highlights case studies of smart city development in Saudi Arabia. A comparison of the Saudi case studies with frameworks and practices found in the literature is presented. This paper concludes with policy implications for Saudi Arabia and lessons for GeoICT and smart city development. It is concluded that local context has an influence on the implementation of smart cities, ICT infrastructure is necessary but not sufficient for developing smart cities and blending top-down with bottom-up approaches is essential.

Outbreak of Middle East respiratory syndrome coronavirus, Saudi Arabian experience

ObjectiveMERS-CoV infection is uncommonly identified among patients visiting healthcare facilities & we were vigilant in screening all patients entering our hospital to prevent cross infection among patients, visitors & healthcare providers and aiming to prevent potential outbreaks with MERS-CoV infection. In spite of our efforts on practicing Failure Mode Effect Analysis for MERS-CoV infection management we ended up having an outbreak with MERS-CoV. Based on our experience, we actively implemented policies, procedures & practices on early identification & appropriate isolation practices along with supplemental infection prevention & control measures for preventing future outbreaks at our healthcare facility. MethodsRetrospectively we analyzed our failure in preventing the outbreak of MERS-CoV infection among our hospitalized patients by identifying the outbreak & actively intervening as a team to control the outbreak with the support of Hospital Higher management, Administrators, Quality improvement team, Infection prevention & control team & the active support of all healthcare workers of the facility. ResultsFollowing the early identification of MERS-CoV outbreak, we could successfully prevent large scale outbreak both in the hospital & the community. ConclusionContinuous implementation of infection prevention & control standards along with early clinical diagnosis of MERS-CoV infections based on the case definition as laid out by the Ministry of Health will prevent infectious outbreaks at healthcare facilities.

How Foreign Investors Influence Stock Markets? The Saudi Arabian Experience

This paper investigates the impact of foreign institutional investors on valuation, liquidity and volatility in Saudi stock exchange for the pre- and post-period from November 10, 2014 to June 12, 2015 and from June 15, 2015 to January 22, 2016 respectively, utilizing daily market trade data. Saudi regulators allowed foreign investment community to invest in Tadawul (i.e., Saudi stock exchange). The paper finds significant decline in prices of stocks in the post-liberalization period, suggesting that foreign traders aid in price discovery process and bringing the prices back to their fundamental values. In contrast to the policy makers’ intention and empirical evidence, the liquidity decreases and bid-ask spreads widen. These results imply that domestic individual investors engage in non-fundamental trading in the past, avoid trading against sophisticated foreign investors in the presence of heightened asymmetric information risk during the post-liberalization period.

Adjuvant Radioactive iodine 131 ablation in papillary microcarcinoma of thyroid: Saudi Arabian experience [corrected

BackgroundPapillary Microcarcinoma (PMC) of thyroid is a rare type of differentiated thyroid cancer (DTC), which according to the World Health Organization measures 1.0 cm or less. The gold standard of treatment of PMC is still controversy. Our aim was to contribute in resolving the debate on the therapeutic choices of the surgical and adjuvant I-131 (RAI) treatment in PMC.MethodsFrom 2000 to 2012, 326 patients were found to have PMC and were retrospectively reviewed for clinicopathological characteristics, treatment outcomes and prognostic factors.ResultsMean age of cohort was 42.6 years (range: 18–76) and the mean tumor size was 0.61 cm ± 0.24; lymph node involvement was seen in 12.9 % of cases. Median follow up period was 8.05 years (1.62–11.4). Total 23 all site recurrences (7.13 %) were observed; more observed in patients without I-131 ablation (p <0.0001). Ten year DFS rates were 89.6 %. Cox regression Model analysis revealed size, histopathologic variants, multifocality, extrathyroidal extension, lymphovascular space invasion, nodal status, and adjuvant RAI ablation the important prognostic factors affecting DFS.DiscussionDespite excellent DFS rates, a small proportion of patients with PMC develop recurrences after treatment. Adjuvant RAI therapy improves DFS in PMC patients with aggressive histopathologic variants, multifocality, ETE, LVSI, tumor size (> 0.5 cm) and lymph node involvement. Failure of RAI ablation to decrease risk in N1a/b supports prophylactic central neck dissection during thyroidectomy, however more trials are warranted.ConclusionAdjuvant I-131 ablation following thyroidectomy in PMC patients, particularly with poor prognostic factors improves DFS rates.

Utility and diagnostic accuracy of endobronchial ultrasound-guided transbronchial fine-needle aspiration cytology of mediastinal lesions: Saudi Arabian experience.

Objective:The objective of this study is to evaluate the cytological accuracy of endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TFNA) of the mediastinal mass/nodular lesions.Study Design:Over 3½ years from inception at King Khalid University Hospital, a retrospective analysis of the cytological diagnoses of all the EBUS-TFNA procedures performed in 80 patients who had mediastinal mass/nodular enlargement. Cytology results were reviewed and correlated with the histologic follow-up.Results:Of the 80 patients who underwent EBUS-TFNA, 15 cases (18.75%) were positive for malignancy, 48 cases (60%) negative for malignancy and 17 cases (21.25%) unsatisfactory. Of the 48 cases, which were negative for malignancy, 24 (50%) cases were of granulomatous inflammation. The overall diagnostic yield of our EBUS-TFNA specimen was 78.75%. Forty-seven cases (58.75%) of 80 cases had histological follow-up biopsies. Among them, 32 cases (68%) had the same cytological and histological diagnosis and 15 cases (31.09%) had discordance between the cytology and the follow-up histological diagnosis. The sensitivity, specificity, and positive and negative predictive values for diagnosing granulomas by EBUS-TFNA are 77%, 82%, 83%, and 75% and for diagnosing malignancy are 71%, 100%, 100%, and 82%, respectively.Conclusion:Preliminary results show that cytological samples obtained through EBUS-TFNA are accurate and specific in making a diagnosis of the mediastinal mass/nodular lesions. Its optimum use depends on the effective collaboration between the cytotechnologist, pathologist, and the bronchoscopist.

Policing Internet fraud in Saudi Arabia: expressive gestures or adaptive strategies?

This paper contributes to current debates on the policing of Internet fraud by introducing the Saudi Arabian experience. Drawing on field research in the capital city, Riyadh, it assesses the extent to which the Saudi policing response to Internet fraud fits in with contemporary debates on cybercrime control within a late-modern penal framework as theorised in Western literature. It is argued that the only way in which Saudi cybercrime control strategies can be aligned with those followed by Western authorities is in relation to the state's ‘expressive gestures’. In contrast, there is little evidence of plural policing involving networks of calculation deploying instrumental ordering practices and risk-prediction technologies. In addition to the limited relevance in an autocratic society such as Saudi Arabia of the ideological, socio-economic and political conditions that facilitated the emergence of plural policing in Western societies, the Saudi police organisation also appeared unready to engage in networked policing of Internet fraud.

Innovation opportunities in irrigation technology for using virtual water in 21st Century South Africa: Reflections from the past to the present

In 21st century South Africa, new and old technological innovations in agriculture can be employed to protect existing and future water supplies that are increasingly becoming vulnerable to encroaching global warming trends. The purpose of this article is to identify irrigation technology, the impact on irrigative farming of a polluted water environment through mining and other baneful industrial activities in the Republic. It also aims to discuss innovation opportunities in irrigation technology for using virtual water – a concept commonly associated with the Middle East. South Africa possesses arguably the most sophisticated engineering technology in irrigation in southern Africa. In this article, reflections on irrigation from the past to the present will be complemented by a historical focus of the context in which this farming enterprise evolved. A brief historical synopsis of irrigation shows that this activity which became more technologically advanced in the colonial and post-independence eras was also practiced in the pre-colonial period for food security and as an insurance against drought. Irrigation was practised in South Africa before and after the colonisation of the Cape by the Dutch in 1652. Irrigation technology in the seventeenth century tended to lack the sophistication and modernisation of the contemporary world. Innovative improvements became imperative as the state increasingly became more involved in agriculture from the 1920s and 1930s largely as part of a process leading to the evolution of settler irrigation policy which was premised on capital accumulation and the deprivation of Africans of land ownership rights. This policy orientation clearly changed from the advent of independence to the 21st century in favour of a policy that aimed at economically empowering the Black smallholder sector farmers without necessarily neglecting the large• 202 New Contree, No. 61 (May 2011) scale commercial producers. Irrigation farming is not a novel phenomenon to the region. Since the turn of the new millennium, technological innovation has been prioritised because South Africa is situated in a predominantly hot arid zone of the sub-region. Total evaporation creates endemic water shortages. It is therefore imperative that water resources are well managed in a country which thrives largely on mining, industrial and agricultural pursuits. Due to South Africa’s geophysical location in one of the world’s arid terrains, irrigation has been identified as an essential corollary to dry land farming and other economic endeavours. Nevertheless, in spite of advances that have been made in centre-pivot manufacturing, South Africa has generally tended to ignore cheaper irrigation methodologies such as the drip, terracing and flood systems which seem more suitable and appropriate in arid conditions. It has also ignored the fact that using large volumes of both riparian and imported water from Lesotho to irrigate a crop like maize in the Eastern Free State Province, for example, is not only unviable but it is also unsustainable. A major rethink of how food supply can be boosted on the basis of irrigated agriculture, utilising more advanced and peculiarly suitable technology in hot and arid or water deficient areas is vital. This is more so because industrial demand for water – a large quantity of which is expensively procured or transferred from Lesotho through the Vaal River system - is in direct competition with the demand for water to produce surplus food under irrigation. Most industrial and farming activities in Gauteng, Free State and Mpumalanga provinces, to name a few, are dependent on this water which is under threat of depletion. Given South Africa’s arid conditions, the adoption of the virtual water concept, following the Saudi Arabian experience, would be a possible conservationist measure. This article also argues that because water is limited, mining and air pollution which eventually ends up in the water should be controlled to ensure safe drinking and irrigation water.

The Saudi Arabian experience with the bone-anchored solution (BAHA)

The Saudi Arabian experience with the bone-anchored solution (BAHA)

Guiding the transition of nursing practise from an inpatient to a community‐care setting: A Saudi Arabian experience

The purpose of this paper is to provide an overview of the Transitional Practise Model, which was used as the educational learning program to guide the transition of two Saudi nurses from an acute inpatient environment into a community setting. This model was informed by Benner's "novice to expert" concept and is grounded in experiential learning and critical thinking. The aim was to enhance knowledge and skills by providing opportunities for learning in order to make an effective transition from an acute inpatient environment into community nursing. The model was effective in guiding and bridging the gap for nurses to undertake a transition from a hospital inpatient environment into a community setting. The use of preceptors was invaluable in providing an understanding of the nature of professional practise through learning opportunities, mentoring, and support.

Strategies and obstacles in an organ donation program in developing countries: Saudi Arabian experience

Strategies and obstacles in an organ donation program in developing countries: Saudi Arabian experience