King Abdulaziz University Research Articles

Assessing the risk of contrast induced-acute kidney injury (CI-AKI) after enhanced CT scan: Single-centre experience.

Objective: This study was conducted to assess the risk of contrast-induced AKI (CI-AKI), among Saudi patients who underwent enhanced CT scans at a tertiary care hospital; to understand the incidence and the underlying associated factors of CI-AKI. Methods: We conducted a retrospective review of patients who underwent CT scans with IV contrast from 2016 to 2021, at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. All authors had no access to information that could identify individual participants during or after data collection. The occurrence of AKI was defined using the “Kidney Disease: Improving Global Outcomes” (KDIGO) consensus definition. The exclusion criteria comprised age <18 years and records with missing key clinical information. Statistical Package for the Social Sciences (SPSS) software, version 21 was used for statistical analysis. The prevalence is presented as a percentage with a 95% confidence level. A P-value <0.05 was considered statistically significant. Results: We reviewed 2000 patient files, of which 1430 met the inclusion criteria. According to the KDIGO definition of AKI, the overall incidence CI-AKI in our study cohort was 8.7%. The incidence of CI-AKI varied across baseline CKD stages, with significantly higher occurrences observed in individuals with CKD Stage5 at 24.3% and Stage4 at 15.9%. Statistical analysis confirmed that the likelihood of CI-AKI is significantly influenced by the baseline eGFR levels. This retrospective analysis found that individuals with hypertension have significantly higher odds of CI-AKI (OR = 2.02, p=0.001) compared to those without hypertension. Moreover, individuals with hyperuricemia have significantly higher odds of CI-AKI (OR = 2.78, p<0.001), compared to those without. The association remains significant after adjusting for other variables (OR = 2.40, p<0.001). The presence of diabetes, malignancy, anaemia, and ischemic heart disease did not show a significant association with CI-AKI. Conclusions: Based on the results of this retrospective study, the overall incidence of CI-AKI is around 8.7 %, among patients undergoing enhanced CT scan. The risk is low and highly influenced by patients’ baseline kidney function. Hypertension and Hyperuricemia are risk factors found to be associated with CI-AKI after enhanced CT scan. Diagnostic and clinically relevant enhanced CT scans should not be deferred based on the potential risk of CI-AKI. Furthermore, pre and peri-scan prevention protocols can significantly mitigate the risk of CI-AKI, even among high-risk patients.

Long-term Visual Acuity Outcomes of Deep Sclerectomy in Pediatric Glaucoma.

This study provides evidence of the long-term efficacy and safety of Deep Sclerectomy as a successful surgical intervention option in cases with childhood glaucoma. The primary objective was to evaluate the long-term visual acuity outcomes of Deep Sclerectomy in pediatric glaucoma and identify factors predicting poor prognosis. The secondary objective was to evaluate the long-term success rate of Deep Sclerectomy in controlling intraocular pressure. A retrospective review was conducted of all pediatric patients who underwent deep sclerectomy at King Abdulaziz University Hospital (KAUH) between 2001 and 2016. We included all patients who had valid visual acuity tests. The preoperative findings and long-term visual and intraocular pressure outcomes were analyzed. A total of 83 eyes of 68 patients were included. The mean (SD) age of participants was 11.1 (4.0) years (range: 5-25 years). The mean age at surgery was 5.9 months, and the mean follow-up period was 10.75 years. The majority of cases (83.1%) were primary congenital glaucoma. Visual acuity was ≥ 20/40 in 56.6% of cases, ranged between 20/40 and 20/200 in 18.1%, and was ≤ 20/200 in 25.3% of the operated eyes. Complete success rate (IOP ≤ 21mmHg without medications) after one surgery was achieved in 53 eyes (63.86%). Qualified success rate (IOP ≤ 21 mmHg with medications) was achieved in 8 eyes (9.6%), while 22 eyes (26.5%) failed to achieve target IOP of ≤ 21 mmHg or needed additional surgery to achieve it. Nine eyes (10.74%) had post-operative complications. Deep sclerectomy is a reasonable option for pediatric glaucoma that can provide good long-term visual outcomes and IOP control with a lower risk of surgical complications.

Prediction of COVID-19 Hospitalization and Mortality Using Artificial Intelligence.

COVID-19 has had a substantial influence on healthcare systems, requiring early prognosis for innovative therapies and optimal results, especially in individuals with comorbidities. AI systems have been used by healthcare practitioners for investigating, anticipating, and predicting diseases, through means including medication development, clinical trial analysis, and pandemic forecasting. This study proposes the use of AI to predict disease severity in terms of hospital mortality among COVID-19 patients. A cross-sectional study was conducted at King Abdulaziz University, Saudi Arabia. Data were cleaned by encoding categorical variables and replacing missing quantitative values with their mean. The outcome variable, hospital mortality, was labeled as death = 0 or survival = 1, with all baseline investigations, clinical symptoms, and laboratory findings used as predictors. Decision trees, SVM, and random forest algorithms were employed. The training process included splitting the data set into training and testing sets, performing 5-fold cross-validation to tune hyperparameters, and evaluating performance on the test set using accuracy. The study assessed the predictive accuracy of outcomes and mortality for COVID-19 patients based on factors such as CRP, LDH, Ferritin, ALP, Bilirubin, D-Dimers, and hospital stay (p-value ≤ 0.05). The analysis revealed that hospital stay, D-Dimers, ALP, Bilirubin, LDH, CRP, and Ferritin significantly influenced hospital mortality (p ≤ 0.0001). The results demonstrated high predictive accuracy, with decision trees achieving 76%, random forest 80%, and support vector machines (SVMs) 82%. Artificial intelligence is a tool crucial for identifying early coronavirus infections and monitoring patient conditions. It improves treatment consistency and decision-making via the development of algorithms.

A Dedicated Nephrology Daycare Unit: A Step Toward a Patient-Centered Approach.

Background Nephrology services encompass a wide range of day-care procedures. Securing beds for day admissions can be challenging and may lead to significant delays in patient management. Objective This study aims to describe the impact of establishing a dedicated nephrology daycare unit at a tertiary care center. Methods Since January 2021, a dedicated nephrology daycare unit has been operational at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. This observational study retrospectively reviewed the admission records to the KAUH nephrology daycare unit from January 2021 to December 2023. Admissions with missing data were excluded from the analysis. The study outcomes included: 1. the number of patients served in the unit, 2. the scope of services provided, 3. the "time to completion" of immunosuppressive therapy administered in the unit, and 4. the rate of complications related to admission to the unit. Results There were 233 admissions for 157 patients. The scope of procedures included: 1. administration of immunosuppressive therapy (42 doses of cyclophosphamide, 70 doses of rituximab, three doses of methylprednisolone), 2. renal biopsies (25 procedures), 3. tunneled dialysis catheter procedures (40 procedures, both insertion and removal), 4. dialysis access angioplasty (three procedures), 5. IV iron therapy (45 admissions), and 6. other miscellaneous causes (five admissions). Ideal time to completion of cyclophosphamide therapy was achieved in 86% of patients, with the remaining 14% experiencing delays due to reasons other than bed availability. Time to completion of rituximab therapy was achieved without delay in 85% of patients, with a time interval of less than 21 days. There were no reported complications associated with admission to the unit. Conclusions Establishing a dedicated nephrology daycare unit facilitates the delivery of nephrology day-procedures and reduces delays in therapy.

Sydney Reporting System for Lymph Node Fine-Needle Aspiration and Malignancy Risk Stratification: Is It of Clinical Value?

Lymphadenopathy is a common presentation of both reactive and malignant diseases, and lymph node fine-needle aspiration cytology (LN-FNAC) is an effective and inexpensive screening method. It can prevent unnecessary invasive surgery and excisional biopsy, especially in benign cases. Unfortunately, the lack of universally accepted terminology for reporting results has hindered its widespread support. The Sydney system proposal for lymph node cytopathology categorization and reporting introduced five diagnostic categories to address the lack of universally accepted terminology for reporting results in lymphadenopathy. Our study analyzed 188 lymph node fine-needle cytology (FNC) samples from King Abdulaziz University Hospital, Saudi Arabia, examining clinical follow-up data, pathology records, patient information, and final diagnosis from January 2019 to December 2022. Most specimens were from axillary lymph nodes, with 99.5% tissue correlation. The Sydney system category classification identified 56.9% of cases as malignant, while 26.1% were benign. The final surgical specimen diagnosis revealed a higher percentage of malignant diagnoses, with the highest risk of malignancy (ROM) in malignant/category V. In conclusion, our study demonstrates that LN-FNAC offers high diagnostic accuracy for lymph node (LN) aspirates, with the Sydney approach potentially aiding risk stratification and achieving consistency in cytologic diagnosis, but further multi-centric research is needed.

Anemia among adult patients with diabetes attending King Abdulaziz University Hospital: A retrospective study.

The prevalence of anemia in adults with diabetes is of growing importance due to its impact on overall health and the management of diabetes-related complications. This study aimed to determine the prevalence of anemia among adult patients with diabetes at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. A retrospective study was done on 1208 patients with diabetes >18 years who attended the study setting from 2010 to 2022. Data about patients' demographics, body mass index, glycated hemoglobin (HbA1c; %), hemoglobin (Hb), serum ferritin, iron, mean corpuscular Hb, mean corpuscular volume, free thyroxine and triiodothyronine (T3), and serum thyroid-stimulating hormone (TSH) were collected. Of patients, 86.6% had anemia with a prevalence of 30.2%, 47.6%, and 22.2% for mild, moderate, and severe anemias, respectively. The prevalence of anemia was significantly higher among females, those with high serum ferritin, normal serum iron or normal serum T3, lower mean HbA1c level (%), lower serum iron or T3, and higher serum ferritin or TSH. A significant positive correlation was found between Hb level and HbA1c level (%), serum iron, free T3, and body mass index. A significant negative correlation was found between Hb level and mean corpuscular volume, serum ferritin, and serum TSH. Being female, having high serum ferritin, lower mean free T3, and a high TSH were risk factors for anemia. The prevalence of severe anemia was significantly higher among patients with uncontrolled diabetes mellitus. A high prevalence of anemia was found among studied diabetics. Anemia screening should be included in the routine assessment of patients with diabetes. A multidisciplinary approach involving endocrinologists, hematologists, and dietitians is recommended to ensure holistic care and address all aspects of the patient's health. In addition, further research should be supported to better understand the mechanisms linking diabetes and anemia and to establish evidence-based guidelines for managing anemia in diabetics.

Incidence of postoperative pneumonia in various surgical subspecialties: a retrospective study.

Postoperative pneumonia (POP) can be defined as either hospital-acquired pneumonia (HAP, pneumonia developing 48-72 h after admission) or ventilator-associated pneumonia (VAP, pneumonia developing 48-72 h after endotracheal intubation)' or within 30 days in postoperative patients. POP accounts for 2.7-3.4% of postoperative complications. Few studies have evaluated the incidence and the risk factors of POP. This study aimed to estimate the incidence of POP and identify the predictive factors of POP in King Abdul-Aziz University Hospital (KAUH), Jeddah, Saudi Arabia. This retrospective record review included all patients diagnosed with POP at KAUH between 2011 and 2021. Patients younger than 18 years of age and those diagnosed with congenital heart or lung disease were excluded from the study. Data were analyzed using the SPSS program version 26. Of the 2350 patients, 236 met the inclusion criteria. The mean age of patients was 58.12± 17.66 years; 82.6% had comorbidities. ENT (6.4%) and cardiothoracic surgeries associated with POP were the most common surgeries (4.2%). Comorbidities were found as an independent predictor of pneumonia among the studied patients (P = 0.024). The incidence of developing POP was (19.9%). Therefore, Physicians should be aware of POP. Especially when treating patients with comorbidities and patients on corticosteroids.

Exploring university students' nutrition literacy in Saudi Arabia: a cross-sectional survey.

Improving individuals' nutrition literacy can be one way to promote healthy dietary behaviors, which lowers the incidence of non-communicable diseases. In Saudi Arabia, there is a limited information regarding nutrition literacy among students. Therefore, the purposes of this study was to investigate university students' nutrition literacy and identify its predictors in Saudi Arabia. Another objective was to assess how nutrition literacy is associated with eating habits among this sample. This cross-sectional study was carried out among students attending the University of Jeddah and King Abdulaziz University (Jeddah City) in Saudi Arabia from June 2023 to September 2023. Using a convenience sampling approach, 570 students were enrolled in this study. An online-based structured survey tool including demographic details, a food frequency questionnaire, and a nutrition literacy scale was used to collect the data. Descriptive and multiple binary logistic regression analysis were performed. Approximately 40.4% of the participants exhibited poor nutrition literacy. Female students were less likely than male students to have poor nutrition literacy (adjusted odds ratio, AOR = 0.62; 95% confidence interval, CI = 0.42, 0.92). Underweight (AOR = 1.73; 95%CI = 1.22, 4.56) and overweight participants (AOR = 3.1; 95%CI = 2.77, 7.23) were at higher risk of having poor level of nutrition literacy as compared to those who had normal weight. Students who did not take any nutrition-related courses had a 1.3 times higher probability of having a poor level of nutrition literacy compared to their counterparts (AOR = 1.3; 95%CI = 1.05, 3.74). Moreover, poor nutrition literacy was associated with higher weekly consumption frequencies of red meat, processed foods, funk foods and sugar-sweetened beverages. A higher percentage of university students had poor nutrition literacy, which was associated with gender, self-reported BMI status, nutrition-related courses and unhealthy eating habits. These findings can assist university administrators and policymakers in implementing effective measures to enhance students' nutrition literacy rates in Saudi Arabia.

Analysis of Influencing Factors for Choosing Dermatology as a Future Career: A Cross-Sectional Study Among Medical Students at King Abdulaziz University.

Determining the influencing factors of choice of medical specialty is key to a balanced distribution of physicians across specialties. Dermatology, the specialty concerned with treating skin disorders, is known for being among the most wanted; however, studies identifying the factors that attract students to this specialty are lacking. Our study aimed to investigate the influencing factors of the choice of dermatology as a career in clinical-year medical students. We conducted a cross-sectional study with a sample of clinical-year medical students from King Abdulaziz University, Jeddah, Saudi Arabia, between 2020 and 2021. We collected data using an online self-administered questionnaire; we replicated a questionnaire present in prior research. We compared categorical data using the chi-square and Fisher's exact tests. Results: In total, there were 252 participants, with 30 (11.9%) choosing dermatology as a specialty. Over half showed an average grade of more than 4.5 (66.7%), and 83.3% were female. The significant influencing factors of students' choice of dermatology as a career were: the likelihood of dermatologists influencing patients' lives (p=0.000), opportunities to conduct research in dermatology (P=0.000), how Dermatology allows people to have a satisfying family life (P=0.001), and opportunities for part-time work in dermatology (p=0.000). Many factors influenced the choice of a future medical specialty in our sample. Focusing on these factors while guiding students to choose their specialty may enable a promising next generation of physicians.

Comparative analysis of nutritional quality and microbial contamination in camel milk: Evaluating safety and public health risks between camel milk obtained from street vendors and farms in Saudi Arabia.

To evaluate the nutritional quality and microbial contamination of raw camel milk sourced from street vendors and compare it with milk obtained from farms, with a particular emphasis on pathogenic organisms. Twenty samples were systematically collected from street vendors and farms between July 2022 and February 2023 and analyzed at King Fahad Medical Research Centre and the Pharmacy College, King Abdulaziz University, Jeddah, Saudi Arabia. The microbial analysis employed culture-dependent techniques for colony-forming unit analysis and isolation of microbial colonies from milk samples. Microbial identification utilized advanced methods, including VITEK-MS equipment and the MALDI-TOF technique. The chemical composition was analysed through enzyme-linked immunosorbent assays. The findings revealed significant differences in microbial loads, with milk sourced from street vendors exhibiting considerably higher microbial counts than farm-sourced milk, including pathogenic species like Staphylococcus aureus and Escherichia coli. The results indicated that camel milk from street vendors possessed a higher level of microbial contamination, suggesting potential health risks associated with its purchase and consumption from these sources. This study highlights the urgent need for stringent food safety practices in handling, selling, and distributing camel milk to reduce microbial risks to safe levels, thereby mitigating potential health hazards.

Agreement Between Clinical and Histopathological Diagnoses of Oral and Maxillofacial Lesions and Influencing Factors: A Five-Year Retrospective Study.

Diagnosing oral and maxillofacial lesions is a multi-step, multidisciplinary process. If a clinical diagnosis is achievable, then a histopathological diagnosis is indicated to support and confirm the diagnosis. Histopathological examination of tissue biopsies is therefore an essential part of the diagnosis and/or treatment plan. The purpose of this study was to investigate the agreement between the clinical and histopathological diagnoses of oral and maxillofacial lesions and the patient, lesion, and healthcare provider factors that may affect this agreement. This was an observational, cross-sectional study of all patients who had been referred to the Oral Pathology Central Laboratory at the Faculty of Dentistry and University Dental Hospital at King Abdulaziz University in Jeddah, Saudi Arabia, between 2018 and 2022 for diagnosis of oral and maxillofacial lesions. Data extracted included information about the referring dental provider such as their clinical experience (number of years), specialty, certification, and education. Agreement between the clinical and histopathological diagnoses was evaluated, and logistic regression was used to assess provider characteristics associated with the accuracy of diagnosis. The clinical and pathological diagnoses were concordant in 44.1% (n=378) of cases, and concordance was highest for odontogenic tumors (72.7%, n=24), significantly higher than for inflammatory lesions (37.3%, n=111). The anatomical locations with the highest diagnostic accuracy were the ventral surface of the tongue (71.4%, n=5), followed by the lips (52.6%, n=20). Patient age and sex and the dentist's years of experience were not associated with diagnostic agreement (p=0.2, p=0.9, and p=0.08, respectively). However, concordant diagnoses were significantly associated with the dentist's rank (p=0.02) and specialty (p=0.01). Clinical diagnoses made by oral surgeons at the time of biopsy were 1.6-times more likely (p=0.01) to agree with the pathological diagnosis compared with those made by other specialties when controlling for education, certification, and years of experience. These data are a reminder that a clinical diagnosis alone is not sufficient to secure the final diagnosis and to plan treatment. Histopathological examination remains essential for most oral and maxillofacial lesions.

Association Between Smoking and Outcomes of Autoimmune Hepatitis.

Background Autoimmune hepatitis (AIH) is a chronic liver disorder caused by the immune system targeting liver cells. The etiology of AIH remains undefined. Therefore, we aim toexplore the relationship between cigarette smoking and AIH. Methods A retrospective study was done at the Department of Medicine, King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Forty-six inpatients and outpatients managed at KAUH from 2016 to 2021 and diagnosed with AIH were included. Data about patients' age, gender, smoking state, type of liver disease, and any other autoimmune disease were collected. Results In all, 10.9% (n = 5) of patients were active smokers, and 60.0% (n = 3) used cigarettes. The median number of cigarettes smoked per day was 17, while 56.5% (n = 26) had a positive family history of smoking, and 41.3% (n = 19) were passive smokers. Of them, 39.1% (n = 18) had at least one complication of AIH, such as liver cirrhosis, which is the most frequent complication (61.1%; n = 11), followed by esophageal varices (22.2%; n = 4), liver fibrosis (5.6%; n = 1), and fatty liver (5.6%; n = 1). The presence of any complication was not associated with patients' demographics or smoking status. On the other hand, liver cirrhosis was significantly higher among currently active smokers. Conclusion No relationship was found between smoking and the AIH outcomes. Future multi-center studies on larger samples are needed.

Magnetic resonance imaging of the breast: Could it be used as a screening test?

To investigate whether magnetic resonance imaging (MRI) best detects early malignancy in high-risk women. A retrospective, cross-sectional study, carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, included 419 female breast cancer patients aged 16-84 years (mean age of 49). Data were collected from the radiological department's database to compare the MRI, ultrasound (US), and mammography results, with or without tissue biopsy. In diagnosing benign versus malignant lesions, MRI showed significant agreement with tissue biopsy, with high sensitivity (70%) and specificity (87%); its positive predictive value (PPV) was 92% and negative predictive value (NPV) was 56%. While US has a PPV of 84% and NPV of 63%; with a sensitivity (79%) and specificity (71%). In patients without tissue biopsy, there was little difference between mammography and US compared with MRI results. Magnetic resonance imaging is more effective than US and mammography for early detection of BC. It showed high sensitivity in detecting breast lesions and high specificity in characterizing their nature when correlated with pathological results. Ultrasound screening followed by MRI is suggested for undetected or suspected lesions. This will increase the breast lesion detection rate, reduce unneeded tissue biopsies, and enhance the disease's survival rate.

حجية الدليل الإلكتروني أمام القضاء الإداري: دراسة مقارنة

This research comes as part and introduction to a master’s thesis in public law at King Abdulaziz University entitled “The Validity of Electronic Evidence before the Administrative Judiciary a Comparative Study by researcher Saeed Alghamdi and supervised by Associate Professor of Administrative Law, Dr. Alaa El Din Mohammed. There is no doubt that modern means of proof, especially those that are done via the Internet, are important in our contemporary society, what is called digital evidence, and due to the importance of digital evidence in proof, the research addressed the answer to the problem: To what extent is electronic evidence authoritative before the administrative judiciary? Many questions arise from it that do not go beyond this problem in their content. The researcher followed the comparative approach to answer the research question, as a comparison will be made between the Egyptian, Emirati and Saudi laws, and the researcher reached a number of results, the most important of which is that electronic evidence is considered independent evidence and has strong authoritativeness before the judiciary because the Saudi evidence system included electronic evidence as independent evidence and became like other evidence that is independent and it is valid to base the ruling on it and its provisions apply before the administrative judiciary by virtue of what is stipulated in the litigation system before the Saudi Board of Grievances. In light of the previous results, we recommend that the Saudi regulator add a paragraph in Article Nine of the Enforcement System stating that an electronic document authenticated electronically is considered an executive document.

A retrospective study on adjuvant chemotherapy in retinoblastoma: validation of the new recommendation against treatment for pT2a tumors based on the 8th AJCC classification

BackgroundRetinoblastoma (RB) is an intraocular malignant tumor detected in early childhood with variable global impact. Histopathological classification of the tumor in enucleated globes with RB is the key for the decision of adjuvant chemotherapy use. We aim to validate the use of adjuvant chemotherapy in cases with combined pre-laminar/intralaminar optic nerve (ON) invasion and focal choroidal invasion according to the American Joint Committee on Cancer (AJCC) 8th classification.MethodsThis is a retrospective study conducted at King Abdulaziz University Hospital (KAUH) and King Khalid Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia of all RB cases who underwent enucleation over 22 years (2000 to 2021). The histopathological findings were reviewed to identify the enucleated globes classified as pT2a tumors, as an inclusion criterion. Basic demographic and clinical data were collected via chart review Simple descriptive and basic statistical analysis of the data was used where applicable.ResultsThirty-one patients who had an enucleated globe with RB that fit into the above classification were included. Sixteen were males and 15 were females. The median age was 14 months (IQR = 14 months). Most of the patients (93.5%) had no family history of RB. The commonest presentation was leukocoria in 87.1% followed by squint in 32.3%. Fourteen patients (45.2%) were treated by enucleation alone while 17 patients (54.8%) received adjuvant chemotherapy. Out of these, 7 patients had unilateral RB and the remaining 10 patients had bilateral RB. None of our patients developed recurrence or metastatic disease irrespective of the indication for adjuvant chemotherapy use after a maximum period of follow up reaching 17.84 years and a median of 10.6 years (IQR = 5.92).ConclusionsIn patients with 8th AJCC histopathological classification of pT2a, chemotherapy following enucleation might not be justified. The outcome in our untreated group of patients did not differ from the treated group with the absence of metastasis after a relatively long period of follow up with a median exceeding 10 years in both groups. Therefore, the risk and benefit of post enucleation adjuvant chemotherapy in the treatment of unilateral RB should be carefully decided and discussed with the primary caregivers taking into consideration the most recent evidence and recommendations in the literature.

The clinical utility of handgrip strength as a malnutrition screening tool in hospitalized older adults: a cross-sectional study in Saudi Arabia.

Malnutrition is prevalent among hospitalized older patients. Early identification is therefore essential to implementing appropriate therapeutic interventions. This study aimed to explore the correlation between handgrip strength (HGS) and nutritional status in hospitalized older adults. This observational cross-sectional study was conducted at King Abdulaziz University Hospital, where a consecutive cohort of older adult inpatients was enrolled for participation. Shortly after admission, HGS and nutritional status were assessed using a dynamometer and the most recent version of the Mini-Nutritional Assessment Short Form (MNA-SF) test, respectively. Key anthropometric and biochemical indicators were also collected. A total of 135 consecutive patients were evaluated. Among participants with low HGS, 18 (16.22%) were malnourished, 43 (38.74%) were at risk of malnutrition, and 50 (45.05%) had normal nutrition status. The participants with low HGS had low hemoglobin, low lymphocyte levels, high creatinine levels, high BUN levels, high CRP levels, high HbA1c levels, and high vitamin B12 levels. Multiple logistic regression analysis showed that age, hemoglobin, and HbA1C were independently associated with low HGS. Based on the cut-off values for the HGS by the European Working Group on Sarcopenia in Older People-2 (EWGSOP2), low HGS showed high sensitivity to detect "malnourished and at risk of malnutrition" as well as "malnourished alone;" however, the specificity was low to exclude "malnourished and at risk of malnutrition" as well as "malnutrition alone." Age over 75 years, low hemoglobin, and elevated HbA1C levels were independent risk factors for low HGS. While HGS was sensitive in detecting malnutrition or risk, its specificity was low. Therefore, HGS may not be adequate as a standalone tool to assess nutritional status in hospitalized older adults. Replication of this study using locally reliable and validated HGS cut-off values is warranted to confirm these findings.

Investigating how obesity alters cardiac geometry through echocardiography analysis

ObjectivesThe rising prevalence of obesity throughout the world is a major contributor to numerous chronic diseases, including heart disease. This study aimed to explore the relationship between obesity and cardiac geometry using echocardiography. MethodsA retrospective cohort study was conducted from January 2022 to December 2022 at the Cardiology Department in King Abdulaziz University Hospital in Jeddah, Saudi Arabia. This study included 224 patients, who were referred for echocardiographic examinations. The inclusion criteria of the study were patients of both sexes older than 20 without cardiac disease. The patients were classified into four main groups based on their BMI: underweight, normal weight, overweight, and obese. The echocardiogram scanning was performed according to the protocol of the King Abdulaziz University Hospital echocardiography exam. ResultA total of 224 patients were included in this study. The results demonstrated a significant increased thickness in the interventricular septal and left ventricular posterior wall between the different body mass index groups, with the obese group having thickened measurements (p < 0.001 and 0.007 respectively). The left atrial diameter was statistically significantly higher in the obese group compared to the non-obese group (p-value = 0.019). ConclusionA strong relationship was demonstrated between obesity and changes in cardiac geometry. While left ventricular function remained unaffected in this study, these findings reinforce the concern that obesity poses a significant threat to cardiac health. These changes in cardiac geometry can be detected by echocardiography, which is an essential part of cardiological practice. Early intervention through lifestyle modifications is crucial to mitigate the adverse effects of obesity on the heart.

Prevalence of Seizures in Children Diagnosed With Neurodevelopmental Disorders.

Introduction Neurodevelopmental disorders (NDDs) typically emerge in early childhood and have a profound impact on the development of the nervous system, leading to various neurological challenges in cognition, communication, social interaction, motor skills, and behavior. These disorders arise from disruptions in brain development mechanisms. NDDs include conditions such as cerebral palsy (CP), global developmental delay (GDD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), with ADHD and ASD being the most prevalent. However, there is a lack of comprehensive research on the causes of NDDs in children receiving care at tertiary hospitals in Saudi Arabia. Therefore, in this study, we aimto investigate the characteristics of patients with NDDs and explore the association between NDDs and seizures. It also focuses on identifying specific risk factors that may influence the relationship between NDDs and seizures. Methods We conducted a retrospective cross-sectional study at the pediatric neurology and developmental assessment clinic of King Abdulaziz University Hospital in Jeddah, Saudi Arabia. The study involved a review of electronic medical records from January 2021 to May 2023 for 200 pediatric patients who attended the clinic for NDD and seizures. Descriptive statistics summarized the data, using frequencies and percentages for categorical variables, and mean ± standard deviation for quantitative variables. The chi-square test identified differences between qualitative variables, with a significance threshold of p < 0.05. Results The study sample comprised 200 children ranging in age from one month to 14 years, with the majority of patients being from Jeddah city. Participants were categorized into four age groups: 17.0% (n=34) were aged between one month and three years, 18.5% (n=37) were aged between three and six years, 55.0% (n=110) were aged between six and 12 years old, and 9.5% (n=19) were aged between 12 and 14 years. The NDD subtypes identified were ASD 9.5%, ADHD 16.0%, CP 8.5%, GDD 30.5%, ID 5.5%, and 30% had multiple types of NDD. Generalized tonic-clonic seizures were the most common type observed. Conclusion Children with NDDs exhibit a high prevalence of seizures, with the age of the patient and consanguinity emerging as significant influencing factors in this correlation. Among the key findings is an emphasis on the importance of early detection and intervention for children with NDDs at higher risk of developing seizures. Overall, the study sheds light on the characteristics of NDD patients and their association with seizures, contributing to a better understanding of the complex relationship between NDDs and seizure occurrence. It also emphasizes the need for comprehensive assessment and management strategies that consider seizures in children with NDDs.

Venous Thromboembolism Risk Assessment and Prophylaxis in Obstetrics Patients in a Tertiary Health Center in Jeddah, Saudi Arabia.

Aim The study aimed to estimate the proportion of patients who were evaluated for thrombosis risk and received appropriate thromboprophylaxis, if indicated, in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Method This was a retrospective cross-sectional study conducted among inpatients from May 1 to August 31, 2020, in KAUH. Results Out of 298 pregnant women, the mean age was 32.09± 5.29 years. A total of 136 (45.6%) were obese and 97 (32.6%) were overweight. There was a significant relationship between Caprini score categories and the following variables: age, body mass index (BMI), medical disease, history of deep vein thrombosis (DVT), mode of delivery, prophylaxis, and its duration (p < 0.05). Conclusion Awareness about thromboprophylaxis in reducing the risk of developing venous thrombosis has increased compared to before, with more than half of the cases receiving it regardless of the risk level. The highest risk of venous thromboembolism (VTE) was found in older women, obese women, and those with a previous history of DVT. Low-molecular-weight heparin (LMWH) was the main prophylaxis in the hospital with an average duration of three days.

Clinical Significance of Serum Cystatin C in SLE: A Potential Marker of Disease Damage Beyond Lupus Nephritis

Objective: This work aimed to assess the serum level of cystatin C in systemic lupus erythematosus (SLE) patients and to determine the relation to disease characteristics and damage. Methods: The study included 33 SLE patients presenting to the Internal Medicine and Rheumatology Department and Outpatient clinic, King Abdulaziz University, Saudi Arabia. The medical history, clinical examination, laboratory investigations and medications received by the patients were recorded. The systemic lupus international collaborating clinics damage index (SLICC-DI) was assessed. Serum cystatin C was measured using the immune-nephelometric method. Results: The mean age of the patients was 35.3±10.7 years; 28 females and 5 males (F:M 5.6:1), disease duration 5.5±3.1 years and their age at onset was 27.9±10.6 years. Serum cystatin C level was significantly higher in patients with lupus nephritis (LN) (2.47±1.57 mg/L vs v mg/L, p=0.003) and diabetes (4.92±0.05 mg/L vs 1.93±1.34 mg/L; p&lt;0.0001) and was lower in those with thyroid dysfunction (1.41±0.75 mg/L vs 2.3±1.59 mg/L, p=0.047). There was a significant correlation between the serum cystatin C level with proteinuria (r=0.57, p=0.011) and with the SLICC-DI (r=0.42,p=0.016). Serum cystatin C could discriminate patients with LN at cut-off value of 0.904 mg/L with area under the curve of 0.765, sensitivity 87% and specificity 50%; p=0.017. Conclusion: The remarkable association between cystatin C and LN is confirmed and an emerging role is noted in reflecting the extent of disease damage. The likely association with diabetes and thyroid dysfunction should also be taken into consideration when deciding treatment regimens for LN patients.