King Abdulaziz University Research Articles

Evaluation of Factors That Contribute to Intraoperative and Postoperative Complications Following Colorectal Cancer Surgeries at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Colorectal cancer (CRC) is a major contributor to cancer-related mortality and morbidity due to its high prevalence. Surgery remains the curative option. Colorectal cancer patients come to our institute at an advanced stage due to the lack of adequate national screening programs in developing countries. This carries a particularly high risk of morbidity and mortality. In this study, we aim to provide an overview of the complications of colorectal cancer surgery and to describe the preoperative and intraoperative factors associated with it. This retrospective record review was done at King Abdulaziz University Hospital (KAUH), a tertiary center in Jeddah, Saudi Arabia. It included all patients aged 18 and older who have undergone colorectal cancer surgeries from January 2017 until August 2022. In our sample of 195 patients, 52.3% of the patients were males. The mean age of our sample was 59.32 ± 13.21. We found that 19 (9.7%) patients had an intraoperative complication (IOC). The most frequent IOC was bleeding reported in seven patients (3.6%), followed by intestinal injury in three (1.2%), bladder injury in three (1.2%), and ureter injury in three (1.2%). Regarding preoperative lab tests, patients who had low blood albumin levels (P = 0.004) and high preoperative white blood cell count (WBC; P = 0.015) were more likely to experience IOC. There was a statistically significant relationship between the patient's ASA score and IOC (P = 0.011).Postoperative complications (POC) occurred in 58 patients (29.7%). The most frequent POC was surgical site infection (SSI; 16.4%), followed by urinary tract infections (UTI) (6.7%) and prolonged postoperative ileus (5.6%). Patients who initially presented with vomiting (P = 0.015), had free air on a preoperative abdominal computed tomography (CT) scan (P = 0.028), required intraoperative blood transfusions (P = 0.033), were diagnosed with transverse colon tumors (P = 0.045), and required longer hospital stays (P = 0.011) were found to have a higher rate of POC. The incidence of colorectal cancer is increasing, and surgery is a successful treatment option. However, complications from surgery may result in morbidities and prolonged hospital stays. The risk of IOC is increased by preoperative variables such as high WBC levels, low albumin, and ASA scores. Patients with initial obstruction signs, free air on CT scans, intraoperative blood transfusions, transverse colon tumors, and longer hospital stays have a higher rate of POC. Patient monitoring and the provision of standardized clinical tools enhance general survival and quality of life.

The Waqf and its Provisions

This research serves as a part and introduction to a master's thesis in private law at King Abdulaziz University, focusing on the subject of "Waqf" (endowment). The researcher, “Majed bin Abdul Rahman Al-Bahar”, conducted this study under the guidance of Associate Professor of Civil Law, “Dr. Faisal bin Sutouf Al-Assaf”, at King Abdulaziz University in Jeddah. “Waqf" is one of the voluntary contracts that individuals conclude, driven by a desire for reward from Allah Almighty. It is a charitable act aimed at dedicating something beneficial to individuals or entities in need of support and assistance. Due to the importance of "Waqf" in society, this research addresses the answer to the issue of: "What are the legal rulings (ahkam) governing Waqf?" This inquiry encompasses various aspects falling under this overarching issue. The researcher has adopted a descriptive-analytical methodology to answer these questions. This was achieved through the description and analysis of legal articles related to Waqf as stipulated by the Saudi legislations, including the General Authority for Endowments law, the Civil Transactions law, and other relevant regulations. The researcher has arrived at several key findings, with some of the most notable being that Waqf is subject to specific conditions and elements that must be satisfied for its validity. Furthermore, the study highlights that Waqf is characterized by flexibility and inclusiveness, designed to address diverse human needs.

Recent Patterns and Assessment of Long-term Complications followi ngSARS-CoV-2 Infection and Vaccination in the Context of Diabet esPrevalence among Blood Donors.

Much increasing evidence has suggested that long-term complications post vaccination of SARS-CoV-2 experience a wide range of complication including diabetes. The risk and burden of type 1 diabetes is extensively reported, but type 2 diabetes mellitus (T2D) has yet to be characterized. To address this gap, we aimed to examine trends of long-term complications post SARS-CoV-2 infection and vaccination in diabetes incidence among the Saudi population. In this cross-sectional hospital-based study, we analyzed the blood profile of first-time blood donors from the University Hospital of King Abdulaziz University, Jeddah. Saudi Arabia. Various blood parameters, HbA1c was measured in the month of May 2023. All the donors were non-diabetic and were never diagnosed with T2D before the current blood donation. 203 healthy subjects donated their blood, out of which 104 had abnormally high HbA1c tending towards diagnosis of T2D and 99 had with blood profiles. The study followed the STROBE reporting guidelines. Out of 203 donors 104 (male 50(48.1%), female 54(51.9%)) were diagnosed with increased HbA1c (8.24 in males) compared to 7.61 of HbA1c in females. 35.6% were above ˃65 years, with 52.9% with O+ from the ABO blood group. Liver functions indicated significant p˂0.05, 0.04, increased amount of GGT (46.47 U/L), Alkaline phosphatase (99.93 ±64.26 uL) respectively in HbA1c elevated donors KFT represented significant p˂0.05, 0.02 elevated levels of urea (6.73 ±5.51 mmol/L), creatinine (129.97 ±195.17 umol/L) respectively along with elevated values of Lactate dehydrogenase (LDH) (263.72± 196.70 uL) and triglycerides (1.66 ±0.74mmol/L) when compared to normal value of HbA1c donors. In the present cross-sectional study, significant increase in HbA1c, trending towards increased cases of T2D post SARS-CoV-2 infection and vaccination. Males are much affected compared to females. Further maximum number of cases were from donors above the age of 65 years with altered partial LFT (GGT, Alkaline phosphatase), KFT (urea, creatinine), lipid profile (TG) and LDH in post SARS-CoV-2 and vaccination blood donors. Increase in HbA1c in 50% of donors, irrespective of gender, is an alarming figure for health authorities, with altered LFT, KFT and LDH tests and, in the near future, may increase the incidence of T2D. Large-scale population-based studies are required to prevent future incidences of T2D in young children who will be vaccinated.

Prevalence of Esophageal Eosinophilia, Eosinophilic Esophagitis, and Lymphocytic Gastritis in Children with Celiac Disease: A Saudi Tertiary Center Experience.

Celiac disease (CD) is an immune-mediated enteropathy that has been associated with other immune-related gastrointestinal disorders, such as eosinophilic esophagitis (EoE) and lymphocytic gastritis (LG). To our knowledge, this is the first study in Saudi Arabia that has described such an association. To evaluate the prevalence of EoE and LG in children and adolescents with CD. This was a retrospective cross-sectional study of all pediatric patients (aged 0-18 years) with CD following up at King Abdulaziz University Hospital, between January, 2014, and December, 2021. The study examined clinical, demographic, endoscopic, and histopathological data. Seventy-five patients with CD were included in the analysis. The median age was 12 years (range, 2-18 years). Male constituted 54.7% of the overall cohort (n = 41). The most common clinical symptoms were short stature (54.7%), weight loss (34.7%), abdominal pain (33.3%), abdominal distension (29.3%), anorexia (29.3%), diarrhea (24%), and vomiting (21.3%). The esophageal biopsy results reported were basal cell hyperplasia in 24 patients (32.9%), esophageal eosinophilia in 23 patients (31.5%), and EoE in 3 patients (4.1%). The gastric biopsy results were normal in 40 patients (53.3%). The most common abnormality was chronic inactive gastritis with no Helicobacter pylori (HP) infection (16%). LG was found in 3 patients (4%). The prevalence of EoE in this cohort of patients with CD was lower than the prevalence recorded in a number of other studies. Further studies are needed to determine the effects of a gluten-free diet (GFD) on EOE and LG.

Knowledge, Attitude, and Practice Toward Dietary Salt Intake Among Medical Students at King Abdulaziz University.

Background Since the beginning of the century, dietary patterns have been changing rapidly due to evolving lifestyles, restaurants that cater to dietary restrictions, etc. As a result, populations started consuming a large amount of salt in their diets. Years of research have found that high salt intake is strongly related to many serious health problems like hypertension and cardiovascular diseases. This study's objective is to evaluate knowledge, attitudes, and practices regarding dietary salt intake among medical students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia, and to identify barriers and concerns related to optimum dietary sodium intake. Method A cross-sectional study done at KAU among 310 students using an online questionnaire included items to assess their knowledge, attitudes, and practices related to dietary salt intake. There were 24 questions to assess knowledge, six questions to assess attitude, and eight questions to assess practice. Results The mean age of the participants was 21.52 ± 1.94 years; 180 of the 57.5% were female. A score of "1" was given to the right answer for knowledge, positive attitude, and correct practice. The mean knowledge, attitudes, and practices scores were 16.99 ± 3.8, 3.03 ± 1.46, and 2.13 ± 1.34, respectively. The percentage of poor, fair, and good knowledge levels regarding dietary salt intake among studied students was 72:23%, 210:67.1%, and 31:9.9%. While the prevalence of negative, fair, and positive attitudes was 111:35.5%, 141:45%, and 161:9.5%. As for practice level, none of the students had good practice, while 263:84% and 50:16% had poor and fair practice, respectively. Conclusion In conclusion, the majority of students were aware that a high-salt diet can result in serious health issues. They were also uncertain of whether their salt intake was extremely high or not, which is consistent with thefact that they were ignorant of the daily salt intake guidelines. The findings in our study can stand as a reference point for salt-related knowledge, attitude, and practice (KAP) studies to help further future research in Saudi Arabia and other countries. Multi-sector coordination between the food suppliers, health agencies, and government is necessary to increase public awareness, decrease the salt content of food, and lower individual salt consumption in Saudi Arabia.

Assessment of Medical Students' Knowledge of Ocular First Aid During Trauma: A Cross-Sectional Study From King Abdulaziz University.

Background Ocular trauma is defined as an eye injury of diverse types and subtypes, all of which can threaten vision. Hence, a precise first-aid approach is crucial to salvage the eyes and prevent blindness. Therefore, this study was designed to assess the level of knowledge among medical students at King Abdulaziz University (KAU) and identify factors that affect knowledge regarding ocular first aid in cases of trauma. Methodology A cross-sectional approach was used, targeting KAU medical students. First, students were asked to voluntarily respond to a previously used questionnaire that contained demographic data, including gender, marital status, socioeconomic status, academic year, and city of residence, followed by a history of ocular trauma. Then, questions were asked to assess their knowledge regarding different types of ocular trauma and proper first aid. Results A total of 310 participants responded to the questionnaire. Participants included both sexes, with 169 (50.8%) being males. Only 89 (26.7%) participants had a history of managing ocular injury. Knowledge levels were divided into good 76 (27%) and poor 201 (73%). Third-year students had the highest percentage of poor knowledge, whereas sixth-year students had the highest level of knowledge. The source of knowledge was mainly from studies. Conclusions The ocular first-aid knowledge level was predominantly poor, accounting for 201 (73%) of all responses. Thus, steps to enhance knowledge should be taken.

The detailed profile of congenital heart diseases in 254 children with Down syndrome in Saudi Arabia

BackgroundDown syndrome is the most common chromosomal abnormality in humans. It is associated with several congenital anomalies, including a spectrum of congenital heart diseases. Understanding the true prevalence and distribution of congenital heart diseases is essential for health resource planning, outcomes, and family counseling.This study aimed to assess the prevalence and distribution of congenital heart disease in children with Down syndrome. It is a retrospective cohort review that included all patients treated at King Abdulaziz University Hospital. Frequencies were estimated using the SPSS software and comparisons were made using Student’s t test.ResultsThe ages of the 254 subjects ranged from less than 1 year to 53 years. Of these, 44.5% were female and 40.6% were Saudi nationals. Congenital heart disease was present in 66.5% with a significant difference between Saudi nationals 44.6%) and non-Saudi nationals 71.5% (P = 0.01). The atrioventricular septal defect was the most common pathology, representing 33.1% of all congenital heart diseases followed by perimembranous ventricular septal defect 18.9%, and right ventricular pathology 10.2%.ConclusionThe prevalence of congenital heart diseases in Saudi children with Down Syndrome is similar to that reported worldwide. Septal defects and right-sided pathologies are the dominant forms of congenital heart diseases, with atrioventricular septal defect and perimembranous ventricular septal defect representing the most common pathologies.

Association of ABO Blood Groups and Obesity in Patients With Diabetes Mellitus in King Abdulaziz University Hospital.

Differences in the blood, resulting from the presence or absence of antigens corresponding to specific blood types, have indirect implications for susceptibility to diseases. The aim of this study was to examine the association between the ABO type and obesity in patients with diabetes mellitus. This is a cross-sectional observational study that was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Data were collected using a simple random method through hospital records during the period between August and September 2022. Patients with type 1 diabetes mellitus (T1DM) and T2DM were included in this study. Binary logistic regression analysis was used to identify the association between blood group and obesity. A total of 411 patients were involved in this study. More than half of the patients (54.3%; n= 223) are diagnosed with T1DM. O-positive was the most common blood group type among the patients, accounting for 38.6% (n= 161). Only 23.6% (n= 97) of the patients were classified as having normal weight. Around 32.6% (n= 134) of the patients were classified as having the pre-obesity stage. More than one-third of the patients (35.1%; n= 145) were classified as being obese. There was no statistically significant difference between the patients in terms of their blood type group and its association with obesity (p>0.05). Many diabetics are overweight or obese, according to thisstudy. This shows the importance of weight management for diabetes treatment. Many patients were overweight, emphasizing the importance of obesity prevention and diabetes care. Most patients were O-positive, according to blood type tests. Previous research suggests that blood types may be linked to diabetes. However, this study found no significant relationships. More research is needed to understand the complex link between blood types, weight, and diabetes.

Evaluation of medical students' understanding and implementation of vitamin D and calcium at a tertiary healthcare facility in Jeddah, Saudi Arabia, a cross-sectional study

Objective: This study aimed to determine how well-informed the undergraduate medical students of Jeddah, Saudi Arabia, were on the importance of calcium and vitamin D. Methods: Using an online self-administered, pre-designed questionnaire distributed from July to August 2021, a cross-sectional study was conducted among fellow undergraduate medical students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia. Results: A total of 472 undergraduate medical students participated in the study, where number of students in their clinical years was predominant (61.7%; n = 291). Nearly all the students were aware of the significance of vitamin D (99.6%; n = 470) and calcium (99.8%; n = 471) as essential components for body functioning. Their main knowledge sources were doctors (79.9%; n = 377) and social media (77.1%; n = 364). However, their general attitude was inadequate, with female students exhibiting a better attitude towards sunlight exposure and diet, including supplements. Conclusion: The current study showed that undergraduate medical students of both genders at KAU were satisfactorily informed about the significance of calcium and vitamin D. Female students displayed a better attitude, yet the overall attitude was still inadequate. More effort is required to encourage and guide students.

Promoting Arabic Sign Language Skills Among Dental Students.

While the services available to deaf people in the Middle East have yet to be documented, they need improvement in several countries. The aim of this article was to reduce miscommunication between dentists and deaf patients through the introduction of an optional sign language course for pre-doctoral students and faculty of dentistry at King Abdulaziz University (KAUFD). All fourth-year pre-doctoral students were invited to participate in an Arabic sign language course. A survey with 11 multiple choice and 38 true/false questions with an "I don't know" option was distributed, both before and two weeks after the course. This survey was extensively validated and pilot-tested before distribution. The response rate was 141 students (84.9%), 49 of which were males (34.8%) and 92 of which were females (65.2%). The pre-doctoral students had a higher overall knowledge score (mean 22.9±14.8) and sign language skills (11.1±1.7) after the course compared to before the course (9.8±7.1, and 3.7±3.3, respectively) (all P-value <0.001). All the pre-course individual questions had lower scores compared to the post-course questions (P-value <0.05). Deaf people might face difficulties communicating at dental health care clinics, which may be improved by equipping dentistry providers with cultural competency training, like this course.

Preferences and Perceptions of Paediatric Dentists’ Attire among 4-12-year-old Children: A Cross-sectional Study

Introduction: Dentists’ attire includes their choice of clothes and Personal Protective Equipment (PPE) required to follow infection control measures. Investigating and understanding the paediatric patient’s preferences and perceptions towards the dentist’s attire can aid in establishing a more efficient and smoother relationship between them. Aim: To determine the children’s preferences and perceptions of their paediatric dentist’s attire and PPE among four to 12- year-old children. Materials and Methods: This cross-sectional study included four to 12-year-old Arabic-speaking children attending Department of Paediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia for dental treatment with their parents/ guardians between February 2022 and April 2022. Data were collected from the participants using a validated Arabic electronic questionnaire to determine their preferences regarding different parts and types of the dentist’s attire and PPE, as well as their perceptions and feelings of comfort towards the dentist wearing the full standard PPE. Data were summarised as frequencies and percentages for categorical variables or means and standard deviations for continuous variables. The significance threshold was set at 0.05. Results: A total of 362 participants with a mean age of 8.4±2.3 years and their parents/guardians participated in the study. Female dentists were significantly more favoured by both male and female participants, with statistical significance among females (p&lt;0.001) and younger participants (p&lt;0.001). Both males and females (p=0.025) and older participants (p = 0.001) significantly favoured the traditional white coats over colourful paediatric coats. Furthermore, older participants significantly preferred surgical masks over paediatric masks (p&lt;0.001), face shields as eye protection (p&lt;0.001), and no head cover over colourful paediatric caps (p&lt;0.001). Male participants showed significantly better acceptability towards the dentist wearing the full standard PPE. Conclusion: Both genders and younger children preferred female dentists. The traditional white coat is the most preferred attire by both genders and older children. Male and older children showed higher acceptability for the full standard PPE.

The readiness of Saudi nursing interns for the professional role.

The nursing education program offers opportunities to prepare nursing students with the knowledge and skills required for their professional roles. The level of their readiness and confidence will affect their ability to provide effective and sufficient nursing care. The purpose of this study is to assess nursing interns readiness for professional roles. To accomplish the study's objectives, a cross-sectional, descriptive design was employed. All nursing interns who graduated from the KAU School of Nursing in the academic year 2018-2019 were recruited from different hospitals in Jeddah, Saudi Arabia, from March 2019 until May 2019. Participants completed the Casey-Fink Readiness for Practice Survey. Descriptive statistics were conducted to answer the research questions. The results of this study demonstrated that the students felt ready and confident to assume their professional nursing roles. The students had some difficulties with managing multiple patients and certain skills, such as how to deal with dying patients and prioritize patient care needs. The findings of this study showed the students felt entirely ready for the professional nursing role. The nursing college at King Abdul-Aziz University is making a great effort to prepare its students for their professional roles. We still need to develop skills and clinical competencies in preparation for effective professional roles. In addition, continuous assessment is considered important for patient safety, to increase nurses' work retention, and to enhance professional nurse confidence and the quality of care they must provide.

Evaluating Oral Hygiene Practices: Tooth Brushing and Miswak Use in Dental Students at King Abdulaziz University

Evaluating Oral Hygiene Practices: Tooth Brushing and Miswak Use in Dental Students at King Abdulaziz University

Cardiovascular Consequences of Sickle Cell Disease.

Sickle cell disease is an inherited blood disorder which can lead to severe complications, particularly in the cardiovascular and respiratory systems, potentially resulting in arrhythmias, pulmonary hypertension (PH), and cardiomegaly. This study aims to investigate the risk of PH and arrhythmias in adult SCD patients. Retrospective analysis of medical records from King Abdulaziz University Hospital (KAUH) for patients with SCD aged 15 and above between 2009 and 2021. The study included 517 patients, with echocardiograms and electrocardiograms assessed according to the European Society of Cardiology/the European Respiratory Society (ESC/ERS) guidelines for categorizing PH risk (low, moderate, high) and detecting arrhythmias. Data analysis employed the Statistical Package for the Social Sciences (SPSS), utilizing quantitative and qualitative data representation. Multivariate logistic regression identified independent risk factors with odds ratios at a 95% confidence interval (CI). Among participants, 50.3% were male, with a total sample average age of 34.45 ± 9.28 years. Results indicated that 1.4% of patients experienced arrhythmias, 3.7% had a moderate PH risk, and 3.3% were classified as high PH risk. Logistic regression revealed significant independent risk factors for PH and arrhythmia in patients with SCD, with chronic kidney disease (CKD) carrying the highest odds (26.4 times higher odds of PH and 15.36 times higher odds of arrhythmias). Patients with SCD are at risk for developing PH and various arrhythmias but are often underdiagnosed. Key risk factors for PH included CKD, liver cirrhosis, and pre-existing cardiac conditions. Arrhythmias were significantly associated with CKD and pre-existing cardiac conditions. To mitigate these risks, we recommend involving a multidisciplinary healthcare team in the care of adult patients with SCD. Future prospective studies are advised for early detection of PH and arrhythmias in hemoglobinopathy patients, potentially reducing mortality.

Insights into Risk: Exploring Retinopathy of Prematurity and Short-term Comorbidities in Moderate-to-Late Preterm Infants.

Retinopathy of prematurity (ROP) and short-term comorbidity data moderate-to-late preterm (MLP) infants in Saudi Arabia are limited. The present study mainly aimed to identify ROP incidence and severity in MLP infants. The secondary objective was to explore whether moderate preterm infants are more prone to systemic short-term comorbidities compared to late preterm infants. This retrospective study was conducted at King Abdulaziz University Hospital, a tertiary center in Jeddah, Saudi Arabia. Two-hundred and sixty-eight MLP infants born with gestational ages (GAs) of 32 to 36 + 6 weeks were included. Births were classified as moderate preterm (GA 32 to 33 + 6 weeks) and late preterm (GA 34 to 36 + 6 weeks) and the two groups were compared with an independent t-test. ROP incidence was 1.5%; all cases were stage 1 and involved zone II or III. No patient had type 1 ROP requiring treatment. The short-term comorbidity incidence was high (76.1%) and included hyperbilirubinemia (n = 206, 76.7%), respiratory distress syndrome (n = 178, 66.4%), hypoglycemia (n = 32, 11.9%,), and transient tachypnea of newborn (n = 25, 9.3%). Moderate preterm infants were more likely to have lower birth weight (P < 0.001), any-stage ROP (P = 0.032), respiratory distress syndrome (P = 0.031), intraventricular hemorrhage (P = 0.038), and hyperbilirubinemia (P < 0.001) compared to the late preterm infants. Any-stage ROP incidence among MLP infants was low, with no type 1 ROP cases requiring treatment. Short-term comorbidity incidence was relatively high among the moderate preterm infants. Despite the low non-type 1 ROP incidence at our center, MLP infants require proper surveillance of systemic short-term comorbidities.

UTILITY OF THE 2023 BETHESDA SYSTEM AUS SUBCATEGORIZATION ON THYROID ASPIRATES.

The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is widely used for the standardized reporting of thyroid fine-needle aspiration (FNA) cytology. The 2023 revision of TBSRTC introduced specific subcategories for the classification of atypia of undetermined significance (AUS). This study tests the association between AUS subtypes and malignant diagnoses, namely AUS-nuclear atypia and AUS-other, in archived thyroid - FNA specimens with atypia from 2018-2022 at King Abdulaziz University Hospital. A total of 104 thyroid - FNA specimens with AUS were re-evaluated cytologically and correlated with subsequent surgical outcomes, along with a discussion of discrepant cases.

Postoperative outcomes in distal pancreatectomy: A single-center experience

Abstract Context: With the development of new advanced diagnostic modalities, distal pancreatectomy is nowadays performed more frequently. Pancreatic surgeries are considered overall highly morbid, with fistula development being the most serious and feared complication. Aim: This study aims to review a tertiary care center’s experience with distal pancreatectomy and to define the outcomes and mortality associated with this procedure. Subjects and Methods: A retrospective observational study was conducted among 18 patients who underwent distal pancreatectomy in the time between 2012 and 2022, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Results: Of a total of 18 patients, 44.44% were above the age of 50, and 77.77% were females. Indications related to the procedure include: 38.88% were pancreatic tumors and 38.88% were cystic neoplasms. About 94.44% of patients had their procedure combined with splenectomy, and 50% of them underwent multivisceral resection. There was no reported mortality within the 30 days postoperatively. The most frequent complication was pancreatic fistula, which occurred in 16.66% of the patients. Conclusions: One of the limitations of our study is the small sample size, which restricts a strong conclusion. However, in our center’s humble experience, there were no mortalities among the patients undergoing distal pancreatectomy, although it was associated with some morbidity.

Comparison of Various Tree Features for Blocking Solar Radiation in the Arid Urban Environment

In the arid urban environment, pedestrians are often exposed to high amounts of solar radiation during summer, which can limit their activities. Shades are essential for reducing the harmful effects of solar radiation, particularly ultraviolet (UV) rays, which can be dangerous to human health. This study thoroughly evaluated the effect of various tree features for their efficacy in blocking solar radiation, especially photosynthetically active radiation (PAR) and ultraviolet A (UVA). Tree height, trunk height, canopy height and diameter, leaf area index (LAI), leaf size and type, planting techniques (individual and cluster), and agriculture services for eight common tree species used in the Landscape at King Abdulaziz University campus in Jeddah, KSA, were examined. Measurements were taken at noon when the solar zenith angle was perpendicular. The study found that the ability to block PAR and UVA varies based on several factors analyzed. Canopy height and diameter increased a tree's capability to block radiation, with pyramid-shaped trees and simple leaves being the most effective. Higher LAI, cluster planting, and removal of lower branches also increased a tree's radiation-blocking power. In conclusion, shade trees mitigate PAR and UVA and provide pedestrians with more opportunities to enjoy open landscapes in arid regions. KEYWORDS landscape planting, leave index, solar effect, trees benefits, ultraviolet radiation, arid environments

Assessing Preferences and Sociodemographic Influences on Conveying Bad News in an Emergency Department: A Cross-Sectional Study at a Tertiary Hospital in Jeddah

Background: Breaking bad news encompasses conveying information that significantly impacts an individual&amp;apos;s view of their present and future. In emergency departments (ED), medical professionals often face the challenge of delivering distressing news. This study explored patient and family preferences for receiving bad news in the ED, considering sociodemographic factors such as education and gender. Methods: This cross-sectional study involved 304 patients from the ED of King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. The participants were divided into four groups based on their gender and educational level. A P-value of

Children Anxiety and Pain while Performing Interim Therapeutic Restorations with Hand Instruments compared to Rotary Instruments: A Randomised Clinical Trial

Introduction: Children with dental anxiety may avoid visiting the dentist until a more serious and painful condition develops. Dentists could use less stressful techniques, like Interim Therapeutic Restorations (ITR), to treat dental cavities in difficult or young patients. ITR performed with hand tools may be preferred due to the absence of handpiece vibration, sound, or smell. Aim: To assess the anxiety and pain levels experienced by children during ITR procedures performed with hand instruments compared to rotary instruments. Materials and Methods: The present randomised clinical trial was conducted in the Department of Pediatric Dentistry at King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The inclusion criteria consisted of children aged 3-12 years visiting the dental clinic for the first time and having a carious primary anterior (incisor or canine) tooth. Patients were recruited from the paediatric screening clinic and randomly assigned to either the “Hand instrument group” or the “Rotary instrument group.” Caries excavation was performed using a hand instrument in the former group, while a low-speed handpiece was used in the latter group. Anxiety levels were assessed using Venham’s anxiety rating scale before and after the procedure. Heart rate was measured using pulse oximetry every two minutes. Pain levels were evaluated using the Wong-Baker Faces Pain Rating Scale after completing the procedure. Results: The study included 60 patients, with a mean age of 5.87±2.09 years. The anxiety score after the procedure was significantly lower in the hand instrument group compared to the rotary instrument group (p=0.007). Although the heart rate was lower in the hand instrument group compared to the rotary instrument group, the difference was not statistically significant. The subjects in the hand instrument group reported lower pain levels compared to those in the rotary instrument group (p=0.029). Conclusion: Performing ITR using hand instruments resulted in reduced anxiety and pain levels among young children compared to ITR performed using rotary handpieces.