King Fahad Specialist Hospital Research Articles

Diagnosis and evaluating the urgent CT KUB at king Fahad specialist hospital, Buraydah, Saudi Arabia 2022.

PURPOSE: The aim of this research was to evaluate the diagnostic yield of urgent CT KUBs and assess the appropriateness of their use in the investigation of acute renal colic at King Fahad specialist hospital , Buraydah, Saudi Arabia 2022. METHODS: All data were collected retrospectively from patient’s records including all patients who presented to the emergency and inpatients undergo unenhanced CT KUB to rule out urinary tract stones . Follow-up requests of known urolithiasis and any scan done for other clinical indications were excluded ,representing 3.7% . RESULTS: This study reviewed 1671 patients, 24.9% were aged between 31 and 40 years old, with nearly 60% being males. Most patients were admitted to ER (98%) and referred by non-urology physicians (99%). The prevalence of patients who were diagnosed with renal stones was 38.7%. Among patients who were presented with acute renal colic and CT scan revealed no urolithiasis, there was 11% with incidental and other alternative diagnosis. The most common finding was genitourinary diseases (48.9%), followed by gastrointestinal diseases (27.2%). CONCLUSION: The significant percentage of negative CT KUB of the examined patients reflects the physicians misapplication with this technique with a subsequent reduction in the rate of renal calculi detection with unnecessary radiation exposure as well as increased the alternative/incidental of extraordinary findings, which may indicate further emergency abdominal CT studies. Therefore, urology opinion before CT-KUB requested for patients with atypical presentation is highly advised. Additionally , departmental ultrasound is suggested mainly for the young females prior to CT scan to rule out any gynecological conditions that can mimic renal stones.

Impact of Pre- and Post-therapeutic Exercises in Sarcopenia and Pain in Liver Transplant Patients.

Sarcopenia, a state considered by the loss of muscle function and mass, is progressively recognized as a common complication of advanced cirrhosis and is related to negative clinical consequences. Liver transplantation (LT) is one of the options in the treatment of cirrhosis. This study aimed to evaluate the impact of exercise in newly developed (ND) sarcopenia through measurement of the psoas major muscle at the level of the third lumbar vertebra by abdominal computed tomography (CT) images in liver transplant patients. This analytical case-control longitudinal study was conducted on patients aged between 16 and 70 years at King Fahad Specialist Hospital (KFSH-D) in Dammam, Saudi Arabia. The patients were divided into two groups:an intervention group consisting of liver transplant patients (LTx, n=26) and a control group consisting of end-stage liver disease patients (ESLD, n=23) who were not candidates for LT. All participants were treated with a therapeutic exercise program through three phases. The first phase included pre-operative exercises, the second phase included early post-operative exercises, and the last phase included late post-operative exercises. CT scan of the psoas major muscle was performed pre- and post-LT to assess sarcopenia. Pain was measured with a numerical pain scale before and after exercise to evaluate the impact of exercise on pain. Psoas muscle index (PMI) for post-therapeutic exercises in the control and liver transplant groups showed significant differences for both male and female patients compared with the normal range (p<0.05). The liver transplant group showed a significant difference in mean weight loss, body mass index (BMI), and numerical pain rating scale (NPRS) observed on post-therapeutic exercises compared to baseline data. Conclusion: By and large, the finding revealed a substantial impact of therapeutic exercise on patient outcomes in terms of anthropometric characteristics, abdominal pain, handgrip strength (HGS), and PMI. The mean PMI at post-therapeutic exercises showed a significant increase by measuring the psoas major muscle at the level of the third lumbar vertebra by abdominal CT, which may indicate the extent of improvement and recovery from the ND sarcopenia in LTx.The results emphasize the potential advantages of pre- and post-therapeutic exercise in LTx, including enhancements in muscle strength and mass, as well as pain management associated with liver function and general health. Optimizing patient outcomes and promoting a more comprehensive approach to liver disease treatment may be achieved by including exercise activities in pre- and post-LT care procedures.

Diagnostic evaluation of patients with epileptic spasms in the era of next-generation sequencing.

Epileptic spasms (ES) can be caused by a variety of etiologies. However, in almost half of cases, the etiology is unidentified. With the advent of next-generation sequencing (NGS), the recognition of genetic etiologies has increased. We retrospectively reviewed the medical records of patients with ES who were evaluated in the comprehensive epilepsy program at King Fahad Specialist Hospital Dammam between 2009 and 2022. Our data show that in 57.7% of patients with ES, the etiology was unidentified after a standard clinical evaluation and neuroimaging. Of these patients, n = 25 (35.2%) received a genetic diagnosis after some form of genetic testing, and 3.1% of patients from specialized metabolic work indicated the need for genetic testing to confirm the diagnosis. Karyotyping led to a diagnosis in 3.6% of patients, and chromosomal microarray led to a diagnosis in 7.1%. An NGS epilepsy gene panel (EP) was done for 45 patients, leading to a diagnosis in 24.4% (n = 11). Exome sequencing was done for 27 patients, including n = 14 with non-diagnostic panel testing; it led to a diagnosis in 37.3% (n = 10). Exome sequencing led to a diagnosis in 61.5% of patients without a previous panel test and in only two patients who had previously had a negative panel testing. In this article, we present the diagnostic evaluations of ES for a cohort of 123 patients and discuss the yield and priority of NGS for evaluating ES. Our findings suggest that exome sequencing has a higher diagnostic yield for determining the etiology of ES in patients for whom the etiology is still unclear after an appropriate clinical assessment and a brain MRI.

Emergence of Multidrug-resistant Acinetobacter baumannii: A Growing Health Concern in the Qassim Region, Kingdom of Saudi Arabia

Introduction: Acinetobacter baumannii is a multidrug-resistant bacterium commonly associated with hospital-acquired infections. The rapid spread of A. baumannii has raised concerns, as it has been linked to the emergence of clones in healthcare facilities worldwide. The challenges of treating and controlling infections caused by this bacterium in hospital settings are exacerbated by its resistance profile. The proliferation of clones worldwide highlights the need for careful infection control procedures and new tactics to fight illnesses caused by drug-resistant A. baumannii strains. Materials and Methods: Between January 2019 and December 2020, a total of 26,250 specimens were collected by personnel from the Department of Microbiology at King Fahad Specialist Hospital. Results: Our study highlights a significant surge in antimicrobial resistance, indicating a relative increase in multidrug-resistant A. baumannii isolates. Despite extensive resistance, azithromycin, cefoxitin, norfloxacin, penicillin, piperacillin, tetracycline, ceftriaxone, nitrofurantoin and aztreonam showed 91.2%–100% efficacy against these strains. Conclusions: This study emphasises the critical need for stringent infection control measures and judicious antibiotic strategies to curb multidrug-resistant A. baumannii outbreaks in healthcare settings. The identification of alternative therapies is imperative for improved management of infections caused by multidrug-resistant A. baumannii.

The Outcome of Outpatient Intermediate and High Dose Cytarabine Consolidation Chemotherapy in Patients with Acute Myeloid Leukemia. The Experience of King Fahad Specialist Hospital in Dammam, Saudi Arabia

Background: Adult patients with Acute Myeloid Leukemia (AML) have traditionally been hospitalized for the duration of intensive consolidation chemotherapy until blood count recovery to avoid complications. Recently, there has been a trend to shift the care of AML patients treated with intensive chemotherapy from inpatient to outpatient settings to reduce treatment costs and save beds. Methods and materials: A retrospective study of AML patients who received cytarabine consolidation chemotherapy between the 1st of August 2016 and the 31st of December 2023 at King Fahad Specialist Hospital in Dammam, Saudi Arabia was performed. Results: Over a period of 7 years and 4 months, 62 patients received a total of 127 cycles of intensive consolidation chemotherapy at outpatient setting. At diagnosis: 12 patients had extramedullary disease, and 17 patients had adverse cytogenetic abnormalities. Following the 127 cycles of chemotherapy, 38 episodes of febrile neutropenia were encountered, and 46 hospital admissions were required. No complications were encountered following 62.2% of the cycles of consolidation therapy and no early mortality due to intensive consolidation therapy was reported. Out of 62 patients studied, 36 patients underwent various forms of hematopoietic stem cell transplantation. Disease relapses were encountered in 24 patients and the 5-year incidence of relapse for the entire group of patients was 42%. The 5-year leukemia-free survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 43%, 38%, and 50% respectively. The 5-year overall survival for the: entire study patients, transplanted patients, and non-transplanted patients were: 44%, 34%, and 65% respectively. At the end of follow-up: 37 patients (59.68%) were alive, 24 patients (38.71%) were dead, and the fate of 1 patient (1.61%) was unknown as the patient moved to another hospital. Conclusion: Administration of intensive consolidation chemotherapy for patients with AML at outpatient setting is safe, feasible, and cost-effective. The incidence of infectious complications was relatively low. No early treatment-related mortality due to intensive consolidation therapy was encountered. Outpatient administration of intensive consolidation therapy can save beds, reduce hospital costs, and is associated with short-term and long-term outcomes that are comparable to inpatient administration of consolidation therapy.

The Outcome of Patients with Leukemia Presenting with Hyperleukocytosis Requiring Leukapheresis. The Experience of King Fahad Specialist Hospital in Dammam, Saudi Arabia

Background: Patients with acute and chronic leukemia presenting with hyperleukocytosis are at risk of developing leukostasis which has serious and life-threatening complications. Leukapheresis is usually performed to reduce the complications of leukostasis in patients presenting with hyperleukocytosis and clinical manifestations compatible with leukostasis. Methods and materials: A retrospective study of patients with acute and chronic leukemia who received leukapheresis for hyperleukocytosis between the 1st of January 2013 and the 31st of December 2023 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia was performed. Results: Over a period of 11 years, a total of 50 patients with acute and chronic leukemia presenting with hyperleukocytosis and clinical manifestations of leukostasis; 32 patients with acute leukemia (AL) and 18 patients with chronic myeloid leukemia (CML); received leukapheresis at our institution. Among the 32 patients with AL who received leukapheresis, 24 patients (75%) had acute myeloid leukemia (AML), 7 patients (21.88%) had acute lymphoblastic leukemia (ALL) and 1 patient (3.13%) had bilineage acute leukemia (BAL). At presentation of their AL: 3 patients (9.38%) had fever, 9 patients (28.13%) had infections, 4 patients (12.5%) had palpable spleen or liver, 6 patients (18.75%) had palpable external lymph nodes, and 9 patients (28.13%) had extramedullary disease (EMD). After receiving induction and consolidation cycles of chemotherapy, 11 patients (34.38%) of AL patients received allogeneic hematopoietic stem cell transplantation (HSCT). At the end of the follow-up, 17 patients (53.1%) with AL were alive while 15 patients (46.9%) were dead. The 8-year overall survival (OS) for all patients with AL subjected to leukapheresis was 47%. The 5 years OS for patients with AL who subsequently received HSCT and those who did not receive allogeneic HSCT were 70% and 40% respectively. The mean white blood cell (WBC) count of CML patients subjected to leukapheresis was 465.5 × 109/L, 11 patients (61.11%) had clear signs of leukostasis, and 8 patients (44.44%) had splenomegaly at presentation. Regarding the disease stage at presentation, 14 CML patients (77.78%) had chronic phase (CP), 2 patients (11.11%) had accelerated phase (AP) and 2 patients (11.11%) had blast phase (BP). Regarding the fate of CML patients at the end of the study were: 15 (83.33%) were alive, 1 (5.56%) dead, and 2 (11.11%) were unknown as they lost follow-up. However, the 10-year OS of patients with CML subjected to leukapheresis was 90%. Conclusion: Patients with acute or chronic leukemia presenting with hyperleukocytosis and either ongoing or impending leukostasis should have urgent cytoreductive chemotherapy and leukapheresis to prevent life-threatening complications. Although the outcome of AL patients presenting with leukostasis is generally poor, prompt cytoreductive therapy and leukapheresis, followed by induction chemotherapy and allogeneic HSCT may improve the outcome. Also, urgent cytoreduction including leukapheresis improves the outcome of patients with CML presenting with hyperleukocytosis and leukostasis.

Clinical Characteristics of Celiac Disease Patients in Qassim Region.

It is well known that celiac disease has a negative influence on patients' health and quality of life. It has a wide range of presentation from symptomless to multiple organ dysfunction but mainly gastrointestinal symptoms. Consequently, it is considered a main cause of mortality, morbidity, and health burden. We aim to evaluate the quality of life affected in gluten-free diet and to identify the serological characteristics of celiac disease patients in the Qassim Region of Saudi Arabia and King Fahad Specialist Hospital. This is a cross-sectional-based study conducted in King Fahad Specialist Hospital, Saudi Arabia, composed of 58 patients with celiac disease for 9 years between August 2011 and August 2020. Fifty-eight patents were included (79.3% females and 65.5% married), who were divided according to their ages into five groups. Abdominal pain, diarrhea, and/or weight loss were the major patient complaints. A total of 64% of the patients had a +ve (tTG) IgA test at the time of diagnosis, while 17% were -ve. Of the studied patients, 78% reported that they had undergone a duodenal biopsy sampling. No other significant abnormalities were detected between females and males or among the five diagnosed age groups. Patients with celiac disease reported poor health-related quality of life across the board. However, social interaction, emotional role functioning, and emotional well-being were the most important factors.

The Influence of Honey and Hydrogel Products Therapy on Healing Time in Diabetic Foot.

Diabetic foot ulcer is a serious and common complication of diabetes that often leads to significant morbidity and even amputation if not properly treated. Current treatment options, such as wound dressing, have limitations in promoting efficient healing. There is a need for effective interventions that can expedite the healing process and enhance the time required for complete healing. This prospective single-blinded randomized control trial studied diabetic mellitus type 2 patients with ulcer in their second-degree feet from February 2019 to February 2023 in the Diabetic Foot Center, King Fahad Specialist Hospital Al Qassim-KSA. This study involved 120 patients with a mean age of 59.64 ± 10.21. And 63% to 52.5% of them were males and 57% to 47.5% were females. The mean healing time was about 12.76 ± 4.08 days. Cases were divided into 4 equal groups with altered treatment procedures: honey alone, hydrogel alone, honey, and hydrogel combination alternately (3 intervention groups), and fucidin ointment or cream alone (1 control group), with 30 participants in each group. We revealed that the mean healing times for honey alone, hydrogel alone, and honey and hydrogel alternately were 12.20, 13.97, and 10.83 days, respectively. While it was 14.03 days in the control Fucidin ointment or cream [significantly P < .05 (P = .004)]. From the findings of the present study, we noticed that faster healing time among diabetic foot cases could be accomplished by treatment with a combination of honey and hydrogel alternately. Therefore, this therapy is effective in reducing the risk of diabetic foot ulcers.

The effect of having a physician in the triage area on the rate of patients leaving without being seen: A quality improvement initiative at King Fahad Specialist hospital.

To evaluate the effect of the presence of a physician in the triage area on the number of patients who leave without being seen (LWBS) and some of the factors affecting emergency department (ED) crowding. This was a pre-post study carried out at King Fahad Specialist Hospital, Dammam, Saudi Arabia. The 3-month study, consisting of 7826 patients, was split into pre-physician and post-physician periods. Variables compared across these periods were the number of LWBS patients, length of hospital stay, time to physician, and time to disposition decision. Statistical analysis was carried out using R version 4.3.0. Our results showed that the presence of a triage physician significantly decreased the number of LWBS patients (p<0.001) and the time taken to encounter an ED physician (p<0.001). However, it did not have any significant impact on the length of hospital stay (p=0.5) or time to disposition decision (p=0.9). The appointment of a triage physician has streamlined patient flow and decreased LWBS rates in the ED, demonstrating the need for more thorough research in this area.

The Frequency and Common Causes of Unscheduled Adult Emergency Department Return Visits Within 72 Hours at King Fahad Specialist Hospital in Dammam: A Cross-Sectional Study

Background: Emergency Departments (ED) are becoming one of the most overcrowded departments globally. This study aims to investigate the frequency and causes of unscheduled patient return to the ED in King Fahad Specialist Hospital in Dammam (KFSH-D) within 72 hours of discharge. Method: This study is a cross-sectional retrospective study done between February and May, of 2023 at KFSH-D, Saudi Arabia. A total of 295 patients where included. Patients were selected using a simple random sampling technique. Medical record numbers (MRNs) of patients with unscheduled return visits within 72 hours were gathered from the hospital&amp;apos;s electronic medical record-integrated database (Medica Cloudcare) which were then entered on a random number generator. 295 MRNs were selected and included in the study. This study includes male and female patients older than 16 years who returned to the ED within 72 hours. Results: Results showed cancer as the most common comorbidity resulting in revisits within 72 hours. Regarding the emergency department triage category, category 3 was the most common category in revisiting patients (70.2%). Pain was the most common chief complain in the initial and second visit to emergency department, 61.0% and 61.4%, respectively. Most of the patients return due to patient-related causes, specifically no improvement (75.3%). Conclusion: The quality of patient care is negatively affected by the increasing patient demand. Although not much can be done for first visit patients, some simple actions could be done to reduce the rate of second visits.

Peritoneal Dialysis of Three‐Cuff Catheter Experience in Qassim Province, Saudi Arabia

Background: The global rise in noncommunicable diseases, including chronic kidney diseases (CKDs), has led to a significant increase in the use of dialysis units to enhance patient longevity and quality of life. Over time, two‐cuff catheters have been replaced by three‐cuff catheters, with their usage expanding in nephrology centers across Saudi Arabia. This study aimed to evaluate the benefits, complications, and duration of therapy associated with three‐cuff catheters in peritoneal dialysis (PD) patients.Methodology: To ensure the reliability of our results, we conducted a comprehensive cross‐sectional study involving 257 patients who underwent three‐cuff PD catheter (PDC) insertion and omentopexy. Data were retrospectively collected from 2016 to 2023 at King Fahad Specialist Hospital, Buraidah. The questionnaire was designed based on available variables in the records section and validated by subject experts and experienced research faculty. Data were then entered and analyzed using SPSS version 21.0. Descriptive statistics were employed for inferential statistics, while the chi‐square test and logistic regression analysis were used to identify predictors of PD outcomes.Results: The average duration of therapy was 27.84 months, with a standard deviation of 27.23 months. Early complications were minimal, with just 5.1% (n = 13) experiencing peritonitis, 0.8% (n = 2) facing catheter migration, and 0.4% (n = 1 each) encountering omental wrap and exit site infection (ESI) within 30 days of catheter insertion. Remarkably, only 7.8% (n = 20) required catheter reinsertion. In addition, catheter removal due to catheter‐related issues was low, affecting only 3.8% of patients.Conclusions: According to the study findings, three‐cuff catheters exhibited fewer complications, superior performance, and longer therapy duration. These outcomes may be attributed to the thorough design of the three‐cuff catheters, the dedication of the staff, and the implementation of strict policies. To maintain these positive results, it is crucial for the Ministry of Health and the Health Cluster to adopt long‐term supportive measures.

Predictive factors of postoperative anastomotic leakage after bowel surgeries, retrospective chart review

Objective: This study aimed to identify host-related and operation-related risk factors and recognize factors that can help in predicting postoperative anastomotic leakage. Methods: It was a retrospective analytical study, conducted in King Fahad Specialist Hospital, Saudi Arabia. Data were collected from medical records. Results: The current study revealed male predominance (57.8%) with 35.9% aged over 60 years. Most participants had no Crohn\&amp;apos;s Disease (81.4%). Hemicolectomy was the common procedure (50.8%), with tumor resection as the primary cause (49.5%). Anastomotic leakage (36.9%) was prominent, and associated with lower albumin levels. Surgery site, reason, and Crohn\&amp;apos;s Disease did not significantly correlate. Bowel resection/anastomosis and emergent surgeries showed notable associations with anastomotic leakage. Conclusion: The study highlighted male predominance and a significant occurrence of anastomotic leakage, correlated with lower albumin levels. Surgery site, reason, and Crohn\&amp;apos;s Disease did not show significant associations, contrasting with bowel resection/anastomosis and emergent surgeries.

Prevalence and Pattern of Oral and Maxillofacial Pathology in Al‐Qassim Region, Saudi Arabia

Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al‐Qassim region, Saudi Arabia.Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients’ data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel.Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological‐mediated lesion category (13%). The sub‐diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively.Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al‐Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region.

Effects of Neuromuscular Electrical Stimulation on Spasticity and Walking Performance among Individuals with Chronic Stroke: A Pilot Randomized Clinical Trial.

Stroke and its associated complications are a major cause of long-term disability worldwide, with spasticity being a common and severe issue. Physical therapy, involving stretching exercises and electrical stimulation, is crucial for managing spasticity. Therefore, this study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) combined with a conventional rehabilitation program (CRP) on plantarflexor muscle spasticity and walking performance among individuals with chronic stroke. A pilot randomized clinical trial (RCT) with two groups (active NMES and placebo) was conducted at the physical therapy departments of King Fahad Specialist Hospital, Buraydah, and Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia (November 2020). The assessor and participants were blinded for the group assignment. The active NMES group received exercise and stimulation at the dorsiflexor muscles on the paretic leg for 30 min for 12 sessions. The placebo group received exercise and sham stimulation at the same position and duration as the active group. Of interest were the outcomes for plantarflexor muscle spasticity measured by the modified Ashworth scale (MAS), gait speed measured by 10 m walk test (10-MWT), and functional mobility measured by functional ambulatory category (FAC). Nineteen participants were randomized into active NMES (n = 10) and sham NMES (n = 9) groups, with no significant baseline differences. Within the active NMES group, significant improvements were observed in MAS (p = 0.008), 10-MWT (p = 0.028), and FAC (p = 0.046), while only 10-MWT time improved significantly in the sham NMES group (p = 0.011). Between-group analysis showed that only MAS was significantly lower in the active NMES group (p = 0.006). Percent change analysis indicated a significantly higher increase in percent change for MAS in the active NMES group compared to the sham NMES group (p = 0.035), with no significant differences in other outcome measures. This study showed that NMES in the active group led to significant improvements in spasticity, walking performance, and functional ambulation. Further research is needed to determine the ideal parameters, protocols, and patient selection criteria for NMES interventions in stroke rehabilitation.

Postoperative Complications in Patients With the Preoperative COVID-19 Infection at King Fahad Specialist Hospital: A Retrospective Cohort Study.

Coronavirus disease (COVID-19) is an infectious disease caused by a new coronavirus strain. Indeed, the timing of COVID-19 infection before surgery plays an important role in the surgery outcomes and complications. In this study, we aimed to assess the prevalence and predictors of postoperative complications for patients who underwent surgery with previous COVID-19 infection. This was a retrospective hospital-based study which was conducted on 75 patients who had been infected with COVID-19 and underwent surgery. We included 75 patients. The time between COVID-19 infection and the surgery was from one to six months in 52% of patients, 24% of patients were more than six months, and 24% of patients were less than one month. In this study, most of the patients had no complications (77.3%) while 22.7%of patients had complications that were mainly respiratory (n= 13). The overall mortality in our study was 5.3%. There was a significant association between comorbidity and postoperative complications, and the status of COVID-19 preoperativeand postoperative complications (p < 0.01) but not patients' age as well as the type of anesthesia and postoperative complication (p > 0.05). Respiratory complications were the most common postoperative complications in patients who had surgery after COVID-19 infection. Comorbidity and COVID-19 status were significantly associated with higher postoperative complications. Mortality was relatively small. We recommend extreme care to patients with COVID-19 infection prior to surgery to decrease the COVID-19 hazards that develop post-surgery.

Knowledge of Complications of Diabetes Mellitus Among Patients Visiting the Diabetes Clinics: A Cross-Sectional Study in the Qassim Region.

Background and objectives Diabetes mellitus (DM) is a chronic complex metabolic disease characterized mainly by hyperglycemia. It appears to be a global epidemic and an increasingly major non-communicable disease, posing a threat to both affluent and nonaffluent societies. Diabetes dramatically increases the risk of developing stroke, chronic kidney disease, and coronary artery disease. These complications include chronic kidney disease, retinopathy, coronary artery disease, stroke, and diabetic foot ulcers. Compared to people without diabetes, adults with diabetes have a two to four times greater risk of dying from heart disease and stroke. This study aimed to assess the knowledge and attitude regarding complications among patients with diabetes visiting the Diabetes Clinics at King Fahad Specialist Hospital (KFSH) in the Qassim Region, Saudi Arabia. Methodology A cross-sectional study was conducted in which patients with DM who visited the Diabetic Clinics at KFSH from February 2023 to July 2023 were recruited using a nonprobability sampling technique. A validated questionnaire from previous research was used to collect data on the sociodemographic features of the participants and their knowledge regarding diabetic complications. Data were described using mean with standard deviation for continuous variables and proportion for categorical variables. Results A total of 368 patients were recruited. The majority of the respondents (144, 39.1%) had been living with diabetes for over 10 years, followed by 23.1% (85) of those with less than one year. Exactly 239 (64.9%) reported having a family history of diabetes. About 75% (276) of participants knew about diabetic complications, and 247 (67.1%) reported that their doctor had addressed them about diabetes complications. Among the sources of diabetes complication information, diabetologists were reported by 131 (35.6%) of the respondents, followed by 81 (22.0%) through social media, 65 (17.7%) from relatives, and 39 (10.6%) from family medicine doctors. On the other hand, the findings reveal that the different age groups have different levels of knowledge of hyperglycemia and hypoglycemia as diabetic complications (P = 0.031). However, there were no significant differences in the level of knowledge regarding complications between male and female patients (P > 0.05). Conclusions The study found that while the studied population had a relatively good knowledge of diabetic complications, some still lacked knowledge. The study also supports the need for individuals with a family history of diabetes to be aware of their risk and take steps for prevention, as a large proportion of participants reported having a family history of diabetes. Healthcare providers and diabetologists were the most frequent sources of information on diabetic complications. However, some also turned to social media. Focused education and awareness actions are crucial to ensure that people with diabetes have access to reliable information from various sources.

PREVALENCE AND SYMPTOMS OF ASTHMA AND ALLERGIC RHINITIS IN ADULTS WITH CHRONIC RHINOSINUSITIS IN THE EASTERN REGION OF SAUDI ARABIA

Background: This cross-sectional study explores the prevalence and symptoms of asthma and allergic rhinitis among adults diagnosed with Chronic Rhinosinusitis (CRS) in the Eastern Region of Saudi Arabia. Methods: Involving 386 participants, the research employs demographic profiling and symptom analysis and explores the interplay of upper and lower airway conditions. This study investigates the prevalence of asthma and allergic rhinitis among 386 adults with chronic rhinosinusitis (CRS) in Eastern Saudi Arabia. Employing a cross-sectional design, participants from King Fahad Specialist Hospital and Jubail General Hospital were selected through random and stratified sampling. Results: The study reveals a higher prevalence of asthma (40.6%) compared to allergic rhinitis (25.1%), emphasising the need for a comprehensive understanding of these respiratory conditions. Intriguing associations between asthma attacks and specific CRS symptoms, such as chest tightness and waking due to shortness of breath, provide insights into shared pathways. Demographically, higher prevalence is observed among females, individuals with lower educational attainment, and nonsmokers, highlighting socio-demographic influences on respiratory health. Conclusion: The study discloses a noteworthy prevalence of asthma (40.6%) in comparison to allergic rhinitis (25.1%) among adults with Chronic Rhinosinusitis in Eastern Saudi Arabia. Asthma attacks showcase distinctive associations with specific CRS symptoms, emphasising the intricate interplay of these respiratory conditions. The demographic influences of education and smoking underscore the importance of lifestyle factors. Recommendations for future research include longitudinal studies and clinical validations to enhance the validity and depth of our findings.

Diabetic Ketoacidosis After COVID-19 Vaccine in Patients with Type 1 Diabetes Mellitus.

The coronavirus disease 2019 (COVID-19) vaccine is one of the few vaccines that obtained emergency authorization to combat the fatal pandemic. Despite the fact that some available literature addressed its short-term side effects, there are still limitations on its effects on type 1 diabetes mellitus (T1DM). The aim of the present study was to assess the association between COVID-19 vaccination and diabetic ketoacidosis (DKA) among individuals with T1DM. Additionally, the study aimed to determine the effects of the vaccine on glucose control, variability, and risk of hypoglycemia. This retrospective study was conducted at King Fahad Specialist Hospital (KFSH) in Qassim Region, Saudi Arabia. Diabetic ketoacidosis cases admitted to the hospital within February 2020 and August 2022 were included in the study based on specific inclusion criteria. Finally, a total of 49 patients were included in statistical analyses. Out of the 62 patients admitted to the hospital, 49 met the diagnostic criteria for DKA and agreed to participate in the study. The majority of the remaining patients (n = 13) refused to participate, and only a few of them lacked complete documentation. Of the 49 patients who were included in the study, 46 cases had a history of T1DM; nevertheless, 3 patients were newly diagnosed with T1DM. Additionally, among these participants, 16 (32.7%), 19 (38.8%), and 14 (28.6%) patients had mild, moderate, and severe DKA, respectively. There were 27 male (55.1%) and 22 female (44.9%) patients. About 91% of the patients were vaccinated against COVID-19, 30.6% of whom were vaccinated within 29 days of being diagnosed with DKA. The pH and bicarbonate levels were observed to be significantly high among those who were diagnosed with DKA within 29 days of vaccination, with p-values of 0.031 and 0.037, respectively. Similarly, pH and random blood sugar (RBS) were observed to be significantly higher among the vaccinated patients than in the non-vaccinated subjects (P = 0.044 and P = 0.032, respectively). The study findings revealed that some of the DKA indicators were evident among the vaccinated patients. However, larger-scale and multi-center studies are recommended in order to have more conclusive evidence and generalize the findings.

Quality of Life in Thyroid Cancer Patients.

Thyroid cancer ranks as the ninth most common cancer worldwide and third in Saudi Arabia. Given thyroid cancer's high incidence, thyroid cancer patients' quality of life (QoL) has been a concern for many years. However, no study has been dedicated to assessing thyroid cancer patients' QoL in Saudi Arabia. Thus, we aimed to fill this gap by assessing thyroid cancer patients' QoL in Saudi Arabia. This cross-sectional study was conducted among thyroid cancer patients attending outpatient clinics at the Diabetes and Endocrinology Centre, King Fahad Specialist Hospital, Qassim region, Saudi Arabia, from 2017 to 2023. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) assessed the patients' QoL through an individual interviewer-administered technique. We used RStudio to perform statistical analysis. Statistical differences between groups based on QoL scores were assessed using the Wilcoxon and Kruskal-Wallis rank-sum tests. Our results showed that for QoL scores of functional domains, the lowest was in social functioning, and the highest was in cognitive functioning. Regarding the subscales of symptoms, the highest scores were fatigue and insomnia. In conclusion, numerous factors affect thyroid cancer patients' QoL. Recognition and appropriate management of these factors will improve the overall QoL; there is a need to understand what is driving these factors in further clinical studies.

Anxiety and Depression in Patients With Inflammatory Bowel Disease at King Fahad Specialist Hospital, Qassim Region.

Background Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). It carries a risk of annual relapses and multiple intense flares, which require lifelong treatment and, sometimes, surgical interventions. This affects patients negatively in various aspects of their functioning, and they are left with an increased risk of disturbed quality of life and mental illnesses. Aim This study is carried out to describe the prevalence and risk factors of anxiety and depression symptoms among adult patients with IBD at King Fahad Specialist Hospital, Qassim, Saudi Arabia, and to examine the relationship between mental illness and disease activity. Patient and methods This cross-sectional descriptive study targets adult patients with IBD attending a gastroenterology clinic and medical day care unit. A self-administered questionnaire was given to patients with the help of an IBD nurse. The questionnaire includes the patient's demographic data (i.e., age, gender, etc.), symptoms and treatment patterns, the General Anxiety Disorder (GAD) questionnaire to measure anxiety, and the Patient Health Questionnaire (PHQ-9) to measure depression. Results Among the 179 IBD patients, 60.9% were males, and 40.8% were in the age group of 25-35 years. CD was the most prevalent IBD (73.2%). Perineal CD was detected in 45%. The prevalence of patients who were positive for anxiety symptoms was 17.3%, while the prevalence of depressive symptoms was 19.6%. The independent risk factor for anxiety was female gender, while the independent risk factor for depression was extraintestinal manifestation. The preventive factor for depression was treatment with IV medication. Conclusion Almost one-fifth of IBD patients were considered to have either anxiety or depression. Female gender was a risk factor for anxiety while extraintestinal manifestation of IBD was a risk factor for depression. Interestingly, treatment with IV medication was found to be the protective factor for depression. More investigations are warranted to give more insights regarding the prevalence and risk factors of psychological disorders among patients with IBD in our region.