King Khaled Hospital Research Articles

Prevalence of multidrug-, extensively drug-, and pandrug-resistant bacteria in clinical isolates from King Khaled Hospital, Najran, Saudi Arabia

Abstract Background Saudi Arabia faces a growing antimicrobial resistance (AMR) problem, exacerbated by the widespread use of antibiotics in clinical and agricultural settings. Despite this, AMR surveillance has been limited, particularly in regions like Najran, making this study critical for informing local and national public health strategies. Aim This study explored the prevalence of multidrug-resistant, extensively drug-resistant, and Pandrug-resistant bacteria in Najran, Saudi Arabia. Study design This is a cross-sectional study. Methods This study included 559 diverse clinical samples (urine, wound, etc.) collected from various departments in King Khaled Hospital, Saudi Arabia. The Phoenix BD instrument was used for complete bacterial identification and antibiotic sensitivity testing. Demographic and clinical data were analyzed statistically. Results Of the 559 samples, the culture positivity rates were as follows: 51% for Escherichia coli, 22% for Staphylococcus aureus, 14% for Klebsiella pneumoniae, 6% for Acinetobacter baumannii, 6% for Pseudomonas aeruginosa, and 1% for Enterococcus faecium. Majority of the cases were from male (57%), and age 50+ (59%) recorded highest cases. Participants from outpatient department (OPD) ward recorded the highest (56%) cases, while urine sample recorded the highest (49%) cases. About 84% of the isolates were multidrug‑resistance (MDR), 10% were extensively drug‑resistance (XDR), and 6% pandrug‑resistance (PDR). Our analysis showed high sensitivity to Oxazolidonone, Tetracycline, carbapenems, Lipopeptide, Aminoglycopeptide classes of antibiotics. Conclusions The study revealed a high prevalence of drug resistance, highlighting the critical importance of continued surveillance and research to mitigate the spread of antimicrobial resistance and preserve the effectiveness of existing therapies.

Beyond dialysis: Assessing therapeutic regimen compliance and sleep quality in chronic renal failure patients undergoing maintenance hemodialysis in Saudi Arabia.

Given its potential to impact physical and mental health, sleep quality is one of the most significant clinical outcomes among hemodialysis patients. Patients undergoing hemodialysis are required to adhere to an intricate treatment plan that consists of regular hemodialysis treatments, dietary and fluid restrictions, and a multi-drug regimen. Investigate the relationship between adherence to a therapeutic regimen and sleep quality among chronic renal failure patients undergoing maintenance hemodialysis. A descriptive correlational research design was followed. The study was conducted at the hemodialysis units in Hafr Albatin City, specifically at Hafr Albatin Central Hospital and King Khaled Hospital, Saudi Arabia. A convenience sample of 100 adult patients was selected for the study. The Hemodialysis Patients Adherence Questionnaire and Pittsburgh Sleep Quality Index were utilized to collect the data in 5 months from September 20, 2023 to February 15, 2024. The study revealed that more than half of the studied patients adhered to the therapeutic regimen, while (46%) did not adhere to it. More than half of the patients had poor sleep quality and were nonadherent to diet and fluid restrictions. Overall adherence score is negatively correlated with the global sleep quality score (r = -0.368, p < 0.001), indicating that poorer sleep quality is associated with lower overall adherence to the therapeutic regimen. While a significant proportion of the patients demonstrated adherence to overall therapeutic regimens, including dialysis sessions and medication intake, there was notable nonadherence to fluid and diet restrictions. Poor sleep quality, prevalent among two-thirds of the participants, correlates negatively with adherence to therapeutic regimens.

Assessment of Parental Risk Factors Involved in Orofacial Clefts in Hail, Saudi Arabia: A Retrospective Cohort Study.

Background Orofacial clefts are congenital anomalies affecting the development of the oral and facial structures, influenced by genetic and environmental factors. The prevalence of orofacial clefts varies globally, necessitating region-specific studies to understand contributing factors.Orofacial clefts are among the most common congenital defects affecting the head and neck, underscoring the importance of investigating paternal and maternal influences on their development to enhance awareness and understanding of potential contributing factors.Therefore, this research aimed to investigate parental risk factors contributing to the development of orofacial clefts. Methods A retrospective cohort study was conducted at the Oral and Maxillofacial Department of King Khaled Hospital,Hail, Saudi Arabia, involving 40 parents of children born between 2019 and 2023 with orofacial clefts. Data collection included interviewer-administered questionnaires with parents addressing demographic information, pregnancy details, parental medical history, and postoperative outcomes. Statistical analysis utilized descriptive statistics, chi-square tests, Fisher's exact test, and linear regression, with significance defined as p<0.05. Results The study had a gender distribution of 19 males (47.5%) and 21 females (52.5%) among orofacial cleft cases (p<0.75), with cleft palate (13 cases, 32.5%) and cleft lip (11 cases, 27.5%) being the most prevalent anomalies (p<0.05). Maternal supplementation rates were high, with 34 mothers (85%, p<0.05) taking folic acid and 36 mothers (90%, p<0.05) taking iron, yet orofacial clefts incidence persisted. Paternal risk factors such as tobacco use were reported by 19 fathers (47.5%, p<0.05), and familial history of orofacial clefts was noted in nine cases (22.5%, p<0.05). Postoperative outcomes indicated varying levels of functional recovery and satisfaction. Conclusion This study explored the complex origins of orofacial clefts, emphasizing genetic and environmental influences. The findings suggest a potential paternal risk factor. The study highlights the need for further investigation into genetic mechanisms and the development of effective prevention strategies.

Quality of Life among Colostomy Patients in Najran, Saudi Arabia

Abstract Background: Colostomy surgery significantly impacts the quality of life (QoL) of patients, encompassing physical, psychological, social, and spiritual well-being. This study aimed to assess QoL among colostomy patients in Najran, Saudi Arabia, using the City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ) Arabic version. Methodology: A cross-sectional study was conducted with 73 colostomy patients at King Khaled Hospital. Demographic characteristics, colostomy-related factors, and QoL scores were analyzed using the descriptive statistics and analysis of variance. Results: Participants aged 18–30 years reported higher physical QoL scores than older age groups. Marital status before colostomy, educational level, and body mass index significantly influenced psychological, social, and spiritual QoL domains. Fecal incontinence as a reason for colostomy was associated with lower psychological well-being scores. Notably, participants with “I do not know” as the type of colostomy reported higher spiritual QoL scores. The findings emphasize the intricate relationship between demographic and colostomy-related factors and QoL domains. These insights underscore the need for comprehensive care strategies, acknowledging the multidimensional nature of patients’ well-being. Conclusion: This study advances our understanding of QoL among colostomy patients in Saudi Arabia, offering insights for health-care professionals to develop more holistic care approaches. The findings illuminate the significance of multidimensional factors in shaping patients’ overall well-being, thus contributing to enhanced patient-centered care and improved QoL outcomes.

Anemia Profiles in Cancer Patients: Prevalence, Contributing Factors, and Insights From a Retrospective Study at a Single Cancer Center in Saudi Arabia.

Anemia, a common complication of cancer and its treatments, significantly affects cancer patients' survival and quality of life. Nevertheless, there is limited research conducted in the southern region of Saudi Arabia regarding its effects. This study aims to assess the prevalence of anemia, as well as its associated factors, among cancer patients undergoing active chemotherapy treatment. This retrospective study analyzed adult cancer patients who underwent chemotherapy at King Khaled Hospital's oncology department in Najran, Saudi Arabia, between 2017 and 2022. We aimed to determine the prevalence and contributing factors of anemia through comprehensive demographic and clinical assessment. Univariate analysis was performed to assess factors necessitating blood transfusion. A total of 95 cancer patients received chemotherapy, with a mean age of 52.2 ± 16.5 years. The majority were females (65.3%) aged between 18 and 64 years (74.7%). Gastrointestinal (42.1%) and breast (17.9%) cancers were the most prevalent malignancies. Most patients (56.8%) were in locally advanced stages. Anemia was present at admission in 48 (50.5%) patients with a higher prevalence among colorectal and genitourinary tract cancer patients. The mean hemoglobin (Hb) drop during treatment was 9.1 ± 2.1 g/dL. Anemia severity was stratified as follows: life-threatening (7.4%), severe (33%), moderate (31%), and lower limited (29%). Blood transfusions were required in 79% of cases. Advanced age, increased chemotherapy cycles, and anemia of chronic disease (ACD) were significantly associated with increased anemia severity (p<0.05). Increasing chemotherapy cycles also correlated with an increased need for blood transfusion (p<0.001). Older patients (≥65 years) had higher anemia at admission, poor Eastern Cooperative Oncology Group (ECOG) performance status, more Hb decrease during treatment, and increased need for blood transfusions (p<0.05) compared to younger patients (<65 years). The study noted a high prevalence of anemia (50.5%) in patients receiving active cancer treatment, specifically in the context of genitourinary and gastrointestinal tract cancers. Advanced age, frequent chemotherapy cycles, and ACD were associated with increased severity of anemia. Furthermore, older patients displayed a higher frequency of anemia, poorer performance status, and an increased requirement for transfusions with an escalating number of chemotherapy cycles.

Predictors and outcomes of patient safety culture at King Abdulaziz Medical City, Jeddah, Saudi Arabia. A nursing perspective

BackgroundPatient safety culture assessment is viewed as the starting point from which action planning begins and helps hospitals get a good idea of the patient safety features that need immediate attention, identify the strengths and weaknesses of their safety culture, help units find their most common patient safety problems, and compare their scores to those of other hospitals. This study aimed to assess nurses’ perceptions of patient safety culture composites in a Saudi hospital in the Western region and to explore the association between patient safety culture predictors and outcomes, taking into consideration nurses' characteristics.MethodsThis study employed a cross-sectional descriptive design with a convenience sample of 184 nurses who are working at inpatient care units at King Khaled Hospital- King Abdulaziz Medical City in Jeddah, Western region, Saudi Arabia. The data were collected through a structured questionnaire consisting of nurses’ demographics and work characteristics, and the Patient Safety Culture Hospital Questionnaire (HSOPSC), which proved valid and reliable. Descriptive status, correlation, and regression analysis were applied to patient safety culture composites for statistical analysis.ResultsThe overall positive response rate of the predictors of patient safety culture in the HSOPSC survey was 63.46%. The mean percent score for predictors ranged from 39.06% to 82.95%. "Teamwork within units" (82.95%) was the highest mean, followed by "organizational learning" (81.88%) and "feedback and communication about errors" (81.25%). In addition to the overall perceived patient safety (59.0%), safety grade, frequency, and number of events are also reported as safety outcome measures.Conclusions and recommendationsRegardless of the percentage of the safety culture domains, this study agrees that all the domains should be considered high-priority and focused areas for continuous improvement. The results confirmed the need for continuous staff safety training programs to improve their perception and performance of the safety culture.

Clinical and Therapeutic Profile of Non-Hodgkin’s Lymphoma: A Retrospective Study From a Najran Oncology Center

Background Non-Hodgkin lymphomas (NHL) represent a group of lymphoproliferative disorders, with a limited understanding of their clinical spectrum, primary extranodal variety, histopathology, and immunohistochemistry, particularly in developing countries. The objective of this study was to evaluate the clinicopathological characteristics and survival rates of NHL patients treated at King Khaled Hospital in Najran City, Saudi Arabia. Method In this retrospective chart review of NHL cases that received chemotherapy at the Oncology Center of King Khaled Hospital in Najran City, Saudi Arabia, between 2014 and 2021, we evaluated the clinicopathological features, survival rate, and associated factors. Using standardized data collection sheets, we extracted information on patients' age, gender, tumor type, stage, baseline laboratory evaluations, disease status, cancer treatment, and survival from electronic medical records. Univariate analysis was employed to identify factors associated with mortality and relapse. Results We included 43 NHL patients with a mean age of 59.23 ± 20.17 years, with a higher frequency among females (65.1%). B symptoms were present in 32 (74.4%) cases. The common primary site was peripheral lymph nodes (79.1%). Diffuse large B-cell lymphoma was the most common morphologic type (67.4%), and 46.5% of the patients had advanced-stage disease (stages III-IV). All patients received the first line of treatment, with the most common chemotherapy used being the RCHOP regimen (67.4%). Additionally, radiotherapy was performed in seven (16.3%) cases. Relapse occurred in eight (18.6%) cases with a median period of 47.5 months (Min: 20 - Max: 77 months). The mean overall survival time was 43.25 ± 2.98 months (range 12-168 months), and the one, three, and five-year survival rates were 91%, 58%, and 38%, respectively and the mortality rate was 32.6%. Univariate analysis showed that Burkitt lymphoma had (odds ratio (OR): 11.87; 95% confidence interval (CI): 1.58-89.09, p=0.016) and elevated lactate dehydrogenase (LDH) ((OR: 1.26; 95% CI: 0.35-4.54), p=0.014) were associated with mortality. Moreover, advanced age and the total number of first chemotherapy cycles were associated with relapse (p&lt; 0.05). Conclusion The study highlights the variability of NHL cases, with a significant proportion presenting with advanced-stage disease and in middle age. The results suggest poor survival rates for patients with Burkitt lymphoma subtypes and elevated LDH levels.

Forms of marital violence directed by husbands towards wives: An applied study

The aim of this paper is to find out what types of violence that husbands inflict on their wives are most common among married women in the city of Ha'il, Saudi Arabia, and what causes it. The study used both descriptive and analytical methods. The descriptive method was used to achieve the objectives of the study, and the analytical method was used to show how the variables in the study are related to each other. The study relied on a questionnaire to collect primary data, including personal and social variables. The study relied on a comprehensive survey of all the studied abused women (130 women who visited King Khaled Hospital and the Civil Protection Center from September 2019 to December 2019). The results of the study indicate that psychological violence and economic violence are the most common types of violence. Physical violence ranked third. The findings also suggest that working women are less affected by violence in all its forms than non-working women and that women who have children are more affected by psychological violence than women who do not have children. The results suggest that there is a relationship between the husband's religion and his tendency to be violent. While there is a negative association between the husband's violence and the level of education and the three types of violence, there is no association between the age of the battered woman, the level of education, and exposure to all forms of violence The study recommends that there should be rehabilitation centers for those seeking marriage, especially young people.

Brucellosis trends in Majmaah city, Riyadh, Saudi Arabia: A trend of 5-year retrospective study (2016-2020)

Brucellosis, also called Malta fever, is a contagious disease caused by Brucella species and can affect one or more organs of the body. Globally, the number of brucellosis cases in the past five years (2016-2020) is 500,000 infections per year. However, in Saudi Arabia, infections of brucellosis are extremely low in the same past five years with a range of 4,167 infections per year. Therefore, the goal of conducting this cross-sectional study is to measure the prevalence and incidence rates of brucellosis in the past five years (2016-2020) in Majmaah city in Saudi Arabia and compare these rates with national rates of brucellosis in Saudi Arabia. Data of all patients of brucellosis in King Khaled hospital for the past five years (2016-2020) were collected from the hospital’s archives. Statistical analysis system software (SAS version 9.4) was used to clean, edit, and analyze these row data. As a result, incidence rates of brucellosis in Majmaah city in the last five years has been increased and decreased similarly in the line of Saudi Arabia. In 2016, in incidence rate was 78.27 and increased to 90.15 per 100,000 population in 2018. In 2020, that rate has decreased to 62.19 per 100,000 population. This cross-sectional study concluded that brucellosis infection rates among the population of Majmaah city are consistent with brucellosis infection rates in Saudi Arabia.

D-dimer as a predictive and prognostic marker among COVID-19 patients.

To examine D-dimer, coagulation profile, and platelet count among patients hospitalized with coronavirus disease-19 (COVID-19) and compare them to findings from non-COVID-19 subjects. The participants in this retrospective hospital-based observational study design included 112 confirmed diagnosed with COVID-19 who were admitted to King Khaled Hospital, Najran, Saudi Arabia, and another 112 non-COVID-19 subjects as a comparative group. Laboratory investigations, demographic and clinical records were obtained from participants' electronic indexed medical records. Coronavirus disease-19 diagnosis was confirmed according to positive real time polymerase chain reaction assay carried out at the hospital's central laboratory, where samples were extracted from a nasopharyngeal swab. Pneumonia related to COVID-19 is classified as critical, severe, moderate, mild, and asymptomatic whereas thrombocytopenia was marked when the platelet count was <150.00×109/L. Suitable statistical analysis was applied to determine possible differences between the findings from the 2 groups. The D-dimer and activated partial thromboplastin clotting time mean values were significantly elevated (p<0.001). The international normalized ratio and platelet count mean values confirmed a significant decrease (p<0.001). Thrombocytopenia was found 9 times in COVID-19 higher than in the non-COVID-19. D-dimer and prothrombin time mean values increased significantly among the COVID-19 patients with all patterns of symptoms on admission (p<0.001). D-dimer mean values increased significantly in deceased COVID-19 and in hospitalized intensive care unit (ICU) wards patients (p<0.001), indicating a potential predictive and prognostic severity marker, particularly among COVID-19 patients in the ICU.

Medication errors in Najran, Saudi Arabia: Reporting, responsibility, and characteristics: A cross-sectional study

BackgroundMedication error is a preventable adverse effect of medical care, whether or not it is evident or harmful to the patient. Disclosure of medication errors and improvement of patient safety are inexorably related, and they provide one of the strongest reasons to report and disclose errors, including near misses in which no harm comes to the patient. This study aimed to identify medication errors at the southern province of Saudi Arabia. MethodsA cross-sectional retrospective study was conducted by reviewing all medical records in the King Khaled Hospital in Najran, Saudi Arabia. Medication errors related information were extracted from the electronic medical system for the duration between 2018 and 2020. ResultsDuring the study period of 2018 to 2020, a total of 4860 medication errorswere identified. More than half of the reported medicationerrors (66.9%) were linked to ordering, prescribing, or transcribing medications. The most commonly reported medicationerrors connected to ordering/prescribing/transcribing were inappropriate dosage, dosage units, and therapeutic duplication of medication. The most commonly reported medication errors linked to administration were missing documentation during administration, not performing independent double-checks during the administration of high alert medications, and the administration of look-alike sound-alike (LASA) medications. The intensive care unit (ICU), female medical ward, and male medical ward were the most commonly reported locations for medication errors. Pharmacists detected more than half of the reported medication errors. Physicians were found to be responsible for 66.0% of reported medication errors, followed by nurses. ConclusionMedication errors are common in hospital settings in Saudi Arabia's southern provinces. Efforts should be made to improve drug ordering, prescribing, and transcription in hospital settings. To guarantee optimum practices, the entire medical team should take responsibility for the patient's optimal medication administration.

THE ROLE OF INFORMATION TECHNOLOGY AND COMMUNICATION IN ENHANCING THE QUALITY OF THE PERFORMANCE OF HUMAN RESOURCES: A FIELD STUDY AT KING KHALID HOSPITAL IN NAJRAN, SAUDI ARABIA

&lt;p&gt;The study aimed to examine the role of information technology and communication in boosting the quality of the performance of human resources at King Khaled Hospital in Najran, Saudi Arabia in the light of variables (information systems and databases, communication systems, information technology in human resources). The descriptive-analytic approach was used to verify the role of information and communication technology in improving the quality of the performance of human resources. The study sample consisted of (133) employees in King Khalid Hospital in Najran. They responded to a closed-item questionnaire. The results found that there was a statistically significant relationship at the level of significance (α ≤0.05) between information technology (information systems and databases, communication systems, information technology in human resources) in the quality of the performance of human resources. It also confirmed that there was a statistically significant relationship at the level of significance (α ≤0.05) for information technology (communication systems, communication techniques) in improving human resource functions. This study recommends that the hospital administration should pay attention to information and communication technology because of its significant impact on the quality of the performance of human resources and its application in all other government agencies and institutions. It is also recommended for the need to keep abreast of technical developments and information technology and work to use them in human resources. In addition, there is a need to develop specialized training programs for human resources staff to work on all programs and use devices to raise the level of performance in a way that benefits the achievement of competitive advantage, excellence, and quality in performance. &lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;JEL: D83; J24; I10&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0989/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Perceptions of Knowledge, Attitudes, and Skills about Non-Suicidal Self-Injury: A Survey of Emergency and Mental Health Nurses

Objective: The purpose of the study is to assess emergency department and mental health nurses’ knowledge, attitudes and skills related to non-suicidal self-injuries. Method: A descriptive cross-sectional research design was adopted in this study. The study used the convenient sampling method to recruit a sample of 195 emergency department and mental health nurses from three different settings; the psychiatric mental health hospital, King Fahad hospital, and King Khaled hospital in Tabuk city. To collect data, the study used the questionnaire that consisted of two parts: the socio-demographic part and the knowledge, attitudes, and skills related to non-suicidal self-injuries (27 statements). Result: The results of the study showed that emergency department and mental health nurses had a moderate level of knowledge about non-suicidal self-injuries (30.95±9.90), a high level of skills related to non-suicidal self-injuries (26.5±5.2), and neutral attitudes towards non-suicidal self-injuries (35.5±7.15). In addition, it was found that there was a significant statistical difference in knowledge about non-suicidal self-injuries referred to gender, unit/department, and receiving formal training about non-suicidal self-injuries. Moreover, it was found that there was a significant statistical difference in the mental health and emergency department nurses’ skills related to non-suicidal self-injuries referred to participants’ receiving formal training related to non-suicidal self-injuries, and there were significant statistical difference in attitudes towards non-suicidal self-injuries between nurses referred to unit/department, working institution, and receiving formal training related to non-suicidal self-injuries. Conclusion: The study concluded that emergency department and mental health nurses in Saudi Arabia have moderate level of knowledge, high level of skills and neutral attitudes towards non-suicidal Self-Injury.

Perceptions of Knowledge, Attitudes, and Skills about Non-Suicidal Self-Injury: A Survey of Emergency and Mental Health Nurses

Objective: The purpose of the study is to assess emergency department and mental health nurses’ knowledge, attitudes and skills related to non-suicidal self-injuries. Method: A descriptive cross-sectional research design was adopted in this study. The study used the convenient sampling method to recruit a sample of 195 emergency department and mental health nurses from three different settings; the psychiatric mental health hospital, King Fahad hospital, and King Khaled hospital in Tabuk city. To collect data, the study used the questionnaire that consisted of two parts: the socio-demographic part and the knowledge, attitudes, and skills related to non-suicidal self-injuries (27 statements). Result: The results of the study showed that emergency department and mental health nurses had a moderate level of knowledge about non-suicidal self-injuries (30.95±9.90), a high level of skills related to non-suicidal self-injuries (26.5±5.2), and neutral attitudes towards non-suicidal self-injuries (35.5±7.15). In addition, it was found that there was a significant statistical difference in knowledge about non-suicidal self-injuries referred to gender, unit/department, and receiving formal training about non-suicidal self-injuries. Moreover, it was found that there was a significant statistical difference in the mental health and emergency department nurses’ skills related to non-suicidal self-injuries referred to participants’ receiving formal training related to non-suicidal self-injuries, and there were significant statistical difference in attitudes towards non-suicidal self-injuries between nurses referred to unit/department, working institution, and receiving formal training related to non-suicidal self-injuries. Conclusion: The study concluded that emergency department and mental health nurses in Saudi Arabia have moderate level of knowledge, high level of skills and neutral attitudes towards non-suicidal Self-Injury

Cost Utility of Splenic Artery Angioembolization for High-Grade Splenic Injury

Abstract Background: Management of blunt spleen injuries has evolved from mandatory splenectomy to non-operative man-agement (NOM) allowing for splenic salvage, Splenic artery embolization (SAE) has been shown to be an effective treat-ment for hemodynamically stable patients with high-grade blunt splenic injury. However, there are no local estimates of how much treatment costs. Aim of Study: The aim of this study was to evaluate the cost of providing SAE to patients in the setting of blunt abdominal trauma with splenic injury and to determine if the costs of an added, preventative procedure (SAE) early in management of blunt splenic injury would be offset by added utility by avoiding splenectomy. Patients and Methods: This study was a retrospective cohort study from a tertiary institution (50 patients in King Khaled Hospital Trauma Center, Hail, KSA and 9 patients in Al Hussein University Hospital, Cairo, Egypt). A total of 59 patients were treated with embolization in this period for blunt trauma, and however 39 cases were excluded given the presence of multiple concomitant injuries. Isolated splenic injury treated with SAE were identified in 20 patients and included for final analysis. Of these 10 patients, none required subsequent splenectomy following SAE. Results: The mean total angiography costs were 1837.94± 405.368 $, the costs of post-procedure management of patients including all hospital costs prior to discharge with associated length of stay. Conclusion: Splenic embolization is a low-cost procedure for management of blunt splenic injury. The cost to provide SAE at our center was much lower than previously modelled data from overseas studies. Further research is advised to directly compare the cost of SAE and splenectomy in other countries.

MASIMO AS NONINVASIVE CONTINUOUS MONITORING FOR GUIDING FLUID IN INTENSIVE CARE UNIT

Background: It is necessary to keep tracks of blood and fluid treatment during admission patient in intensive care unit Patient may have signs of hypovolemic but fluid administration is not always beneficial, we are in need of bedside devices and techniques which can predict fluid responsiveness effectively and safely. The pleth variability indices (PVI) allow noninvasive assessment of fluid management. It is based on respiratory changes in arterial pulse pressure. PVI reflect vascular tone, circulating blood volume and intra thoracic pressure. Objective: To compare between PVI and CVP (central venous pressure) as effective measures to manage of fluid loading in monitorization in I.C.U. Patients and Methods: This study was carried out at King Khaled Hospital between June 2017 and October 2018 on 200 randomized patients dividing into two equal groups: Group (I) measuring fluid by CVP, and Group (II) measuring fluid by Masimo to assess fluid management therapy. Results: In comparison of fluid management in I.C.U, the amount of fluid replacement was 3500 ± 1980.2 in group (I), and 1913 ± 540 in group (II). There was no significant difference between the two groups in red blood cells transfusion or hemoglobin level. Conclusion: Masimo can be used as bedside non-invasive technique to measure fluid responsiveness in operating room and intensive care unit without complication, and more reliable than some invasive technique in guiding fluid therapy.

The effect of warm compresses on perineal tear and pain intensity during the second stage of labor: A randomized controlled trial.

Warm compress is believed to reduce perineal tear occurrence and decrease pain intensity during the second stage of childbirth. This study aimed to determine the effect of warm compresses on perineal tear and pain intensity during the second stage of labor. A randomized controlled trial was conducted between 28 September 2018 to 30 October 2018 in King Khaled Hospital (KKH), affiliated with the Ministry of National Guard Hospital Affairs, King Abdul-Aziz Medical City Western Region, Saudi Arabia. According to eligibility criteria, the sample randomly recruited through lottery included 100 primigravida pregnant women, with 50 in each intervention and control group. Data were presented in the form of frequency and percentages, standard deviation, and mean. Chi-square test was used for data analysis, with p-value significance at ˂ 0.05. Sociodemographic data revealed no statistically significant difference in the age, education, occupation, and residence of both the control and experimental group. The perineum area's pain intensity after birth showed a statistically significant difference between the intervention and the control groups (p = 0.001). The perineal tear was also significantly different between both groups (p = 0.001). The applied warm compresses on the perineum area positively reduce second and third-degree perineal tear and pain intensity during the second stage of labor and after childbirth. Therefore, midwives and nurses are expected to actively provide effective planned in-service training programs regarding warm compresses' advantages in the second stage of labor and apply this procedure actively.

Analysis of prevalence and incidence trends of diabetes mellitus in Majmaah city, Riyadh Region, Saudi Arabia: A trend of 3 years retrospective study (2017-2019)

Diabetes Mellitus (DM) remains a global disease and prevalent among 415 million people. Saudi Arabia is the second-highest country in the Middle East region and the seventh in the world in its prevalence rate. Population-based prevalence and incidence data are ultimate to evaluate the effects of prevention strategies for diabetes and such relevant studies in Saudi Arabia are scarce. Quantification of prevalence and incidence of DM is significant in rural-based populations to allow for clinical resource management. Therefore, this study is designed to determine the prevalence of diabetes among the population of Majmaah city, in the Riyadh region of Saudi Arabia in the past three years (2017-2019) and compare them with prevalence and incidence rates in Saudi Arabia. The data of patients with DM for the past three years were collected from archives of King Khaled hospital in Majmaah city and analyzed with different statistical methods frequency distribution using SAS software. DM's annual incidence (AI), incidence rate (IR), and average annual incidence (AAI) with confidence intervals of 95% are reported. It was found that incidence rates of both type 1 and type 2 DM of all age groups have increased in the last three years. The incidence rate of type 1 DM patients has increased by 20.23% while in type 2 DM has increased by 9.31%. Finally, this study suggested that DM trends among the population in Majmaah city are consistently increasing year by year and it is also in line with the trend of the whole Saudi Arabia irrespective of gender and age.

Identifying the Risk Factors and the Prevalence of Poor Glycemic Control among Diabetic Outpatients in a Rural Region in Saudi Arabia

Aim: This cross-sectional study aimed to assess the prevalence of poor glycemic control and risk factors associated with it among diabetic patients in the central rural region of Saudi Arabia.&#x0D; Methods: The study included a review of diabetic patients’ medical record in King Khaled Hospital in Al-Kharj from the beginning of January 2019 to the end of June 2019. Poor glycemic control was defined as the current use of diabetic-lowering medication associated with HbA1c levels ≥7%. Multivariate analysis was done to identify the associated factors of poor glycemic control.&#x0D; Results: Of 1,010 consecutive outpatients’ diabetic patients were involved in the study sample, poor glycemic control presented in 496 (49.1%). Individuals who were at risk to have poor glycemic control those between 45 and 65 years with odds ratio (OR) of 1.927 (95% CI: 1.143–3.248), obese 1.496 (95% CI: 1.085–2.063) and diagnosed with asthma 2.062 (95% CI: 1.637–3.504).&#x0D; Conclusion: The extent of poor glycemic control in the study sample was found high. Age, obesity, and having asthma are the most important factors of increased risk of poor glycemic control. Improving glycemic control would need rigorous efforts by addressing these factors.

Diabetic Complications and Factors Affecting Glycemic Control Among Patients With Type II Diabetes Mellitus Attending the Chronic Illness Clinics at Tabuk, Saudi Arabia

BackgroundDiabetes mellitus (DM) is one of the most common diseases worldwide and affects many patients all over the globe. Diabetic complications vary between microvascular and macrovascular, affecting a wide range of organs and systems in the body. Understanding, determining, and in return, preventing such factors is essential to alleviate the quality of life of diabetic patients. Therefore, we aim to determine the poor glycemic control and the factors associated with it in our diabetes population.MethodsThis is a retrospective study where data was reviewed for all patients with Type II DM (T2DM) who attended the chronic illness clinic at King Khaled Hospital in Tabuk. We included patients aged ≥ 18 years, of Saudi nationality, and residents of the Tabuk region. Any patient not satisfying all the inclusion criteria was excluded from the current study. Diagnosis with diabetes was made according to the American Diabetes Association guidelines, 2020. Patients’ demographic data, medical history, and social and lifestyle history were extracted from records. In addition, age, body mass index (BMI), drugs (insulin vs. oral hypoglycemic agents), duration of the disease, lipid profile, and other comorbidities were also extracted from the files. A p-value of <0.05 was selected as the statistically significant level in all tests.ResultsA total of 697 patients were included in the current study, with a mean age of 58.2±11.6 years. The mean glycosylated hemoglobin (HbA1c) of the study participants was 8.4±1.7%, and their fasting blood sugar (FBS) level was 9.9±3.9 mmol/l. With HbA1c cut-off at 7%, the overall prevalence of poor glycemic control was 81.5% (565/693). A higher prevalence of poor glycemic control was reported among study participants with higher DM duration (p=0.002). Diabetes complications were found in 208 (29.8%) of the study participants, where microvascular complications were present in 140 patients, and microvascular ones were found in 102. In the logistic regression model, older patients were less prone to poor glycemic control (OR=0.98; 95% CI=0.96-0.99; p=0.010). In addition, longer disease duration was a predictive factor of poor glycemic control (OR=1.05; 95% CI=1.02-1.08; p=0.003). Furthermore, the usage of combined insulin and tablet treatments were associated with a higher risk of poor glycemic control when compared to insulin only treatments (OR=4.65; 95% CI=1.55-13.94; p=0.006).ConclusionThe results of this study indicate a high prevalence rate of poor glycemic control among Saudi patients, which is higher than previous reports have shown. More interest should be given to awareness programs with regard to promoting self-control protocols for the disease.