National Guard Hospital Research Articles

Total Number of Lymph Nodes in Neck Dissection and Its Relation to Cancer-Positive Lymph Nodes as a Prognostic Indicator in Aerodigestive Tract Cancers: A Multi-Center Study.

Objectives Few studies have been conducted on the total number of lymph nodes (LNs) in neck dissection and the lymph node ratio (LNR; number of positive lymph nodes divided by number of excised lymph nodes), or their potential use as a prognostic indicator for cancers of the upper aerodigestive tract (UADT) and its treatment. We aimed to measure the number of lymph nodesdissected and the LNR to assess their prognostic value for cancers of the UADT, as well as their effect on overall survival and disease-free survival. Methods We performed a retrospective study of patients diagnosed with cancer of the UADT who underwent neck dissection as the primary or secondary modality of their treatment plan at King Abdulaziz University Hospital and the National Guard Hospital, Jeddah, Saudi Arabia. Data were collected through medical records and analyzed to assess prognosis and calculate survival rates in relation to the number of lymph nodes and LNR. Results A total of 121 patients were included: 14 women (11.57%) and 107 men (88.43%). The median age was 60 years and the mean follow-up period was 2.7 years. Of the malignancies, 44.63% were of the oral tongue and 35.54% were laryngeal. A median of 38 lymph nodes were dissected during neck dissections. The distribution of the individual LNRs was characterized by mean values. A mean LNR of 0.04 was considered the cutoff value, an LNR of > 0.04 a high LNR, and an LNR of < 0.04 a low LNR. Kaplan-Meier survival estimates for the cohort showed a three-year overall survival rate of 88% (95% confidence interval [CI]: 77% to 94%) for patients with a low LNR, but 71% (95% CI: 47% to 85%) for patients with a high LNR, which was statistically significant. A similar significant decreasing trend persisted at the four-year follow-up, where the disease-free survival rate was 73% (95% CI: 61% to 82%) for patients with a low LNR compared with 56% (95% CI: 35% to 72%) for patients with a high LNR. Conclusion The number of excised lymph nodes in neck dissections and the LNR might be a good prognostic indicator for overall survival and disease-free survival in patients with cancers of the UADT and may serve as a valuable tool in deciding on different treatment plans.

The Prevalence of Hyperthyroidism Amongst Atrial Fibrillation Patients in the National Guard Hospital, Riyadh, Saudi Arabia: A Cross-Sectional Retrospective Study

The Prevalence of Hyperthyroidism Amongst Atrial Fibrillation Patients in the National Guard Hospital, Riyadh, Saudi Arabia: A Cross-Sectional Retrospective Study

Awareness of healthcare providers on environment-friendly practices in operating rooms in selected hospitals in Riyadh, Saudi Arabia.

Climate change will have a great impact on humanity in upcoming years and will affect the health of all living creatures. Hospitals play a significant role in climate change due to their substantial waste production and they are considered a profound pollution source, with the Operating Theater as a main contributor. This study was aimed to examine the level of knowledge among healthcare professionals in Saudi Arabia concerning the proper implementation of operating room (OR) environmental procedures and efficient management of hospital waste. This is a cross sectional study performed across 3 hospitals in Riyadh, Saudi Arabia. The hospitals included are Prince Sultan military hospital, National guard hospital and King Salman hospital. The study included all the staff and health workers in OR (operating room), excluding all staff and health workers not in OR. The study took place between September 1 and November 1, 2022. None of the study participants mentioned that their institute or hospital fully engaged in Greenhealth Greening the OR initiative. Almost 1 to 3rd of the study participants (38.1%) mentioned that endorsement and participation in the practice of Greenhealth Greening the OR initiative was not implemented at all, and 45% of the participants were completely unaware of such an initiative. The study's findings suggest that healthcare providers in Saudi Arabia are not fully aware of environmentally friendly practices. Further, the current initiatives undertaken by the hospital administration fall short in attaining environmentally sustainable benchmarks.

Risk Factors for Postoperative Infections in Cardiac Surgery Patients: A Retrospective Study.

Background and objective Cardiac surgery is one of the most common surgical proceduresglobally; its incidence has been on the risedue to the faster pace ofpopulation aging thanks to technological and epidemiological advances. Patients who undergo cardiac surgeriesmayface various postoperative complications that might affect their survival, and one of these major complicationsis infection. Nosocomial pneumonia, surgical site infection (SSI), mediastinitis, bacteremia, and sepsis are common infections encountered after surgeries. In this study, we aimed to determine the common risk factors related to postoperative infections at the King Faisal Cardiac Center from January 2014 to September 2020. Materials and methods Records from 364 patients who underwent cardiac surgery and were aged above 18 yearswere assessed for postoperative infections in this retrospective cohort study. Patients who were immunosuppressed or had active systemic infections were excluded. Consent was waived by the Institutional Review Board. All procedures were performed at the King Faisal Cardiac Center, National Guard Hospital, Jeddah. Results Of the total 364 patients,105 were women and 259 were men. The mean age of the cohort was 59 years (SD = 13) and the mean BMI was 29.1 kg/m2 (SD = 5.3). The study population showed a high prevalence of cardiac risk factors and diseases: diabetes (n = 244, 67%), hypertension (n = 230, 63%), dyslipidemia (n = 144, 40%), smoking (n = 80, 22%), heart failure (n = 41, 11%), and chronic obstructive pulmonary disease (n = 6, 1.6%). The overall rate of postoperative infection was 32.7% (n = 120), and 17 (14%) of these infected patients underwent reoperations for infection. Conclusion Based on a thorough analysis of 364 patients undergoing various cardiac surgical procedures, including a multivariate analysis accounting for preoperative factors, there was a significant association between postoperative infections and hypertension, diabetes, increased preoperative activated partial thromboplastin time, and elevated HbA1c.

The perception of pediatric sickle cell anemia patient's caregivers toward hematopoietic stem cell transplantation (single-center experience, Saudi Arabia).

Sickle cell disease (SCD) is a relatively common genetic disorder in Saudi Arabia characterized by the predominance of sickle hemoglobin (HbS). Although multiple supportive care options exist for patients with SCD, hematopoietic stem cell transplantation (HSCT) is the only cure available and has become highly successful, with an almost 91% overall survival rate. However, pursuing this procedure is still restrained as a curative treatment option. Therefore, this study aimed to evaluate the perception of parents' caregivers at the National Guard Hospital pediatric hematology clinic regarding using HSCT as a curative approach for their children with SCD. This is a cross-sectional study of the interviewer-administered survey distributed utilizing electronic devices to caregivers of pediatric patients with SCD. Subjects were recruited from Pediatric Hematology & Oncology clinics at National Guard Hospital Affairs in King Abdulaziz Medical City, Jeddah, Saudi Arabia. An estimated sample size of 100 was initially calculated out of 140 pediatric SCD patients; 72 responses were collected from participants. All study participants gave informed consent. All results were analyzed using SPSS; moreover, statistics were set at a CI of 95% and a p < 0.05. In addition, inferential and descriptive statistics were done. Of all respondents, 42 (67.8%) would accept HSCT if their hematologist recommended it. However, approximately 7 (11.3%) were not interested in the procedure, and the rest, 13 (21%), were uncertain. The most reported reasons for HSCT rejection among all respondents were attributed to side effects 31 (50.8%), lack of knowledge 8 (13.1%), and misconception toward the procedure 22 (36.1%). The results of this study were consistent with the fact that most caregivers would follow along with HSCT if it seemed to be fit and was recommended by their hematologists. However, to the best of our knowledge, our study being the first of its kind in the region, further research in the kingdom on the perception of HSCT is needed. Nonetheless, further patient education, an increase in caregivers' knowledge, and enlightenment of the medical team on HSCT as a curative option for sickle cell disease are vital.

Electrolytes Play a Role in Detecting Cisplatin-Induced Kidney Complications and May Even Prevent Them-Retrospective Analysis.

Background and Objective: Cisplatin is a chemotherapy drug used to treat several types of malignancies. It is a platinum-based compound that interferes with cell division and DNA replication. Cisplatin has been associated with renal damage. This study evaluates the early detection of nephrotoxicity through routine laboratory tests. Materials and Methods: This is a retrospective chart review based on the Saudi Ministry of National Guard Hospital (MNGHA). We evaluated deferential laboratory tests for cancer patients treated with cisplatin between April 2015 and July 2019. The evaluation included age, sex, WBC, platelets, electrolytes, co-morbidities and interaction with radiology. Results: The review qualified 254 patients for evaluation. Around 29 patients (11.5%) had developed kidney function abnormality. These patients presented with abnormally low magnesium 9 (31%), potassium 6 (20.7%), sodium 19 (65.5%) and calcium 20 (69%). Interestingly, the whole sample size had abnormal electrolytes presenting magnesium 78 (30.8%), potassium 30 (11.9%), sodium 147 (58.1%) and calcium 106 (41.9%). Some pathological features were detected, such as hypomagnesemia, hypocalcemia and hypokalemia. In addition, infections that needed antibiotics were dominant in patients treated with cisplatin alone, representing 50% of this group. Conclusions: We report that an average of 15% of patients with electrolyte abnormalities develop renal toxicity and reduced function. Moreover, electrolytes may serve as an early indicator for renal damage as part of chemotherapy complication. This indication represents 15% of renal toxicity cases. Changes in electrolyte levels have been reported with cisplatin. Specifically, it has been linked to hypomagnesemia, hypocalcemia and hypokalemia. This study will help reduce the risk of dialysis or the need for kidney transplant. It is also important to manage any underlying conditions and control patients' intake of electrolytes.

Clinical and pathological characteristics of extra-cranial germ cell tumors: A 30-year single-center experience in Saudi Arabia.

To investigate the clinical and pathological characteristics of extracranial germ cell tumors (GCTs) in children aged 0-168 months treated at the National Guard Hospital, Jeddah, Saudi Arabia from 1990 to 2020. In this retrospective analysis, the data for all cases of GCTs were collected from 1990 to 2020. Statistical analyses were carried out using JMP software. The data was divided into 4 main categories: demographics, pathological/clinical features, recurrence, treatment and outcome. The study included 50 patients, with a mean age at diagnosis of 56.52 months. The median follow-up duration was 30 months. Most tumors were in the gonads, and among the extragonadal tumors, the sacro-coccyx was the most frequent site of the disease.The most common histological subtype of GCTs is yolk sac tumor, accounting for 28% of cases. Of the 50 patients, 46% received chemotherapy, and 54% underwent surgery without chemotherapy. Ten (20%) patients experienced recurrence after treatment. At the last follow-up, 96% of the patients were alive, and only 2 of the patients died due to advanced disease. Our findings were comparable to international data, but improvement in surveillance is required for long-term survivors.

Adherence therapy for adults with type 2 diabetes: a feasibility study of a randomized controlled trial

BackgroundAdherence Therapy is a candidate intervention to promote consistent medication taking in people with type 2 diabetes. The aim of this study was to establish the feasibility of conducting a randomized controlled trial of adherence therapy in people with type 2 diabetes who were non-adherent with medication.MethodsThe design is an open-label, single-center, randomized controlled feasibility trial. Participants were randomly allocated to receive either eight sessions of telephone-delivered adherence therapy or treatment as usual. Recruitment occurred during the COVID-19 pandemic. Outcome measures—adherence, beliefs about medication, and average blood glucose (sugar) levels (HbA1c)—were administered at baseline and after 8 weeks (TAU group) or at the completion of the treatment (AT group). Feasibility outcomes included the number of people approached to participate in the trial and the numbers that consented, completed study measures, finished treatment with adherence therapy, and dropped out of the trial. Fieldwork for this trial was conducted in the National Guard Hospital, a tertiary care provider, in the Kingdom of Saudi Arabia.ResultsSeventy-eight people were screened, of which 47 met eligibility criteria and were invited to take part in the trial. Thirty-four people were excluded for various reasons. The remaining thirteen who consented to participate were enrolled in the trial and were randomized (AT, n = 7) (TAU, n = 6). Five (71%) of the seven participants in the adherence therapy arm completed treatment. Baseline measures were completed by all participants. Week 8 (post-treatment) measures were completed by eight (62%) participants. Dropout may have been linked to a poor understanding of what was involved in taking part in the trial.ConclusionsIt may be feasible to conduct a full RCT of adherence therapy, but careful consideration should be given to developing effective recruitment strategies, consent procedures, rigorous field testing, and clear support materials.Trial registrationThe trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12619000827134, on the 7th of June 2019.

Descriptive Study and Surgical Management Among Infiltrating Lobular Carcinoma Patients Admitted to King Abdulaziz Medical City From 2000 to 2017: A Retrospective Cross-Sectional Study.

Invasive lobular carcinoma (ILC) is the second most common histologic type of breast carcinoma. The etiology of ILC is unknown; however, many contributing risk factors have been suggested. Treatment of ILC can be divided into local and systemic. Our objectives were toassess the clinical presentations, risk factors, radiological findings, pathological types, and surgical options for patients with ILC treated at the national guard hospital. Identify the factors associated with metastasis and recurrence. Retrospective cross-sectional descriptive study at a tertiary care center in Riyadh.All adultpatients aged 16 years and above, from different nationalities, and both genders, were diagnosed with ILC from 2000 to 2017 and followed up at KAMC. The sampling technique was a non-probability consecutive technique.Among 1066 patients identified, 91 patients were diagnosed with ILC over seventeen years study period. The median age at the primary diagnosis was 50. On the clinical examination, 63 (71%) cases were found to have palpable masses which was the most suspicious finding. On radiology, the most encountered finding was speculated masses which were seen in 76 (84%). Regarding the pathology, unilateral breast cancer was seen in 82 while bilateral breast cancer was found only in eight. For the biopsy, a core needle biopsy was the most commonly used in 83 (91%) patients. The most documented surgery for ILC patients was a modified radical mastectomy. Metastasis in different organs was identified with the musculoskeletal system being the commonest site. Different significant variables were compared between patients with or without metastasis. Skin changes, post-operative invasion, estrogen, progesterone, and HER2 receptors were significantly associated with metastasis. Patients with metastasis were less likely to have conservative surgery. Regarding the Recurrence and five years survival, out of 62 cases, 10 had recurrence within five years, which was more prevalent in patients who had fine needle aspiration, excisional biopsy, and nulliparous patients. To our knowledge, this is the first study to exclusively describeILC in Saudi Arabia. The results of this current study are highly important, as these results provide baseline data of ILC in the capital city of Saudi Arabia.

The three major themes of women's birthing experiences: A qualitative study in Saudi National Guard hospitals

AbstractChildbirth is the most significant interaction between pregnant women and the health system. Women's satisfaction during the birthing process is an essential indicator of care quality because satisfaction reflects the gaps between expected and actual care and services. In‐depth studies of women's birthing experiences and maternity services provided in public and private sectors in the Kingdom of Saudi Arabia are needed to improve the health system. Such studies are particularly critical because ongoing privatization policies continue to change Saudi Arabia's approach to childbirth. This qualitative study drew on 78 semistructured interviews to better understand the key themes that arose regarding women's satisfaction with their birthing experiences. The study compared women's birthing experiences in public and private sections of two selected National Guard hospitals in Saudi Arabia. The findings yielded three major themes as follows: Hospitals, Doctors, and Nurses. Overall, women in the public sections of hospitals were less satisfied with their quality care due to a lack of privacy, and the respondents reported receiving mediocre attention from nurses when compared with that received by women in private sections. The study's findings stand to inform policymakers about the current situation of the Saudi Arabian health‐care system and the services rendered. Thus, leaders implementing strategic plans should pay careful attention to the three revealed themes to create better care quality and increase women's satisfaction during privatization.

Prevalence of microvascular complications among patients with type 2 diabetes mellitus who visited diabetes clinics in Saudi Arabia.

To determine the microvascular complications prevalence in patients with type 2 diabetes mellitus (DM) in the eastern province of the Kingdom of Saudi Arabia. The participants in this retrospective, cross-sectional study included patients with type 2 DM who visited the diabetes clinics of primary health care centers of 2 National Guard Hospitals, Eastern Province, Saudi Arabia. This study included 935 patients with type 2 diabetes (54.1% women versus 45.9% men). Oral hypoglycemic medication was the most common treatment (90.3%). Overall, 55.1% of patients visited the ophthalmology clinic for retinopathy screening. The last glycated hemoglobin A1c result (mean: 8.04%) was higher than the second-to-last result (mean: 8.03%), or the third-to-last result (mean: 7.99%). The prevalence of microvascular complications of DM was 55.1%. Independent significant factors linked with a higher risk of microvascular issues of DM were higher age, visits to an ophthalmology clinic, and the use of injection therapy. The most typical complications that our patients experienced was nephropathy (80.2%), followed by retinopathy (32.7%), and neuropathy (8.4%). Microvascular complications were extremely common in type 2 DM patients in our region. Being older, regularly visiting an ophthalmologist, and using injection therapy were predictive factors correlated with a higher chance of experiencing these complications.

The Incidence of Long-Term Fatigue in Patients Who Achieved Remission From COVID-19 at King Abdulaziz Medical City.

Introduction Long-term fatigue is a common condition that involves both physical and psychiatric symptoms, and it affects multiple age groups and causes morbidity and disabling symptoms that range from mild to severe symptoms. Many patients are discharged following coronavirus disease 2019 (COVID-19) infection without proper follow-up and evaluation of long-term effects, resulting in the improper treatment of the long-term symptoms, which increases the burden on the patients and healthcare systems. Coronavirus disease 2019 (COVID-19) is a disease caused by the novel SARS-CoV-2. It results in a variety of symptoms, including fever, cough, respiratory distress, the loss of the sense of smell and taste, and long-term effects such as post-severe acute respiratory syndrome (SARS), which is characterized by chronic fatigue, sleep disturbances, myalgia, weakness, and depression. The aim of this study is to assess the incidence of long-term fatigue in patients who achieved remission from COVID-19 at King Abdulaziz Medical City (KAMC), National Guards Health Affairs, Riyadh. Methods We conducted a cross-sectional, non-probability convenience sampling study. All participants who were diagnosed with COVID-19 and achieved remission were approached in an outpatient department (OPD)setting and signed an informed consent form and were evaluated by standard questionnaires at clinics after remission from COVID-19 at King Abdulaziz Medical City in Riyadh, Saudi Arabia. A total of 343 subjects who fit the inclusion criteria of any patients who have been diagnosed with COVID-19 and achieved remission were included in the study. This study included patients from the National Guard Hospital, students, and staff members. The primary outcome variable was the incidence of long-term fatigue in patients who achieved remission from COVID-19 as measured by the Chalder fatigue scale (CFQ). The participants were approached in clinics and general OPDby one of the research teams. Results Based on the study design, 343 patients were selected from King Abdulaziz Medical City in Riyadh, the incidence of long-term fatigue in patients who achieved remission from COVID-19 was 55.7%, and the rest were normal (44.3%). The incidence of long-term fatigue was statistically significantly higher in femalesand those who had been diagnosed with COVID-19 and achieved remission for more than two months. Theage of the participants ranged from 18 to more than 45, with a predominance of females (60.6%). Regarding body mass index (BMI), 39.9% were overweight, and 29.2% were obese. Additionally, the incidence of patients with associated chronic disease was 27.4%; among these chronic diseases, hypertension was the most common one (18.1%), followed by diabetes (17%) and thyroid diseases (14.9%). Conclusion To the best of our knowledge, this is one of the few studies that were carried out in Saudi Arabia that assess long-term fatigue post COVID-19 infection. In our study, we discovered that long-term fatigue was highly prevalent (55.7%). We found that among those participants, more than half of those who reported chronic fatigue had a COVID-19 diagnosis for longer than two months. Furthermore, females made up the majority of those who had long-term fatigue. We urge that additional longitudinal and standardized studies be carried out in order to thoroughly determine the severity of long-term fatigue in patients who obtained remission from COVID-19.

Assessment of the satisfaction level with antenatal care services among pregnant females in AlAhsa, Saudi Arabia

Background: Satisfaction, which reflects the evaluation of outcomes by beneficiaries, is an important aspect of healthcare. In the context of antenatal care (ANC), satisfaction represents the pregnant patient&amp;apos;s experience with the provided healthcare services. To improve ANC, it is crucial to continuously evaluate the quality of care by assessing patient satisfaction. This study aims to assess the level of satisfaction among pregnant females towards ANC in AlAhsa, Kingdom of Saudi Arabia. Methods: A descriptive cross-sectional study was conducted using a validated questionnaire derived from a previously validated version. Cluster sampling was employed, with three clusters assigned: Primary Healthcare Centers, Ministry of Health Hospitals, and National Guard Hospital (NGH). By utilizing the Cochrane Formula with a 95% confidence interval and 5% margin of error, a sample size of 500 was estimated. Results: Overall, participants in AlAhsa expressed satisfaction with ANC services, with a Likert scale score of 4 out of 5. The NGH exhibited the highest percentage of total satisfaction (satisfied and strongly satisfied) at 82%. Waiting time received the lowest satisfaction percentage of 45.5%, with a mean score of 3.3 ± 1.4. Conclusion: The study found that 73.5% of participants were satisfied with ANC services. Notably, the NGH achieved the highest level of satisfaction. To enhance satisfaction levels, facilitating appointments booking could potentially reduce waiting times.

Knowledge and Practice of Foot Self-Care Among Diabetic Patients in National Guard Primary Care in Riyadh

Objective: This study aimed to evaluate the level of knowledge and practice of foot self-care in diabetic patients in Primary care at National Guard hospital, Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted among diabetic patients attending the three biggest primary healthcare centers of the National Guard Health Affairs in Riyadh, Saudi Arabia (ISKAN clinic, HCSC, and NGCSC). The patients were asked to fill a self-administrated questionnaire that investigated demographics, knowledge, inspection, and practice. Results: Among 390 diabetic patients, 74.1% had type 2 diabetes, 6.4% had foot ulcers, and 23.1% received training on diabetic care. The knowledge score was 10.86 ± 1.66, whereas practice score was 20.2 ± 3.5. The mean score of knowledge was significantly affected by education level (p &amp;lt; 0.001), whereas the mean score of practice was significantly varied regarding gender (p &amp;lt; 0.001), education level (p-value = 0.001), occupation (p &amp;lt; 0.001), duration of diabetes (p-value = 0.001), and treatment (p-value = 0.001). Conclusion: Diabetic patients in this study had a good level of knowledge regarding foot self-care, whereas the practice was acceptable but not optimum.

The association of chest compressor&amp;apos;s physical activity level with the quality of continuous chest compressions during a stimulated cardiac arrest in an education center

Background: Cardiopulmonary resuscitation (CPR) is a lifesaving procedure performed by qualified rescuers. The quality of CPR depends on effective chest compression (CC) characteristics: rate, depth, hand position, and chest recoil. Besides CC, previous research has proven that physical activity level (PAL) varies among rescuers and affects CPR quality. This study aims to assess the association between PAL and the quality of continuous chest compressions-cardiopulmonary resuscitation (CCC-CPR) for 5 minutes by qualified rescuers at the National Guard Hospital in Jeddah (NGHA-J). Methods: This is a cross-sectional study. The global physical activity questionnaire was used to measure the participants&amp;apos; PALs, and the SimMan 3G mannequin was used to measure the four CC characteristics. The recommended sample size is 45 of the rescuers at NGHA-J. Results: A total of 45 members were involved in the study, and most participants were 27 (60%) males. Most participants are classified as having high PAL 21(46.67%). The study indicates that there is no significant effect among the PALs and the CCC-CPR effectiveness according to (p 0.65) which is determined by the non-parametric Kruskal Wallis test. The optimal effective CCs between the three groups of PALs were achieved by the moderate PAL participants with a median of 47.5 (IQR 35). Conclusion: The study findings deny any relationship between the quality of the CCC-CPR and the PAL of the rescuers.

Prevalence of blood donation at Almaarefa University, Riyadh, Saudi Arabia

Background: World Health Organization reports that the safest blood donors come from low-risk communities and donate blood freely and for free. The student population that is healthy, active, and receptive may donate blood to meet the demand for safe blood. We aim to determine the prevalence of blood donation among the students and employees of Almaarefa University. Methods: A cross-sectional study targeting Almaarefa University staff members and students was carried out in collaboration with the National Guard Hospital, Riyadh Saudi Arabia. Data was gathered via a straightforward questionnaire. The primary requirements for participation were: being medically healthy, older than 20 years old, weighing more than 55 kg, having a hemoglobin level of more than 11 mmHg, and have not donated blood in the past 60 days. Results: The majority of the volunteers were male (59%), weighing 55-65 kg (44.6%), from the age group of 20-22 (76.4%), and 66.2% of them were Saudis. Further, 46.5% were from the College of Medicine. A statistically significant association was found between gender and weight (p-value = 0.001). Conclusion: To increase the frequency of blood donation, it is necessary to develop specific programs with interactive blood donation awareness workshops that target youngsters and encourage them to become regular volunteer blood donors. Exploring and evaluating barriers to blood donation, especially for women, is essential. Efforts must be made to put the information and encouraging attitude toward contribution into practice.

Outcomes of Gestational Trophoblastic Disease in King Khalid National Guard Hospital

Objective: The objective of this study is to review the outcomes of gestational trophoblastic disease in our center, and to compare it with international figures. We will calculate the rates of remission, recurrence, and mortality. Also, we will determine the mean duration taken for normalization of β-hCG level after initiation of treatment, and the distribution of the disease by age and parity. Methods: Retrospective chart review of the patients diagnosed with gestational trophoblastic disease (GTD) and treated in King Khalid National Guard Hospital in the period between January 2000 and December 2005. Results: During the study period, there were 29 cases of gestational trophoblastic disease. The majority of the cases were non-metastatic GTD (55.2%) followed by, in decreasing order of frequency, molar pregnancy (24.1%), metastatic high-risk GTD (10.3%), metastatic low-risk GTD (6.9%) and placental-site trophoblastic tumor (3.4%). Patient's age ranged from sixteen to fifty-three years old, with the majority in the fourth decade of life (37.9%). The parity as well was highly variable from zero to fifteen, with the majority between five and ten (37.9%). Remission rate in the malignant GTD was 85.7%. There were no cases of recurrence during the follow-up period. The overall mortality rate was 3.4%. The mean duration required for normalization of β-hCG level was 10.3 weeks for molar pregnancy and 11.6 weeks for malignant GTD. Conclusion: The chemotherapy success rate, remission rate &amp; mortality rate were similar to that reported in earlier studies. There is a need for patient education regarding strict follow-up for early detection and intervention of malignant sequelae.

Perception of herbs use in treating diabetes among patients attending specialized polyclinics of National Guard Health Affairs, Jeddah.

Diabetes mellitus represents a major burden globally and locally. Some diabetic patients may resort to the use of herbal medicine as another approach to control their blood glucose levels. This study aims to assess the prevalence and the perception of diabetic patients toward the usage of herbs in treating diabetes. A cross-sectional survey was conducted in a specialized polyclinic of the primary health care center in the National Guard hospital located in Jeddah. The questionnaire was interviewer-administered and a total of 196 diabetic patients were interviewed. Of 196 patients interviewed, most (59.7%) have used herbs to treat diabetes. Cinnamon, garlic, fenugreek, and moringa were the most common herbs used by diabetic patients. Many herbal users (49.9%) reported that herbs can play a role in decreasing blood glucose levels and (48%) of herbal users prefer the use of herbs over conventional medicine in treating diabetes. Most diabetic patients (37.3%) gained their knowledge about herbs through media and the experiences of other diabetic patients and we found that the reason to use herbs the majority was to reap the benefits of the herbs (48.7%) or because of herbs on controlling diabetes and reducing diabetic complications (30.7%). This study concluded that herbs are commonly used among diabetic patients and the majority of patients perceive herbs as a cofactor in controlling diabetes.

Safety of labor induction by dinoprostone (PROPESS) among grand multipara in King Abdulaziz Medical City, Jeddah, Saudi Arabia

Background: Dinoprostone is a synthetic prostaglandin (PG) that induces labor. In multiparity, the use of dinoprostone could be stressful and dangerous. Thereby, this study aimed to evaluate the safety of vaginal dinoprostone (PROPESS) Prostaglandins E2 (PGE2) used for the induction of labor in grand multiparous women and great grand multipara (GMP). Methods: This was a retrospective chart review that was conducted on all GMP and great GMP women whose labor was induced by dinoprostone. The study was conducted at King Abdulaziz Medical City, the National Guard Hospital located in Jeddah in the Western region of Saudi Arabia, in the period from 2018 to 2020. Results: The grand multiparous women were 353 from the total deliveries observed with a mean ± SD age of 36.6 ± 5 years. Results showed that 95.75% labor induction success was achieved by dinoprostone, and 92.1% was delivered via spontaneous vaginal delivery. The major causes of labor induction included gestational diabetes mellitus (45.6%) and post-date (34.3%). The success of dinoprostone was significantly influenced by maternal age (p = 0.006) and gestational age (p = 0.03). No severe maternal complications were observed such as infection or uterine rupture, or cesarean hysterectomy or maternal death. Conclusion: There were no major complications reported after inducing by dinoprostone. Thus, as no adverse events were reported in this study, it is safe to use vaginal PGE2 Dinoprostone for the induction of labor in grand multiparous women and in great grand multiparous women. However, randomized controlled trial for further validation of these findings is recommended.

Comparison of the Effects of Regular Periods of Immobilization and Prolonged Immobilization on Hand Function Post Distal Radial Fracture.

Introduction Distal radius fracture (DRF) is one of the most common orthopedic cases managed in the emergency room. DRF treatment is either non-operative or operative. Regardless of the treatment methodology, a period of immobilization of 4-6 weeks is required. Purpose The study aims to evaluate hand function for patients who sustained DRF with different immobilization periods in King Abdul-Aziz Medical City, National Guard Hospital - Jeddah (NGHA) from December 2016 until December 2019. Materials and methods This is a retrospective cohort study where we collected data of DRF patients managed in NGHA. Data was collected directly from NGHA medical records (December 2016-December 2019). A total of 44 patients met the inclusion criteria. Patients were divided into two groups; a group that was immobilized as per protocol (six weeks) and a group that deviated from protocol and immobilization exceeded six weeks. A data collection sheet included the patient's demographics, history, fracture description, management method, and hand function measurements. Results Of the 44 participants, 24 (54%) deviated from protocol; the remaining 20 (46%)were immobilized as per protocol. The prolonged immobilization group had limitations in hand function,restriction in extension (P-value=0.641), and a decrease in grip strength (P-value =0.291) compared to the per-protocol group. Flexion and radial deviation were affected similarly in both groups. Conclusion Although the results were not significant,immobilization for more than six weeks is associated with decreased hand function, range of motion (ROM), grip strength, and higher pain scores based on occupational therapy (OT) measurements.