non-Saudi Patients Research Articles

Assessment of Medication Compliance and Follow-Up Clinic Attendance Among Patients With Cardiovascular Diseases in the Jazan Region.

Cardiovascular diseases are common causes of mortality in Saudi Arabia and the world. This study aims to assess medication compliance and regularity of follow-up for cardiovascular patients in the Jazan region. An analytical cross-sectional approach was used to target all registered cardiovascular patients attending the cardio clinic in a Jazan region hospital. Data were collected using an interview questionnaire developed by the researchers with the help of experts. The questionnaire included the patients' sociodemographic data, clinical characteristics, disease-related data, drugs, and appointments. The study included 259 patients diagnosed with cardiac disease. About 53.7% of the patients were males. All the cases had the disease for one year or more. About 56% of the patients hadno difficulty remembering their medications, while 44% had problems remembering to take them. More than half of the patients had good medication adherence, and 79.6% had good appointment adherence. Only 20.4% of patients had a poor adherence rate. The adherence rate for the patients' medication and appointments was satisfactory due to high patient awareness. On the other hand, poor adherence was related more to non-Saudi patients.

Gender-driven thyroid dysfunction in systemic lupus erythematosus patients: Clinical significance of an overlooked association and global stance

Aim of the workThis study aimed to determine the association of thyroid dysfunction in systemic lupus erythematosus (SLE) patients. Patients and methodsOut of a cohort including 312 adult SLE patients those with thyroid dysfunction (n = 53) were further evaluated. The medical history, clinical examination, laboratory investigations and medications received were recorded. The SLICC damage index (SLICC-DI) was assessed. ResultsThyroid dysfunction formed 17 % of the patients and their mean age was 39.5 ± 11.5 years and disease duration 5.6 ± 3.3 years were comparable to those without thyroid disorder, however female gender was predominantly higher (F:M 52:1 vs 6.2:1, p < 0.0001). The frequency of thyroid dysfunction was alike in Saudi (16 %) and non-Saudi (17.9 %) patients (p = 0.66). The majority of cases (96.2 %) had hypothyroidism, one with autoimmune thyroiditis, while only 2 (3.8 %) had hyperthyroidism. There was a significantly increased frequency of associated neuropsychiatric manifestations (64.2 % vs 45.2 %;p = 0.012), and hematological involvement (32.1 % vs 14.3 %; p = 0.011) and less complement (C4) consumption (15.1 % vs 23.6 %; p = 0.048) in those with thyroid dysfunction compared to those without. The frequency of anti-double stranded deoxyribonucleic acid (anti-dsDNA) positivity tended to be higher (71.7 % vs 66.8 %) and its titre significantly lower (316.3 ± 319.8 IU/ml vs 461.3 ± 459.1; p = 0.013). The SLICC-DI and mortality rate were comparable between groups. Only the presence of proteinuria inversely significantly correlated with the level of T4 (r = -0.31, p = 0.007). ConclusionThyroid dysfunction forms a notable percentage of SLE patients with a prominent female gender propensity. The significant relation of thyroid disorders to neuropsychiatric manifestations, hematological involvement, C4 consumption and anti-dsDNA deserves recognition.

Normative parameters of the Evans Index using Computer Tomography in the Saudi population.

To calculate The Evans Index (EI) in normal Individuals. Ventricular enlargement is referred to as hydrocephalus. Computer tomography (CT) scans are commonly used to investigate such intracranial pathologies. The EI is an important parameter for diagnosing hydrocephalus. We included all patients who underwent Computer tomography (CT) scan of the brain that was reported as normal. The mean EI was calculated for the whole sample stratified by age, gender, and ethnicity. Patients with an initial report indicating any intracranial pathology, such as hydrocephalus, tumors, hemorrhages, or neurodegenerative disorders, were excluded. A total of 1,330 brain CT scans carried out at our institution were reviewed retrospectively from August 2021 to December 2021. A total of 423 CT scans were screened after excluding 25 patients with abnormal imaging findings and 14 repeated images for the same patients. A total of 384 patients were included. The mean EI for the entire sample was 0.2550±0.0277. There was a minimal but statistically significant difference based on gender, with a mean EI of 0.2588±0.0274 for males and 0.2517±0.0276 for females (p=0.012). There was no statistically significant difference between Saudi and non-Saudi patients. EI increased progressively with age in both genders. Our EI values were similar to many of those reported in other countries, which supports the use of the 0.3 cutoff for the diagnosis of hydrocephalus, regardless of gender, age, or ethnicity.

Factors Associated with Nonadherence to Dietary Prescriptions among Hemodialysis Patients, Makkah, Saudi Arabia.

The nonadherence of hemodialysis (HD) patients correlates with morbidity and mortality. Despite severe consequences, noncompliance with their medical regimen is the norm for HD patients rather than the exception. Factors associated with nonadherence to dietary restrictions among HD patients have been explored in many studies; however, most were in Western countries and there is a remarkable paucity of studies in Saudi Arabia. HD patients have several features that put them at an increased risk of nonadherence to dietary restrictions, including prolonged, intensive treatment, and their medical regimens are easily determined with objective measures. This crosssectional study aimed to determine factors related to nonadherence to dietary restrictions among 361 HD patients randomly selected from HD centers in Makkah, Saudi Arabia. Individuals were assessed for adherence using the End-Stage Renal Disease - Adherence Questionnaire in addition to clinical examinations and laboratory investigations. Female patients were more likely to be nonadherent to dietary restrictions. Adherence to dietary restrictions was relatively higher among non-Saudi patients, older people, those who are married, those with university qualifications, those who are employed, and those with higher monthly incomes; nevertheless, these differences were not statistically significant. Despite the relatively higher frequency of adherence to dietary restrictions among patients with a duration of dialysis of <60 months, hypertensive patients, patients with a previous kidney transplant, and those with a previous history of psychiatric illnesses, these differences were not statistically significant. Patients with factors associated with nonadherence to dietary restrictions deserve special attention and support to improve their adherence.

Endovascular Interventions for Peripheral Arterial Disease in Saudi Patients: A Cross-Sectional Study Assessing Efficacy and Economic Impact.

Introduction Peripheral Arterial Disease (PAD) is characterized by arterial narrowing or blockage, causing pain and reduced quality of life. Endovascular interventions, like angioplasty and stenting, offer less invasive treatment options with potential benefits. This study, conducted in the Al-Ahsa region of Saudi Arabia from January to August 2023, aims to assess the impact of these interventions on PAD management in Saudi patients. Specifically, we aim to evaluate their effectiveness in improving clinical outcomes, such as symptom relief and quality of life, and their cost-effectiveness in the Saudi healthcare system. By addressing these objectives, our research provides evidence to support informed clinical decisions and healthcare policy in Saudi Arabia, ultimately enhancing patient care. Methods In this study, a cross-sectional design was used to assess the impact of endovascular interventions on PAD management in Saudi patients in the Al-Ahsaregion. Data collection took place from January to August 2023. The study focused on a sample of 385 or more Saudi patients who had undergone endovascular interventions. Inclusion criteria involved diagnosed PAD patients who had received these interventions, while non-Saudi patients and those without PAD or interventions were excluded. Data was collected through an online questionnaire distributed in hospitals. The study considered demographic and clinical/economic variables to evaluate intervention effectiveness and cost-effectiveness. Results The findings of this study emphasize the significance of variables such as gender, education level, employment status, and geographic location in shaping perceptions concerning the effectiveness and cost-effectiveness of endovascular interventions for the management of PAD. Participants in the study reported substantial improvements in symptom relief, quality of life, and daily activities following endovascular interventions. Moreover, the study revealed divergent perceptions regarding the cost-effectiveness of these interventions among participants. Conclusion This study highlights a positive association between the use of endovascular interventions and improved clinical outcomes in Saudi patients diagnosed with PAD. The results of this research indicate that endovascular interventions are not only more cost-effective when compared to alternative treatment modalities for PAD management but also lead to significant enhancements in symptom relief, quality of life, and daily activities among patients. The implications of these findings for the Saudi healthcare system are substantial, underscoring the importance of evidence-based decisions in the adoption of endovascular interventions for PAD management.

Assessing Social Determinants of Health Among Patients With Depression at Primary Healthcare Centers in Riyadh City.

Depression is a common and serious medical illness that is greatly influenced by socioeconomic, demographic, and biological factors. The recognition of social determinants of depression can help reduce the risk factors and promote mental health.The purpose of this study was to assess the social determinants of health (SDOH) of patients with depression and to classify its categories at primary healthcare centers (PHCs) in Riyadh, Saudi Arabia. A cross-sectional study using a self-administered questionnaire was conducted among 322 participants who were selected through a convenience sampling technique from June 2021 to August 2022. The study included Saudi and non-Saudi patients at the Ministry of Health PHCsin Riyadh, Saudi Arabia, aged 12 years and older. Independent samples of t-test and one-way ANOVA test were used to assess differences in means of numerical variables. Correlations were made by the Pearson correlation coefficient. A p-value of <0.05 was set as the level of statistical significance. Logistic regression was used to determine the main variables associated with moderate to severe depression. The findings showed 51% had minimal to mild depression, 27% had moderate depression, and 22% had moderately severe to severe depression. A greater proportion of females had moderate to severe depression (61%) (p=0.007). Also, moderate to severe depression was higher in those with lower monthly income(54%)(p=0.03). Saudi nationals were found to have a higher percentage of moderate to severe depression(51%)(p=0.007). Marital status was found to be associated with depression as single respondents were more likely to have moderate to severe depression (p=0.052) with 54%. SDOH including gender, income, marital status, and nationality are associated with depression. Having a comprehensive system focusing not only on mental health services but also on the social determinants of mental health is very important. Future research is needed to understand the association between depression and SDOH in Saudi Arabia. The study results can help policymakers determine the areas that require improvements.

Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Hemodialysis Patients at Kano Kidney Center.

Background Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections are more prevalent in hemodialysis patients compared to the general population. The objective of this study was to evaluate the prevalence of HBV, HCV, and HIV infections in hemodialysis patients dialyzing regularly at Kano Kidney Center (KKC) in the Eastern Health Cluster of Saudi Arabia in 2022. Methods This retrospective study included all hemodialysis patients who were dialyzed regularly at KKC during 2022. Their electronic medical records were reviewed for the results of HBV, HCV, and HIV along with the patient's demographics, comorbid conditions, and dialysis history. The study was approved and monitored by the Institutional Review Board of Dammam Medical Complex. Results A total of 239 regular hemodialysis patients were included, consisting of 142 males and 97 females (59.41% and 40.59%, respectively), with a mean age of 52.71±15.83 years. Most of the patients were Saudis (156 patients, 65.27%) with the non-Saudi patients being composed mostly of Arabian patients.Nine patients (3.77%) tested positive forhepatitis B surface antigen (HBsAg), the serologic hallmark of HBV infection. Two patients (0.84%) had resolved HBV infections as evidenced by positive hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs). However, the majority (226 patients, 94.56%) were never tested for anti-HBc. Anti-HBs, which can imply long-term immunity against HBV from prior immunizations or infections, were positive in 165 patients (69.04%). A protective anti-HBs level of ≥ 10 IU/L was detected in 158 patients (66.11%) including 104 patients (43.51%) having ≥ 100 IU/L. Eighteen patients (7.53%) had reactive HCV antibodies. Four patients (1.67%) had chronic HCV infection as they had detectable HCV RNA. The remaining 14 patients (5.86%) cleared HCV either spontaneously (seven patients, 2.93%) or by medications (seven patients, 2.93%). HIV screening tests were negative in all 239 patients (100%). HBsAg-positive patients did not have any statistically significant differences from HBsAg-negative patients. On the other hand, the patients who were positive for HCV antibodies were older than the patients who were negative for HCV antibodies (60.66 vs 52.05 years on average, p-value <0.05). They also contained a statistically larger proportion of non-Saudi patients than the patients with no evidence of prior infections (61.11% vs 32.13%, p-value <0.05). Conclusions The study found that the prevalence of HBV and HCV infections among hemodialysis patients in KKC at 3.77% and 1.67%, respectively, is higher than that reported in the general populationin Saudi Arabia, with non-Saudis having a higher prevalence rate of HCV infection than Saudis.However, the current prevalence rate is lower compared to the previous studies that were conducted in Saudi Arabia in the first decade of the 21st century, and there were no cases of HIV infections. Nevertheless, a significant proportion of patients had unprotective or negative anti-HBs antibody titers, indicating the need for strict vaccination protocols and monitoring of antibody titers to ensure optimal protection.

Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor.

(1) Background: Disparity in clinical care on the basis of gender, socioeconomic status, ethnic and racial variation is an established phenomenon. The focus on health disparities was led on by the report of the Secretary's Task Force on Black & Minority Health, which emphasized that the burden of death and illness was in excess among black people and other minorities. In Saudi Arabia, cardiac health care is being provided to a heterogeneous group of patients during pilgrimage time. This mixed population comprises different socio-economic backgrounds, demographics, ethnicities and languages. This study was carried out to assess for any disparities in cardiac surgical outcomes after isolated CABG surgery between Saudi citizens and non-Saudi patients. (2) Methods: The data of 2178 patients who underwent isolated coronary artery bypass surgery at King Abdullah Medical City from December 2014 to July 2020 were extracted. Patient demographics, clinical features, comorbidities, diagnoses, surgical procedures, complications, length of hospital stay and mortality were included in the data. The primary outcome was mortality after coronary artery bypass grafting surgery. (3) Results: A total of 2178 isolated CABG procedures were conducted during the study period with almost 57.5% of patients being Saudi citizens in comparison with 42.5% of non-Saudi citizens. The male gender represented the majority of the population, with a total of 1584 patients, representing 72.7% of the total study population. The rate of mortality had no statistical significance with the mortality rate of 5% vs. 5.3% (p < 0.786). The postoperative morbidities were comparable for all the parameters except for postoperative extracorporeal membrane oxygenation (ECMO). (4) Conclusions: In the present study, the chances of survival and postoperative outcomes are not associated with nationality per se, but with underlying comorbidities.

Waiting time and patients' satisfaction in the emergency department in Taif city, Saudi Arabia

Background: Patients' satisfaction in emergency departments (EDs) could be improved by providing estimates of the expected waiting time. Aim: The aim of this study was to determine waiting time and assess patients' satisfaction in EDs. Setting and Design: A descriptive, cross-sectional study was carried out in Taif city included patients who come to EDs of three main hospitals throughout the period from mid-August to mid-September 2022 if they aged from 18 to 65 years. Materials and Methods: Data were collected through a pretested Arabic version of the Brief Emergency Department Patient Satisfaction Scale questionnaire. Statistical Analysis: Data were entered into the Statistical Package for the Social Sciences (SPSS) software version 26 for Windows. Results: The study included 612 patients. Almost a quarter (23%) aged 25–34 years. Regarding satisfaction of patients with ED, the highest score was observed concerning physicians' care (4.31 ± 0.88) whereas the lowest satisfaction score was reported regarding arrival in reception (AIR) (3.57 ± 1.08). The highest score was observed among those who attended King Faisal Medical Complex (4.19 ± 0.74), whereas the lowest score was observed among those who attended Alhada Armed Forces Hospital (3.75 ± 0.91), P &lt; 0.001. The highest score of satisfaction was observed among patients aged 65 years/above (4.08 ± 0.76), P = 0.041. Non-Saudi patients were more likely to be satisfied compared to Saudi patients (4.33 ± 0.77 vs. 3.89 ± 0.87), P &lt; 0.001. Patients who did not read/write were more likely to be satisfied compared to educated patients (4.23 ± 0.83 vs. 3.89 ± 0.87), P = 0.001. The waiting time exceeded 2 h among 13.9% of patients. With decreasing the waiting time, the patients' satisfaction with ED was increasing, P &lt; 0.001. Conclusion: The overall patients' satisfaction with ED was high; it was lowest regarding AIR. In addition, longer waiting time was associated with patients' dissatisfaction.

Correlation of Lactate Dehydrogenase Level with Severity of Disease and In-hospital Outcome in Individuals Diagnosed with COVID-19: A Retrospective Study

Introduction: The presence of tissue damage in the lungs, kidneys, heart, or other organs can be detected by monitoring the level of Lactate Dehydrogenase (LDH) in the blood and considered a reliable biomarker in early prediction of patients’ prognosis. Aim: To determine extent of correlation between LDH level with the spectrum and in-hospital outcome of Coronavirus Disease2019 (COVID-19) infected patients. Materials and Methods: This retrospective research was undertaken during March 2020 to May 2020, based on the data of 205 COVID-19 infected patients, reported at Dammam Medical Complex, Dammam, Eastern Province, Saudi Arabia. Patients’ records were retrieved and the following data were recorded-age, gender, nationality, co-morbidities, lactate dehydrogenase level, number of days since the patient tested positive (Up to 7,14 and &gt;14 days), COVID-19 symptoms [mild, moderate, or severe as per British Thoracic Society guidelines (CURB (Confusion, Blood Urea Nitrogen, Respiratory Rate, Blood Pressure)-65)]. The data was collected and tabulated as mean±SD, frequency and percentages. Analysis was carried out using specialized software of Statistical Package for Social Sciences (SPSS) version 20.0. Results: On analysis of the collected data of all 205 included patients, the LDH level was found significantly high among males, 46-60 years old, and among non-Saudi patients. The severity of COVID-19 symptoms and LDH levels were found to have a strong relationship (p-value&lt;0.001). Patients between the ages of 46 and 60 were more likely (4.3 times) to have poor outcomes, and diabetes mellitus was predicted to be 2.32 times more likely to be associated with poor COVID-19 outcomes. Raised LDH levels were &gt;5 times more likely to lead to in-hospital poor outcomes compared to those with borderline LDH levels. Conclusion: LDH level is a reliable predictor for the cause of COVID-19. The results of the present study suggest that patients aged 46-60 years, diabetic patients, or those suffering from severe symptoms of COVID-19 have raised levels of LDH.

Correlation of Lactate Dehydrogenase Level with Severity of Disease and In-hospital Outcome in Individuals Diagnosed with COVID-19: A Retrospective Study

Introduction: The presence of tissue damage in the lungs, kidneys, heart, or other organs can be detected by monitoring the level of Lactate Dehydrogenase (LDH) in the blood and considered a reliable biomarker in early prediction of patients’ prognosis. Aim: To determine extent of correlation between LDH level with the spectrum and in-hospital outcome of Coronavirus Disease2019 (COVID-19) infected patients. Materials and Methods: This retrospective research was undertaken during March 2020 to May 2020, based on the data of 205 COVID-19 infected patients, reported at Dammam Medical Complex, Dammam, Eastern Province, Saudi Arabia. Patients’ records were retrieved and the following data were recorded-age, gender, nationality, co-morbidities, lactate dehydrogenase level, number of days since the patient tested positive (Up to 7,14 and &gt;14 days), COVID-19 symptoms [mild, moderate, or severe as per British Thoracic Society guidelines (CURB (Confusion, Blood Urea Nitrogen, Respiratory Rate, Blood Pressure)-65)]. The data was collected and tabulated as mean±SD, frequency and percentages. Analysis was carried out using specialized software of Statistical Package for Social Sciences (SPSS) version 20.0. Results: On analysis of the collected data of all 205 included patients, the LDH level was found significantly high among males, 46-60 years old, and among non-Saudi patients. The severity of COVID-19 symptoms and LDH levels were found to have a strong relationship (p-value&lt;0.001). Patients between the ages of 46 and 60 were more likely (4.3 times) to have poor outcomes, and diabetes mellitus was predicted to be 2.32 times more likely to be associated with poor COVID-19 outcomes. Raised LDH levels were &gt;5 times more likely to lead to in-hospital poor outcomes compared to those with borderline LDH levels. Conclusion: LDH level is a reliable predictor for the cause of COVID-19. The results of the present study suggest that patients aged 46-60 years, diabetic patients, or those suffering from severe symptoms of COVID-19 have raised levels of LDH.

Prevalence of periodontitis based on retrospective radiographic evaluation at dental hospital in Eastern Province of Saudi Arabia: A retrospective study

ObjectivesThe contemporary information on the prevalence of periodontitis and associated risk factors is deficient in the Kingdom of Saudi Arabia. Our aim was to measure the prevalence of periodontitis and associated risk factors among the Saudi population in the Eastern Province of Saudi Arabia who visited the University Dental Hospital. MethodsIn this retrospective study, the demographic data and medical and dental records of 700 subjects were examined. Bitewing radiographs were analyzed to measure the alveolar bone loss in posterior teeth by measuring the distance between the cementoenamel junction and the crest of the alveolar bone. A chi-square test was performed to compare the severity of periodontitis. A comparison of multivariate mean bone loss was performed using a t-test. Logistic regression analysis was used to evaluate the predictors of periodontitis. A P-value equal to or under 0.05 reflected statistical significance. ResultsAmong 700 cases, the patients’ mean age was 35.6 ± 12.1; 52.6 % were male and 47.4 % were female. Overall periodontitis prevalence was 52.1 %. The distribution of mild, moderate, and severe periodontitis prevalence was 36.1 %, 14.1 %, and 1.8 %, respectively. The severity of periodontitis was statistically similar between males and females (p = 0.148); however, significantly more Saudi than non-Saudi patients had moderate periodontitis. Higher proportions of severe periodontitis were seen in the age group of over 50-years-old (p < 0.001) and in patients with poor oral hygiene (p < 0.001), diabetes mellitus (p < 0.005), and hypertension (p < 0.002). Six total predictors of periodontitis were depicted, i.e., age > 50 years (OR = 3.73), poor OH status (OR = 2.24), BOP (OR = 3.35), presence of plaque (OR = 2.61), diabetes mellitus (OR = 3.19), and hypertension (OR = 3.62). ConclusionThe primary factors associated with the prevalence of periodontitis were age, nationality, diabetes, hypertension, BOP, plaque, and OH status. However, no association was observed between gender or cardiovascular disease and the prevalence of periodontitis in the studied population.

Intracerebral Hemorrhages Related to Clinical Conditions and Associated Outcomes Among Saudi and Non-Saudi Patients in a University Hospital: A Retrospective Study.

Objective: Intracerebral hemorrhage (ICH) is the second most common subtype of stroke. The objective of this study was to identify differences between Saudi and non-Saudi patients regarding demographics, clinical conditions, and associated ICH outcomes. Methods: This retrospective study included patients with ICH (ICD-10 code I61) admitted to a university hospital in Saudi Arabia from April 2014 to April 2019. ICH prevalence patterns were divided into 4 age groups: aged < 60, 60–69, 70–79, and ≥ 80 years. Patient data were collected from the hospital stroke registry. Several outcomes were investigated including death, modified Rankin Scale (mRS) score, external ventricular drain (EVD), and hemicraniectomy. The influence of various demographic and risk factors was studied for each outcome using several analytic techniques. Results: Of 148 patients, 53% were Saudi and 47% were non-Saudi. Death was reported in 28% of patients and was influenced by many factors including impaired renal function test (> 1.2 mg/dL in females and > 1.4 mg/dL in males) and hematoma size expansion. An unfavorable mRS score after ICH was influenced by impaired renal function test, Glasgow Coma Scale score, and smoking history. EVD insertion was influenced by intraventricular extension of hematoma and being non-Saudi. Hemicraniectomy procedures were associated with impaired renal function test. Conclusion: Non-Saudi ICH survivors had significant intraventricular extension of hematoma and required more neurosurgical interventions such as EVD procedures compared to Saudi patients. Both groups had associated comorbidities that may influence the incidence of ICH. Appropriate medical care to prevent stroke complications, especially for the older male population, as a strategy for secondary prevention of such neurologic sequelae is recommended.

Assessment of satisfaction level among patients toward services provided by dental clinics: A cross-sectional study

Background: Although, patient satisfaction is an important factor of the quality of health care, few studies have been conducted in Saudi Arabia to assess the satisfaction of patients toward health care services in dental clinics. Thus, in this study we aim to assess patient satisfaction with healthcare services in the dental clinics in Saudi Arabia using The Patient Satisfaction Questionnaire Short-Form (PSQ-18). Methodology: This is a cross-sectional study that was conducted among patients who were admitted to dental clinics in order to assess the satisfaction level toward health services using The Patient Satisfaction Questionnaire (PSQ-18) that was distributed among the participants using online Google sheets. Results: In this study, we were able to collect data from 300 patients who went to private and governmental dental clinics and who agreed to participate in this study. Among the participants, 37.3 % were younger than 30 years old and 71.0 % of the participants were females and 96.3 % of the participants were Saudi Arabian. In general, 54.3 % of the participants were satisfied with the health service provided by the dental clinics. The results of the study showed that age was a significant factor affecting the satisfaction level of the participants (P=0.001) while there is no significant difference between genders considering satisfaction (55.42 vs 54.35). Furthermore, higher education of the participants was associated with higher level of satisfaction (P=0.002) where housewives reported the lowest level of satisfaction and students had the highest level of satisfaction (P=0.005). There is no significant difference in satisfaction between participants depending on type of clinics (P=0.963), type of the visit (P=0.841), waiting time (P=0.45), distance of the dentist (P=0.082) or location (P=0.124). Conclusion: This study showed slightly more than half of the patients of dental clinics were satisfied with health services provided by the clinics especially considering technical aspects. Older patients, non-Saudi patients, less educated patients, and those with lower income showed lower level of satisfaction. Keywords: satisfaction, dental clinics, Saudi Arabia

Assessment of satisfaction level among patients toward services provided by dental clinics: A cross-sectional study

Background: Although, patient satisfaction is an important factor of the quality of health care, few studies have been conducted in Saudi Arabia to assess the satisfaction of patients toward health care services in dental clinics. Thus, in this study we aim to assess patient satisfaction with healthcare services in the dental clinics in Saudi Arabia using The Patient Satisfaction Questionnaire Short-Form (PSQ-18). Methodology: This is a cross-sectional study that was conducted among patients who were admitted to dental clinics in order to assess the satisfaction level toward health services using The Patient Satisfaction Questionnaire (PSQ-18) that was distributed among the participants using online Google sheets. Results: In this study, we were able to collect data from 300 patients who went to private and governmental dental clinics and who agreed to participate in this study. Among the participants, 37.3 % were younger than 30 years old and 71.0 % of the participants were females and 96.3 % of the participants were Saudi Arabian. In general, 54.3 % of the participants were satisfied with the health service provided by the dental clinics. The results of the study showed that age was a significant factor affecting the satisfaction level of the participants (P=0.001) while there is no significant difference between genders considering satisfaction (55.42 vs 54.35). Furthermore, higher education of the participants was associated with higher level of satisfaction (P=0.002) where housewives reported the lowest level of satisfaction and students had the highest level of satisfaction (P=0.005). There is no significant difference in satisfaction between participants depending on type of clinics (P=0.963), type of the visit (P=0.841), waiting time (P=0.45), distance of the dentist (P=0.082) or location (P=0.124). Conclusion: This study showed slightly more than half of the patients of dental clinics were satisfied with health services provided by the clinics especially considering technical aspects. Older patients, non-Saudi patients, less educated patients, and those with lower income showed lower level of satisfaction. Keywords: satisfaction, dental clinics, Saudi Arabia

Influence of demographic characteristics, tooth loss, and tooth wear on condylar movements: Cross-sectional study

ObjectivesThe study’s aim was to assess and compare the values of the sagittal condylar angle (SCA), the Bennett angle (BA), and the immediate side shift (ISS) between fully dentate and partially dentate patients, male and female patients, and Saudi and non-Saudi patients. The study also aimed to statistically analyze the correlation of the different condylar movements with tooth loss and tooth wear. Materials and MethodsUsing the electronic pantograph (Cadiax Compact II), the SCA, BA, and ISS were recorded at a 10-mm condylotrack distance in dentate and partially dentate patients, from both genders, older than 20 years, medically stable, and with normal temporomandibular joint movements and normal activity of masticatory muscles. The recorded average values were compared between the groups using an unpaired t-test. ResultsThe average condylar movements between dentate (n = 57) and partially dentate (n = 39) groups revealed no significant differences concerning right SCA, left SCA, right BA, right ISS, and left ISS. However, the left BA showed significant differences (P = 0.011) in the dentate compared with the partially dentate group. Gender (male: n = 24, female: n = 72) showed no statistical significance between groups when measuring SCA, BA, or ISS. When comparing Saudi (n = 78) with non-Saudi patients (n = 18), it was found that the mean right SCA was significantly higher in Saudi than in non-Saudi patients (P = 0.024). Condylar inclination values in relation to tooth wear showed no statistical significance (P > 0.05), except left ISS, which was significantly higher among those who had tooth wear (P = 0.040). ConclusionTooth loss had a major impact on the left BA, while patients with tooth wear had a significantly increased ISS on the left side.

Traumatic Spinal Injuries in Saudi Arabia: A Retrospective Single-center Medical Record Review

Introduction: The aim of this retrospective medical record review was to describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary care trauma center in Riyadh, Saudi Arabia.&#x0D; Methodology: Data of all patients who presented at a setting level-1 trauma center with any type of spinal trauma between February 1, 2016 and December 31, 2018 were review. The data obtained included age, gender, nationality (as Saudi and non-Saudi), date of presentation, site of fracture/injury, associated injuries, mechanism of injury, presence of neurological involvement, and hospital mortality. The main outcome of the review was frequencies of different types of TSI across various subgroups.&#x0D; Result: We identified 692 patients who presented with TSI during the study period. The mean age was 36.9 years. Males represented 83.2% (n = 576) of the sample size, and the most common mechanism of injury was motor vehicle collision (MVC), accounting for 66.8% of the cases (n = 462), while fall-related injuries were seen in 31.6% of the cases (n = 219). A total of 454 (65.6%) of all patients were Saudi, and 332 (73.1%) of the TSIs in Saudis were due to MVC. Non-Saudi cases accounted for 238 (34.4%) of all patients, and 89 (37.4%) of the non-Saudi injuries were due to falls from height, this association was statistically significant (p &lt; 0.001).&#x0D; Conclusion: TSI was not thoroughly examined in Saudi Arabia; therefore, this study is considered the first to be done in the Kingdom using a representative sample. The fact that non-Saudi patients had a higher proportion of falls as a mechanism of injury should be taken into consideration in terms of raising awareness and taking more safety precautions, as most construction workers tend to be expatriates.

CUTANEOUS LEISHMANIASIS INFECTION AMONG PATIENTSIN AL-MADINA AL-MUNAWARAH, KSA

Background: Cutaneous leishmaniosis (CL) is a major tropical infection of public health importance. It is caused by a group of protozoanintracellular parasites.Coinfected individuals with Leishmania-HIV have high risk of having a complete clinical illness and high recurrence rates and mortality. Antiretroviral therapy lowers disease onset, delays relapse, and boosts coinfected patients survival. In Brazil, Ethiopia and the Bihar region in India, high Leishmania-HIV coinfections are recorded.CL is considered as a distinct public health hazard due to the catastrophic effects on the patient. With an estimated yearly average rate of 321,300 cases, in the Middle East and throughout central Asia, CL is endemic. Among the countries of this region, Saudi Arabia has reported an estimated incidence between 9600 and 15,800 cases per year as the fourth endemic focus on zoonotic CL in Afghanistan, Iran and Pakistan. Objective: our present retrospective investigation aims to describe the epidemiology profile of CL in Madinah province. Methods: Human data were collected from the dermatology service of AL-Meqat Hospital. Results: A total of 203 cases of CL confirmed were examined. The seasonal distribution of the phlebotomine fly is followed by cutaneous leishmaniasis. Non-Saudi patients are reported to be more infected with CL (145) than Saudi individuals (58). Conclusion: This study indicates that CL is endemic in Al-Madinah Almonawarah region.CL is a major health problem occur in variable clinical forms.

Determinants of intensive care unit admission of hospitalized patients with COVID-19 in Saudi Arabia: An analytic retrospective cohort

Background: In March 2020, Saudi Arabia (KSA) experienced a coronavirus disease 2019 (COVID-19) outbreak. The mitigation strategy aimed to reduce both the impact on vulnerable groups and the risk of admission to the intensive care unit (ICU). Risk factors, such as sequential organ failure, comorbidities, ventilation, and mortality, have not been described in different settings of care. Materials and Methods: A multicenter, retrospective chart review of 220 adults with COVID-19 admitted to the ICU included demographics and ICU admission factors (e.g., quick sequential organ failure assessment (qSOFA) score, ventilator status, comorbidities, days from laboratory confirmation to ICU admission, and days from hospitalization to ICU admission). Regression was utilized to identify predictors of need for mechanical ventilation (MV) and mortality in ICU patients. Results: ICU admission, COVID-19 hospital mortality, and ventilator-associated mortality rates were 26.5%, 44%, and 30.5%, respectively. The mean patients' age was 30 years. Across four cities, Jeddah patients were at the highest risk of MV (&lt;0.001). Within the 1st day of hospitalization, without lymphocytopenia, non-Saudi patients with a qSOFA score of 2 and 3 were at the highest risk of ventilation (odds ratio [OR], 3.9; 95% confidence interval [CI], 1.72–8.66; OR, 11.4; 95% CI, 2.35–55.47; and OR, 6.1; 95% CI, 1.0–37.33, respectively). Moreover, within the same period of hospital stay, mechanically-ventilated patients with a qSOFA score of 3 who received antiviral medications were significantly at the higher risk of death (OR, 2.8.4; 95% CI, 1.44–5.64; OR, 13.1; 95% CI, 1.23–39.68; and OR, 2.2; 95% CI, 1.14–4.14, respectively). Conclusions: The 1st day of hospitalization, along with an assessment of the dyspnea status using the qSOFA score, is the window of opportunity for minimizing ICU admission risk. Neither lymphocytopenia nor comorbidities are associated with the risk of mechanical ventilation. Factors were also discussed. Reviews are needed on the indications for the use of antiviral agents, intubation, and ventilation in hospitalized patients.

Functional multigenic variations associated with hodgkin lymphoma

The current study aimed to describe genotypes associated with Hodgkin lymphoma (HL) in a cohort of Saudi and non-Saudi patients and discuss their possible susceptibility to HL. We studied clinical, histopathological, and laboratory findings of HL patients admitted over 12years duration, at King Fahd University Hospital, KSA. The genomic DNAs of HL patients (n=61) and normal control subjects (n=36) were extracted, and genotyping was performed using the Illumina human exome bead chip. Set of HL patients and set of normal controls were included in this study. A total of 35 DNA variants were found to be highly significant with the P-value <9.90×10-11 among 243345 exonic biomarkers and obeying the Hardy-Weinberg equilibrium. Nine, MEGF11-rs150945752 (P-value 1.20×10-12 ), CACNA1I- s58055559 (P-value 1.93×10-12 ), DECR2-rs146760080 (P-value 2.19×10-12 ), STAB1-rs143894786 (P-value 2.45×10-12 ), ZNF526-rs144433879 (P-value 2.76×10-12 ), CPLANE1-rs200612080 (P-value 3.77×10-12 ), DLK1-rs1058009 (P-value 5.95×10-12 ), RTN4RL2-rs61745214 (P-value 7.71×10-12 ), and PGRMC1-rs145582672 (P-value 8.56×10-12 ), exonic variants on chromosomes 15, 22, and 16 were highly associated with HL cases. THE HIGHLY SIGNIFICANT HAPLOTYPES AT CHROMOSOME 3: rs143894786G; rs149982219G with P-value=3.43×10-14 was found to be the risk haplotype for the HL patients. The opposite alleles at chromosome 3: rs143894786A; rs149982219G is protective with P-value=2.46×10-12 . Maximum number of SNPs at the chromosome 19: rs144433879C; rs181265966G; rs201144421C; rs145591797G; rs200560875G; rs77270337G (risk P-value=2.24×10-12 ) and its opposite allele rs144433879A; rs181265966A; rs201144421T; rs145591797A; rs200560875A; rs77270337A (protective P-value=2.60×10-9 ) were found to be associated haplotype with the HL and controls, respectively, in Saudi population. Our study concludes that the HL is genetically heterogeneous with multigene causation.