Saudi Arabian Hospital Research Articles

Enhance Staff Nurses' Proficiency And Knowledge In Wound Assessment And Management Using The NERDS & Stones Technique

Aim: This study aims to enhance the knowledge and proficiency of staff nurses in wound assessment and management using the NERDS & STONES technique through targeted educational interventions and hands-on training. Methods: A quasi-experimental, one-group pre-and post-test design was used. A total of 89 registered nurses from one hospital in Saudi Arabia participated in the study. The intervention consisted of lectures, hands-on workshops, and case study discussions. Pre- and post-intervention data were collected using the Wound Care Knowledge Assessment Tool, which measured nurses' knowledge of wound assessment and infection identification. Paired-sample t-tests were conducted to compare pre-and post-intervention scores. Results: The results showed a significant improvement in nurses' wound care knowledge after the educational intervention using the NERDS & STONES technique. The pre-intervention mean score was 4.44 (SD = 1.74), which increased to 5.98 (SD = 2.13) post-intervention, with a mean difference of -1.54 (SD = 3.12). A paired ttest revealed a statistically significant increase in knowledge (t = -4.66, p < 0.001). The effect size, as measured by Cohen’s d, was 0.494, indicating a medium effect of the intervention. Conclusion: The educational intervention using the NERDS & STONES technique significantly improved nurses' wound care knowledge, demonstrating the effectiveness of targeted training. These findings highlight the importance of structured educational programs in enhancing clinical skills and promoting better patient care outcomes.

Bridging cultural gaps in end-of-life care: the experiences of international charge nurses in Saudi Arabia

IntroductionThis qualitative study explores the experiences and perspectives of international intensive care unit charge nurses providing end-of-life care to Muslim patients in Saudi Arabia. It examines how these nurses navigate the complexities of delivering culturally sensitive care, particularly regarding Islamic beliefs and practices. The study also investigates the challenges encountered by international nurses due to differing healthcare expectations between themselves and patients’ families, highlighting the interplay between cultural sensitivity and effective end-of-life care in this unique context.MethodA qualitative descriptive design was employed, using semi-structured interviews to gather data from eight international ICU charge nurses working in a tertiary hospital in Saudi Arabia. Thematic analysis was used to analyze the interview transcripts.ResultsThis qualitative study explored the experiences of international ICU charge nurses in Saudi Arabia regarding culturally sensitive end-of-life care within Islamic traditions. Analysis revealed nine key themes and 31 subthemes reflecting the multifaceted nature of this sensitive domain. These themes encompassed intercultural anxieties, emotional burdens on families and nurses, the importance of bridging cultural divides, advocating for change in end-of-life care practices, and honoring diverse spiritual needs. Key findings emphasized the significance of family presence, honoring faith in the absence of family, and ensuring peaceful and compassionate passings, highlighting nurses’ commitment to holistic, patient-centered care that respects both cultural and individual beliefs..ConclusionThis study provides valuable insights into the cultural nuances of end-of-life care in Saudi Arabia. The findings underscore the importance of culturally sensitive practices that respect Islamic beliefs, prioritize family involvement, and address the holistic needs of patients and their families.ImplicationsThis study underscores the need for culturally sensitive communication training for healthcare providers working with diverse patient populations. Hospitals and healthcare institutions should prioritize educational initiatives that equip staff with the skills to engage in open dialogues about death and dying, navigate cultural differences in end-of-life preferences, and address the use of traditional healing practices. By fostering greater cultural understanding and communication competency, healthcare systems can better support both patients and families in navigating the complexities of end-of-life care.

The Effect of Service Quality on Patient Satisfaction at King Faisal Hospital in Saudi Arabia

The healthcare sector offers medical services to those in need of medical attention. Clinics, hospitals, and community health services are all part of the health services sector. One healthcare facility crucial to enhancing the general state of public health is the hospital. In the healthcare sector, achieving patient satisfaction depends heavily on service quality. As a result of the growing degree of competition, hospitals are becoming more conscious of how important it is to give their patients the highest caliber of care. Aim: to investigate the impact of Service Quality (SQ) on Patient Satisfaction (PSAT). Methodology: a quantitative cross-sectional correlational study, a convenience sample of 380 in-patients receiving treatment at a governmental hospital, King Faisal Hospital in Saudi Arabia. Data was collected by using two questionnaires: Service Quality (SQ) and patient satisfaction (PSAT) with data analysis conducted using Amoss26 and SPSS26. Conclusion: The findings revealed Service Quality (SQ) positively influenced patient satisfaction. Limitation: Since there are fewer studies on Service Quality (SQ) in the healthcare sector than in manufacturing industries, this research substantially contributes to existing literature and merits additional study. Furthermore, this research offers significant perspectives for managers in the healthcare industry about strategic planning and decision-making procedures.

Prognostic Significance of DSCC1, a Biomarker Associated with Aggressive Features of Breast Cancer

Background and Objectives: Invasive breast cancer (BC) was traditionally investigated visually, and no technique could identify the key molecular drivers of patient survival. However, essential molecular drivers of invasive BC have now been discovered using innovative genomic, transcriptomic, and proteomic methodologies. Nevertheless, few evaluations of the prognostic factors of BC in Saudi Arabia have been performed. Evaluating the biomarkers associated with the development of early-stage BC could help determine the risk of metastasis and guide treatment decisions. In a previous study, using large BC cohorts and artificial neural network techniques, DNA replication and sister chromatid cohesion 1 (DSCC1) was found to be one of the principal genes in invasive BC samples. To date, no studies have addressed the prognostic significance of DSCC1 in invasive BC and its association with aggressive tumor behavior. This research aimed to address this gap. Materials and Methods: The association of clinicopathological features and patient outcomes with DSCC1 expression at the mRNA level was assessed using the Molecular Taxonomy Breast Cancer International Consortium (METABRIC; n = 1980) and The Cancer Genome Atlas (TCGA; n = 854) cohorts. DSCC1 was also evaluated at the protein level using immunohistochemistry on samples from invasive BC patients (n = 100) presenting to King Abdul Aziz Specialist Hospital in Saudi Arabia. The association of clinicopathological parameters (including patient age, tumor grade, tumor size, and patient outcome) with protein level was also evaluated. Results: In both METABRIC and TCGA cohorts, high expression of DSCC1 was significantly associated with high histological grade, large tumor size, lymphovascular invasion positivity, and hormone receptor negativity (all p < 0.001). A high DSCC1 mRNA level was associated with poor outcomes (p < 0.001 for METABRIC, p = 0.23 for TCGA). At the protein level, high DSCC1 expression was associated with high histological grade (p = 0.001), lymph node presence (p = 0.008), hormone receptor negativity (p = 0.005), high Ki67 expression (p = 0.036), and shorter survival (p = 0.008). Conclusions: This study confirmed the prognostic significance of DSCC1 in invasive BC patients. DSCC1 could be a therapeutic target in BC cases with poor outcomes.

Nurses' attitudes towards safety and their association with nurses' perceptions of adverse events and quality of care: a cross-sectional study.

To explore nurses' attitudes towards safety and their association with nurses' perceptions of adverse events and quality of care in Saudi Arabian hospitals. A cross-sectional study using a web-based survey. A web-based survey was administered to nurses working in five hospitals in Saudi Arabia. Nurses' attitudes regarding safety, nurses' perceptions of the frequency of seven adverse events, and nurses' views on quality of care were collected. Descriptive and predictive analyses were performed. Nurses' attitudes regarding safety (n = 653) were classified as less than positive, with an overall score of 68.96%. The highest subscale mean score was for safety behaviour (73.1%), which was followed by job satisfaction (72.6%); the lowest subscale mean score was for working conditions (61.7%). Positive attitudes towards safety were associated with a lower frequency of pressure injuries, patient falls, healthcare-associated infections and unexpected deaths due to deterioration; positive attitudes towards safety were also associated with higher quality of care. Nurses' attitudes towards safety contribute to preventing avoidable adverse events and to improving quality of care. This study builds on the growing body of evidence that demonstrates fostering a strong safety culture is essential for improving patient outcomes.

Assessing the effect of implementing a central line care bundle on central line-associated bloodstream infections in a tertiary hospital in Saudi Arabia

Central line-associated bloodstream infections (CLABSIs) are severe bloodstream infections caused by catheter use and are often associated with a longer hospital stay, increased healthcare costs, and a higher mortality rate. However, catheter-related bloodstream infections can be successfully treated. It is essential that healthcare workers are aware of central line (CL) insertion and maintenance bundles to reduce and prevent the incidence of CLABSI. The objective of this study was to assess the impact of implementing CL care bundles on hospital-wide CLABSI incidence rates. This is a prospective study conducted at the King Faisal Specialist Hospital and Research Center in Saudi Arabia from January 2017 to December 2021. The research period was divided into two phases: the pre-intervention phase (January 1, 2017 to December 31, 2018) and the post-intervention phase (January, 2019 to December 31, 2020). During both phases, outcome variables, including CLABSI rate, were assessed. In the present study, the total number of CLABSIs is 439, of which 266 were in the pre-intervention phase and 173 were in the post-intervention phase. The overall CLABSI rate significantly decreased from 1.6±0.05 in the pre-intervention phase to 0.9±0.05 in the post-intervention phase. This decline in CLABSI was significant (p<0.0001) across all hospital settings, including critical care and non-critical care units. The implementation of care bundles is essential and has been shown to significantly reduce CLABSI rates in nearly all participating units.

Drivers to utilise evidence-based practice among nurses: A study in tertiary military hospital in Saudi Arabia

Nurses' knowledge, facilitators, and barriers related to Evidence-based Practice (EBP) are among the main issues that may determine the readiness of nurses to practice EBP it in their clinical settings. To identify factors that facilitated or hindered the adoption of EBP and to evaluate nurses' readiness to implement EBPs for evidence-based decision-making. The quantitative study involved 300 nurses currently working in the organization studied and used Rogers' diffusion of innovation theory to evaluate the factors that promote or hinder the implementation of EBP in their work settings. The data were gathered using a questionnaire and has been analyzed descriptively and inferentially, specifically using one-way ANOVA and regression analysis. Simple regression analysis showed a significant link between nurses' knowledge of EBP and facilitating factors on their readiness to implement EBP. Multiple regression confirmed that knowledge of EBP significantly influences nurses' readiness. While job positions had an insignificant impact, years of experience moderately influenced EBP readiness, and higher qualifications were positively correlated with readiness. The moderating effect of facilitating factors or barriers was not significant. The findings suggest that nurses' readiness to implement EBP is more influenced by their knowledge of EBP than by the barriers they face or the facilitating factors they receive. Nurses' knowledge towards EBP are crucial in determining their readiness to implement EBP in the healthcare settings. Hence, the healthcare organizations should emphasize improving their knowledge and ability to evaluate evidence by providing adequate education, training and support, develop protocols and guidelines and to fortify EBP readiness.

Challenges and barriers toward conducting research at a tertiary hospital in Saudi Arabia

Background: In healthcare, research is essential for improving disease diagnosis and treatment, patient outcomes, and resource management, while fostering evidence-based practice. However, conducting research in this sector can be challenging, and healthcare workers may face various obstacles while engaging in research activities. Therefore, understanding healthcare workers’ attitudes toward research participation is essential for overcoming barriers and increasing research engagement. In this study, these aspects are examined through the analysis of survey data from a tertiary healthcare institution in Saudi Arabia. Method: Data obtained via a survey conducted between April and November 2022 among the healthcare workers and employees at a tertiary care hospital in Saudi Arabia were analyzed using descriptive and bivariate statistics. Results: The study sample comprised 713 respondents, 61.71% of whom were female, 58.06% were 26–41 years old, and 72.93% had not undertaken any research as employees or affiliates. A significant association was noted between age group and time constraints (p = 0.004) and lack of opportunity for research (p = 0.00), which were among the identified barriers to research participation. A significant association was also found between gender and barriers to pursuing research (p = 0.012). When the 193 (27.07%) participants who conducted research were asked about the challenges they encountered during this process, gender was significantly associated with difficulties in allocating time for conducting research (p = 0.042) and challenges in accessing journals and references (p = 0.016). Conclusion: The study findings highlight the importance of addressing the barriers and challenges in promoting positive attitudes toward research participation among healthcare workers considering their gender and age. In this manner, healthcare institutions can adopt an environment conducive for professional research engagement.

Characteristics and outcomes of pediatric brucellosis cases collected from a tertiary academic hospital in Saudi Arabia

Brucellosis is a zoonotic disease caused by Brucella spp., affecting different body systems and leading to multiple complications. Although brucellosis is prevalent in several regions, including Saudi Arabia, limited research has focused on childhood brucellosis. This study aimed to characterize the features and outcomes of brucellosis in pediatric patients. We conducted a retrospective descriptive study involving children (<18 years) with confirmed brucellosis (diagnosed through culture, serology, or both) who received antibiotic therapy. Subjects were stratified into two groups based on age: younger (≤8 years) and older (>8 years). We assessed treatment outcomes, including clinical cure, mortality, and hospital length of stay. A total of 20 patients were included, with 52.3% in the younger group and 47.7% in the older group. The majority were male (65%), with a mean age of 8.9 years, and 45% required hospitalization. Out of all the patients, only 6 (30%) reported consuming dairy products. Serologically, the baseline median antibody titers for Brucella melitensis and Brucella abortus were 1:1280 and 1:640, respectively. In the younger group, half reported arthralgia and presented with fever. While white blood cell elevation was not significant, C-reactive protein, erythrocyte sedimentation rate, and liver enzymes were elevated at baseline. The administered regimen varied, but about half of the patients received at least three antibiotics. All patients experienced clinical cures, and there were no deaths. This study highlights the characteristics of pediatric brucellosis in a country where the disease is endemic and provides evidence of positive prognosis associated with appropriate antibiotic therapy.

Prevalence of Obesity and Its Associated Comorbidities in Adults with Asthma: A Single-Center Study in Saudi Arabia.

Background and Objectives: Asthma is associated with several comorbidities, one of which is obesity. The worldwide increase in obesity has been accompanied by a parallel rise in asthma prevalence, with obesity recognized as a significant risk factor for both the development and severity of asthma. Obesity is often linked to various comorbidities, which can complicate asthma management and lead to poorer clinical outcomes. This study aims to investigate the prevalence of obesity and its comorbidities in adults with asthma in a single center in Saudi Arabia, providing an overview of the associated health implications. Materials and Methods: This single-center, retrospective study aimed to assess the prevalence of obesity and other comorbidities in asthma patients. Data were collected from King Khalid University Hospital in Saudi Arabia between July 2023 and December 2023. Results: This study revealed that 72.1% of asthma patients were either obese or overweight. Female patients had significantly higher BMI values compared to males. Our study revealed that 38.21% of female asthma patients (mean age = 57 ± 13.85 years) had comorbidities compared to 24.14% of male asthma patients (mean age = 59 ± 14.02 years). Furthermore, the proportion of obese asthmatic patients with comorbidities was significantly greater than those without comorbidities. Conclusions: This study investigates obesity prevalence and associated comorbidities in adult asthmatics in a single center in Saudi Arabia. The findings reveal a 72.1% rate of obesity and overweight among asthmatic patients, with higher BMI and comorbidity prevalence in females. These results underscore the need for targeted interventions addressing obesity and comorbidities, especially in female asthmatics.

Emergency consultations to pediatric dermatology at a large children’s hospital in Saudi Arabia

Dermatology is commonly considered a non-urgent and outpatient-centered specialty. Limited studies have evaluated skin diseases presenting to the pediatric emergency department. This study aims to characterize the most common pediatric dermatological conditions prompting an emergency department visit between August 2018 and August 2023 in a large children’s hospital in Riyadh, Saudi Arabia. A total of 183 patients were included. The majority of patients were 2 years old and younger [87 (47.5%)]. Gender was almost equally distributed, with 51.4% of the population being females. Infectious and inflammatory disorders were the most commonly encountered conditions, accounting for 35.5% and 33.9%, respectively. The top three diagnoses were atopic dermatitis (12.02%), impetigo (6.56%), and infantile hemangioma (6.01%). Understanding the variety of skin disorders presented to pediatric emergency departments can positively enhance patient care in dermatology clinics and promote preventative public health initiatives, thus minimizing emergency department visits.

Healthcare Resilience in Saudi Arabia: The Interplay of Occupational Safety, Staff Engagement, and Resilience.

This research investigates the relationships between occupational health and safety (OHS), staff resilience (SR), staff engagement (SE), and organizational resilience (HOR) within Saudi Arabian hospitals. Employing a quantitative, cross-sectional design, data were collected from 127 administrative staff members working in both public and private hospitals in Saudi Arabia. Using SmartPLS to test the hypothesized relationships and mediation effects, the findings reveal that OHS significantly impacts both SR and SE, and SR significantly influences HOR. Additionally, SE significantly affects HOR. This study also confirms a partial mediation effect of SE and SR in the relationship between OHS and HOR. The model demonstrates substantial explanatory power for HOR, SE, and SR. These results underscore the critical role of OHS in fostering a resilient healthcare environment by enhancing staff engagement and resilience. This study's implications highlight the importance of targeted interventions to improve OHS practices, promoting overall hospital resilience in alignment with Saudi Arabia's Vision 2030.

Outcomes of clubfoot conservative treatment using the Ponseti technique in an academic hospital in Saudi Arabia

Objectives: Congenital talipes equinovarus (CTEV), commonly known as clubfoot, affects 1–4/1000 births, predominantly males. Without intervention, children face mobility limitations and deformities. Conservative treatment, particularly the Ponseti technique, which boasts a success rate exceeding 90%, is favored despite potential complications. Methods: This study aimed to assess the efficacy of the Ponseti technique through a retrospective analysis of idiopathic CTEV cases. Data on pre- and post-treatment Pirani scores were analyzed across variables including age, sex, number of casts, Achilles tenotomy, surgical intervention, and complications. Participants were categorized based on treatment outcomes to identify contributing factors. Results: Among 42 participants (69 feet), 62% were male, presenting at an average age of 9 weeks and receiving an average of 5.26 casts per patient. Pre-treatment Pirani scores averaged 4.52, significantly decreasing to 0.88 post-treatment. Feet managed without surgery demonstrated greater improvement in Pirani scores (mean change 3.888) compared to those requiring surgery (mean change 2.364), a statistically significant difference (P < 0.001). Acceptable outcomes were observed in 84.06% of feet. Percutaneous Achilles tenotomy was performed in 84% of cases. Surgical intervention was necessary in 15.94% of feet. Casting complications occurred in 14.49% of feet. Conclusion: This study confirms the Ponseti technique’s effectiveness in managing idiopathic CTEV, emphasizing early detection and initiation of conservative treatment. The early findings establish the Ponseti technique as the preferred initial approach for CTEV management.

The Manifestations and Complications of X-linked Hypophosphatemia in Saudi Arabia: A Retrospective Study

Background: X-linked hypophosphatemia (XLH) is a genetic disease of phosphate metabolism in which inactivating mutations of the phosphate regulating endopeptidase homolog, X-linked (PHEX) gene lead to local and systemic effects. In our pediatric clinics, XLH was observed to be associated with multiple complications despite conventional treatment. There is a need for novel treatment modalities to prevent disease progression and aid in the resolution of symptoms. Methods: This retrospective cross-sectional study aimed to understand the manifestations and complications of XLH in patients followed up at the endocrinology clinics in King Faisal Specialist Hospital and Research Center in Saudi Arabia. The study was conducted by reviewing the medical files of all XLH patients at the King Faisal Specialist Hospital and Research Center. Results: All the patients (N=24) who were included in this study had PHEX gene mutations. The mean age was 18.7 13.6 years and 68% were females. The mean height standard deviation score (HSDS) was ‑2.96 (-5.25 to -0.97) and 12 patients reached their final height (mean final HSDS, -3.28 [-1.39 to ‑5.39]). Skeletal deformities (mainly genu varum) were observed in 68% of the patients and 29% had craniosynostosis; 54% had undergone corrective osteotomy. Hyperparathyroidism was observed in 54% of the patients and 45% of the patients had nephrocalcinosis (grades 2/3). Conclusions: In our study, a majority of the XLH patients suffered from complications arising from the use of conventional therapy, thus indicating the need for novel treatment modalities for these patients. Additionally, no correlation between genotype and phenotype was found.

Patient Characteristics and Clinical Outcomes During the 2020-2021 COVID-19 Wave: An Observational Study at a Tertiary Hospital in Saudi Arabia.

Background and objective The continued prevalence and threat of coronavirus disease 2019 (COVID-19) have been reported, and evidence suggests that several people still get infected with the virus. Gaining a thorough understanding of the patient demographic factors and laboratory findings could contributeto assessing the severity, mortality, and progression of COVID-19. In light of this, the current study aimed to evaluate the demographic characteristics, laboratory findings, and outcomes of confirmed COVID-19 patients at a tertiary hospital in the Kingdom of Saudi Arabia (KSA). Methodology We collected data spanning the period 2020-2021 from the electronic health records of Al-Noor Specialized Hospital, Maincluding demographics (age, gender, and nationality), severity (i.e., ICU admission), length of hospital stay, mortality, and laboratory parameters. Results We observed an overall mortality rate of10.2% (338 of 3,307 patients). The mortality rate was significantly higher in males (n=210; 62.1%) and patients aged more than 70 years (n=91; 26.9%). Patients with blood group O comprised 131 (29%) of the 338 non-survivors, followed by those with A (n=85; 25.1%) and Bgroups (n=79; 23.4%). The mortality rate among ICU patients was 63.3% (n=214). Furthermore, the following laboratory findings showed abnormal mean values in terms of severity and mortality in COVID-19 patients: hemoglobin (HB) concentration, white blood cell (WBC) count, lymphocyte count (LC), C-reactive protein (CRP), creatinine (CREA), and uric acid (UA) levels. Conclusions Old age, male gender, and certain laboratory findings have a critical role inthe severity and mortality risk in COVID-19 patients. There was no significant association between blood type and the severity and mortality of COVID-19. Continuous monitoring based on these findings may be essential to managing COVID-19 patients.

The sensitivity and specificity of fine needle aspiration cytology in detecting thyroid malignancy according to Bethesda system at a teaching hospital in Saudi Arabia

ABSTRACT Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) aims to standardize the terminology and morphologic criteria associated with thyroid fine-needle aspiration cytology (FNAC) results while also providing corresponding risk assessments for malignancy. contributing to more consistent and standardized reporting of thyroid nodules and aiding clinicians in making informed decisions. Since then, it has been undergoing revisions and updates to further improve its utility and accuracy. Materials and Methods: This is a retrospective study conducted at a tertiary care center. All patients with a history of thyroid gland swelling who had previously undergone FNA were included. The procedure included cytopathologists performing FNAC for all cases of midline neck swelling. Demographic and histopathology data were correlated with the cytological diagnosis. Results: We included 288 cases. Of those, 234 (81.3%) were female and 54 (18.8%) were male. The presentation age range was 18–91 years. The most reported category was benign, which constituted 30.9% of the cases followed by malignancy (27.1%). As for thyroid lesions, papillary carcinoma was the most prevalent (43.6%). The correlation on cyto-histopathology was presented in every diagnostic category, showing high heterogeneity in diagnostic specificity and sensitivity. The overall diagnostic specificity and sensitivity were 56.05% (95% confidence interval [CI]: 47.92–63.95%) and 80.92% (95% CI: 73.13–87.25%), respectively. Positive and negative predictive values were 60.57% and 77.88%, respectively. Conclusion: Our data suggests that the TBSRTC system promotes similar sensitivity and specificity to those reported elsewhere. It standardizes reporting and improves communication between cytopathologists and clinicians.

Achievement of No Evidence of Disease Activity-3 with Oral Disease-Modifying Treatment in Patients with Relapsing-Remitting Multiple Sclerosis.

There is scant data regarding the use of oral disease-modifying treatments (oDMT) in patients with relapsing-remitting multiple sclerosis (PwRRMS) from Saudi Arabia. This study aimed to identify the response rate to oDMT in PwRRMS compared to interferon (IFN) in terms of achieving no evidence of disease activity-3 (NEDA-3). This retrospective study was conducted at a tertiary care hospital in Saudi Arabia and included all adult PwRRMS over a 2-year period who were on oDMTs or IFN for <1 year. The achievement of overall NEDA-3 and its components (namely, relapse, disability progression, and focal MRI activity) were assessed for each treatment. A total of 231 patients were included for the analysis of NEDA-3 status, of which 78 (33.8%) were on oDMTs (namely, dimethyl fumarate, teriflunomide, and fingolimod). NEDA-3 status was achieved in 51.3% (OR: 1.86, 95% CI: 1.28-2.71) of patients on oDMTs and in 32% of patients on IFN (OR: 0.72, 95% CI: 0.58-0.89) (P < 0.001). Compared to the IFN group, the oDMT group had significantly lower rates of clinical relapse (P < 0.001), disability progression (P = 0.004), and new focal MRI activity (P = 0.01). Patients on dimethyl-fumarate had higher odds of achieving NEDA-3 (OR: 2.18, 95% CI = 1.09-4.34; P =0.02) compared with those on fingolimod (OR 2.15, 95% CI = 0.70-6.58; P =0.16) and teriflunomide (OR: 1.53, 95% CI = 0.81-2.91; P =0.18). More than half of the patients with relapsing-remitting multiple sclerosis on oral DMTs achieved NEDA-3 status in this study. Significant differences were observed in NEDA-3 status parameters and achievement between patients on oral DMTs and interferon, with the likeliness being highest among patients treated with dimethyl-fumarate.

Types of nasal deformities in individuals seeking rhinoplasty at governmental hospital in Saudi Arabia.

This study explores the profound impact of nasal structure on individuals' self-image and emotional well-being, emphasizing the increasing popularity of rhinoplasty in Saudi Arabia, influenced by societal beauty standards portrayed on social media. The investigation aims to unravel the complex interplay between demographic factors, such as gender and age distribution, and prevalent nasal deformities in a cohort of 293 participants. This retrospective study at the University of Hail and King Khalid Hospital, Saudi Arabia, investigated nasal deformities in 293 participants aged 15-54. Ethical approval was obtained, and data, including bio-demographics and nasal deformities, were retrospectively reviewed. Statistical analyses, utilizing chi-square and Fisher exact tests, assessed associations, enhancing internal validity. The study targeted a diverse population, emphasizing ethical guidelines and systematic sampling. Our study of 293 participants revealed a prevalence of common nasal deformities. Dorsal hump deformity (59.0%) was the most prevalent, followed by external nasal deviation (54.6%). Significant gender differences were observed, with males more prone to external nasal deviation (65.6%), while decreased nasal tip rotation was more common in females (40.6%). Variations in nasal tip shape were statistically significant, with broad nasal tip shape more prevalent in females (35.2%). In conclusion, our study highlights the prevalence of common nasal deformities, emphasizing significant gender variations. These findings contribute to a deeper understanding of nasal anatomy, essential for informed decision-making in rhinoplasty.

Evaluating applied security controls for safeguarding medical device‐integrated electronic medical records

AbstractRationale, Aims, and ObjectivesMedical device‐integrated electronic medical records (MDI‐EMR) pose significant challenges in ensuring effective usage, data security and patient safety. The complexities of MDI‐EMR necessitate applying various security mechanisms to safeguard against cyber threats. Therefore, we evaluated cyber threats to MDI‐EMR and the effectiveness of applied security controls using a proposed framework from sociotechnical and risk assessment perspectives.MethodWe conducted a qualitative case study evaluation in a general hospital in Saudi Arabia using interviews, observation, and document analysis from the perspectives of major MDI‐EMR stakeholders, including healthcare providers, IT professionals and cybersecurity specialists.ResultsThe results showed the interplay among physical, technical and administrative security controls that maintained a secure posture of MDI‐EMR. The effectiveness of security controls is highly influenced by the staff's cybersecurity awareness and training. The perceived effectiveness of security controls varied among users, with some expressing satisfaction with the ease of use and reliability, while others highlighting challenges such as password complexity and access procedures. Understanding these diverse perspectives is crucial for tailoring security measures to meet the needs of different stakeholders effectively.ConclusionCollaboration among the key stakeholders is crucial for implementing security controls for MDI‐EMR. Balancing security measures with usability concerns is essential, as highlighted by challenges in implementing technical controls. A comprehensive approach encompassing physical, technical and administrative controls, continuous education and awareness initiatives are significant to empower staff in recognising and mitigating cyber threats effectively to safeguard medical data and ensure the integrity of healthcare systems.

Predicting blood transfusion needs in colorectal surgery at a university hospital in Saudi Arabia: insights into anemia, malnutrition, and surgical factors

BackgroundIn Saudi Arabia, nearly a quarter of a hospital’s blood supply is consumed in operating rooms. However, blood is a scarce resource, and its unavailability has led to the cancellation of many surgeries. This study aims to identify risk factors for perioperative blood transfusion in colorectal surgery, thus providing valuable insights for better blood management and transfusion planning.MethodsWe conducted a retrospective cohort study of patients who underwent colorectal surgery at King Abdulaziz University Hospital from 2013 to 2022. Data on patient demographics, comorbidities, surgical details, and transfusion outcomes were collected and analyzed. Statistical analyses included logistic regression to identify predictors of transfusion and over-transfusion.ResultsWe collected data from 434 patients. Women were almost twice as likely (OR = 1.98; 95%CI = 1.35–2.90) as men to receive one or more units of RBCs. Also more likely to be transfused were patients with a higher ASA score; a lower pre-operative serum hemoglobin (Hgb) level; and malignant disease as the reason for surgery (all p < 0.001). On multivariable analysis, receiving a transfusion of packed blood cells (RBCs) was statistically linked to volume of intra-operative blood loss and Hgb level (both p < 0.001); as well as to pre-operative body mass index (BMI), with patients who were under-weight and of normal weight most at risk, and patients with a BMI between 25 and 35 less likely to be transfused. Patients whose pre-operative serum Hgb level was 12 g/dL or higher were more than twice as likely to not receive a transfusion, while those with pre-operative Hgb levels from 8.0 to 9.9 g/dL were three times more likely than not to receive blood, and those with a pre-operative Hgb under 8.0 g/dL almost five times as likely as not.ConclusionsKey risk factors for perioperative blood transfusion in colorectal surgery are preoperative anemia, diabetes, low BMI, and significant blood loss. Addressing these through a multidisciplinary approach and the development of perioperative protocols may reduce transfusion needs. Future prospective studies are needed to validate these findings and refine transfusion risk assessments.