Tertiary Care Hospital In Riyadh Research Articles

Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study.

Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department. This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms. A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52%and upper gastrointestinal in 48% of patients. Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.

Antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated at tertiary care hospital in Riyadh, Saudi Arabia.

Staphylococcus aureus is an important human pathogen that has a major impact on public health. The objective of the present work was to determine the prevalence and the pattern of antibiotic susceptibility in S aureus (MRSA) isolates from the King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. The isolates were collected from different body sites of infection and the antibiotic susceptibility was confirmed on the Vitek 2 system. A total of 371 MRSA isolates from clinical samples were received over a 12-month period from January 2021 to December 2021. The results showed that infection was predominant among males (55.8%) and most of the isolates occurred in the older age groups, with a mean age of 43.7 years and an age span from <1 to 89 years old. The majority (34.5%) recovered from wound infection followed by (14.6%) from blood. We have observed peaks of MRSA infections during the autumn, especially in September and November. All MRSA isolates were resistant to Amoxicillin + clavulanic acid, Ampicillin, Imipenem, Oxacillin, Cloxacillin, and Penicillin while all isolates were sensitive to Daptomycin and Nitrofurantoin. Furthermore, Vancomycin was resistant in (0.3%) of MRSA isolates, and (2.9%) was resistant to Linezolid. The current study concluded that MRSA strains had developed resistance toward 24 tested antibiotics, including the previous effective drugs vancomycin and linezolid. Therefore, there is an urgent need for continuous review of infection control practices to prevent any further spread of resistant strains.

Lithium-Associated Hypothyroidism in a Specialized Lithium Clinic at a Tertiary Care Hospital in Riyadh, Saudi Arabia: A Retrospective Study.

Hypothyroidism is a common side effect of lithium use and is associated with a slower response to treatment and poorer long-term remission in patients with bipolar disorder. No studies have examined the prevalence of lithium-associated hypothyroidism or its associated factors in Saudi Arabia. We aimed to estimate the prevalence of lithium-associated hypothyroidism among psychiatric patients in a specialized lithium clinic at a tertiary care hospital in Saudi Arabia and to examine the possible risk factors for its development. This retrospective observational study included 117 participants. The prevalence of secondary hypothyroidism was 15%. The median duration between the start of lithium therapy and the first abnormal thyroid test result was 341 days. The multiple logistic regression showed that none of the studied variables, namely, sex, current age, age of lithium initiation, continuity on lithium, lithium level (≤0.5 mmol/L or >0.5 mmol/L), and prescription of as-needed medications, was significantly associated with secondary hypothyroidism. Our study also shed light on the possible clinical significance of baseline TSH levels in developing hypothyroidism secondary to lithium. Further multicenter studies with larger sample sizes are warranted to examine the generalizability of these results.

Prevalence of Latent Tuberculosis Infection Among Nurses Working in Critical Areas at a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Introduction Tuberculosis is a critical health issue worldwide.Most infected persons are asymptomatic and categorized as having a latent tuberculosis infection (LTBI). Healthcare workers (HCWs) are more prone to being infected with tuberculosis and should be enrolled in a screening program for early detection. Objectives The study aims to estimate the prevalence of LTBI among nurses working in critical areas which include adult intensive care units, pediatric intensive care units, emergency departments, oncology departments, dialysis departments, tuberculosis labs, isolation rooms, and cardiac center intensive care units. Methods A record-based cross-sectional survey measured the prevalence of LTBI among nurses working in critical areas at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. We reviewed the occupational health records of all nurses working in critical areas from June 1, 2021, to June 1, 2022. We recorded the data reviewed throughout the year in the Occupational Health Department at PSMMC. We excluded all participants with previously documented positive tuberculin skin test (TST) from the study. We analyzed the sociodemographic data, working years, working location, job title, and TST results. Results We included a total of 771 out of 2025 nurses in this study. Participants were mostly women (88%) and in the 26-35-year age group (67.7%). Most of the participants were originally from the Philippines (66.3%). The overall LTBI prevalence among nurses was 34.5%. The highest prevalence of LTBI was among nurses working in the cardiac intensive care unit (53.5%), and the lowest prevalence was among nurses working in the isolation department (8.9%; p-value <0.0001). Those who worked more in the hospital were significantly more infected with LTBI (p-value <0.04). Conclusion LTBI remains a significant health risk worldwide andin the Middle East as well as among HCWs. This underscores the necessity of comprehensive pre-hiring screening, annual screening, infection control protocols, and active management of HCWs with LTBI.

Burnout Among Intensive Care Units Physicians and Nurses at Tertiary Care Hospitals in Riyadh, Saudi Arabia

Introduction: Medical staff, particularly those working in the intensive care unit (ICU), are among the populations most vulnerable to stress and burnout. The objective of this study was to estimate and compare the prevalence of burnout among ICU physicians and nurses at tertiary care hospitals in Riyadh, Saudi Arabia. Methods: In this cross-sectional study, 159 ICU physicians and nurses from four tertiary hospitals in Riyadh, Saudi Arabia were included in the study. The study was conducted between July 2021 and March 2022. The participants were asked to complete a self-administered questionnaire consisting of two sections. The first section collected demographic data, while the second section focused on assessing burnout using Maslach Burnout Inventory™️ (MBI) for Medical Personnel. Results: The overall prevalence of burnout among all participants was 60%. The mean score for emotional exhaustion (EE) was 27.93 ± 12.14, for low personal accomplishment (PA), it was 29.62 ± 9.51, and for depersonalization (DP), it was 11.46 ± 6.71. Factors identified to be associated with burnout include age, gender, job rank and type, number of shifts per week, number of hours per shift and smoking status. Conclusion: The findings of this study highlight the high risk of stress and burnout among ICU staff, characterized by exhaustion, depersonalization, and a lack of accomplishment. It is crucial for critical care societies and policymakers to take proactive measures in developing policies aimed at addressing the underlying causes of stress and reducing burnout.

The Prevalence of Multidrug-Resistant Organisms in Patients with Surgical Site Infections in Riyadh, Saudi Arabia: A Cross-sectional Study at a Tertiary Care Hospital

Background: Multidrug-resistant (MDR) infections are a threat in patients undergoing surgery. This study was undertaken to determine the prevalence and possible predictors of MDR infections over a two-year period in patients with surgical site infection (SSI) at a tertiary care hospital in Riyadh, Saudi Arabia. Methods: We conducted a cross-sectional study from April 2016 to April 2018 by reviewing hospital records of patients with a diagnosis of SSI based on a physician report and laboratory findings. The isolation of MDR organisms (MDRO) from SSI was the primary outcome variable as well as other risk factors. Results: SSI was diagnosed in 55 out of 77 patients under study, with MDRO prevalence rate of 44%. Previous antibiotic use and hospitalization in the last 90 days were strongly associated with developing MDRO infection often due to ESBL producing Gram-negative bacterial pathogens. Superficial and deep incisional SSI were more frequent in patients compared to organ/space SSI. History of diabetes mellitus, duration of surgery and bacterial colonization at other body site also increased the likelihood of MDRO. Factors such as trauma, obesity, general anesthesia, and wound types were not found to increase the risk for MDRO. Conclusions: Our study identified recent antibiotic use and hospitalization as major risk factors for MDRO surgical site infections. Other predisposing factors include diabetes mellitus, duration of surgery and bacterial colonization. MDRO isolated include E. coli and Pseudomonas aeruginosa. Bacterial pathogens harboring multiple resistant mechanisms can complicate SSI adversely affecting clinical outcomes following routine surgical procedures.

Awareness of Medical Professionals Regarding Research Ethics in a Tertiary Care Hospital in Riyadh, Saudi Arabia: A Survey to Assess Training Needs.

Ethics is an essential component of human research, and knowledge and awareness of ethical guidelines are required to conduct research involving human subjects and ensure the participants' safety. To investigate medical professionals' and researchers' knowledge of national and international research ethics guidelines, key principles in human research projects, ethical issues in different types of research, the importance of informed consent, and institutional review boards. A cross-sectional study with 251 participants, including physicians, nurses, and researchers from three different research centers and hospitals in Riyadh city, was carried out using an electronic self-structured questionnaire. The sample size was estimated using OpenEpi, Version 3. The questionnaire contained six different sets of questions to analyze knowledge about research ethics and guidelines. The results were analyzed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). About 53.78% of the participants had received research ethics education, out of which 78.51% of the participants expressed the need for more training in research ethics education. The Belmont Report showed a high level of unawareness among nurses (88.3%), physicians (73.8%), and researchers (55.32%). Nurses had a high level of positive attitude about all the key principles of human research. The highest level of awareness of ethical issues in clinical trials and interventional studies was found among researchers (54%), and the lowest level of awareness was exhibited by nurses (19.32%). Nurses (74.34%) and physicians (62.79%) had the lowest positive attitudes about obtaining children's assent in pediatric research. Physicians and researchers had a higher awareness of the IRB than nurses. Researchers were well-versed in research ethics, regulatory guidelines, and ethical issues in various types of research, whereas nurses were enthusiastic about key principles in human research and the importance of informed consent. This study shows that a very low percentage of nurses have received research ethics education and emphasizes the critical importance of including research ethics education in nursing curricula, as the involvement of nurses in research is inevitable. This study also shows the lack of knowledge among nurses, researchers, and doctors about various international guidelines. It emphasizes the importance of adding regulatory guidelines to the curriculum and teaching them effectively to students. Also, periodic workshops should be conducted to enhance the practical knowledge of the professionals regarding the guidelines and guide them in overcoming the practical difficulties they encounter during their practice.

COVID-19 Infection Among Healthcare Workers at a Tertiary Healthcare Hospital.

SARS-CoV-2 or COVID-19 virus was the culprit of the global pandemic that began in 2019. With alarming mortality rates reaching sky-high worldwide, the virus prompted the masses to switch to online working. However, this was not feasible for healthcare workers (HCWs) exposed to a higher-than-normal risk of acquiring COVID-19 infection. This study aims to observe the prevalence of COVID-19 positivity among the various areas of a healthcare facility in Saudi Arabia. A cross-sectional study of positive employees among all departments at a tertiary care hospital in Riyadh, Saudi Arabia, such as administration, capital projects/facilities, and healthcare. The study included all hospital employees-permanent staff, rotating physicians, and trainees-who tested positive for COVID-19 between March20, 2020 and December 30, 2020. It was found that HCWs had the most significant number of infected individuals with nursing staff being the predominant demographic. This was followed by the capital projects/facilities departments, of which the environmental services staff were the most infected. It is pertinent that strict protocols be taken by hospital management to limit the spread of future infectious diseases within hospital settings. This includes the provision of personal protective equipment (PPE) and adequate education on its proper usage, alongside regular surveillance of staff with regard to adherence and early detection of symptoms.

COVID-19 Contact Tracing Experience at a Tertiary Healthcare Center in Saudi Arabia.

Introduction As of May 2023, the end of the pandemic, the cumulative number of COVID-19 cases reached more than 841,000 cases. Healthcare workers (HCWs) especially have been at the frontline during this pandemic and are at a higher chance of contracting COVID-19. Approximately half of all high-risk exposures were to healthcare personnel with COVID-19. While several tools for contact tracing were developed for the general public, contact tracing for infectious diseases in the healthcare setting is limited, and global testing of HCWs, or in-hospital digital tracing, is not performed in most facilities. The King Faisal Specialist Hospital and Research Center (KFSH&RC) collaborated with the Infection Control and Health Information Technology Affairs (HITA)to create an automated COVID-19 contact tracing tool specifically for HCWs who worked at the institute. This study aims to describe the contact tracing experience at KFSH&RC. Methods A retrospective study was conducted to describe the use of an automated tool that was developed to assist in the contact tracing process and that was to be used by KFSH&RC employees who had been in contact with a COVID-19-positiveindividual. This tool is utilized for the early identification of possible COVID-19 cases and risk stratification of the exposed individuals. The tool can be accessed through the KFSH&RC website; it also collects information about the COVID-19 exposure rate among the different departments such as administration, capital projects/facilities, and healthcare at a tertiary care hospital in Riyadh, Saudi Arabia Results The tool has been utilized 7,353 times by contact cases. Approximately 7% of those tested later developed a COVID-19 infection. When assessing the positivity rates per department, The Environmental Services Department had the highest positivity rate of 28.21%, followed by Health Information Technology and Analytics (HITA), and then the Central Transportation Department. Conclusion This study acts as the first of its kind to describe the successful use of the healthcare contact tracing system in one of Saudi Arabia's largest hospitals (KFSH&RC) and describe the infection trends in different departments of the hospital. Through the tracing system, the departments with the highest COVID-19 infection occurrences at the hospital were identified in a timely manner, and safety protocols were implemented.

Complications of Percutaneous Radiologic Gastrostomy Among Patients in a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Percutaneous radiologic gastrostomy (PRG) is the method of choice for patients incapable of ingesting nutrition orally. The complications related to PRG are classified into major and minor complications. This article presents the prevalence of major and minor complications of PRG among adult patients admitted to King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia between 2017 and 2018. This was a retrospective cross-sectional study, which included adult patients who underwent a new PRG intubation between 2017 and 2018 in KAMC in Riyadh, Saudi Arabia. The variables reviewed were the demographics, comorbidities, indications of tube insertion, major and minor complications, and mortality rates. A total of 105 patients who underwent PRG were covered in this study with a mean age of 69.2 + 20.4 years. The most common indications were neurogenic pharyngeal dysphagia (31%) and dementia (29%). Most of the complications reported were minor (40%)and major complications were found in 2%. The percentage of patients with both minor and major complications was 37%. The patients who had no complications made up 21%. Major skin complication was reported in 19 patients (18%), while leakage was the most occurring minor complication found in 49 patients (47%). The 30-day mortality was observed in five patients (5%) and one-year mortality was observed in 21 patients (20%), and none of them were related to the PRG tube. This study found that the PRG procedure had low rates of complications in KAMC. The majority wereminor complications, and the mortality rate was low with none being related to the tube itself. So PRG may be considered to be a relatively safe procedure.

Susceptibility pattern of multi-drug resistance Pseudomonas aeruginosa isolates from tertiary care hospital in Riyadh, KSA

ObjectivesPseudomonas aeruginosa is important pathogens commonly cause nosocomial infections. The occurrence of multi-resistant organisms (MROs) of Pseudomonas aeruginosa strains have been increased worldwide and limiting the therapeutic options. The MRO of Pseudomonas aeruginosa phenotype can be mediated by a variety of resistance mechanisms and highly versatile property to mutate. Therefore the our study aimed to evaluate the resistance pattern of Pseudomonas aeruginosa collected from Riyadh tertiary care hospital, Kingdom of Saudi Arabia. MethodsDuring the period from 2019 to 2021 clinical samples were collected from microbiology lab at King Khalid University Hospital and analysed for the antibiotic susceptibility pattern. ResultsSuggested that the rates of resistance for the three years were higher for isolates collected from patients older than 50 years if its compared with the strains collected from young age. A total of 1024 Pseudomonas aeruginosa isolates were collected during the last three years, the prevalence rate were 44.6%, 32.6% and 22.7% during the period of 2019, 2020, and 2021 respectively. Meanwhile, the highest percentages of multi drug resistance Pseudomonas aeruginosa strains were recovered from body fluids; about 38 (47.5%) out of 80 Pseudomonas aeruginosa isolates were MRO Pseudomonas aeruginosa. The rate of resistances showed that Imipenem was significantly higher in resistant among the clinical isolates (77.8%), then Meropenem (61%), Aztreonam (42%) and Ceftazidime (36%) than other antibiotics. Most of isolates were sensitive to colistin except (2.7%) were resistance. Moreover, antibiotic resistantbacteriahave beenobserved withincreasingfrequency over the pastthree years. ConclusionsThe current study reports that the susceptibility among P. aeruginosa isolates have been decreased in KSA, perhaps due to the massive use of antibiotics, the lack of adherence to approved infection control practices by hospitals, or due to the changes to the public health infrastructure.

Postpartum Depression at a Tertiary Care Hospital in Saudi Arabia: Prevalence and Associated Factors.

Objectives Postpartum depression (PPD) is a significant health concern associated with several risk factors. This study aims to assess the prevalence of PPD and its related factors in a tertiary care hospital in Riyadh, Saudi Arabia, specifically King Khalid University Hospital (KKUH). Methods A cross-sectional study was conducted of 187 females aged 18 to 50 years old who gave birth at KKUH. Data were collected from the same participants at two stages using the same questionnaire, which consisted of the Edinburgh Postnatal Depression Scale (EPDS) and demographic questions. In the first stage, the participants were selected randomly. The second stage included participants who scored less than 9 on the EPDS in the first stage and were asked to retake the questionnaire four weeks later. Results The prevalence of PPD found in this study was 50.3%, which is higher than in other studies that have been conducted in the country. Furthermore, factors such as sleep disturbances (p = 0.005), loss of interest in daily activities (p = 0.031), mood swings (p = 0.021), frequent bouts of sadness (p < 0.0001), and frustration or worry (p < 0.0001) were all found to significantly increase the risk of PPD. Conclusion This study demonstrates a high prevalence of PPD in women who delivered at KKUH. More studies with a more rigorous methodology are warranted.

Abdominal X-Ray Findings of Patients With Crohn's Disease Presenting With Acute Abdominal Pain.

The primary objective of this study is to describe the most common radiological findings found on abdominal X-rays of patients with Crohn's disease (CD) presenting with acute abdominal pain. A cross-sectional study was conducted at a tertiary care hospital in Riyadh. Data from CD patients who presented with acute abdominal pain between December 2016 and December 2021 was analyzed. A total of 144 abdominal X-rays met the inclusion and exclusion criteria and were included in the study. The medical records of patients who had the X-rays were subsequently reviewed for the presence or absence of follow-up imaging studies. Of the 144 abdominal X-ray studies, 54 (37.5%) had positive findings, while 90 (62.5%) were unremarkable. The most common category of findings was small bowel findings (32.6%), acute complications (32.6%), followed by extraintestinal findings (2.7%), and colonic findings (1.35%). About 29.2% of the abdominal X-rays had subsequent follow-up imaging done. The multivariate logistic binary regression analysis demonstrated that males had an odds ratio of 2.25 of undergoing follow-up imaging compared to females (p = 0.049). The non-specific findings found on the majority of the abdominal X-rays may indicate that it is of limited diagnostic value in this patient population. However, they play an integral role in ruling out acute complications in CD patients presenting with abdominal pain and exhibiting disease activity.

Quality of Life of Saudi Women With Chronic Lower Urinary Tract Symptoms.

Background Chronic lower urinary symptoms (LUTS) are reported to affect more than half of women of all ages and have a significant impact on their quality of life (QoL). We aimed in this study to assess the QoL of adult Saudi women with chronic LUTS. Methods A cross-sectional study was done on 390 female patients diagnosed with LUTS at three tertiary care hospitals in Riyadh, Saudi Arabia, from October to December 2021. LUTS are classified into three categories: symptoms related to bladder storage (increased daytime frequency, nocturia, and urinary incontinence [UI]), symptoms of bladder voiding (hesitancy, extended micturition time, and insufficient emptying), and symptoms involved in the post-urination phase such as post-micturition dribbling. The data was collected using a self-administered questionnaire which comprised demographic characteristics, International Prostate Symptom Score (IPSS) for assessment of LUTS severity, and King's Health Questionnaire (KHQ) for assessment of QoL. Results After analyzing the study results, we found that symptoms were mild, moderate, and severe in 11%, 51%, and 39% of participants, respectively. Increased age and parity were found to have a significant association with increased symptom severity (p-value <0.05). The current study reported a moderate effect of LUTS on QoL. There was a significant correlation between increased symptom severity and negative impact on QoL, excluding the personal relationships domain. The highest scores in KHQ, which indicate worse QoL, were found in the domains of incontinence impact and emotions, while the lowest scores, which indicate better QoL, were found in the domains of social limitations and severity measures. Employed females were found to have worse QoL in the severity measures domain, which refers to the degree of urinary symptoms affecting day-to-day functioning. In addition, younger age, below 45 years, was found associated significantly with better QoL, especially in the domains of general health, personal relationships, and severity measures. Conclusion In the current study, the majority of patients reported moderate symptoms severity. Chronic LUTS have a significant impact on the QoL of Saudi women in many aspects, including physical, social, and emotional health, especially for those who have moderate to severe symptoms. Healthcare providers should assess high-risk women for the presence of LUTS. Furthermore, we recommend evaluating the QoL of patients with LUTS as a part of routine management.

Barriers and Key Determinants to Optimize the Discharge from Inpatient Rehabilitation: A Saudi Perspective

<h3>Research Objectives</h3> To explore the barriers and key determinants of an effective discharge process from the perspective of rehabilitation clinicians. <h3>Design</h3> A cross-sectional study. <h3>Setting</h3> Rehabilitation hospital in a tertiary care hospital in Riyadh, which is considered the largest governmental medical city in Saudi Arabia, is composed of four specialized hospitals and four specialized centers. <h3>Participants</h3> 121 rehabilitation staff, recruited through convenience sampling, completed surveys; 6 participants were excluded due to incomplete responses to 11 or more of the 65 questions. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> A newly developed questionnaire with 10-domains and 65-items was developed and used after validity and reliability testing. Exploratory factor analysis and principal component analysis were conducted resulting in a final questionnaire of 43-items in 7 components. <h3>Results</h3> Of the 115 included participants, the male-to-female ratio was 5:2; 47.8% were allied health professionals of diverse specialties, 10.4% were physiatrists, and 41.7% were rehabilitation nurses. 20% have a postgraduate degree, and 63.5% have more than five years of clinical experience. Forty-three items categories within seven components were identified as critical determinants of effective discharge. Within component 1, meetings with patients and family to address patients' goals and needs (r=0.400), weekly team meetings formulation of discharge plans (r=0.519), and display form (r=0.523), effective team dynamics (r=0.645), adequate patient and caregiver education and training (component 4, r=-0.457), and early identification of the discharge destination and disposition plan (component 5, r=-0.402) have been identified as critical determinants of effective discharge. In addition, all items of early identification and planning to overcome discharge barriers of component 7 were weakly correlated with effective discharge. Finally, barriers to effective discharge were demonstrated by the inverse relation between effective discharge and recurrent modification of rehabilitation program goals (component 2, r=-0.402), patient/family unrealistic expectations (component 3, r=-0.018), and multiple changes of the discharge date (component 6, r=-0.107). <h3>Conclusions</h3> This study demonstrated several key determinants and barriers that can improve the patient discharge from a Saudi rehabilitation setting. <h3>Author(s) Disclosures</h3> The authors declare that there is no conflict of interest.

Sexual Harassment and Mental Health of Female Healthcare Workers in a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Background In this study, we aimed to estimate the prevalence and identify thecorrelates of sexual harassment among female healthcare workers in a tertiary care hospital in Riyadh, Saudi Arabia. Methodology A cross-sectional study was conducted among 432 female healthcare workers in both Arabic and English languages.The questionnaire consisted of five sections which included the sociodemographic characteristics, a sexual harassment survey, the Kessler distress scale, social support, and the Rosenberg self-esteem scale. Unadjusted odds ratios with 95% confidence intervals were calculated to identify the significant factors associated with harassment. Results Sexual harassment was reported by 15.5% of the participants, with verbal harassment being the most commonly reported (66%), followed by physical harassment (34%). Around three-fourths of harassment acts took place during the daytime, and 18% of the participants preferred to keep quiet about it. Moderate distress [2.38 (1.17, 4.84)] and severe distress [2.31 (1.09, 4.90)], feeling hopeless [2.86 (1.47, 5.57)] and feeling depressed [3.70 (1.62, 8.48)] were significantly associated with sexual harassment. Low self-esteem items, such as "I don't have good qualities" [4.78 (2.0, 11.43)], "don't have much to be proud of" [2.10 (1.22, 3.63)], "wish that I have more respect for myself" [2.30 (1.36, 3.90)], and "inclined to feel that I am a failure" [2.27 (1.24, 4.16)] were significantly associated with sexual harassment. Conclusions It is important for all employees to know about their rights and report all types of harassment acts. Counseling sexually harassed victims should focus on improving the self-esteem and mental distress of these women. Prevention of harassment against female healthcare workers can improve their mental health as well as their quality of work.

Quality of Life in Outpatient Primary Hypothyroidism in Riyadh

Objective: To estimate the Primary Hypothyroidism and to study its effects on the Quality of Life of those patients. Study design: It was a Cross-Sectional Study done using random sampling. Sample size: 463 patients Duration and location of the study: It was done between December 2018 and December 2019 in outpatient clinics of a tertiary care hospital in Riyadh. Study tool: The quality of life of these patients was assessed by World Health Organization (WHO) Health Survey 36-Item Short Form (SF-36) questionnaire with a score less than 50% was considered to be ‘Poor quality’. Results: The response rate of participants was 92.6% and the prevalence of Primary Hypothyroidism was observed to be 47.8%. They experienced a poor mental health with an average score (35.1 ± 1.6). Factors such as illiteracy (35.0 ±1.0), primary level of education (29.4 ± 3.6), housewife (43.49 ± 38.19) and the retired patients (20.31 ± 37.88) had a poor Physical function (P=0.001). However, the patients without primary hypothyroidism had better quality of life with physical, social and mental functional scores (P=0.001). The statistically significant poor quality of life observed due to poor education, income level and marital status exposed the need for the guidelines and management of this morbidity in the Saudi community. Keywords: Primary Hypothyroidism, SF-36, Quality of Life, Cross-Sectional study

The effectiveness and safety of direct-acting antivirals for hepatitis C virus treatment: A single-center experience in Saudi Arabia

BackgroundThe introduction of direct-acting antivirals (DAA) to treat the hepatitis C virus (HCV) overcame many drawbacks of interferon-based therapy. DAA achieved sustained viral response (SVR) rates above 90% and overcame many drawbacks of pegylated interferon regimens.The HCV genotype (GT) distribution varies by geographical area, with GT-4 being most prevalent in the Middle East region, including Saudi Arabia. Yet, the real-world evidence about using DAAs in the Saudi population is limited.Thus, the aim of this study to investigate the effectiveness and safety of DAAs in Saudi patients with HCV infection. MethodsA retrospective cohort study included patients treated with DAAs from 2015 to 2017 at a tertiary care hospital in Riyadh, Saudi Arabia. All patients with HCV treated with either ledipasvir plus sofosbuvir (LDS/SOF) ± ribavarin (RBV) or ombitasvir-paritaprevir-ritonavir (OBV/PTV/r) ± dasabuvir (DSV) ± RBV were included. Using a per-protocol analysis, the effectiveness outcome was the end-of-treatment response (EOTr) and Sustained virologic reponce12 weeks after competing the regimen (SVR12). The secondary safety outcome was the adverse event related to the therapy reported by the patients. ResultsA total of 97 patients were included; with the majority infected with GT-4 (64 %), followed by GT-1 (18 %), in addition to 8 % having a mixed GT (1 + 4). The EOTr and SVR12 rates were 98 % and 96 %, respectively. SVR12 was 94.4 % within the LDS/SOF ± RBV group and 97.7 % within the OBV/PTV/r ± DSV ± RBV group. Only 4 % had a response failure due to relapse or breakthrough, and all were infected with mixed GT1 + 4. Medications were well tolerated with minimal side effects, including vomiting, nausea, and weakness. ConclusionDAAs regimens are associated with high rates of SVR12 and are well tolerated with a good safety profile in Saudi HCV-infected patients.

Predictors of recurrent arteriovenous fistula stenosis in Saudi patients undergoing hemodialysis.

Objectives:To identify predictors of recurrent arteriovenous fistula (AVF) stenosis. It also seeks to calculate the average primary patency duration in Saudi patients undergoing hemodialysis.Methods:A retrospective case-control study was conducted at a tertiary care hospital in Riyadh. Data from 180 patients who had undergone angioplasty between May 2009 and May 2020 were analyzed. Following the inclusion/exclusion criteria, 99 patients were included. Based on the presence or absence of recurrent AVF stenosis, the patients were divided into cases and controls, respectively. Recurrence was defined as an occurrence of stenosis within <12 months of a previous stenotic event, or patients who had >3 total stenotic events. Clinical, radiological, and laboratory variables were collected and subjected to multivariate binary regression analysis to assess the odds of a recurrence of fistula stenosis.Results:A total of 29 patients were categorized as cases, while 70 patients were categorized as controls. The median primary patency duration was found to be seven months. Multivariate binary regression analysis revealed higher levels of serum calcium (p=0.012) and BMI (p=0.007) in patients with recurrent stenosis. A positive association was also observed between the use of antiplatelets (0.039) and recurrent stenosis.Conclusion:Higher levels of corrected calcium, BMI, and the application of antiplatelet therapy were found to be predictors of recurrent AVF stenosis. No other traditional variables were found to be significant.

Prevalence of Aggressive Behavior Toward Fellows, Residents, and Nurses at a Tertiary Care Hospital in Riyadh, Saudi Arabia.

BackgroundWorkplace bullying (WPB) is a form of mistreatment toward an individual manifested by physical, verbal, or indirect aggression. Affected victims display a wide range of signs and symptoms that impact their health. This study aimed to investigate the prevalence of aggressive behavior toward healthcare workers and its effects on job satisfaction, general health, and mental health.MethodologyAn online survey comprising a revised version of the Negative Acts Questionnaire-Revised (NAQ-R) was distributed to the fellows, residents, and nurses working in a tertiary care hospital. The survey collected information regarding the group’s demographics and their exposure to WPB encountered in the work environment while maintaining confidentiality. Survey results were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA).ResultsAmong the 339 participants who filled the survey, 53% of healthcare practitioners in different services had experienced some form of WPB. Among the targeted group, it was noted that female gender (50%), age between 31 and 41 years (57.03%), nurses (51.98%), non-Saudi practitioners (41.94%), and those working in inpatient settings (49.74%) were the most commonly affected individuals in the medical facility. Furthermore, higher bullying prevalence was correlated with lower job satisfaction and mental health levels.ConclusionsAge, gender, job, and nationality were factors associated with increased susceptibility to WPB. WPB in any facility is an unfortunate event, especially in a healthcare setting. It affects health practitioners by decreasing job satisfaction, jeopardizing health, and increasing the risk of harm to patients. WPB will eventually have a negative impact on the medical facility and the healthcare sector. Hence, hospital administrations should be alarmed about the rise in WPB, and adequate measures must be taken to deal with the root cause of the problem.