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    Prevalence And Etiology of Ecchymosis In Ksa: A Protocol For Systematic Review

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    Background: Several variables, one of which is geography, influence the prevalence of bleeding disorders. Even minor bleeding issues may cause iron shortage, illness, and even death in extreme circumstances. Clinicians have a difficult but essential challenge when attempting to quantify hemorrhagic symptoms as part of the therapy of bleeding diseases. Methods: A comprehensive search was conducted using electronic databases, including PubMed, Embase, and Cochrane Library, to identify relevant studies published from 2000 to 2023. The search was limited to English-language studies that examined the prevalence and etiology of ecchymosis in KSA. Results: This systematic review investigated 26 studies initially identified from major databases, ultimately selecting 10 for in-depth analysis. Two pivotal studies were featured, providing insights into bleeding disorders from diverse perspectives. The first study examined bleeding disorders in adult students across four locations in Saudi Arabia, revealing significant regional variations (14.03% to 32.3%) and gender differences (54.9% females, 45.1% males). It emphasized the necessity of quantifying hemorrhagic symptoms and advocated for a nationwide monitoring system. The second study focused on von Willebrand Disease patients in a Saudi tertiary care hospital, uncovering diverse bleeding sources and highlighting blood type O's significant associations. The results underscored the complexity of bleeding disorders and advocated for tailored diagnostic and treatment strategies, contributing valuable information for future research and clinical practice. Conclusion: The results of this research show that moderate bleeding problems are more common in certain ethnic groups and that men and women experience them differently. To better treat these patients, a nationwide monitoring system is necessary. Our cohort's most prevalent clinical manifestations were bleeding in the muscles and joints. Our group had the highest incidence of type 1 vWD, but type 3 was much more common, which may be attributable to racial disparities or referral bias. In terms of FVIII and vWF:Ag, we discovered a statistically significant difference between O and non-O blood types. In terms of vWD activity, as measured by vWF:RCo, we found an even more dramatic difference, with blood type O serving as the underlying component

    Thyroid Nodules and Thyroid Cancer In Adult Age In Ksa

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    Objective: In terms of thyroid illnesses, thyroid cancer has one of the highest prevalence rates and is the second most common form of neoplasia in the Saudi population. The focus of this study is a thorough analysis of trends in rising incidence rates and the distribution of various thyroid cancer patterns in the population of Saudi Arabia. Methods: This research employs a cross-sectional study design. Cross-sectional studies involve collecting data from a specific population at a single time to determine the prevalence of a certain condition and assess the distribution of variables of interest. Results: The study included 558 participants. The most frequent age among them was 18-28 years (n= 256, 45.9%), followed by 29-39 years (n= 138, 24.7%). The most frequent gender among study participants was Female (n= 367, 65.8%) followed by Male (n= 191, 34.2%). The most frequent nationality among study participants was Saudi (n= 533,95.5%), followed by non-Saudi (n=25, 4.5%). Educational level study participants most of them university (n= 453, 81.2%) followed by high school (n= 83, 14.9%). %). The most frequent job among study participants was government (175, 31.4%), followed by the student (128, 22.9%). Participants were asked about the symptoms of thyroid tumors the most frequently answered that they didn’t know (243, 20.8%), followed by difficulty swallowing (167, 14.3%), and the least was cough (47, 4%). The most frequent address among them was city (n= 506, 90.7%%), followed by countryside (n= 52, 9.3%). Figure 6 shows the address distribution among study participants. The most frequent income level among them was middle (n= 393, 70.4%), followed by high (n= 92, 16.5%), and the least was weak (n=73, 13.1%). Participants were asked about what thyroid diseases they suffer from the most frequently answered was I don’t suffer from thyroid disease (445, 79.7%), followed by other than that (75, 13.4%), and the least was Malignant tumor of the thyroid gland (7, 1.3%). Participants were asked about what chronic diseases do you have the most frequently answered was other 127 (127, 48.7%), followed by Hypertension (35, 13.4%), and then Type 2 diabetes (33,12.6%), the least heart disease (9, 3.4%). Conclusion: The results of the study showed that most of the study participants were Saudis, and most of them lived in the city. Most of them were women. Most of the participants have an average monthly income. Most of the study participants had thyroid disease

    Association of Body Mass Index With Type 2 Diabetes Mellitus Among Adult Population in Ksa: A Cross-Sectional Study

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    Background: Diabetes Mellitus (DM) stands as a chronic metabolic disorder characterized by persistent hyperglycemia stemming from anomalies in insulin secretion, insulin action, or a combination thereof. Its global prevalence has soared, posing substantial public health ramifications. This scenario holds for the Kingdom of Saudi Arabia (KSA), where the prevalence of DM has surged to a critical juncture, warranting heightened attention as a paramount health challenge. In this milieu, the identification of robust markers conducive to early detection and preventive interventions for DM is a matter of paramount significance. One such marker of potential relevance is the Body Mass Index (BMI), a metric ubiquitously deployed to gauge an individual's weight status Methods: A cross-sectional study design will be employed to investigate the association between Body Mass Index (BMI) and Type 2 Diabetes Mellitus (T2DM) among the adult population in the Kingdom of Saudi Arabia (KSA). The study will be conducted within various urban and rural settings across different regions of KSA, aiming for a representative geographic distribution. The study population will comprise adults aged 18 years and older residing in the Kingdom of Saudi Arabia.  A multistage stratified random sampling method will be used. Firstly, distinct geographical regions will be chosen as strata. Then, within each stratum, random sampling will be performed to select specific cities, neighborhoods, and households. From these households, eligible individuals will be invited to participate. Individuals aged 18 years and older, regardless of gender, who are willing to participate and provide informed consent will be eligible for inclusion. Individuals with pre-existing medical conditions affecting BMI and T2DM status will be excluded. Data will be collected through structured interviews. Information on demographics, medical history, lifestyle factors, and dietary habits will be gathered through face-to-face interviews. Anthropometric measurements (height, weight, waist circumference) will be obtained using standardized procedures. The data collection instruments will include a questionnaire encompassing demographic and medical history sections, lifestyle assessment, and dietary intake. Standardized instruments will be used for anthropometric measurements to ensure consistency. The questionnaire will undergo expert review and pilot testing to enhance its validity. Anthropometric measurements will be taken by trained professionals using calibrated equipment to ensure reliability. Pre-established protocols will be followed for both data collection and measurement procedures. Results: The researchers obtained results and information from 808 adults collected from various regions of the Kingdom of Saudi Arabia. A multi-stage stratified random sampling method was used. There was no significant difference between the number of males and females in the sample, as the number of males reached 407, representing 50.4%. The average age in the study was 40 years. There was a statistical significance between gender and cumulative blood sugar. The normal blood sugar level was the most common in the study at 69%, followed by those with diabetes at 21.28% Conclusion: The most common values ​​that affect type 2 diabetes mellitus among the adult population in KSA were BMI followed by blood pressure, family history, number of medications, family history, and commitment to taking medications

    Role of Application of SWCR Guidelines In Management of Sacral Pressure Injury (PI)

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    A pressure injury is localized tissue necrosis following pressure injury to the skin and/or underlying tissue for prolonged period. The process of ulceration is aggravated by simultaneous shear or direct injury to skin continuity. The terms “decubitus ulcer,” “bedsore,” and “pressure sore” are often used interchangeably, but they do not describe the condition as accurately as pressure injury. The word ‘decubitus’ – derived from the Latin ‘decumbo’ or ‘decumbere’, meaning ‘to lie down’ or ‘recline’ – as the ulcer occur commonly over areas of bony prominences in recumbent position, e.g., the sacrum, trochanter, heel, and occiput. The term ‘pressure ulcer’ describes these ulcers better with pressure as an important etiologic factor.Aim of this case report is to assess the role of applying SWCR guidelines in management of pressure injuries.

    Impact Of Bariatric Surgery on Gastroesophageal Reflux Disease: A Cross-Sectional Study

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    Objective: To assess the occurrence of GERD after bariatric surgery and surgery impact on GERD. Methods: This research employs a cross-sectional study design to investigate the impact of bariatric surgery on Gastroesophageal Reflux Disease (GERD) among individuals who have undergone various types of bariatric surgeries. Results: The study included 302 participants. The most frequent weight among them was more than 96 kg (n= 130, 43%) followed by 76-85 kg (n= 51, 16.9%). The most frequent height among study participants was 1.61-1.70 m (n= 100, 33.1%) followed by 1.51-1.60 m (n= 99, 32.8%). The most frequent body mass index (BMI) value among study participants was more than 35 kg/m2 (n= 126, 41.7%) followed by 25-29.9 kg/m2 (n= 67, 22.2%). The most frequent age among study participants was 26-36 years (n= 104, 34.4%) followed by 15-25 years (n= 83, 27.5%). The most frequent gender among study participants was Female (n= 162, 53.6%) followed by Male (n= 140, 46.4%). Participants were asked about the type of obesity surgery. The most frequent was Gastric sleeve (n=222, 73.5%), followed by Gastric bypass (n=33, 10.9%).   Conclusion: Study results showed that most of the study participants are extremely obese according to their BMI. The most common obesity surgery type was a Gastric sleeve followed by a Gastric bypass. The most of participants were a non-smoker. Most of them had weight loss. In addition, most of the study participants had good social connection

    Association between Serum Vitamin B12 Concentration and Obesity Among Adults in The Ksa

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    Objective: To investigate the relationship between serum vitamin B12 levels and weight among the adult population in KSA. Methods: This research will employ a cross-sectional study design to investigate the association between serum vitamin B12 concentration and obesity among adults in the Kingdom of Saudi Arabia (KSA). Cross-sectional studies are suitable for examining relationships between variables within a specific population at a single point in time. The target population for this study includes all adult residents of the KSA aged 18 years and older. Results: The study included 869 participants. The most frequent weight among them was 51-65 kg (n= 255, 29.3%), followed by 66 -75 kg (n= 214, 24.6%). The most frequent height among study participants was 161-170 cm (n= 324, 37.3%) followed by 151-160 cm (n= 266, 30.6%). The most frequent body mass index (BMI) value among study participants was Normal 18.5-24.9 kg/m2 (n= 344, 39.6%), followed by overweight 25-29.9 kg/m2 (n= 281, 32.3%).  Vitamin B12 varied among study participants, with most of them having a normal range (n= 319, 36.7%) followed by a low range (n= 117, 13.5%) and the least common high range (n= 23, 2.6%). On the other hand, among 410 participants, 47.2% did not know their vitamin B12 value. Wech may indicate a lack of knowledge about the topic. Figure 4 shows the vitamin B12 levels among study participants. Conclusion: Study results showed that most of the study participants do not know their vitamin B12 level and need to increase awareness, followed by those who have a normal vitamin B12 level. The most common BMI was the normal level. There was a relationship between vitamin B12 levels and obesity.

    Clinical Correlation Between Back Pain and Osteoarthritis Among Adults: A Cross-Sectional Study

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    Objective: To investigate the clinical correlation between back pain and the role of osteoarthritis in the etiology of this pain. Methods: This research employs a cross-sectional study design to investigate the clinical correlation between back pain and osteoarthritis in adults. Cross-sectional studies provide a snapshot of data at a specific time, making them suitable for assessing the prevalence and potential associations between variables of interest. Results: The study included 1106 participants. The most frequent age among them was 40-50 years (n= 486, 43.9%), followed by 18-28 years (n= 340, 30.7%). The most frequent gender among study participants was female (n= 560, 50.6%) followed by male (n= 546, 49.4%). The most frequent marital status among study participants was married (n= 702, 63.5%), followed by single (n= 353, 31.9%). The most frequent job among study participants was a government job (n= 480, 43.4%), followed by a private sector job (n= 177, 16%). Duration of suffering from back pain among study participants with most of them being 1 to 5 years (n= 505, 45.7%), followed by nothing (n= 373, 33.7%), and the least was 23 years and above (n= 13, 1.2%). Participants were asked about evaluating the impact of back pain on life. For personal care, the most frequent was (currently, I do not feel any pain) (n= 514, 46.5%). The severity of pain, the most frequent, was (I can usually take care of myself and do my own things without adding to my pain) (n= 923, 83.5%). The lift and move things, the most frequent was (I can lift heavy objects without it adding to my pain) (n= 524, 47.4%). The walking, the most frequent was (The pain does not prevent me from walking any distance) (n= 801, 72.4%). The Sitting, the most frequent was (I can sit in any chair for as long as I want) (n= 661, 59.8%). The stand-up, most frequent was (I can stay standing as long as I want without increasing my pain) (n= 523, 47.3%). For sleep, the most frequent answer was (My sleep is never disturbed by pain) (n= 611, 55.2%). The Social-life, most frequent was (My social life is normal and does not cause me more pain) (n= 860, 77.8%). Conclusion: The results of the study showed that most of the participants were married and taught in government jobs. The majority of them do not suffer from severe back pain that affects their lives. In addition, most of the study participants had good and effective communicatio

    Role of Biodegradable Temporising Matrix (BTM) in Electrical Burns

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    Aim of this case report is to assess the role of in management of Biodegradable Temporising Matrix (BTM) in non healing ulcer due to electrical burns. Clinical examination of the non healing ulcer before and after use Biodegradable Temporising Matrix (BTM) was done

    Thyroid hormones and hepatorenal function in Diabetes Mellitus : A Conclusion from Indian Study.

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    Background: Presence of hypothyroidism in Diabetes Mellitus (DM) is a foundation for development of complications. Thyroid hormones have been hypothesised to affect and be affected by hepatorenal function. These hypotheses warrant further study into the topic. Materials & methods: 81 diabetics and 81 age & sex-matched healthy volunteers participated in the study. Their blood samples were analysed for fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), total triiodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH) and liver & renal function tests. Data was analysed using appropriate statistical tests. Results: 42 males and 39 females each were recruited as cases and controls. FBG, HbA1c, FT4, TSH, serum alanine transaminase (ALT), alkaline phosphatase (ALP) and serum creatinine (CR) were higher in diabetics. T3 and FT3 were lower in diabetics. T3, FT3, and albumin (ALB) were lower in diabetics with CR ≥ 1.30 mg/dL. FBG, direct bilirubin (DBIL), ALP and CR were higher and T3 and FT3 were lower in hypoproteinemic diabetics. Total proteins (TPRO) and ALB positively correlated with T3 and FT3. TBIL positively correlated with FBG. ALP positively correlated with HbA1c. Conclusion: Hypoproteinemia predicts poor glycemic control, renal dysfunction and hypothyroidism. High-normal circulating levels of T3 and FT3 being correlated with lower levels of CR may imply that a thyroid-sufficient state is largely protective against renal dysfunction in DM. In summary, routine LFT and RFT investigations can be indicative of subclinical hypothyroidism and thus an underlying cause of resistance to anti-hyperglycemic therapy; treating the same may improve therapeutic outcomes.

    True Penicillin Drug Allergy

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    Introduction A drug allergy is an abnormal immune system reaction to a medication. Any medication can induce a drug allergy. However, a drug allergy is more likely with certain medicines, one of which is penicillin. The most common signs and symptoms of drug allergy are hives, rash, or fever. Up to 15.6% of patients self-reported having an allergy to penicillin, and most of those reported allergies lacked proper documentation (1). In addition, 90 percent of penicillin-allergic patients can tolerate penicillin and, therefore, are labeled unnecessarily (2,3). Using alternative broad-spectrum antibiotics in those patients prevents optimal medical care (1). Skin tests provide confirmatory evidence of sensitization to a given allergen. Therefore, the primary objective of this study is to estimate the prevalence of penicillin drug allergy by medical chart review and to identify the true drug-allergic patients. Methodology This is a retrospective observational study of the population by reviewing charts. The inclusion criteria were all patients labeled allergic to penicillin at KAMC between 1982 and December 2017. The second objective is a prospective interventional study of a skin prick and intradermal test (IDT) for penicillin allergy. We calculated the sample size, and the total required number of patients for the testing was 133. Results Of 2738 labeled allergic patients, 455 were labeled as penicillin allergy (16.6%). The majority were female participants, accounting for 338 (74.3%). Table 1 shows the baseline characteristics. Among all the participants, maculopapular rash was the most common documented symptom. Moreover, 18.7% (n=85) of the patients had either unknown or undocumented reactions. Penicillin drugs were classified into subgroups in which patients reacted. Penicillin (63.3%) was the most common, followed by Augmentin (15.8%), then amoxicillin (11.0%). Thirty participants (6.6%) received penicillin after they were labeled as allergic to penicillin and did not report any further reactions except for one participant who developed the rash. Conclusion As many as penicillin-labeled allergic patients, only a few are truly allergic to penicillin. This fact is attributed to poor documentation of allergies and based on the history taken from the patient that he might falsely relate a symptom or adverse effect to penicillin without being tested for penicillin allergy. This study recommends using proper documentation standards, such as penicillin skin tests when documenting patient allergies


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