Utilization of cross-matched blood in elective thyroid and parathyroid surgeries: a single-center retrospective study

Abdulmajeed Fahad Alahmari, Hani Z Marzouki, Mohammed Saad Alsallum, Ahmed Hussein Subki, Mazin Merdad Department of Otorhinolaryngology, Head and Neck Surgery, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Background: Hospital blood banks face the common challenge of maintaining an adequate supply of blood products to serve all potential patients while minimizing the need to discard expired blood products. This study aimed to determine the risk of blood transfusion during elective thyroid and parathyroid surgery and potential factors related to blood loss and risk of transfusion in these cases. Methods: The study included all thyroid and parathyroid surgeries performed at King Abdulaziz University Hospital between January 2015 and December 2017. After exclusion of patients with incomplete data, 179 patients with complete data who had undergone thyroid and parathyroid surgery were analyzed. Results: Of the 179 patients included in this study, 33 (18.4%) were male. Overall, patients had a mean age and body-mass index of 44.55±13.67 years and 27.66±5.38 kg/m2, respectively. The mean duration of surgery was 168.48±90.69 minutes. None of the patients had a history of previous radiotherapy, bleeding disorder, or blood transfusion. Benign goiter was the most common finding (n=78, 43.6%), followed by papillary carcinoma (n=49, 27.4%). During surgery, most patients (n=136, 76.0%) experienced minimal blood loss. None of the patients in our cohort (n= 179) required any blood transfusion or products. Conclusion: In this study, we aimed to audit the surgical blood-ordering and -transfusion practices associated with elective thyroid and parathyroid surgeries at our institution. These practices are intended to balance the availability of blood products with the avoidance of unnecessary wastage. In our study of patients who underwent elective thyroid and parathyroid surgeries, parathyroid surgeries, none required blood transfusion. Keywords: cross-matched blood, thyroid surgery, parathyroid surger

Trends in mitral valve prolapse: a tertiary care center experience in Jeddah, Saudi Arabia

Ahmed Hussein Subki, Mahmoud Ghaleb Bakhaidar, Moaz Abdulrahman Bakhaider, Ali Abdulrahman Alkhowaiter, Rakan Salah Al-Harbi, Mohammed Ali Almalki, Khalid Abdullah Alzahrani, Maged Mazen Fakeeh, Siham Hussein Subki, Wesam Awad Alhejily Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Background: Mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in developed countries and it is associated with considerable morbidity and mortality. Aim of work: To study the clinical presentations, risk factors, and echocardiographic features of patients with MVP in Jeddah, Saudi Arabia. Materials and methods: A retrospective chart review study was conducted in King Abdulaziz teaching hospital in Jeddah, Saudi Arabia, from 2007 to 2017. All patients with MVP who were admitted at the hospital during this time period were recruited to this study, and demographic, clinical, and echocardiographic variables were analyzed using IBM SPSS. Results: Ninety-seven patients were recruited to this study, with a mean age of 43.82±16.16 years. Females constituted 67%. The body mass index (BMI) was 24.9±6.3 kg/m2. Hypertension, diabetes, and dyslipidemia occurred in 19.6%, 5.2%, and 5.2% of patients, respectively. A single patient had Marfan syndrome. Chest pain, palpitations, and dyspnea were the presenting symptoms in 23.7%, 11.3%, and 9.3% of patients, respectively, with elderly individuals presenting disproportionally (93.3%) with palpitations. Fifty-five percent of patients had an anterior leaflet prolapse. The presence of posterior leaflet prolapse and severe mitral regurgitation (MR) was significantly associated with left atrial and left ventricular dilatation (P<0.05 and P<0.001, respectively). Conclusion: MVP is more prevalent in women and middle-aged individuals with normal BMIs in this population. The most common clinical presentations were chest pain, palpitations, and dyspnea, which did not differ significantly with age or gender. The anterior leaflet was the most commonly prolapsed in the studied patients and presented with mild MR. Posterior leaflet MVP, while of low prevalence, was associated with severe MR and poor left ventricular function. Keywords: clinical presentation, echocardiography, mitral valve prolapse, prevalence, risk factor

Atrial fibrillation: risk factors and comorbidities in a tertiary center in Jeddah, Saudi Arabia

Abdullah Abdulfattah Mashat, Ahmed Hussein Subki, Moaz Abdulrahman Bakhaider, Wejdan Mohammad Baabdullah, Jawaher Badr Walid, Abdulrahman Hatim Alobudi, Maged Mazen Fakeeh, Anas Jamal Algethmi, Wesam Awad Alhejily Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Introduction: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia worldwide and carries significant risk of morbidity and mortality. The prevalence of AF is high in significant parts of the world, but not much is known from countries, such as Saudi Arabia.Aims: To study the risk factors, etiologies, comorbidities, and outcome of AF in Saudi Arabia. Patients and methods: A retrospective study was conducted in King Abdul-Aziz Hospital in Jeddah during the period 2010–2017. Data were collected from both the electronic-and paper-based medical records of patients with AF. The data included the demographic information, adverse lifestyle (smoking and obesity), cardiothoracic surgery, and comorbidities. Results: A total of 167 patients were included in the analysis (43% were males). The mean age was 63.3±35 years and the mean body mass index was 28.8±83. Hypertension (HTN) was the most prevalent risk factor encountered (73.1%). This was followed by valvular heart disease, and type 2 diabetes mellitus (T2DM), which occurred in 58.7% and 53.3% of patients, respectively. Valvular heart disease was significantly associated with older age (P=0.002) and coronary artery disease (CAD) (P=0.001). Heart failure (HF) was associated with HTN (P=0.005), coronary heart disease (P=0.001), and chronic kidney disease (CKD) (P=0.003). Conclusion: AF was more prevalent among females in Saudi Arabia. HTN, valvular heart disease, and T2DM were the most prevalent risk factors of AF in Saudi Arabia. Valvular heart disease was more prevalent among older patients and significantly associated with CAD. HTN, CAD, and CKD were the most significant risk factors for HF in patients with AF. Keywords: atrial fibrillation, comorbidities, complications, risk factors, Jeddah, Saudi Arabi

Population awareness of coronary artery disease risk factors in Jeddah, Saudi Arabia: a cross-sectional study

Mohammed Ali Almalki, Maram Nader AlJishi, Maie Abdulrhman Khayat, Hotoun Fayez Bokhari, Ahmed Hussein Subki, Abdulrahman Mousa Alzahrani, Wesam Awad Alhejily Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Background: Coronary artery disease (CAD) is a serious cardiovascular disorder affecting middle-aged individuals. It is a major cause of death among adults over the age of 35 years. In Saudi Arabia, CAD is associated with higher mortality rate, and Saudi patients are reported to have significantly higher prevalence of risk factors for CAD than the Western population. Furthermore, as, to date, there is no definite cure for CAD, prevention of the disease and tight control of the known risk factors are the cornerstones for reducing CAD-associated mortality. Thus, the present work aimed to assess the population awareness of CAD risk factors in Saudi Arabia.Methods: A cross-sectional study was conducted in Jeddah during the period January 2017 to December 2017 by using an online survey questionnaire to assess participants’ awareness of 14 risk factors for CAD, namely: smoking, lack of physical activity, fast food and soft drink intake, television and computer use; history of diabetes mellitus, myocardial infarction and stroke; as well as a family history of diabetes mellitus, diabetes, hypertension, hyperlipidemia, CAD and myocardial infarction.Results: Of 468 respondents, 41% were males. The mean age was 31.9±12.4. Approximately 86% were Saudi, and ~60% had a university education. The mean overall awareness score was 4.31±1.36 (1.00–8.00). Fast food, soft drinks, and family history of diabetes were the most commonly identified risk factors, reported by 74.8%, 64.3%, and 47.2% of participants, respectively. There was a strong correlation between overall awareness score and awareness of each risk factor individually (P<0.003).Conclusion: There is an evident limited knowledge among the population in Jeddah, Saudi Arabia regarding the risk factors for CAD, and it is recommended that the healthcare sector in the country focus on public health education programs about the disease. Keywords: population, public, awareness, coronary artery disease, risk factors, Jeddah, Saudi Arabi

Peripheral artery disease risk factors in Jeddah, Saudi Arabia: a retrospective study

Abdulrahman Ibrahim Mufti Alsadiqi, Ahmed Hussein Subki, Rami Hussam Abushanab, Mohammed Rashid Ocheltree, Hattan Ahmed Bajahmom, Yosef Ibrahim Mufti Alsadiqi, Wesam Awad Alhejily Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Background: Peripheral artery disease (PAD) is a major health problem in Saudi Arabia with considerable implications for morbidity and mortality. Many risk factors have been established for developing PAD, but the prevalence of these risk factors is variable from one country to another.Aim: To identify the risk factors for PAD and study their prevalence in Jeddah, Saudi Arabia.Methods: A retrospective chart review study was conducted in a tertiary center in Jeddah from July 2012 to September 2015. All patients with PAD were recruited into this study, and their data were analyzed using IBM SPSS. Correlation between PAD and various risk factors was studied using Spearman’s coefficient.Results: A total of 261 patients were recruited, of which 55% were males. Hypertension, diabetes type 2, and obesity were found among 34.2%, 33.3%, and 29.2% of the patients, respectively. About 45% had a history of previous vascular surgery, and amputation was performed in 6.9% particularly in legs. Hypertension and metabolic syndrome were the only risk factors that showed a significant correlation with PAD (P=0.039 and 0.040, respectively).Conclusion: The most prevalent risk factors for PAD in Jeddah were hypertension, diabetes, obesity, and smoking. Hypertension and metabolic syndrome were the only risk factors significantly associated with PAD. Males were often more affected by PAD than females. The most commonly affected site was the lower limbs. Keywords: prevalence, peripheral artery disease, risk factors, Saudi Arabia&nbsp

Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

Hazim Abdulkarim Khatib,1 Waleed Ahmed Alghamdi,2 Ahmed Hussein Subki,3 Nadeem Shafique Butt,4 Mohammed Saad Alsallum,5 Ahmed Salem Alsulaimani,6 Sara Faisal Alnajjar,7 Fahad Daifallah Alzaidi,8 Abdulrahman Ali Alasmari,9 Hussein Mesfer Alshamrani,10 Faten Al-Zaben,2 Harold G Koenig2,11,12 1Department of Internal Medicine, King Abdulaziz Hospital, Jeddah, Saudi Arabia; 2Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 4Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Neurology, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 6Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia; 7Department of Diagnostic Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 8Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 9Department of Forensic Medicine, Forensic Medicine Center, Jeddah, Saudi Arabia; 10Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 11School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China; 12Department of Psychiatry, Duke University Medical Center, Durham, NC, USACorrespondence: Waleed Ahmed Alghamdi; Harold G Koenig, Email [email protected]; [email protected]: Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah.Methods: This descriptive cross-sectional study was conducted in the city of Jeddah. The Skin Picking Scale-Revised (SPS-R) scale was administered to a convenience sample of 520 respondents. A partial least squares path model (PLS-PM) for “impairment” and “symptoms severity” subscales was assessed by evaluating the validity of measurement and structural models.Results: Skin picking behavior was reported by 28.8% (n=150). A significant level of skin picking disorder symptoms was present in 1.2% (n=6). Skin picking visual effect, depressive symptoms, and being unmarried were the only positive independent predictors of the total SPS-R score.Conclusion: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.Keywords: skin picking disorder, dermatillomania, excoriation disorder, prevalence, risk factors, The Skin Picking Scale-Revised scal

Parental perceptions of dental health and need for treatment in children with epilepsy: a multicenter cross-sectional study

Ahmed Hussein Subki,1 Abdel Moniem Mukhtar,2 Omar M Saggaf,1 Ragaa A Ali,3 Khalid A Khalifa,3 Dalia M Al-Lulu,3 Mohammed Saad Alsallum,1 Diyaa H Bokhary,1 Ayman M Baabdullah,1 Sulaiman M Kassar,1 Basil M Jan,4 Muhab M Hindi,1 Mohammed M Jan1 1Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 3Batterjee Medical College, Jeddah, Saudi Arabia; 4Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia Background: Epilepsy is a common neurological disorder in childhood. However, there have been limited studies on its impact on the oral health of affected children. Our study aimed to assess the oral health of children with epilepsy in the city of Jeddah, Saudi Arabia, as perceived by their mothers. Methods: We conducted a cross-sectional study in three hospitals. We included children 2–18 years old with physician-confirmed epilepsy diagnosis. We assessed parental perception of dental status and need for dental care using a standardized questionnaire that was completed by the mothers. To adjust for potential confounding variables, we used univariate and multivariate logistic regression. Results: We included 96 children with epilepsy in our study. Their mean age was 6.4±3.4 years. In 55.2% (n=53), dental status was rated as bad, and in 84.4% (n=81) a need for dental care was expressed. Cerebral palsy (OR 5.06, 95% CI 1.28–19.99; P=0.021), motor disability (OR 6.41, 95% CI 1.12–36.73; P=0.037), referral from a pediatric neurology clinic to a dentist (OR 10.755, 95% CI 3.290–35.151; P<0.001), and irregular brushing of teeth (OR 5.397, 95% CI 1.536–18.961; P=0.009) were significantly associated with increased risk of perceived bad dental status. Perception of the child as being overweight (OR 0.117, 95% CI 0.034–0.400; P=0.001) was significantly associated with decreased risk of perceived bad dental status. Motor disability (OR 5.73, 95% CI 1.64–20.04; P=0.006) was significantly associated with increased parental expression of need for dental care. Conclusion: In most children with epilepsy, perceived dental status was bad and there was a high expressed need for dental care. Interventions to improve the dental health of children with epilepsy should focus on those with cerebral palsy and motor disability. Keywords: oral, dental, teeth, hygiene, health, epilepsy, chil