Prevalence of Metabolic Syndrome in Primary Health Care, Riyadh, Saudi Arabia

Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly increase the risk of diabetes, cardiovascular disease, and stroke. It is characterized by obesity, hyperglycemia, dyslipidemia, and hypertension. Multiple definitions and criteria of MS exist. The most widely used set of criteria are the US National Cholesterol Education Program (NCEP) ATP III and the International Diabetes Federation (IDF), both of which are used in this study. Due to different defining criteria and population demographics, the prevalence of MS varies widely across countries, regions, and continents.Objective: This study investigates the prevalence and risk factors of metabolic syndrome among primary healthcare attendees in Riyadh, Saudi Arabia.Methods: A cross-sectional study was conducted over 12 months at the Prince Sultan Military Medical City (PSMMC) Wazzarat Center in Riyadh, Saudi Arabia, involving 262 participants. The study aimed to determine the prevalence and predictors of MS among primary healthcare attendees using ATP III and IDF criteria. Participants were assessed for sociodemographic features, comorbidities, vital signs, and laboratory data related to MS. Statistical analysis utilized R v 4.3 for descriptive statistics, Pearson correlation, Chi-square tests for categorical variables, and the Mann-Whitney test for continuous variables.Results: Among the study participants, 20.2% met the criteria for MS according to ATP III, and 19.9% according to IDF criteria, with a strong concordance between the two (Kappa statistic = 0.92, P < 0.001). The median age of individuals with MS was significantly higher (45 years) than those without (35 years, P < 0.001). Significant predictors included age, with BMI and fasting blood glucose showing a strong positive correlation (r > 0.5, P < 0.001). Notably, 60.7% of the cohort were medically free from conditions contributing to MS.Conclusion: The prevalence of MS among primary healthcare attendees in Riyadh, as defined by ATP III and IDF criteria, underscores the importance of age and lifestyle factors as predictors. The findings advocate for targeted preventive strategies focusing on lifestyle modifications to mitigate the risk of MS. Further research is suggested to explore the long-term impact of these interventions

Diagnostic accuracy and correlation between Double Inversion Recovery (DIR), FLAIR and T2W imaging sequences with EDSS in detection of lesions at different anatomical regions in MS patients

The aim of our study is to evaluate the diagnostic accuracy of double inversion recovery (DIR) in detection of multiple sclerosis (MS) lesions as well as the correlation between the expanded disability status scale (EDSS) and lesion load measurement detected by DIR, fluid attenuated inversion recovery (FLAIR) and T2 weighted imaging (T2WI) in order to reveal the essential role of DIR sequence in assessing clinical inability as a practicable experiment. A total of 97 patients were assessed on a 3T Siemens Skyra MRI scanner using DIR, FLAIR, and T2W_TSE sequences. EDSS was used to assess the physical disability in patients with MS. The diagnostic accuracy of DIR, FLAIR and T2WI sequences was also determined in different anatomical regions. Sensitivity and specificity were assessed by relative operating characteristics/ receiver operating characteristics (ROC) curve at different cut off points. Spearman correlation was applied to identify the significant relationships between the number of lesions displayed by DIR, FLAIR and T2WI at different regions and EDSS score. Our results pointed out the highest sensitivity (92.9%) and specificity (73.5%) for the number of lesions in infratentorial region at the cut-off point of 4.5 and the highest correlation between the number of lesions and EDSS was observed in infratentorial region (r= 0.584, p<0.001) for DIR sequence. According to the findings of ROC analysis, the number of lesions detected by DIR technique in the infratentorial region is the best predictor of EDSS as a gold standard. DIR can be used as a complementary technique comparing to conventional T2 and FLAIR sequences and describe physical and cognitive dysfunction as well. Due to the higher potential of the DIR sequence to reveal a greater number of MS lesions and to overcome the technical defect of conventional MRI sequences in the diagnosis of cortical lesions, it is recommended that DIR sequences be routinely added to MRI imaging protocols for patients with MS

Overview On Surgical Management Of Overactive Bladder

Overactive bladder syndrome is a persistent and incapacitating disorder that has profound medical, psychological, and social implications, greatly impacting the wellbeing of countless individuals globally. A significant number of individuals experience urine urgency, which can be extremely bothersome. The primary indicator of overactive bladder (OAB) is a sense of urgency, often accompanied by increased urine frequency and nocturia. After ruling out other medical conditions with similar symptoms, the initial approach to managing OAB is providing guidance on fluid consumption and bladder training. If needed, antimuscarinic medicines may be added as a supplement. If patients have significant distress from OAB symptoms even after maximizing medicinal treatment, they may choose to undergo invasive procedures. There is currently a limited understanding of the hierarchical structure of central nervous system control. However, the use of functional imaging is starting to reveal the difficulties that need to be addressed in this area. Current research is exploring the use of botulinum neurotoxin-A injection, oral β3-adrenergic agonists, and innovative methods for nerve stimulation as potential therapies. The inherent subjectivity of urine urgency, the absence of animal models, and the complex pathophysiology of overactive bladder (OAB) pose substantial obstacles to achieving effective clinical therapy

A cross-sectional study on the flood emergency preparedness among healthcare providers in Saudi Arabia

This study used a descriptive cross-sectional methodology to measure healthcare workers’ knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals’ ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts

Persistent COVID-19 symptoms at least one month after diagnosis: a national survey

Background Post-acute COVID-19 syndrome (PACS) is an important healthcare burden. We examined persistent symptoms in COVID-19 patients at least four weeks after the onset of infection, participants’ return to pre-COVID-19 health status and associated risk factors. Methods Cross-sectional study was conducted (December 2020 to January 2021). A validated online questionnaire was sent to randomly selected individuals aged more than 14 years from a total of 1397,386 people confirmed to have COVID-19 at least 4 weeks prior to the start of this survey. This sample was drawn from the Saudi ministry of health COVID-19 testing registry system. Results Out of the 9507 COVID-19 patients who responded to the survey, 5946 (62.5%) of them adequately completed it. 2895 patients (48.7%) were aged 35–44 years, 64.4% were males, and 91.5% were Middle Eastern or North African. 79.4% experienced unresolved symptoms for at least 4 weeks after the disease onset. 9.3% were hospitalized with 42.7% visiting healthcare facility after discharge and 14.3% requiring readmission. The rates of main reported persistent symptoms in descending order were fatigue 53.5%, muscle and body ache 38.2%, loss of smell 35.0%, joint pain 30.5%, and loss of taste 29.1%. There was moderate correlation between the number of symptoms at the onset and post-four weeks of COVID-19 infection. Female sex, pre-existing comorbidities, increased number of baseline symptoms, longer hospital-stay, and hospital readmission were predictors of delayed return to baseline health state (p < 0.05). Conclusion The symptoms of PACS are prevalent after contracting COVID-19 disease. Several risk factors could predict delayed return to baseline health state

Extraintestinal Manifestations Of Ulcerative Colitis In Saudi Arabia: Systematic Review

Background: Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), exhibits varied clinical presentations and extraintestinal manifestations (EIMs) that impact the overall well-being of affected individuals. This systematic review aims to consolidate recent studies conducted in Saudi Arabia to comprehensively analyze the sociodemographic characteristics and clinical features of UC patients, with a specific focus on bone-related complications. Objective: To systematically review Extraintestinal Manifestations of Ulcerative Colitis in Saudi Arabia Methodology: Using the PRISMA guidelines, a comprehensive A systematic search was conducted to identify relevant studies published between 2014 and 2023 on PubMed in English that investigated UC in Saudi Arabia. resulting in the inclusion of seven studies with a collective participant count of 1580. Sociodemographic characteristics &amp; Clinical characteristics, particularly the prevalence of bone-related complications, were examined across these studies. Results: The sociodemographic analysis of 1580 participants from seven studies highlighted variations in extraintestinal manifestations in IBD. Due to the inflammatory nature of the UC disease, and increased glucocorticoids concentrations, bone-related complications, including osteoporosis and osteopenia, were prevalent in UC patients, with distinct patterns observed in different studies. Arthropathy emerged as one of the most common extraintestinal manifestation. Moreover, renal stones are another issue for these patients. Finally, all of these manifestations contribute to the prevalence of anxiety and depression symptoms that was identified among UC patients, that indicated that fifth of these cohort suffer from, psychological disease. Conclusion: This systematic review provides a comprehensive overview of recent studies on UC in Saudi Arabia, emphasizing the prevalence of bone-related complications as predominant extra intestinal manifestations. The findings underscore the importance of addressing these complications in the management of UC patients, necessitating regular testing of the bone density in these patients and provide supplements and other necessary treatments for these patients. Moreover, it is important to consider the psychological impact of such disease on the quality of life of patients. Comprehensive multi-disciplinary medical teams need to work together to address various clinical aspects regarding Ulcerative colitis. This does not only include gastroenterologist, nephrologists and general internists, but also include psychologists/therapists to ensure all patients needs are addressed. Finally, further research is needed to have comprehensive view of UC in Saudi Populations and improve the overall quality of care

Managing Chronic Diseases in Family Medicine: Best practices and Evidence-Based Approaches

The management of chronic diseases within the realm of family medicine presents a multifaceted challenge with profound implications for healthcare systems and patients alike. Chronic diseases, such as diabetes, hypertension, and cardiovascular conditions, are prevalent and impose a significant burden on individuals, families, and society as a whole. This article explores best practices and evidence-based approaches for managing chronic diseases in family medicine. It delves into the epidemiological landscape of chronic illnesses, emphasizing the need for effective prevention and management strategies. Evidence-based Models, such as The Chronic Care Model (CCM), Patient-Centered Medical Home (PCMH), and Self-assessment models are discussed in the context of family medicine. The importance of comprehensive, coordinated, and patient-centric approaches is underscored, highlighting the pivotal role of primary care physicians in the ongoing&nbsp;battle against chronic diseases. It is clear, that development in the field of family medicine underscores the importance of patient involvement in diseases management process through shared-decision making model. Although such model require physicans to spend more time educating patients so they can make informed decisions and implement self-management strategies, it has overall better health outcomes and eventually needs to requiring less intervention by physicians

Perceived Risk of falls among Acute Care Patients

Purpose: In an effort to lower the number of falls that occur among hospitalized patients, several facilities have begun introducing various fall prevention programs. However, the efficacy of fall prevention programs is diminished if patients do not consider themselves to be at risk for falls and do not follow recommended procedures. The goal of this study was to characterize how patients in four different acute care specialist services felt about their risk of falling while in the hospital. Methods: One hundred patients admitted to the study hospital with a Morse Fall Scale score of 45 or higher were given the Patient Perception Questionnaire, a tool designed to assess a patient's perception of their own fall risk, fear of falling, and motivation to take part in fall prevention efforts. Scores on the Morse Fall Scale were gathered through a historical assessment of medical records. Descriptive statistics, Pearson's correlation coefficients, and independent sample t tests were used to examine the data. Results: The average age was 65, and around half (52%) were men and half (48%) were women. Based on their ratings on the Morse Fall Scale, all 100 participants were classified as being at high risk for falls. However, only 55.5% of the individuals agreed with this assessment. The likelihood that a patient would seek assistance and the degree to which they feared falling both declined as their faith in their mobility improved. Patients hospitalized after a fall exhibited considerably lower confidence scores and greater fear scores than patients who had not been injured in a fall. Conclusions: Patients who have a high fall risk assessment score may not believe they are at risk for falls and may not take any steps to reduce their risk. The prevalence of falls in hospitals might be mitigated by the creation of a fall risk assessment technique that takes into account both objective and subjective factors