The prevalence of Factor V Leiden (Arg506Gln) mutation in King Khalid University Hospital patients, 2017–2019

Arg506Gln mutation is responsible for one of the procoagulant factors and most common inherited thrombophilia in the Factor V Leiden (FVL) family. The replacement of the missense mutation for Arg506Gln / R506Q is at 1691st position from Guanine to Adenine with the modification of the amino acid from arginine to glutamine. The aim of this study was to investigate the current prevalence of the G1691A mutation in the FVL gene in the capital city’s King Khalid University Hospitals (KKUH). Since 2017–2019 we have recruited 482 patients in these cross-sectional studies to test the G1691A mutation in KKUH’s FVL gene. DNA was extracted using 2mL of the EDTA blood and genotyping was performed with polymerase chain reaction and the data was analyzed using Sanger sequencing. In this study, 4.4% of the G1691A mutation was found to be positive (combined heterozygous-GA and homozygous-AA variants) and 95.6% of them with negative, i.e., homozygous normal-GG genotypes. Our study concludes that with the advances in genetic testing and their recent availability, early mutation detection could approve the genotype risks for many patients and this mutation is not as rare as previously believed in the Saudi region as our study has established with a 4.4 percent prevalence.departmental bulletin pape

A comparative study between a single-dose and 24-hour multiple-dose antibiotic prophylaxis for elective hysterectomy

Introduction: Surgical site infections (SSIs) are a major health issue in surgical specialties in terms of health care costs and patients’ clinical outcomes. At the level of the patient, prolonged hospital stays or readmissions for SSIs, can affect the patient’s quality of life. At the level of the health care system, it exhausts the hospital’s resources and increases the burden on the medical staff due to the need for continuous wound care, microbiological cultures, laboratory tests and medications. In this study, we assessed the effectiveness of two antibiotic prophylaxis regimens for the prevention of SSIs in patients undergoing elective hysterectomy surgeries. Methodology: A retrospective cohort, analyzing 141 patients, was conducted between November 2016 and January 2019 at a university hospital. We compared the efficacy of a single dose vs. 24-hour multiple doses of Cefazolin in patients who underwent elective hysterectomy for benign or malignant indications. The secondary objective was to identify potential risk factors associated with SSIs. Results: There was no statistically significant difference between both groups (p = 0.872). Obesity and a laparotomy surgical approach are risk factors to the development of SSIs (p = 0.001 and 0.014, respectively). Other potential risk factors include the duration of hospital stay, the duration of the surgery and the amount of blood loss. Conclusions: Although the rate of SSIs is not significantly different between both groups, risk stratification can be done after screening patients and the prophylactic regimen must be tailored for each patient in a cost-effective manner and using a multidisciplinary approach

Application of Mirena Intrauterine Device in Cesarean Section: Experience from a Private Hospital in Saudi Arabia - A Prospective Cohort Comparative Study

Background: Postpartum application of an intrauterine device (IUD) is often challenging to many women and induces fear, especially when performed without general anesthesia. This renders insertion difficult, which may predispose to complications, or the women to delay her decision for contraception. Our study compared the complications of Mirena IUD insertions during cesarean section (CS) versus 42 days postpartum. Methods: This study is a prospective cohort comparative study conducted in a private hospital in Saudi Arabia, from May 2021 to December 2021. Women were assigned into two groups. The first group (post-placental) contained 48 women in whom Mirena IUDs were inserted during CS, after placental delivery. The second group (postpartum) included 48 women where the intrauterine contraceptive device (IUCD) was inserted after 42 days postpartum. The primary outcome was the expulsion rate of IUD, while secondary outcomes were infection, perforation, bleeding, and displacement. The patients were followed up one month and three months after Mirena’s insertion. Results: There was no significant difference between the two groups regarding the expulsion rate (p = 0.646). Also, there was no significant difference between the two groups in terms of secondary outcomes (p > 0.05). Conclusions: Post-placental application of Mirena IUD is more accessible, more convenient, and less fearful for the patients

Enhancing responsivity of silicon PIN photodiodes at 1064 nm via light trapping and geometry optimization: a simulation study

Nd:YAG laser light detection at 1064 nm is widely used in applications requiring high-performance photodiodes to measure low light intensities. This study investigates the impact of light trapping and geometric variations on the responsivity of silicon-based PIN photodiodes at 1064 nm. Simulations using Ansys Lumerical FDTD and CHARGE reveal several key findings. Without diffuse reflectors, the responsivity of the photodiodes aligns with theoretical and literature values of approximately 0.4–0.45 A/W. When rear-side diffuse reflectors are used, larger photodiode dimensions result in higher responsivity, with a peak of 0.58 A/W for photodiodes with a 400 µm thickness. Our simulations suggest that combining light trapping with optimized geometries or side reflectors could surpass the current responsivity ceiling of ∼0.57 A/W, offering a pathway to exceed this limit without sacrificing electrical performance. Also, light trapping reduces the required thickness of Si PIN photodiodes for achieving specific responsivity at 1064 nm. For instance, 100 µm thick photodiodes with diffuse reflectors exhibit a responsivity of approximately 0.31 A/W, compared to 0.28 A/W in 400 µm thick photodiodes without reflectors. However, the enhancement from light trapping diminishes as photodiode thickness increases. Optimal photodiode dimensions for balanced performance are suggested to be a thickness of 200–300 μm and an area of 0.6–2.5 mm2. Experimental validation is recommended to assess texturing-related effects, such as increased dark current or recombination

Realizing the potential of real-time clinical collaboration in maternal–fetal and obstetric medicine through WhatsApp

Background This study aimed to explore the potential of using instant messaging to enhance patient-care and physician-education in obstetric medicine and maternal–fetal medicine. Methods This retrospective study examined real-time correspondence between a closed group of maternal–fetal medicine physicians and fellows-in-training. Correspondence was grouped into four domains. Time to obtain a response and their utility was analysed. Results Over the two-year period, 41 international members contributed 534 clinically relevant messages (291 stems and 243 responses). Of these, 33% were advice seeking, 23.4% case-sharing, 35% educational content and 8.2% miscellaneous content. The median response time was 52 min, and 53% responded in less than 60 min. At least one response in each case influenced clinical management. Conclusion Instant messaging is effective for real-time clinical collaboration and could serve as an important platform for enhancing management and continuing education for obstetric medicine and maternal–fetal medicine physicians. International societies should consider exploring this avenue further. </jats:sec

Sickle cell disease and pregnancy outcomes: population-based study on 8.8 million births

Abstract Objective: To estimate the prevalence of sickle cell disease (SCD) in pregnancy, and to measure risk factors, morbidity, and mortality among women with SCD with and without crisis at the time of birth. Methods: We conducted a population-based, retrospective cohort study on all births in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) from 1999 to 2008. Births to SCD with and without crisis were identified using ICD-9 codes. Adjusted effects of risk factors and outcomes were estimated using logistic regression analyses. Effect of hemoglobin variants among women with SCD was analyzed as a predictor of crisis. Results: There were 4262 births to women with SCD for an overall prevalence of 4.83 per 10,000 deliveries. 28.5% of women with SCD developed crisis at the time of delivery. The maternal mortality rate was 1.6 per 1000 deliveries in women with SCD, compared to 0.1 per 1000 in women without SCD. Pregnant women with SCD had a higher risk of developing preeclampsia, eclampsia, venous thromboembolism, cardiomyopathy, intrauterine fetal demise, and intrauterine growth restriction. Cesarean delivery rates were higher in women with SCD. Among the 1898 SCD women with identified hemoglobin variants, homozygous SS was the greatest risk factor for sickle cell crisis, accounting for 89.8% of all women who developed crisis. Conclusion: Pregnant women with SCD have a high risk of morbidity and mortality. Developing acute sickle cell crisis worsened perinatal outcomes.</jats:p

What Are the Saudi Community Attitudes Towards Domestic Violence Against Women? A Cross-Sectional Study From Riyadh

Introduction: Culture and social norms shape attitudes towards domestic violence against women (DVAW). Attitudes accepting DVAW contribute to violence. There is scarce evidence about community attitudes towards DVAW in Saudi Arabia. The study explores the Saudi community attitudes towards DVAW. Methods: The study utilized a descriptive cross-sectional design using a self-report structured questionnaire to collect socio-demographic data and participants’ attitudes towards DVAW. Results: The study sample included 831 Saudi participants, 414 females and 417 males, between 18 and 79 years old. The majority of participants (69.5%) showed rejection of DVAW. Women were five times more likely to reject DVAW than men (OR = 5.19, 95% CI [3.6–7.4]). Participants with pre-university education and lower living standards reported rejection of DVAW compared to their counterparts. Discussion: The results can help stakeholders develop strategies and awareness campaigns targeting different educational and living levels to minimize DVAW. </jats:sec

Cervical Cancer and Human Papillomavirus Awareness among Women in Saudi Arabia

Background and Objectives: Cervical cancer (CC) is the eighth most common cancer among Saudi women of all ages. With limited national data, we aimed to evaluate the public awareness of cervical cancer, CC risk factors, HPV infection, and HPV vaccines in different regions of Saudi Arabia. Materials and Methods: This was a survey-based cross-sectional study that encompassed 564 Saudi women over a period of a month. A self-administrated questionnaire was distributed through different social media platforms. Results: The collected data included sociodemographic variables and questions assessing awareness of CC, and the attitudes toward CC screening and human papillomavirus (HPV) vaccination. Most respondents were aware of CC (84.0%), although their primary source of information was the internet. However, only 45 females (8.0%) had a history of cervical screening. Furthermore, most females did not know that HPV was transmitted sexually (78.9%), or that it caused genital warts (81.7%) and CC (81.9%). Regarding the HPV vaccine, 100 females (17.7%) had heard about it, but only 11 (2.0%) took the vaccine, although more than half of the respondents (54.1%) were willing to take the vaccine after being informed about it. Conclusions: We noticed a remarkable lack of awareness among the respondents regarding HPV&rsquo;s clinical implications; and the HPV vaccine, and its importance and availability. The main source of information for most of the Saudi women in this study was the internet, which may be an unreliable source, or provide misleading information that may delay screening or discourage vaccination. Thus, organized campaigns by the Ministry of Health or other health-advocating agencies, in addition to screening and vaccination programs, are strongly encouraged