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 & 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

Knowledge, perceptions and confidence of physicians and pharmacists towards pharmacogenetics practice in Kuwait.

BACKGROUND:Pharmacogenetics practice has been successfully implemented in many developed countries to enhance personalized medicine and improve clinical and economic outcomes. An understanding of healthcare providers' knowledge, perceptions, confidence towards pharmacogenetics, and their active enrollment with pharmacogenetic testing is essential for test acceptance and utilization. This study was designed to assess physicians' and pharmacists' knowledge, perceptions, and confidence towards pharmacogenetics, determine the preferred learning format for their future education in pharmacogenetics, and identify the barriers to its application in their practice settings. METHODS:A cross-sectional survey was conducted using a pretested self-administered questionnaire on a sample of 629 randomly selected physicians and pharmacists. Descriptive and comparative analyses were used in data analysis. RESULTS:The response rate was 98.1%. Less than one-tenth of respondents were exposed to pharmacogenetics education or training (8.9%), applied pharmacogenetics testing in their practice (9.4%), or provided patient counselling on the results of the pharmacogenetic testing (9.1%), and over 90% of them were physicians. The overall respondents' mean (SD) total knowledge score percentage was low [45.0% (24)] and there was no significant difference between the physicians and pharmacists scores (p>0.05). Only 16.0% of participants indicated that they felt confident in applying pharmacogenetics in their practice settings. Despite these low levels of knowledge and self-confidence, 70.2% of participants expressed overall positive perceptions towards pharmacogenetics and its clinical implications. These positive overall perceptions were found to be significantly more common among pharmacists compared to physicians (p<0.05). The top two perceived barriers facing the implementation of pharmacogenetics in Kuwait were lack of education or training and clinical guidelines. CONCLUSIONS:These findings highlight important concerns and will aid in the assessment of current pharmacogenetics practice. Also, they will provide further insight in designing future targeted multifaceted interventions to promote the adoption and utilization of pharmacogenetics testing in Kuwait

Maturity Assessment for Integrated Care during Health Transformation Using SCIROCCO Tool

Background: Integrated health care has the ability to provide adequate care system in different modalities of medical care. Saudi Arabia is going through major transformation in its health care services in order to provide sufficient resources. A 12-dimension SCIROCCO online self-assessment tool, was extracted from the B3-MM, was used for the scaling up of health intervention and for assessing the maturity level of integrated care within different regions. SCIROCCO tool assess a step wise scaling up technique to evaluate how to scale up integrated care during heath transformation. By having knowledge of the factors which make this strategy difficult to implement this study evaluates to what extent SCIROCCO technique was applied. Methods: The SCIROCCO tool was used to assess the maturity of systems of Jazan, Saudi Arabia for integrated care system and for the evaluation of factors affecting scaling up. Data was collected from Stakeholders from multiple disciplines including decision-maker, healthcare professional, IT specialist by self-assessment method. The outcomes of the self-assessment process were visually captured in the form of spider diagrams. Results: All three fundamental steps of the scaling up procedure were executed with satisfactory devotion. Integrated heath transformation in Jazan yielded 18 points out of 60 on spider diagram according to SCIROCCO tool. Majority of the dimensions have no more than 3 score. Digital Health care transformation in Jazan needs to be improved in most of the aspects. Conclusion: This study assesses maturity level of integrated care in Jazan and concludes that An ICT infrastructure to support integrated care has been agreed together with a recommended set of technical standards but there are Still local variations or some systems in place are not yet standardized. Learning about integrated care and change management was in place but not widely implemented

High prevalence of lack of knowledge and unhealthy lifestyle practices regarding premature coronary artery disease and its risk factors among the Saudi population

Abstract Objective Literature regarding coronary artery disease (CAD) and awareness of its risk factors is available in Saudi Arabia (SA). However, it is lacking with respect to premature coronary artery disease (PCAD). Therefore, it is necessary to evaluate the lack of knowledge of this underrepresented critical issue and to devise a well-constructed strategy for PCAD. This study aimed to assess the knowledge of PCAD and its risk factors in SA. Methods A cross-sectional questionnaire-based study was performed in the Department of Physiology, College of Medicine, King Saud University (KSU), Riyadh, SA between July 01, 2022, and October 25, 2022. A validated proforma was sent to the Saudi population. The sample size was 1046 participants. Results Proforma results indicated that 46.1% (n = 484) of participants believed that CAD could occur in people under the age of 45, whereas 18.6% (n = 196) did not believe, and 34.8% (n = 366) did not know. There was a highly statistically significant association present between sex and the belief that CAD can affect people who are under the age of 45 (p < 0.001), with 355 (73.3%) females believing that CAD can affect people below the age of 45 compared to 129 (26.7%) males. The results also showed a highly statistically significant relationship between educational status and the belief that CAD can affect people who are under the age of 45 (bachelor’s degree, 392 participants, representing 81.1%; p < 0.001). Furthermore, having employment was notably positively associated with that belief (p = 0.049) as was having a health specialty (p < 0.001). In addition, 62.3% (n = 655) of participants were not aware of their lipid profile, 49.1% (n = 516) preferred using vehicles to get to nearby places, 70.1% (n = 737) did not undergo regular medical checkups, 36.3% (n = 382) took medications without consultations, 55.9% (n = 588) did not exercise weekly, 69.5% (n = 112) were E-cigarette smokers, and 77.5% (n = 810) consumed fast food weekly. Conclusions Individuals from SA have an evident lack of public knowledge and poor lifestyle practices regarding PCAD, which demonstrates the need for health authorities to take a more targeted and attentive approach toward PCAD awareness. In addition, extensive media involvement is required to highlight the severity of PCAD and its risk factors in the population

Profile of facial palsy in Arar, northern Saudi Arabia

Abstract Background: The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. Common causes of facial paralysis include infection or inflammation of the facial nerve, head trauma, head or neck tumor, stroke. Objective: To outline the incidence of several etiologies and the profile of patients with peripheral facial paralysis attending the outpatient clinic of the neurology department in Hospitals of Arar City, Saudi Arabia. Methods: This cross-sectional study was carried out in Arar city from October 2016 to May 2017. The study was conducted in the outpatient clinic of the neurology department in hospitals of Arar City. Any ages of both sexes of all newly diagnosed unilateral facial palsy were included in the study. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. P-value was considered significant if <0.05 Results: The mean age of the facial palsy cases was 33.65 (±11.71) years. Among the studied participants, the total prevalence of facial palsy was 26.3% (61% females and 39% males). The right side of the face was affected in 51.2% and the etiology was exposure to cold air current in 92.7% of cases. The treatment was physiotherapy in 80.5% of the cases, medical in 17.1% and surgical in 2.4%. There was significant relationship between smoking and the occurrence of facial palsy (p<0.05). Conclusion: The study revealed that facial palsy was common in Arar city. The rate is higher among males than females. We also concluded that exposure to cold air current was the main etiology. We recommend health education sittings to bring awareness to the public about the nature, causes, risk factors, prevention and treatment of the diseas

A Glance at the Development and Patent Literature of Tecovirimat: The First-in-Class Therapy for Emerging Monkeypox Outbreak

Monkeypox disease (MPX) is currently considered a global threat after COVID-19. European Medicines Agency (EMA) approved Tecovirimat in capsule dosage form (200 mg) as the first treatment for MPX in January 2022. This article highlights Tecovirimat&rsquo;s development and patent literature review and is believed to benefit the scientists working on developing MPX treatments. The literature for Tecovirimat was gathered from the website of SIGA Technologies (developer of Tecovirimat), regulatory agencies (EMA, United States Food and Drug Administration (USFDA), and Health Canada), PubMed, and freely accessible clinical/patent databases. Tecovirimat was first recognized as an anti-orthopoxvirus molecule in 2002 and developed by SIGA Technologies. The USFDA and Health Canada have also recently approved Tecovirimat to treat smallpox in 2018 and 2021, respectively. The efficacy of Tecovirimat was verified in infected non-human primates (monkeys) and rabbits under the USFDA&rsquo;s Animal Rule. Most clinical studies have been done on Tecovirimat&rsquo;s safety and pharmacokinetic parameters. The patent literature has revealed inventions related to the capsule, injection, suspension, crystalline forms, amorphous form, and drug combinations (Tecovirimat + cidofovir) and process for preparing Tecovirimat. The authors foresee the off-label use of Tecovirimat in the USA and Canada for MPX and other orthopoxvirus infections. The authors also trust that there is immense scope for developing new Tecovirimat-based treatments (new drug combinations with other antivirals) for orthopoxvirus and other viral diseases. Drug interaction studies and drug resistance studies on Tecovirimat are also recommended. Tecovirimat is believed to handle the current MPX outbreak and is a new hope of biosecurity against smallpox or orthopoxvirus-related bioterrorism attack

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population