Search

Saad Mohammad Alsaad,1,2,&ast; Fahad Alajlan,2,&ast; Reema Alserhani,3 Nouf Alhussaini,3 Najoud Alali,3 Saud Abdullah Alatawi3 1Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Fahad Alajlan, Department of Family and Community Medicine, King Saud University Medical City, Saudi Arabia, Email Fahadajl64@gmail.comBackground: Continuity of care is one of the main principles of family medicine, described as a relationship with a single provider that extends beyond a single illness episode. This retrospective study, conducted at King Saud University Family Medicine Center in Riyadh, Saudi Arabia, aimed to investigate the impact of having a regular primary care provider on clinical outcomes and preventive service delivery for patients with diabetes and/or hypertension.Methods: The study, spanning 2017 to 2019, included 400 patients diagnosed with diabetes and/or hypertension for at least six months before the 6-month pre-attachment period to regular family medicine physicians in 2018. Data before and after attachment for at least six months were compared using electronic health records.Results: The mean age of the patients was 60.9, with a predominant female representation (66.8%) and 90.7% Saudis. Results indicated a significant improvement in glycated hemoglobin (HbA1c) levels (p = 0.005) and systolic blood pressure (p = 0.014) post-attachment. Preventive service delivery saw notable enhancements, with increased colon cancer screening (p = 0.03), breast cancer screening (p < 0.001), and retinal screening (p < 0.001) post-attachment.Conclusion: This study’s findings underscore the importance of continuity of care in chronic disease management and provide valuable and promising insights into the Saudi healthcare context, aligning with the Saudi Ministry of Health’s vision for universal access to regular primary care providers.Keywords: continuity of patient care, primary health care, diabetes mellitus, essential hypertension, healthcare quality

Hyder Mirghani,1 Naif Alali,1,2 Hani Albalawi,2 Ruba ALselaimy3 1Internal Medicine and Endocrine, Medical Department, Faculty of Medicine, University of Tabuk, Tabuk, Kingdom of Saudi Arabia; 2Ophthalmology Department, Faculty of Medicine, University of Tabuk, Tabuk, Kingdom of Saudi Arabia; 3Ophthalmology Department, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Hyder MirghaniFaculty of Medicine, University of Tabuk, PO Box 3378, Tabuk, 51941, Saudi ArabiaTel +966569344569Email s.hyder63@hotmail.conmPurpose: Assessing diabetic retinopathy (DR) risk factors and daily nutrition habits are vital for prevention. This study aims to evaluate the relationship between diet soda cans, non-nutritive sweetener consumption, and diabetic retinopathy.Patients and Methods: A cross-sectional study was conducted among 200 patients attending a diabetes center in Tabuk City, Saudi Arabia, from September 2019 to July 2020. A structured questionnaire was used to collect patients’ demographic factors, and DR risk factors including the use of diet soda, non-nutritive sweeteners, and exercise habits. Dilated fundus eye examination was done to detect any diabetic retinopathy. A blood sample was taken for measuring glycated hemoglobin to assess the degree of glycemic control.Results: The participant’s age was 50.74 ± 13.51 years, and the duration since the diagnosis of diabetes was 9.99 ± 6.97 years, body mass index was 27.28 ± 4.68, and HbA1c %, 8.50 ± 1.61), the patients used to consume 1.31 ± 1.57 diet soda cans/week, and 1.06± 1.39 artificial sweeteners/sachet/day. DR was found in 33%. Diet sugar-free carbonated soda beverage was associated with poor glycemic control and retinopathy, while non-caloric flavor consumption was associated with obesity (P-value< 0.05). No association was evident regarding other factors (P-value> 0.05).Conclusion: Diet sugar-free carbonated soda beverage was associated with higher HbA1c and retinopathy, while non-caloric flavor consumption was associated with obesity. No association was evident regarding other factors. Further larger multicenter studies are needed.Keywords: non-caloric flavors, carbonated soda beverage, diabetic retinopathy

Nawaf Osaywid Alrashidi,1 Wafy Abdulrahman Albrak,1 Shaker Osaywid Alreshidi,2 Lama Abdulrahman Alaradi,3 Hatim Adam Nagi Adam,3 Naif Mamdouh Alali,4 Faris Hashem,4 Hani Basher Albalawi,4 Ahmed Yousef Alothman,5 Shaima Sulaiman Alharbi2 1College of Medicine, University of Ha’il, Ha’il, Saudi Arabia; 2Department of Ophthalmology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 3Department of Community Medicine, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia; 4Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 5Ophthalmology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Faris Hashem, Email fhashem@ut.edu.saPurpose: The study aims to assess the perception of optical spectacles use among the Ha’il region population in Saudi Arabia.Patients and Methods: A cross-sectional survey was distributed via various social media applications to the residents of the Ha’il region. An online questionnaire was designed and included informed consent and questions assessing the participants’ perceptions about wearing eyeglasses, contact lenses, and general eye health.Results: 32.4% of the participants think that long-term eyeglasses wearing worsens vision, and 43% think eyeglasses wearing improves vision. 75.2% believe that long-term use of glasses could cause lifetime dependency on eyeglasses. Regarding contact lenses, 45.9% believe that long-term wearing worsens vision, and 24.1% think long-term wearing of contact lenses improves vision. 60% think long-term use of lenses causes lifetime dependency on those contact lenses.Conclusion: Our results highlighted the misconceptions among the study population regarding wearing prescribed eyeglasses and contact lenses. Thus, education programs and media are warranted to correct the misconceptions about spectacles and raise the awareness about refractive errors and treatment options.Keywords: refractive errors, vision impairment, eyeglasses, contact lenses

Hanan M Aljammaz,1 Wijdan M Aleithan,1 Amal Mohammad Albalawi,2 Rabab T Aljayani,3 Rawabi T Aljayani,4 Manal M Aljammaz,5 Saad H Alenezi,6 Shaker Alreshidi,6 Faris Hashem,7 Naif M Alali,7 Hani B ALBalawi7 1Internal Medicine Department, King Fahad Specialist Hospital, Tabuk, Saudi Arabia; 2Psychiatry Department, Eradah Mental Health Complex, Tabuk, Saudi Arabia; 3Ophthalmology Department, Dammam Medical Complex, Dammam, Saudi Arabia; 4Internal Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia; 5Medical Laboratory Department, University of Tabuk, Tabuk, Saudi Arabia; 6Ophthalmology Department, Faculty of Medicine, Majmaah University, Majmaah, Saudi Arabia; 7Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi ArabiaCorrespondence: Faris Hashem, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia, Tel +966507001234, Fax +966144273022, Email fhashem@ut.edu.saPurpose: Dry eye disease (DED) is a common ocular problem that worsens patients’ quality of life. This study aimed to assess DED prevalence and risk factors among medical students at the University of Tabuk.Patients and Methods: This is an analytical, cross-sectional, survey-based study. An online questionnaire was distributed by email to all medical students at the University of Tabuk. A self-administered McMonnies questionnaire was used in the assessment.Results: We included 247 medical students who completed the questionnaire. Most participants were females (71.3%) and were < 25 years old (85.8%). DED prevalence rate was 18.2% (95% CI=13.61% to 23.61%). Furthermore, DED was found to be significantly associated with the presence of irritation of eyes when waking up from sleep (OR=19.315), sleeping with partially opened eyes (OR=19.105), redness and irritation of the eyes when swimming in chlorinated fresh water (OR=7.863), and having prescription eyedrops or other dry eye treatments (OR=3.083).Conclusion: Our study at the University of Tabuk found that 18.2% of medical students had dry eye disease and identified the associated risk factors. Early diagnosis and treatment are crucial to prevent complications due to the high prevalence of DED.Keywords: eye dryness, survey, DED, observational study

Hani B Albalawi,1 Faris Hashem,1 Amal Nafea J Alharbi,2 Naif M Alali,1 Wejdan Mohammed S Alshehri,2 Abdulrahman Arshed N Alharfy,2 Abdulmajeed Mousa M Alzahrani,2 Nouf Mohammed A Albalawi,2 Moustafa S Magliyah,3 Saad H Alenezi4 1Department of Ophthalmology, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 2Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 3Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia; 4Department of Ophthalmology, College of Medicine, Majmaah University, Almajmaah, Saudi ArabiaCorrespondence: Hani B AlbalawiDepartment of Ophthalmology, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia, Email hb.albalawi@ut.edu.saPurpose: This study aims to measure the knowledge levels toward retinopathy of prematurity (ROP) among pediatricians covering neonatal intensive care units (NICUs) in the major hospitals in Tabuk, Saudi Arabia. To our knowledge, this is the first report to assess the awareness level of ROP in the NICU pediatricians in the region.Patients and Methods: This is a quantitative, non-experimental, cross-sectional, descriptive study using self-administered electronic questionnaires to assess the knowledge level among NICU pediatricians at the main hospitals of Tabuk city. We used a self-administer online validated knowledge, attitude, and practice (KAP) questionnaire. A scoring system was implemented in the data analysis, depending on the correct chosen answers on the KAP questionnaire, to present the ROP knowledge level in the participants.Results: The study included 41 NICU pediatricians. Most of the participants’ age exceeded 40 years (51.2%). The majority were recruited from either King Salman Military hospital (34.1%) or King Khalid hospital (31.7%). The average frequency of preterm infants seen per month exceeded 15 infants among 41.4% of the respondents. Most pediatricians recognized the important treatment modalities available for ROP (92.7%); however, only 24.4% of them could recognize that 32 weeks or less is the gestational age of the screening criteria for ROP. The overall knowledge score ranged between 4 and 10, out of a possible maximum of 12 with a mean ± SD of (6.68± 1.47). The majority (75.6%) believe that the ROP treatment can successfully prevent blindness.Conclusion: Our study demonstrated that the NICU pediatricians have good knowledge about the treatment modalities of ROP. However, their knowledge about the inclusion criteria of ROP screening was insufficient. Thus, we highlighted the necessity of raising the awareness level and the strict application of the clinical guidelines among NICU pediatricians and healthcare workers involved in managing ROP.Keywords: retinopathy of prematurity, pediatricians, preventable, preterm infant, knowledge, attitude, practice, ROP

Khalid S Asharari,1 Naif M Alali,2 Moustafa S Magliyah,1 Hassan A Al-Dhibi,3 Faisal A Almarek,4 Hani B AlBalawi2 1Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia; 2Ophthalmology Division, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 3Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 4Department of Ophthalmology, College of Medicine, Imam Mohammad bin Saud Islamic University, Riyadh, Saudi ArabiaCorrespondence: Hani B AlBalawiOphthalmology Division, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi ArabiaEmail hani.albalawi@hotmail.comBackground: Central serous chorioretinopathy (CSCR) is an idiopathic condition characterized by serous retinal detachment and/or retinal pigment epithelial (RPE) detachment, the condition associated with a fluid leak through the RPE into subretinal space. This article reports on an unusual case of CSCR following taking adulterated honey mixed with tadalafil powder.Case Presentation: A 38-year-old male, not known to have any medical illnesses, came to our ophthalmology clinic complaining of sudden onset of blurred central vision in the left eye for five days after taking an adulterated honey which was claimed to improve sexual performance. On taking a history, the patient denied taking any medications or past eye trauma or surgery. On detailed ophthalmologic examination, the best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/80 in the left eye. Dilated fundus examination of the right eye showed a flat retina, normal macular reflex, healthy optic nerve head and the left eye showed blunt foveal reflex with neurosensory retinal detachment at the macula and subretinal fluid. Optical coherence tomography (OCT) of the left eye showed marked macular thickening, leading to the impression of central serous chorioretinopathy (CSCR). Four weeks after stopping the adulterated honey, BCVA improved to 20/20 in the left eye, with complete resolution of subretinal fluids.Conclusion: Our case adds to recently reported cases of a link between tadalafil and CSCR.Keywords: tadalafil, CSCR, sildenafil, adulterated honey

Alanuad I Albazei,1 Omar H Ahmed,1 Naif M AlAli,2 Ruba M Alselaimy,3 Shaker O Alreshidi,4 Moustafa S Magliyah,5,6 Hani B Albalawi2 1Department of Ophthalmology, King Khalid Hospital, Tabuk, Saudi Arabia; 2Department of Ophthalmology, Tabuk University, Tabuk, Saudi Arabia; 3Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Almajmaah University, Almajmaah, Saudi Arabia; 5Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia; 6Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Moustafa S MagliyahVitreoretinal Division, King Khaled Eye Specialist Hospital, Al- Oruba Street, PO. Box 7191, Riyadh, 11462, Saudi ArabiaTel +966 11 482 1234 Ext. 2655Fax +966 11 4821234 Ext. 2764Email mussam8@yahoo.comPurpose: To report the poor visual outcome of ruptured globe caused by camel bites.Observations: A 48-year-old camel caregiver presented to the emergency department after being bitten by a camel in the left side of his face. Ophthalmic examination revealed a superior scleral wound from 9 to 2 o’clock, about 6 mm from the limbus extending to the equator with prolapse of uveal and vitreous tissues, an opaque cornea, total hyphema, diffuse subconjunctival hemorrhage, and a lower lid laceration involving the lid margin and the nasolacrimal duct. The patient has undergone surgical repairs of ruptured globe and lid laceration, followed by retinal detachment surgery. Following these surgical interventions, the patient preserved a light perception vision with flat retina.Conclusion: Camel-related injuries might primarily involve the ophthalmic structures, especially in camel bites. Camel-related eye trauma might lead to poor visual and anatomical outcomes which might not improve following surgical interventions.Keywords: camel attack, ruptured globe, trauma, retinal detachment, animal-related injury, camel-related injury

Introduction The literature informs us that people who are Deaf frequently struggle with health services, which contributes to lower health literacy due to communication and language barriers. Few health professionals understand sign language, so communication between a Deaf person and a health professional may rely on a mediator, usually a family member or an interpreter, to provide communication assistance. Aim This study aimed to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) at King Saud University Medical City (KSUMC) toward Deaf adult patients. Subjects and methods This cross-sectional study was conducted among HCWs at KSUMC, Saudi Arabia. A self-administered questionnaire was sent to the HCWs using an online survey. The questionnaire includes socio-demographic data (i.e., age, gender, marital status, etc.), previous interaction with Deaf patients, and KAP items. Results Of the 351 HCWs, 63.8% were females, and 41.6% were aged between 28 and 37 years old. The overall mean knowledge score was 1.14 out of 7 points. The overall mean attitude score was 46.2 out of 90 points, and the mean practice score was 19.1 out of 35 points. Significant factors of increased attitude include being a non-Saudi, being married, having children, increasing years of working experience, and being a nurse, while being a male, having previous interaction with a Deaf patient, and having skills in any type of sign language were the significant predictors of increased practice. Working in the surgery department was the only predictor associated with increased knowledge. Conclusion There was a significant deficiency, particularly with regard to knowledge and attitude toward Deaf patients. Increasing knowledge was associated with increasing practices but not with attitude. HCWs who had previous interactions with Deaf patients and had knowledge of any sign language tended to demonstrate better practice in dealing with Deaf patients. Further, longitudinal studies are needed to determine the level of KAP among HCWs in our region., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alamro et al.)

Background: Pain management after bariatric surgery remains challenging given the risk for analgesia-related adverse events (e.g., opioid use disorder, marginal ulcers). Identifying modifiable factors associated with patient-reported pain outcomes may improve quality of care. We evaluated the extent to which patient and procedural factors predict 7-day post-discharge pain intensity, pain interference, and satisfaction with pain management after bariatric surgery., Methods: This prospective cohort study included adults undergoing laparoscopic bariatric surgery at two university-affiliated hospitals and one private clinic. Preoperative assessments included demographics, Pain Catastrophizing Scale (score range 0-52), Patient Activation Measure (low [< 55.1] vs. high [≥ 55.1]), pain expectation (0-10), and Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) anxiety and depression scales. At 7 days post-discharge, assessments included PROMIS-29 pain intensity (0-10) and pain interference scales (41.6-75.6), and satisfaction with pain management (high [10-9] vs. lower [8-0]). Linear and logistic regression were used to assess the association of pain outcomes with potential predictors., Results: Three hundred and fifty-one patients were included (mean age = 44 ± 11 years, BMI = 45 ± 8 kg/m 2 , 77% female, 71% sleeve gastrectomy). At 7 days post-discharge, median (IQR) patient-reported pain intensity was 2.5 (1-5), pain interference was 55.6 (52.0-61.2), and 76% of patients reported high satisfaction with pain management. Pain intensity was predicted by preoperative anxiety (β + 0.04 [95% CI + 0.01 to + 0.07]) and pain expectation (+ 0.15 [+ 0.05 to + 0.25]). Pain interference was predicted by preoperative anxiety (+ 0.22 [+ 0.11 to + 0.33]), pain expectation (+ 0.47 [+ 0.10 to + 0.84]), and age (- 0.09 [- 0.174 to - 0.003]). Lower satisfaction was predicted by low patient activation (OR 1.94 [1.05-3.58]), higher pain catastrophizing (1.03 [1.003-1.05]), 30-day complications (3.27 [1.14-9.38]), and age (0.97 [0.948-0.998])., Conclusion: Patient-related factors are important predictors of post-discharge pain outcomes after bariatric surgery. Our findings highlight the value of addressing educational, psychological, and coping strategies to improve postoperative pain outcomes., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: In the current opioid crisis, bariatric surgical patients are at increased risk of harms related to postoperative opioid overprescribing. This study aimed to assess the extent to which opioids prescribed at discharge after bariatric surgery are consumed by patients., Methods: This multicenter prospective cohort study included adult patients (≥ 18yo) undergoing laparoscopic bariatric surgery. Preoperative assessments included demographics and patient-reported measures. Information regarding surgical and perioperative care interventions (including discharge prescriptions) was obtained from medical records. Self-reported opioid consumption was assessed weekly up to 30 days post-discharge. Number of opioid pills prescribed and consumed was compared using Wilcoxon signed-rank test. Zero-inflated negative binomial regression was used to identify predictors of post-discharge opioid consumption., Results: We analyzed 351 patients (mean age 44 ± 11 years, BMI 45 ± 8.0 kg/m 2 , 77% female, 71% sleeve gastrectomy, length of stay 1.6 ± 0.6 days). The quantity of opioids prescribed at discharge (median 15 pills [IQR 15-16], 112.5 morphine milligram equivalents (MMEs) [IQR 80-112.5]) was significantly higher than patient-reported consumption (median 1 pill [IQR 0-5], 7.5 MMEs [IQR 0-37.5]) (p < 0.001). Overall, 37% of patients did not take any opioids post-discharge and 78.5% of the opioid pills prescribed were unused. Increased post-discharge opioid consumption was associated with male sex (IRR 1.54 [95%CI 1.14 to 2.07]), higher BMI (1.03 [95%CI 1.01 to 1.05]), preoperative opioid use (1.48 [95%CI 1.04 to 2.10]), current smoking (2.32 [95%CI 1.44 to 3.72]), higher PROMIS-29 depression score (1.03 [95% CI 1.01 to 1.04]), anastomotic procedures (1.33 [95%CI 1.01 to 1.75]), and number of pills prescribed (1.04 [95%CI 1.01 to 1.06])., Conclusion: This study supports that most opioid pills prescribed to bariatric surgery patients at discharge are not consumed. Patient and procedure-related factors may predict opioid consumption. Individualized post-discharge analgesia strategies with minimal or no opioids may be feasible and should be further investigated in future research., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study aimed at assessing the extent to which the general Saudi population has embraced digital health medical applications to meet their health-related needs so that the Saudi Ministry of Health and government can appropriately be guided on scaling up digital health across the country. As such, this study was guided by the question of to what extent the Saudi people use digital health mobile-based applications. This was a cross-sectional study utilizing snowballing sampling approach. Frequencies, Chi-square, and Spearman rank correlation statistics were used to offer descriptive and inferential analysis of the variables. The majority of the participants were economically able to afford smart devices that have medical apps, had at least an app on such devices, and highly regarded the benefits of the apps. Unfortunately, their understanding of how to use such apps was limited, and this posed a barrier to embracing digital health alongside difficulty downloading apps and medical ethical concerns. Although there is a willingness, extra effort is needed from the Saudi Ministry of Health and the government to promote the uptake of digital health in Saudi Arabia.

Objectives: The purpose of this review study was to assess the risk of exposure to BTEX compounds in gas station workers and operators., Content: The main components of BTEX compounds are Benzene, Toluene, Ethyl benzene and Xylene. Petroleum, coal large quantities in crude oil and its products are the most important sources of BTEX compounds. These compounds have both high solubility (found in surface and underground waters) and evaporate quickly. Gas stations are one of the most important sources of emission of these compounds in communities. Workers who work in these places have a lot of exposure to these compounds. Exposure to these dangerous compounds can cause many problems for workers. This study was a narrative review article. According to different databases: PubMed, Web of Science, Springer, Cochran and Science Direct, 451 articles were retrieved. 55 full-text articles entered into the analysis process. Finally, 32 articles were selected in this study. The search was restricted to English-language papers published between 1 February 1995 and 13 August 2022. The results of our study showed that the carcinogenic risk (ILCR) for gas station workers in Bangkok (1.82 ∗ 10 -4 - 2.50 ∗ 10 -4 ), Shiraz (6.49∗10 -7 - 1.27 ∗ 10 -5 ), Brazil (1.82 ∗ 10 -4 ), Ardabil (390∗10 -6 ± 1884 ∗ 10 -6 ) and Johannesburg (3.78 ∗ 10 -4 ) was high. The non-cancer risk for oil industry workers of Dilijan (Iran) who were exposed to toluene was also reported in the range of 10-6∗176. The health of gas station workers is affected by exposure to BTEX and gasoline vapor emissions. According to the result this study, BTEX compounds cause genotoxic changes, chromosomal and genetic abnormalities., Summary and Outlook: Genotoxicity at high levels in gas station workers can cause cancerous and non-cancerous risks. Improving the production process of diesel fuel and gasoline in refineries, using periodical examinations of workers and operators at gas and fuel stations, using Euro 4 and 5 fuels, and replacing worn out cars can play an important role in reducing the emission of BTEX compounds and thus reducing health risks and carcinogenic., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Introduction: The objective of this study was to assess the epidemiological characteristics, clinical features and visual outcomes of open globe eye injury (OGI) in Tabuk, Saudi Arabia., Methods: A retrospective chart review of OGI patients who had undergone operative repair of their injuries in Tabuk, Saudi Arabia. The collected data included patients' demographics, duration between trauma and presentation and the mechanism of trauma, wound location, extent of injury, presence of intraocular foreign body, and initial and final visual acuity data., Results: Sixty-three eyes of 63 patients who were admitted for traumatic globe rupture were included; 84.1% were males and 39.7% were of pediatric age. Delay in seeking medical care for > 24 h was recorded in 4.8% of patients. The most common (42.9%) mechanism was blunt trauma followed by sharp trauma (38.1%) and projectile trauma (9.5%); 55.6% had the injury in zone 1. Intraocular foreign body was reported in 9.5% of patients. Intraocular foreign bodies were significantly more common in adults (p = 0.018) compared to children. Poor visual acuity was noted in 77.8% of patients upon presentation and 60.3% on last visit., Conclusion: The incidence of OGI was more common in males. The most common cause of OGI was blunt injury, and half of the injuries were in zone 1. Visual outcomes are guarded for most patients with OGIs., (© 2022. The Author(s).)

Objective: To describe the geographic distribution of infections caused by Pythium insidiosum in dogs, horses, and other animal species in the US., Animals: For the last 20 years, we have collected data from cases of pythiosis in 1,150 horses, 467 dogs, and other species (59) from various geographic locations in the US., Procedures: Due to lost data (from 2006 to 2016), the selected cases include years 2000 to 2005 and 2016 to 2020. The selection of cases was based on infected host clinical features, serum samples demonstrating strong positive anti-P insidiosum IgG titers in serologic assays, and positive results on ≥ 1 of the following diagnostic modalities: microbial culture on 2% Sabouraud dextrose agar, histologic evaluation, PCR assay, and wet mount cytologic evaluation (with potassium hydroxide)., Results: Most confirmed P insidiosum infections were found in horses and dogs in the southeastern US. Interestingly, in Texas, no cases were found west of longitude 100°W. Few pythiosis cases were diagnosed in west-coast states. Equine cases were more often diagnosed during summer and fall months, but canine cases were more often diagnosed between September and February. Cases in other species were discovered in the same geographic areas as those in dogs and horses., Clinical Relevance: To our knowledge, this is the first report providing the ecological distribution of P insidiosum infection in affected species in the US. Results of this study illustrated the importance of including P insidiosum in the differential diagnostic scheme of nonhealing skin lesions or intestinal granulomatous masses, particularly in dogs and horses inhabiting or having visited endemic areas.

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents' perspectives on amblyopia and routine examination of their children's eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35-50 years of age (61.5%), 20-34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents' awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.

Objective: In contrast to childhood obesity, studies involving thin children are much fewer, especially in developed countries. Furthermore, most reports do not address the impact of childhood thinness on height velocity. This study investigated the prevalence of thinness and its effect on height velocity in schoolchildren in the United Arab Emirates (UAE). Weight and height were measured in 29,410 schoolchildren (50.5% females), as part of the health assessment (academic year 2014-2015). The body mass index (BMI) was classified as normal, thinness, overweight, or obese using cutoffs established by the International Obesity Task Force (IOTF), World Health Organization, and Centers for Disease Control., Results: The median age was 10.2 years (range, 3-19). Using the IOTF scale, one-quarter of the children aged 4-6 years and one-third of the children aged 7-9 years were thin (BMI ≤ 18.5 kg/m 2 ). Thinness was less prevalent (8-10%) in adolescents. Group peak height velocity was delayed 1-3 years in thin children and was higher in children with excess body fat. In conclusion thinness was the highest (25-33%) in children aged 4-9 years of age and their peak height velocity was delayed 1-3 years when compared to the other children.

Background: Owing to the revolution in technology, the internet has become an important aspect of people's lives. Modern technology is enabling people from diverse educational backgrounds to use the internet for several purposes, one of which is health information seeking. Recently, Web-based health information has become more popular among patients all over the world and among the general public., Objective: This study aimed to investigate the use of Web-based health resources among undergraduate students from different faculties at Kuwait University., Methods: The study employed a cross-sectional design with students selected from 8 faculties of Kuwait University, 4 faculties of Literature and 4 faculties of Science. Data were collected using structured questionnaires, and analysis was done using a chi-square test and binary logistic regression to determine the factors associated with seeking health information on the Web., Results: The sample size obtained was 1132 with a response rate of 90.27% (1132/1254). Overall, the prevalence of students seeking Web-based health information was 92.66%. (1049/1132) The most significant factors associated with seeking health information on the Web were age, gender, faculty, year of study, primary source of internet, and level of experience with internet use. In total, 90.0% (325/361) of students who were aged older than 21 years used Web-based health information compared with 82.8% (275/332) of those who were aged 18 years. In addition, female students showed a higher prevalence (829/934, 88.8%) of Web-based health information seeking than males (210/270, 77.8%). Students who majored in faculties of Science were more likely to seek health information than those who majored in faculties of Literature. All the differences found in the study were statistically significant (P<.05)., Conclusions: The study concluded that many people use the internet for seeking health information. Sociodemographic factors have a significant association with Web-based health information seeking. Therefore, doctors must educate the public about the health information websites that can be trusted., (©Hasan Ashkanani, Rabab Asery, Fajer Bokubar, Noor AlAli, Shahad Mubarak, Ali Buabbas, Abdullah Almajran. Originally published in JMIR Formative Research (http://formative.jmir.org), 31.10.2019.)

Background: Establishment of thromboembolism prevention remains a challenge despite the widespread consensus that thromboprophylaxis safely reduces patient morbidity and mortality. Dabigatran is a nonvitamin K antagonist oral anticoagulant (NOAC) which reduces the risk of thromboembolism. Proper dosing is important to achieve the maximum prophylactic benefit with a maintained safety profile., Objective: To evaluate the appropriateness of dabigatran dosing for stroke and systemic embolism prevention in patients with nonvalvular atrial fibrillation (NVAF)., Methods: This is a retrospective cohort study of adults with NVAF. The data were collected from the electronic filing system of the hospital. Patients receiving dabigatran therapy were divided into two treatment groups according to the dose of dabigatran received. The indications for dabigatran as an oral direct anticoagulant, including age, risk of bleeding, creatinine clearance (CrCl), were collected. Appropriateness of dose reduction included any of the following factors: HAS-BLED score >2 points, age ≥75 years, or CrCl of 30-50 mL/min. The two groups were evaluated according to dose appropriateness., Results: Dabigatran dose of 110 mg was found to be inappropriately low in a large number of patients (31.3%). Multivariate regression analysis showed significant association of age and dose appropriateness ( p  < 0.001)., Conclusion: This study revealed inappropriate prescription of reduced doses of dabigatran in a large number of patients. Age was identified as the main driving factor for underdosing. Physicians' and pharmacists' awareness regarding this type of high-risk medication should be improved to ensure appropriate and safe use of this commonly used drug.

Background : Vaccination of healthcare providers (HCPs) against seasonal influenza has been consistently recommended worldwide. Despite that, healthcare providers (HCPs) globally and in other Middle Eastern countries continue to have a low rate of influenza vaccination due to various reasons. No data are available from our country, United Arab Emirates. Objectives : To identify the percentage of vaccinated HCPs, identify the most common reason for receiving the vaccine or not and to identify the level of HCPs knowledge towards the influenza vaccine itself. Methods : Using a cross-sectional study design, anonymous 18-item self-administered questionnaires were distributed among healthcare providers in the 11 primary healthcare centers of Dubai Health Authority over a period of 5 months. Results : Of the 431 participants who completed the questionnaires, 53.4% reported getting vaccinated. The difference in the vaccine uptake between the different professional categories was significant [P value < .000].The most common reason reported by HCPs for getting the vaccine was to protect themselves (94.8%). Of the 46.6% who did not accept the vaccine, the most common reason for not being vaccinated was their belief of not being at high risk to contract influenza (39.8%). Despite fairly good knowledge (63.3%), healthcare providers continue to have their reservations with regards to the yearly influenza vaccination. Conclusion : Although our HCPs attitude towards vaccine uptake, knowledge and practice were positive; the misconception about the vaccine remains the main reason for not being vaccinated as per our study findings. Overall, the study results raise hope of prospective increase in vaccination through educational and technical interventions and by increasing physician involvement. One suggested method would be to apply mandatory vaccination policies since voluntary vaccinations have shown lesser than satisfactory results and to be integrated in the online staff file system to be able to verify the uptake, in addition to provide easily accessible vaccine centers, during the season in order to facilitate tracking and verification of the vaccination status & to encourage staff compliance.