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Introduction: Autism Spectrum Disorder (ASD) is a lifelong hereditary neurodevelopmental disorder characterised by a lack of social communication and restricted and repetitive behaviours. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classified symptoms of autism into two domains: the social communication and interaction domain. However, studies on autism in Saudi Arabia are still insufficient. Therefore, awareness and knowledge about autism can facilitate early detection and treatment, resulting in better outcomes. Aim: To evaluate parents’ knowledge, awareness, and attitude towards their autistic children in a tertiary care hospital in Saudi Arabia. Materials and Methods: This hospital-based cross-sectional study was conducted at Baljurashi Mental Health Hospital, ALBaha region, Saudi Arabia, from January 2023 to November 2023. A total of 69 parents with autistic children who attended the outpatient clinic at Baljurashi Mental Health Hospital were included in the study. A questionnaire was administered among parents to assess their knowledge, awareness, and attitude regarding autism. Data was statistically analysed using descriptive statistics and the Chi-square test. Results: The age of the parents ranged from 16 to over 50 years, with 47 (68.1%) being males and 22 (31.9%) being females. Almost 29 (42.0%) of the parents were postgraduates, and 21 (30.4%) had a university-level education. About 24 (34.8%) of the participants believed that consanguineous marriage increases the risk of autism, 19 (27.5%) believed that some vaccines increase the risk of autism, and 39 (56.5%) knew that autism is associated with learning disabilities. Three-quarters of the participants, 54 (78.3%), stated that autism was known to them, 50 (72.5%) thought that an autistic child could be affected by a normal child, and 53 (76.8%) had good knowledge about autism. Conclusion: The study showed that the majority of parents had good knowledge about autism disorder. The findings reflect the positive impact of focused training initiatives and public awareness efforts aimed at improving parents’ knowledge, awareness, and attitude toward autism. [ABSTRACT FROM AUTHOR]

Chronic pain in children continues to pose significant challenges. The pharmacological approach most often revolves around trials and errors, expert opinions, and extrapolation of adult study findings. Ketamine is one of the agents used for chronic pain, especially with a neuropathic component. This article aims to provide an overview of its properties and highlight the current evidence for its use in malignant and nonmalignant chronic pain management. A search on the use of ketamine for chronic pain in children up to 18 years of age covering the period from January 1, 2000, to December 14, 2022, was performed through PubMed, Cochrane Library, EBSCO, EBM Review, Wiley, BMJ, Web of Science, Google Scholar, and the Saudi Digital Library. 218 articles were found and 42 underwent full review. Currently, the evidence about ketamine efficacity and safety for chronic pain management is at best of moderate to low quality. The heterogeinity of ketamine infusion protocols and frequent concomitant use of other analgesics make it difficult to draw robust conclusions. The long-term effect of prolonged usage also remains a concern. Nevertheless, with careful monitoring, the drug may be a reasonable choice for malignant and nonmalignant pain management in selected cases, especially for refractory pain not responding to conventional approaches. [ABSTRACT FROM AUTHOR]

With advances in biomedical sciences, a growing number of conditions affecting children have evolved from being considered life-limiting to almost chronic diseases. However, improvements in survival rates often come at a cost of increased medical complexity and lengthy hospitalizations, which can be associated with a poorer quality of life. This is where pediatric palliative care (PPC) can play a significant role. PPC is a specialty of healthcare that focuses on the prevention and relief of suffering in children with serious conditions. Unfortunately, despite the well-identified need for PPC services across pediatric specialties, multiple misconceptions persist. Common myths about palliative care are identified and deconstructed in light of the most recent evidenced-based references in the field to provide guidance to healthcare providers to address these. PPC is often associated with end-of-life care, loss of hope, and cancer. Some healthcare providers and parents also believe that information like diagnosis should be withheld from children for their emotional protection. These examples of misconceptions hinder the integration of pediatric palliative care and its additional layer of support and clinical expertise. PPC providers have advanced communication skills, are able to instill hope in the face of uncertainty, are trained to initiate and implement individualized pain and symptom management plans, and understand how to improve the quality of life in children with serious illnesses. Improved awareness about the scope of PPC is needed to ensure that children benefit from the maximum expertise and support throughout their complex health trajectories. [ABSTRACT FROM AUTHOR]

This study holds practical significance as it delves into the psychological challenges faced by individuals preparing for marriage, a critical phase that sets the tone for their future relationship. By focusing on the pre-marital stage, the study aims to address issues that could impact the success of the marital union. This study Aims to identify psychological issues faced by soon-to-be-married individuals and provide necessary support and counseling, assess the level of psychological health among soon-to-be-married individuals, and to evaluate attitudes towards marriage expectations and forms (early, late, and multiple). The study holds theoretical importance by addressing the rising divorce rates among marriage applicants and contributing to the body of research on marital life. Additionally, it fills a gap in existing research on mental health and attitudes towards marriage specifically in Taif governorate. The results of study concluded the males exhibit a more favorable attitude towards marriage compared to females, Individuals aged 20-25 display the most positive attitudes towards marriage, Undergraduate individuals show better attitudes towards marriage compared to other educational levels, males demonstrate better mental health compared to females, individuals under 20 years old show better mental health compared to other age groups, undergraduate individuals exhibit better mental health compared to other educational levels. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the prevalence of frailty and its associated factors among older patients (≥ 65 years) admitted to the hospital through the emergency room. Methods: This was a cross-sectional analytical study. The sample comprised 367 patients (≥ 65 years) admitted to various wards in King Saud University Medical City (KSUMC) between November 2020 and February 2021. The study adopted the FRAIL scale consisting of five domains (fatigue, resistance, ambulation, illness, and loss of weight). Results: The study showed that the prevalence rates of pre-frailty and frailty were 41.1%, and 51.8% respectively. In addition, there were significant differences between robust health, pre-frail, and frail older patients regarding age (p = 0.027), weight (p = 0.030), gender (p = 0.002), monthly income (p = 0.000), educational qualification (p = 0.001), history of medication (p = 0.024), and polypharmacy (p = 0.001). The results of the multivariate logistic regression revealed that older patients' age was a significant predictor of frailty among hospitalized old patients in KSUMC (p = 0.001). Conclusion: The study concluded that therewas a high prevalence rate of frailty among older patients (≥ 65 years) hospitalized in KSUMC. In addition, age was significantly associated with frailty among older patients. Further studies are needed to explore the impact on mortality and morbidity for frail patients admitted in various medical wards. [ABSTRACT FROM AUTHOR]

Background: The global pandemic of COVID-19 has led to unprecedented psychological stress on frontline health professionals. The objective of our study was to determine the prevalence of perceived stress and its association with having children among physicians in Al Madinah city, Saudi Arabia, during the COVID-19 pandemic. Methods: A web-based analytical cross-sectional study was conducted among the physicians working in Al-Madina, Saudi Arabia. Physicians living in Madina city were invited to participate in this survey by using an online questionnaire that consisted of socio-demographic information, and Perceived Stress Scale (PSS) 10 items questionnaire. The outcome measure was perceived stress score and levels among participants, while exposure factors were having children and the number of children of each participant. Results: Low, moderate and high levels of perceived stress were found in 39.3%, 56.4% and 4.3% of the physicians, respectively. 53.6% of those physicians who have children, had significant moderate perceived stress as compared to 93.3% of those who do not have any children (odds ratio (OR) = 0.08, 95% confidence interval (CI) 0.01–0.65, p=0.004). There was an inversed significant correlation between the number of children a participant had and the perceived stress scale score (R = −0.21, p=0.026). Conclusion: COVID-19 pandemic resulted in perceived stress among physicians in Saudi Arabia, mostly moderate level. Having children was found to be a protective factor. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the outcome of testicular biopsies as well as the etiology of azoospermia and severe oligospermia in Saudi men referred for tertiary care. To correlate testicular histology with patients' clinical and hormonal profiles. Materials and Methods: Charts of men subjected to testicular biopsies in the last 10-year period were retrospectively reviewed. Relative history and physical examination findings were reported. Results of male fertility profile tests and semen analysis of at least two ejaculates were collected. Reported histopathology was obtained. Results: Reports of 229 patients were included; 199 (86.9%) with azoospermia and 30 (13.1%) with severe oligospermia. The mean (SD) age was 30.6 (6.4) years. A small right or left testis was reported in 88 (38.4%) and 87 (38%) of the patients, respectively. The mean (SD) testosterone and follicle stimulating hormone (FSH) values were 17.2 (7.2) nmol/L and 13.1 (10.9) IU/L, respectively. Hypospermatogenesis was the most common histology encountered (36.5%), followed by Sertoli cell-only (SCO) histology (31.5%). Low testicular volume (P = 0.000), high FSH (P = 0.001) and high leutenizing hormone (LH) (P = 0.001) were found to be of significantly adverse effect on spermatogenesis. Despite having bilateral small testes, high serum FSH and LH, 24.3% of our patients showed active spermatogenesis. Conclusions: Hypospermatogenesis was the most common pattern of spermatogenic defect in our patients. SCO histology was the most common pattern in patients with small testes, primary testicular failure, primary infertility and azoospermia. Low testicular volume, high FSH and LH are significantly associated with impaired spermatogenesis. Even with severe male factor infertility disorders, infertile men can have some spermatogenesis. [ABSTRACT FROM AUTHOR]

Background/Aim: Cytomegalovirus (CMV) is the most common congenital viral infection, occurring in 0.4%-2.3% of all live births. The clinical manifestations of CMV are multiorgan involvement. Currently,the numbers of studies of hepatic CMV infection in immunocompetent infants are insufficient and little information exists in the medical literature about the hepatic manifestations and complications of CMV. Patients and Methods: Nine infants diagnosed with hepatic CMV infection were included in the study. The diagnosis was based on the presence of IgM anti-CMV antibodies titer in serum and detection of CMV-DNA in blood. The authors identified clinical characteristics, biochemical characteristics, immunologic markers, and the outcome of hepatic CMV with or without treatment. Results: Jaundice was the most common clinical feature of CMV infection in infancy (100%). Hepatic abnormalities in the form of cholestasis (defined as a serum conjugated bilirubin concentration greater than 17.1 μmol/L or greater than 20% of the total serum bilirubin) were found in all patients (100%), hepatitis (77%), hypoalbuminemia (55%), elevated alkaline phosphatase, and gamma-glutamyltransferase (77%). Other findings showed hepatosplenomegaly (44%), thrombocytopenia (22%) and low birth weight (11%) The treatment of hepatic CMV infection was indicated in 66% and was not indicated in 33%. Both of them had resolved cholestasis and hepatitis. Conclusion: Jaundice and cholestasis were the most common clinical features of hepatic CMV infections. Hepatic CMV infection in young infants is often a self-limited illness that does not require antiviral therapy. Most of the patients with hepatic CMV infection had a favorable outcome. [ABSTRACT FROM AUTHOR]