Search

Introduction : The volume and quality of biomedical research publications from an institution are considered adequate indicators of the quality of medical care in that institute. King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia (KSA), is one of the oldest and most distinguished medical centers in the country. Methods: In this study, we analyzed the number of publications from the Critical Care Unit of the hospital in the past two decades, from 1996 to 2016. The research publications were evaluated on various parameters. Moreover, the impact of their study on global medicine was determined. Results: Our results indicate a steady progression in the number of publications from the institute in the past two decades. An average of 17.3 papers was published each year during this time. Out of the 283 publications from KAMC included in this study, the majority of the publications were original articles, 61 were review articles, 66 were multicenter trial studies and 28 were randomized control trials. The citation profile of the publications was good indicating global impact of the studies. Conclusion: The global impact of research as evaluated through published manuscripts in KAMC is overall good. This was deduced from both the increase in the number of publications each year and also the quality of papers as evidenced by the citation index of the papers published between 1996 and 2016. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluates the satisfaction of urology residents with the Saudi Board of Urology (SBU) Training Program and identifies areas of weakness and strength to improve the educational environment, surgical competency, and overall satisfaction of urology residents with the program. Methods: We administered an electronic self-made questionnaire that included two sections. One comprised demographic data (age, gender, weight, height, marital status, level of training, city of training, and center of training), while the other concerned SBU evaluation (satisfaction with different aspects of training, such as ways of assessment, mentors' feedback, surgical competency, research, and strengths and weaknesses of SBU). Results: The overall satisfaction of urology residency program was 28.8% while 44.2% of residents had a neutral response. The highest level of satisfaction with clinical and surgical practice was among graduates (56.9%) and Riyadh residents (45.1%). Furthermore, good work/life balance received the lowest level of satisfaction (5.2%) among senior residents, while good clinical experience received the highest level (62.7%) among the graduates. Residents reported a high exposure in endourology and pediatric urology, while transplant, reconstructive, and neurourology had the lowest exposure. Forty-two percent of respondents undertook research during their residency training, but most respondents (54%) did not publish any research papers during their training. Sixty-two percent of graduates felt that their training program did not prepare them adequately to perform well on the board examinations. Conclusion: Our results confirmed that satisfaction of residents with the urology program process is variable according to the city of training. Having high satisfaction level in some cities reflects the improvement of urology training program after restructuring. We identified new areas in need of improvement, namely lack of mentorship, clear and formal assessment process, and variation of training process between central and peripheral programs. [ABSTRACT FROM AUTHOR]

Aims: Our primary objective is to investigate the baseline status of patients' awareness, knowledge, and attitudes to patient safety. The secondary objective of this research is to determine factors that influence patients' knowledge regarding patient safety. Methods: We performed a cross-sectional study with a targeted sample of 410 patients at King Khalid University Hospital, Riyadh, Saudi Arabia. Self-administered paper-based questionnaires were distributed to outpatient clinics on February 2, 2019 until March 20, 2019. Finally, the data were analyzed by (SPSS). Results: There were 450 questioners distributed, and 410 were completed and returned (91% response rate). Most of the patients were below the age of 50 (77.9%), 54.8%, of them were females, and almost half received higher education (54.1%). Among the respondents who are taking drugs, 21.6% do not have any knowledge about the side effects of their drugs, and 47.8% of patients said that their physicians do not tell them the side effects of their prescribed drugs. Whereas 20.7% of patients claimed that they experienced a medical error, 66.3% did not report the errors, and the reason was not knowing how to report or to whom in 54.4% of the patients. In regards of infection control, 47% of the participants misunderstood means to prevent the spread of the infections and how it could be transmitted. Conclusion: Patients' knowledge about patient safety need to be improved. We suggest educating the patients by providing training programs for patients, and we recommend further studies. [ABSTRACT FROM AUTHOR]

Objectives: To study the knowledge, attitude and practice level among young Saudi adults regarding osteoporosis. Methods: A cross‑sectional study was done in Riyadh among Saudis, within the age group (17–30 years old), with sample size (663). A validated questionnaire was distributed in paper and electronic forms. The questionnaire had five parts: first part was the demographic variables, second part the source of the participant knowledge about the disease, third part assessed the knowledge about osteoporosis, fourth part assessed osteoporosis attitudes, and the fifth part assessed the practice for prevention of osteoporosis. The collected data was analysed by Statistical Package for the Social Sciences program. Results: It was found that there was low level of knowledge among overall participants; there was no significant difference between male and female in level of knowledge, while the age group 21–25 had the highest knowledge level among all other age groups. Males have better level of practice of a healthy lifestyle that decreases the risk of osteoporosis than females. In total, 52.5% of males have a sufficient level of practice, while only 34.9% of females have acceptable level of practice Conclusion: The study found no significant difference between males and females regarding the knowledge of osteoporosis. Males were found to have better level of practice of a healthy lifestyle that decreases the level of osteoporosis then females. The study recommends similar studies and undertake more efforts in promotion of preventive programs for young adults. [ABSTRACT FROM AUTHOR]

Introduction: Undergraduate oral and maxillofacial radiology curricula are currently undergoing a reform process that is moving toward digital-based radiology that requires dedicated resources to train dental students to the field experience. It is not known if the time is appropriate to totally shift from training students on conventional analog film-based radiology to training them on digital images and the choice of digital system in intraoral and extraoral radiography. Aim: The aim of this study is to assess availability and utilization of the digital radiographic techniques by dental clinics in Riyadh, Saudi Arabia, using a cross-sectional descriptive, epidemiological survey. Materials and Methods: The study included dental departments of nine main governmental hospitals, six dental schools in Riyadh and a representative selected sample of the private dental clinics in Riyadh that included 40 dental clinics. A self-administered e-survey regarding the use of analog or digital radiographic intraoral and extraoral techniques was made. Descriptive statistics are reported in forms of means and range. Results and Discussion: For intraoral radiographic examinations, most clinics (90.9%) used digital systems. Solid-state detectors such as charge-coupled device (CCD) and complementary metal oxide semiconductor sensors were the most popular type digital intraoral sensors (94%) and only 13 locations (26%) used digital photostimulable phosphors plates. For panoramic radiography, almost all (98.1%) used digital systems. Again, the solid-state detectors were the most common digital panoramic system (96.4%). Most respondents had a digital information system to store, retrieve, and display digital radiographs (92.7%), whereas only four locations (5.9%) used hard-copy films or paper prints. Conclusion: Digital imagining is more common than film-based imaging in intraoral radiography in and panoramic radiography in the different dental care delivery sites in Riyadh, Saudi Arabia. [ABSTRACT FROM AUTHOR]

Introduction: Travel medicine deals with prevention and management of health problems of travelers to avoid or reduce the risk of avoidable illnesses. Primary healthcare physicians are the key individuals to provide the same. The objective of current study was to explore the level of knowledge, attitude, and current practical application of travel medicine among primary health care physicians serving in the Riyadh Health Cluster, Saudi Arabia. Methodology: A descriptive cross-sectional study among 210 primary healthcare physicians serving in Riyadh Health Cluster was conducted using a paper-based self-administered questionnaire collecting information on socio-demographic characteristics and knowledge, attitude as well as practice of travel medicine. Results: The majority of study participants were females (117, 55.7%) and 63% (n = 133) were non-Saudi physicians. More than 30% that is 66 participants had clinical experience of less than 5 years and around 67% (i.e., 141) participants were serving at the designation of registrar/senior registrar. One hundred sixty-seven participants (79.5%) had ever provided health advice to the travelers. Majority of the study participants had gained information on the travel medicine through Ministry of Health guidelines (66%). Nearly 11.4% participants were not sure about the cause of occurrence of typhoid infection. As reported by 30.5%, travelers never really sought advice on the travel insurance. Nearly 79.5% participants reported to have provided post-travel consultation for diarrhea, followed by respiratory infection (45.2%), fever (42%), and skin problems (21%). Conclusion: The knowledge, attitude, and practice of travel medicine among primary healthcare physicians was found to be sub-optimal in Riyadh. [ABSTRACT FROM AUTHOR]

Background and Aims: We hypothesized that the prevalence of electronic cigarette vaping among the medical student population is on the rise. Our aims were to assess the prevalence of electronic cigarette vaping among medical students in Saudi Arabia, to understand and analyze the reasons that led them to try it, and to investigate students' perceptions towards electronic cigarette vaping. Methods: An anonymous, paper-based, cross-sectional questionnaire was distributed amongst 401 undergraduate medical students from years 1-5 at Alfaisal University in Riyadh, Saudi Arabia. Prevalence, intensity of e-cigarette use and reasons for it, relation of electronic cigarettes to cessation of tobacco smoking, and side effects were studied. Results: The prevalence of vaping was 49/401 (12.2%). There was a strong association between gender and vaping, with males being 3 times more likely to vape compared to females (χ2 (1) =13.62, P<.001). The three most common reasons for using electronic cigarettes were to enjoy the variability in flavours (61.4%, n = 30), to reduce or quit tobacco cigarettes (29.5%, n = 14), and to avert the public smoking ban (13.6%, n = 7). The three most common side effects experienced by users were coughing (26.7%, n = 13), dry mouth/throat (24.4%, n = 12), and dizziness (20%, n = 10). Conclusion: Use of the electronic cigarettes is not uncommon amongst medical students, mostly due to their appealing flavor variability. Further research is required to define long-term safety and side effect profiles, and to generate evidence-based guidelines concerning e-cigarette safety and efficacy for smoking cessation. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study (1) To evaluate the Saudi public's knowledge and attitude on dental stem cells (DSC) for therapeutic/banking purposes, (2) To evaluate the perception of Saudi dentists towards DSC and their attitude towards banking of DSC. Methodology: This was a cross-sectional study based on an electronic survey distributed through the social media nationwide among the Saudi public, and through paper-based surveys among dentists in Riyadh. By convenience, eligible study participants were Saudi adults from the community and dentists from 17 dental centers in different regions of Riyadh. Using SPSS v. 25, descriptive statistics (n,%; PMS ± SD) and bivariate analyses (Pearson's Chi square, Mann Whitney) were conducted to determine factors associated with the study outcomes, with a P value statistically significant at <0.05. Results: For the Saudi public, 1494 participants completed the survey. The PMS ± SD of public knowledge was 25.5 ± 25.9, while their attitude was 80.2 ± 27.0. Factors associated with higher knowledge scores were younger age groups, while female participants, older age groups, university educated and employed participants had higher attitude. For Saudi dentists, 246/262 (94%) dentists responded to the questionnaire. Their PMS ± SD of perception towards DSC research for regenerative purposes was 74.5 ± 15.6. Factors associated with higher perception scores were those with more experience. Dentists who had higher perception scores towards DSCs were significantly more willing to save teeth for regenerative dental treatment. Conclusion: The Saudi public community had poor knowledge about the therapeutic and research benefits of DSC, yet high degree of attitude to enroll in a future Saudi DSC bank. Saudi dentists had moderately high levels of perception towards DSC research. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute respiratory tract infections are the most common causes of both morbidity and mortality worldwid, and the management and prevention of acute respiratory infections is a global problem, especially in developing countries. This study sought to assess the community's compliance and practice of measures for the prevention of respiratory infections and discover their source of health information. MATERIALS AND METHODS: A cross-sectional study was carried out in the five biggest shopping malls in Riyadh city in July 2014. The required sample size was 980 persons aged 15 or older, with 196 from each of the five biggest shopping malls from each of the five geographic areas of Riyadh. Data was collected by face-to-face interview using standardised questionnaire, and analyzed using SPSS. RESULTS: Overall, 48.3% of the participants thought that they were susceptible to any of the respiratory infections of pandemic influenza; 59.7% always washed their hands with water and soap and 34.8% used antibacterial soap. About 29% reported avoiding touching their eyes, noses, and mouths directly with their hands; 63.5% covered their noses and mouths with tissue paper when sneezing or coughing. A substantial number said they "never" shared their personal stuff, including towels (70.5%) and utensils (49.0%) with others. Only 21.2% avoided crowded places or wore a mask (9.1%) in such a situation. A high proportion (62.8%) did not take the seasonal flu vaccine. The most common sources of health information included television/radio (47.9%), social media (29.4%), and friends/family (28.1%). CONCLUSIONS: Health authorities should seize every opportunity to prevent respiratory infections by adopting all evidence-based infection control measures to improve public awareness, attitude, and practice. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a metabolic disease that is characterized by distortion in the metabolism of carbohydrates, lipids, and proteins and involves hyperglycemia. DM has different types. Several complications are associated with diabetes including diabetic retinopathy (DR). DR can further results in bad outcomes that can be avoided by early diagnosis and management. Aim: The aim of this paper is to assess the awareness and knowledge level about DR among type 2 DM patients in primary health care in security forces hospital. Methods: This is a cross-sectional study that was conducted on Saudi patients with type 2 DM who visited primary health care in security forces hospital. Results: This study included 174 participants, with equal male to female ratio was 1:1, there were 64.9% participants who reported controlled blood glucose level, and 47.1% reported that eye was affected by diabetes. There were 82.8% participants who had awareness about DR; the level of awareness differs significantly with sex (P value = 0.04) and the level of DM control (P value = 0.02). Conclusion: There was high level of knowledge regarding DR; however, there were few percent of participants who had no awareness and still at risk. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID‑19) pandemic has placed enormous pressure on different health‑care systems globally. In Saudi Arabia, the COVID-19 pandemic has considerably increased the number of infected individuals and has caused a major concern among health-care professionals, including the laboratory workforce. This study aimed to measure the impact of COVID-19 workload on clinical laboratory workforce in Riyadh. Methods: This was a cross‑sectional quantitative study. We distributed questionnaires via E‑mail invitations and social media platforms to 252 individuals. The online survey comprised eligibility, demographic, and workload-related questions as well as the 12-item General Health Questionnaire. Results: A total of 123 respondents completed the questionnaire and fit the eligibility criteria. The data showed that the total workload burden remarkably increased the number of tasks among all laboratory workers by 30.0%. In addition, 44.7% of the laboratory personnel reported psychological distress and anxiety during the COVID-19 pandemic. Conclusions: Clinical laboratory workers reported a significant increase in workload burden during the COVID‑19 pandemic. Middle age and limited years of experience were found to be risk factors for psychological distress and anxiety among the laboratory workers. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to determine the levels of knowledge and attitude of dental practitioners (DPs) toward vital pulp therapy (VPT) of young permanent teeth in Riyadh city, Saudi Arabia. Materials and Methods: A descriptive cross-sectional study was carried out by taking convenient sample of general DPs and specialist attending Saudi International Dental Conference, Riyadh, Saudi Arabia. A total of 200 DPs administered a structured, self-administered questionnaire to evaluate their knowledge and attitude toward VPT. The questionnaire comprised four parts: Part I: Characteristics of the study participants; Part II: Items related to indications and diagnosis of VPT; Part III: Questions related to the different VPTs for immature permanent teeth; and Part IV: Dental materials used in VPT and restoration. All the data were entered into the statistical analysis software Statistical Package for the Social Sciences version 21.0 (IBM, Armonk, NY) and analyzed by using descriptive statistics of frequency distribution and percentages for the categorical variables. Results: A total of 193 (men = 57% [110] and women = 43% [83]) DPs participated in this study with a response rate of 96.5%. Less than half of correct responses were observed with (Item 1) related to the duration of complete closure of root apex (43%) and (Item 14) use of sodium hypochlorite to serve as an excellent diagnostic tool to differentiate irreversible from reversible pulpitis. A high percentage of correct responses were seen with the (Item 9) indirect pulp capping––a procedure performed in a tooth with a deep carious lesion without signs or symptoms of pulp degeneration (75%). All other item responses ranged in between 52% and 72%. Conclusion: DPs showed fair-to-good knowledge and attitude toward VPT of young permanent teeth. In general, there is a need to improve knowledge and attitude of dental professionals about the VPT by attending continuing dental educational programs. [ABSTRACT FROM AUTHOR]

Introduction: Sudden infant death syndrome (SIDS) is a leading cause of infant mortality all over the world. Mortality due to SIDS can be averted by educating families and caretakers about safe practices for putting infants to sleep. However, the knowledge, attitude, and practices of mothers while putting the infant to sleep is a gray areas in literature. Aims and Objectives: The objectives of the study were to measure the knowledge and awareness about SIDS and its associated risk factors practiced among Saudi mothers attending well-baby clinics in Saudi Arabia to develop appropriate educational program-based interventions for safe practices of infant care. Methods: This cross-sectional study was carried out among 385 mothers attending well-baby clinics of primary health care (PHC) and prince sultan military medical city (PSMMC) in Riyadh Saudi Arabia. Information was captured on sociodemographic characteristics, the health status of mothers and infants, knowledge, attitude, and practice followed by mothers while putting infants to sleep. Results: From a total number of 385 responses, 350 participants were eventually included in the final sample due to the incompletion of the questionnaire of 350 mothers; only 26% (n = 93) mothers had heard of SIDS. However, 259 mothers were willing to attend the awareness session. Only 94 mothers had knowledge as well as practicing the correct behavior of putting the infant to sleep on the back referred to as "good behavior concordant pairs." Similarly, other good practices include not co-sharing a bed with the infant, removing pillows, blankets, and other wedged objects, using a pacifier, breastfeeding the infant during sleep, not using multiple quilts, not covering the infant's head with a quilt, not using a head cap. The number of good behavior concordant pairs (in green) were 124, 38, 56, 98, 18, 117, and 68 respectively. Conclusions: The rate of knowledge and practice for good behavior regarding SIDS was low among Saudi mothers in Riyadh Saudi Arabia. SIDS-related deaths can be averted by improving the understanding of SIDS risk reduction practices among mothers by using health promotion strategies. [ABSTRACT FROM AUTHOR]

Background: New teaching modalities have emerged throughout the years to help enhance residency training programs. Studies have shown that when establishing a new teaching modality, it is crucial to consider the trainee's perception and feedback as trainee-centered teaching techniques aim to enhance the students' motivations and problem-solving skills. The aim of this study is to discover residents' perceptions of different teaching modalities used through their training programs and to recognize which teaching modality is preferable to residents among the family medicine residents in Riyadh, Saudi Arabia. Methodology: A cross-sectional study was conducted between April 2021 and April 2022 that included all family medicine residents in the Saudi Board Family Medicine Training Program at Prince Sultan Military Medical City (PSMMC) in Riyadh, Kingdom of Saudi Arabia. An online questionnaire included two main parts. The first part collected demographic information. The second part concerned residents' opinions regarding different teaching modalities used throughout their training and factors leading to better learning outcomes. Results: The survey was completed by 60 family medicine residents. Half of the respondents perceived weekly academic day activities [WADA] as the most important teaching style (53.3%), followed by self-directed learning [SDL] (40%), while learning management system [LMS] was not ranked as the top choice by any of the respondents. Conclusion: These findings can be applied to the improvement of family medicine training programs. Understanding the perceptions of different teaching modalities can help enhance training programs to help future family medicine practitioners. [ABSTRACT FROM AUTHOR]

Cefdinir is one of the broad spectrum cephalosporin used as a replacement to amoxicillin in allergic pediatric population. There are reports of forming red stool in patients receiving cefdinir along with iron or iron containing preparations. This is a benign interaction and wane upon completion/discontinuation of cefdinir therapy. This case report describes a 6-month-old boy whose parents were distressed when they found reddening of their ward's diaper while taking cefdinir in presence of iron supplements. [ABSTRACT FROM AUTHOR]

Background: Paediatrics rapid response team (RRT) is a newly developed service under paediatrics home health care (HHC) programme which is a standby visiting team that responds to non‑critical emergency calls. The current study aimed to compare the total emergency visits and hospital admissions before and after implementation of RRT project. Method: A retrospective chart review was conducted from December 2018 to December 2020. Paediatric patients registered under the home health care (HHC) programme were the target population. The admission and hospitalization rates were assessed before and after the implantation of an RRT. The variables related to patient profile were assessed to explore the association between hospitalization and admission. Result: Data for 117 patients and a total of 114 calls attended under HHC covered by RRT were analysed. In the first year after the implementation of RRT, the mean number of ER visits per patient per year was reduced from 4.78 ± 6.10 to 3.93 ± 4.12 with (P value, 0.06). Also, a slight decrease in the mean number of admissions from 3.74 ± 4.43 to a mean of 3.46 ± 4.1 with (P value, 0.29). Follow‑up after receiving an RRT call for an initial complaint was statistically significant in reducing both ER visits and hospital admissions within 7 days with a P value of 0.03 and 0.04, respectively. Conclusion: The RRT was effective in decreasing the ER visits and hospital admissions for a very special group of patients. Additionally, the emplacement of proper triaging code at the time of attending to patients helped in reducing unnecessary ER visit and hospital admission. [ABSTRACT FROM AUTHOR]

Cannabis is an herbaceous flowering plant, originally an indigenous plant in Eastern Asia, which later spread globally due to widespread agricultural practices. Cannabis was used medicinally until the early twentieth century, but subsequently prohibited due to the psychoactive effects. Aims: To explore the medical cannabis-related level of knowledge of physicians at King Abdulaziz Medical City, including patient needs, perceptions of therapeutic effects, potential harm, and the willingness to prescribe if legalized in future. Methodology: The study was a cross-sectional questionnaire-based survey. It was conducted at King Abdulaziz Medical City in Riyadh from February 2020 to February 2021. All physicians from the different specialties, who consented to participate, were included in this study. Statistical Analysis: Descriptive statistics are presented as mean and standard deviation and proportions. An ANOVA test was applied to measure the association of the beliefs regarding the right to prescribe with overall knowledge. All tests were considered significant at P < 0.05. Results: A total of 249 physicians participated with the majority (70%) male. The sample was similar regardless of the physician's position in the medical hierarchy, with a mean work experience of 8 years. Almost half of the participants indicated that they do not have good knowledge regarding the effects of MC products and more than half that they are unaware of the different MC products and formulations currently available. Conclusion: The majority of the sample lacked knowledge about the medicinal use of cannabis for specific indications and felt uncomfortable to discuss the medicinal use of cannabis with their patients. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is the second most common cancer among women. This study was conducted to assess the yield of fine-needle aspiration (FNA) cytology of thyroid nodules in a primary care setting in Riyadh, Saudi Arabia. Materials and Methods: In this retrospective cohort study, primary care patients of both genders with thyroid nodules who underwent FNA above the age of 18 years were enrolled. Patients with a prior history of cancer were excluded. The data was collected from the histopathology reports of FNAs done for thyroid nodules from January 01, 2002 to July 31, 2018. Results: We enrolled 263 patients in this study. The mean age of the study population was 41.3 years old (Standard deviation (SD) ± 10.1), 81.7% were females and 18.3% were males. The rate of abnormal ultrasound (US) was 16%. The mean thyroid-stimulating hormone (TSH) level was 2.3 mU/L (SD ± 5.9). Post-thyroidectomy, 17.5% had carcinoma on pathology reports. Among those who were diagnosed with thyroid cancer, 76.2% had papillary thyroid cancer, 21.4% had follicular thyroid cancer, and 2.4% had medullary thyroid cancer. The mean age for cancer diagnosis was 40 years old (SD ± 8). There was no significant association between FNA findings (benign/malignant) and age, gender, history of smoking, size of the nodule, or TSH level. Conclusion: Thorough investigations including FNA should be considered for patients presenting with suspicious thyroid nodules, regardless of their size or the patients' gender. Access to such investigations and referrals to specialists should be available for primary care physicians. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to estimate prevalence rates of different headache forms among tinnitus patients in Arabia, to investigate whether there is a relationship between tinnitus laterality and headache laterality in patients with unilateral tinnitus and unilateral headache, to explore the relationship between tinnitus and headache over time, and to know the effect of headache pain medications in tinnitus in Riyadh, Saudi Arabia. Method: The study is a quantitative observational cross-sectional study with a convenient sample by data from patients with tinnitus. The participants received a self-administrated electronic questionnaire measuring demographics, prevalence of an associated headache, and the relationship between tinnitus and headache. Results: A total of 226 patients enrolled themselves into the study, and all of them came from the capital city Riyadh of Saudi Arabia. 58% were females, and the remainder of them were males. Females reported significantly more ear tinnitus than males, and patients aged 51 years or older were significantly less inclined to report ear tinnitus compared to those younger; however, those aged 20–31 years were found to be significantly more inclined to report ear tinnitus. There was a statistically significant association between patients experiencing headaches and those experiencing ear tinnitus. Surprisingly, patients who take medications of any type to alleviate their headaches were significantly less inclined to report ear tinnitus than those who do not take medications. However, patients with ear tinnitus experienced longer headache duration in years than those who had no history of tinnitus. Moreover, those people who experienced right-sided tinnitus tended to report significantly more right-sided headaches, and the same goes for left-sided headaches. Conclusion: Our results showed that there is a relationship between headaches and tinnitus. Painkillers also showed a protective effect against tinnitus. High awareness about the relationship between headaches and tinnitus among physicians and patients may lead to early recognition and lead to early implementation of primary prevention, which is the cornerstone of family medicine practice, and treatment without referring to other specialties. However, the pathophysiology is still not clear. Further studies should be performed to know the pathophysiology. [ABSTRACT FROM AUTHOR]

BACKGROUND: Falls among the elderly are one of the major causes of morbidity and mortality worldwide. They constitute the second leading cause of unintentional deaths after road-traffic accidents. The aim of the study was to estimate the prevalence of falls among the elderly and to investigate the factors that contribute to this phenomenon. MATERIALS AND METHODS: A cross-sectional analytical study was conducted in the elderly, over the age of 60, in Riyadh. The sample under scrutiny was estimated to be 357 in total. A pilot study was conducted among 15 subjects. Two questionnaires were used for the interviews which were translated into Arabic using the "Morse Fall Scale." The questionnaires assessed: the participants' previous history of falls, whether a secondary diagnosis had been obtained, whether any ambulatory aids had been used or whether an IV connection had been fitted during convalescence. They also inquired if any gait/transferring device had been used to assist the patient at any time. RESULTS: Out of 357 participants, 206 (57.7%) had a history of falls. Study found an association between the number of falls recorded, the age of the participants, and whether the participant was female. Furthermore, there were statistically significant associations between the history of falls and a condition of impaired health. The results also showed that environmental hazards play a significant role in the occurrence of falls with P ≤ 0.001, in which 103 (81.7%) of the individuals who were exposed to environmental hazards revealed a history of falls. CONCLUSION: Falls among the elderly are common. Significantly, if the health of the individuals is impaired, and there are contiguous environmental risk factors, these elements combine to play a part in the occurrence of such falls. There is, therefore, a need to design and develop a health awareness program to prevent such problems in the elderly. [ABSTRACT FROM AUTHOR]

Introduction: Structured undergraduate research, whether mandatory or elective, provides undergraduate students with a unique opportunity to develop their research skills. However, the majority of the students undertake individual research projects rather than working in a group. This study explores the perceived benefits and challenges of fostering research focused communities of practice at a specialised health sciences university in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted at the College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) Riyadh, Saudi Arabia. The study was approved by the Ethics Committee at the King Abdullah International Medical Research Center (KAIMRC). A self-administered questionnaire was developed that assessed the perceived benefits and challenges of doing research in groups. Data were collected using a mixture of a dichotomous and a 5-point Likert scale and were analysed using Statistical Program for Social Scientists (SPSS). Results: Of the 380 medical students invited to participate in this study, 307 completed the questionnaire, with a response rate of 80.7%. The majority of the medical students (87%) agreed on the importance of teamwork in conducting medical research. Almost all medical students (96%) believed patience and tolerance were required to make the team successful. Significant differences were found between junior and senior medical students regarding their perceived benefits (P-value = 0.0001) and challenges (P-value = 0.0007). Conclusion: Although most of the students believed that doing research in groups is essential and that working within such groups enhances their research knowledge, forming these research groups was not without problems. The need for patience and tolerance to keep the group together, the issue of free-riders and the difficulties related to which research group to join were some of the challenges students encountered. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to assess the prevalence of abusive and disrespectful behavior from healthcare workers toward women during childbirth, to determine the type of abuse with the highest prevalence, and to assess the factors that contributed to the prevalence of abuse and disrespectful behavior. Methods: This is a quantitative observational cross-sectional study that was conducted among mothers who gave birth in a tertiary hospital in Riyadh, Saudi Arabia, from September 2019 to mid-March 2020, with a target sample size of 261. Descriptive statistics were described by frequencies and percentages, bivariate statistical analysis was carried out by using Chi-square test. Results: The overall prevalence of disrespect and abuse (D&A) was 62.5%, the non-consented category was the commonest type in this study. D&A was 2.8 times more prevalent in women whose newborn suffered complications during delivery. Likewise, mothers who delivered in a room with 5 or more caregivers were 2 times more likely to be disrespected than others. Mothers who underwent a natural delivery without episiotomy were 53% less likely to face the risk of being disrespected than others. Conclusion: This study reveals that the prevalence of disrespect and abuse towards women during labor in the chosen setting was high. The type of delivery, number of caregivers present, and complications that occurred during delivery were significantly associated with disrespect and abuse. Therefore, the authors of this study present an IDEAL approach as a way to upgrade the maternity care standards. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is one of the leading causes of death in the world. Dentists play a vital role in tobacco abstinence and counseling. Dental institution being a foundation for a clinical practice from where they can practice and implement the habit of tobacco counseling. E-cigarette can be availed over-the-counter and can be used as alternative to conventional tobacco smoking to reduce ill effects of tobacco. Objectives: The aim of this study is to assess dental student's knowledge, prevalence, and perception about e-cigarette. Materials and Methods: A cross-sectional study was done on 400 dental students studying in different universities at Riyadh region, KSA. Questions related to prevalence, knowledge, and awareness about e-cigarette were asked. Results: Forty-four percent of participants were found to be smokers, 26% of the participants had used an e-cigarette themselves with 21% currently using the same. Conclusion: This effective therapeutic tool should be known well by the upcoming budding and professional practicing dentists with through knowledge of each dimensions, merits and demerits of the same to develop positivity in inculcating and encouraging in patient tobacco abstinence program. [ABSTRACT FROM AUTHOR]

Introduction: Malpractice is one of the most significant hazards to patient safety in healthcare and is considered the second factor associated with the overall quality of the healthcare system. Aims and Objectives: This study aimed to assess the prevalence of malpractice in dentistry and its possible causes in Riyadh, Saudi Arabia during 2009-2015. Methodology: A cross-sectional retrospective analysis of the dental complaints filed by the patients in the general directorate of forensic medicine centers in Riyadh was reviewed, and the data was collected. Descriptive statistics of frequency distribution and percentages were calculated using the collected data. The Chi-square test for categorical variables was performed with a significance level set at P < 0.05. Results: The Riyadh region reported 168 (14.5%) dental malpractice cases during 2009- 2015. The highest number of malpractice cases was reported in 2010 (18.45%), and the least number of cases was reported in 2011 (10.1%). Prosthodontic specialty had the highest number of lawsuits (32.4%), followed by orthodontics (20.2%) and endodontics (15.8%). The Chi-square test showed no association between the different specialties and types of malpractice (P = 0.881) and between compensation and the type of malpractice (P = 0.832). Among the 114 cases, financial compensation was the most common retribution. Conclusion: Dental malpractice prevalence was high in the private sector, followed by the government and military sectors, with the highest number of cases registered against the prosthodontic specialty. Dental malpractice is a serious concern that can be prevented by fair and honest policies and thorough patient education. [ABSTRACT FROM AUTHOR]

Aims: Diabetic retinopathy is called as vision threatening disease. It affects retina very severely. DR is a common public health problem in Worldwide. Our main objective was to identify significant risk factors for diabetic retinopathy among diabetes mellitus patients. Materials and Methods: The present retrospective Case-Control study was conducted with 404 DM patients' records were collected from King Abdulaziz Medical City, Riyadh, Saudi Arabia. Statistical analysis used: Data were presented as descriptive statistics, multivariate logistic regression, association between variables was using odds ratio and 95% confidence interval. Results: Among 404 diabetes patients, 192 (47.5%) were Cases and 212 (52.5%) Controls. In multivariate regression analysis showed that male gender also had a higher likelihood in the development of DR, OR: 1.68 [95% CI: (1.04 – 2.71); p<0.05]. Patients with poor glycaemic control, OR: 4.86 [95% CI: (2.21-10.66); p<0.001]. Similarly, HbA1C, Low LDL was prominent risk factor in the progression of DR except age, hypocholesterolaemia, nephropathy wasn't significant. Conclusions: From our study findings, male gender, tobacco habit, poor glycaemic control, and Low HDL were appeared independently associated with the development of vision-threatening disease. By regular check-up, reducing risk factors or retain their stages in the same stage or to prolong the DR incidents among DM patients. [ABSTRACT FROM AUTHOR]

Background: Despite recent government efforts to control antibiotic purchase by the public, the rate of self-prescription is still alarmingly high in Saudi Arabia. Increased and inappropriate antibiotic use has been identified as an important factor behind bacterial resistance. Recently, there has been an increased interest in the Saudi public's awareness of antibiotic use and resistance. However, none of the local studies examined the awareness and practices among patients attending primary care services. Additionally, the influencing factors of awareness and practices have never been comprehensively examined. Objective: To assess the levels of knowledge, attitude, and practices of antibiotic use and their influencing factors among a sample of patients at a primary care setting. Methods: A cross-sectional design was used to examine patients attending Al Wazarat Health Center in Riyadh between 1 January 2018 and 31 March 2018. Data was collected using a structured study questionnaire which included data on socio-demographic and clinical characteristics of the participants, as well as knowledge, attitude, and practices of antibiotic use. Scores were calculated for knowledge, attitude, and practices of antibiotic use and were translated to a 100-point scale for easy interpretation. Results: The current analysis included 343 participants. The average age was 32.5 ± 10.0 years. The majority of the participants were women (63.0%), married (65.9%), and had college or higher education (57.0%). The overall antibiotic awareness level was 54.7% (including 43.9% for knowledge and 71.7% for attitude) and appropriate antibiotic practices were 68.3%. The scores of both awareness and practices were positively and significantly correlated (correlation coefficient = 0.440, P < 0.001). In addition to appropriate antibiotic practices, awareness was significantly associated with higher educational level and having children. Conclusions: The current findings indicate the need to improve awareness and understanding of the public regarding appropriate antibiotic use by targeting patients who attend primary care services with posters, structured educational sessions, and physician advice. [ABSTRACT FROM AUTHOR]

Background: Having a high quality primary health-care (PHC) system leads to a more efficient health-care system, which lower rates of hospitalization and leads to better health outcomes. One of the main criteria for assessing the quality of PHC services is the assessment of patient satisfaction, so the study aims to assess the chronic disease patients' satisfaction with PHC services provided by centers. Methods: A descriptive cross-sectional study conducted on patients with chronic diseases who follow-up in PHC centers within the Second Health Cluster in Riyadh using a questionnaire to assess their satisfaction level. A total 210 patients with different chronic diseases from the seven PHC centers (30 patients from each PHC center) who agreed to participate were included in the study. Results: In the study, 126 (60%) participants were females and 96 (45.7%) participants were in the age group more than 50 years. The survey showed that patients were satisfied with services offered by physicians, nurses, laboratory, and pharmacy with weighted means (3.81, 3.54, 3.59, and 3.88, respectively), while they were not satisfied with waiting time and services offered by receptionists with weighted means (3.22 and 3.27, respectively). The patient satisfaction showed a significant association with gender and level of education (P = 0.003 and 0.005, respectively). Conclusions: The survey showed that patients with chronic diseases were satisfied with services provided by PHC centers of the Second Health Cluster in Riyadh except receptionists' services, appointments, and waiting time. This survey will guide the policymakers for improving the services provided at the PHC centers. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of the study was to evaluate the accuracy of teleexamination of red eye by a trained general practitioner (GP) compared to the gold standard (in-office consultation by an ophthalmologist). METHODS: This was a study of diagnostic accuracy. We included consecutive male or female patients aged ≥6 months who presented to a primary care clinic in Riyadh, Saudi Arabia, with red eye. All the patients were initially evaluated by a trained GP using a standardized checklist and consulted virtually with an ophthalmologist. This was followed by an in-office eye examination conducted at a well-equipped ophthalmology clinic by a well-trained ophthalmologist. Data were analyzed using STATA 17.0 (StataCorp LLC, College Station, TX, USA). RESULTS: A total of 54 patients with red eye presented to the primary care clinic during September–November 2021 and were initially examined virtually and then in-office. The mean age of the patients was 39.72 ± 21.70 years (range 5–90 years). Thirty-three patients (61.1%) were males. The most common cause of red eye was conjunctivitis (46.3%) followed by dry eye (31.5%). There was a significant association between viral conjunctivitis and age (P < 0.001), and between dry eye and age (P = 0.002). Tele eye examination accurately identified the etiology of red eye in all 54 patients. CONCLUSION: Telemedicine has the potential to correctly diagnose patients with red eye and can result in a substantial decrease in the number of people visiting the health-care centers. [ABSTRACT FROM AUTHOR]

Background: Healthcare is a substantial industry globally, where nurses comprise the largest percentage of the healthcare system. There is a global nursing shortage and nursing staff retention has become a major human resource challenge. One of the critical indicators of quality of care is nurse-to-patient ratio (n:p ratio), but due to the extreme shortage of nurses, the quality of nursing care may have been affected leading to low nurse engagement results and substantial missed on aspects of nursing care. Identifying these key areas among nurses in King Saud Medical City (KSMC) will contribute to the improvement of staffing conditions at any levels. Aim: The primary objectives were (1) to investigate the impact of patient-to-nurse ratio (p:n ratio) on satisfaction and (2) to explore the impact of p:n ratio on missed care. The secondary objectives were (1) to compare the nurses' satisfaction categories, missed care categories across different hospitals included in our medical city, different age categories, and different education levels and (2) n:p ratio will be compared across hospitals. Methods: This was a cross-sectional analytical study. Setting: This was conducted at KSMC, Riyadh, Saudi Arabia, specifically in areas of main general hospital, medical tower, pediatric and maternity hospital. Outcome Measures: (n:p ratio), nurse engagement/satisfaction, and missed nursing care. Results: Of the total of 384 responses (96% response rate), the majority of respondents were satisfied (n=155, 40.4%), followed by Neutral (n=124, 32.3%), very unsatisfied category included only 17 responses (4.4%) and very satisfied were 35 nurses (9.1%). While responses to the missed care section revealed that overall the majority of missed care opportunities were in the category of never missed (278, 72.4%). As for the p: n ratio, the average was 4.2 (patients) ± 1 (nurse). Furthermore, the ratio of patients-to-nurse was not found to significantly impact overall satisfaction, neither in the univariable model nor in the multivariable model adjusted for age, education, and experience. Interestingly, age category was a significant predictor of nurse satisfaction (higher odds of satisfaction category with higher age category) yielding an adjusted odds ratio (OR) of 1.4 (95% confidence interval [CI]: 1.01–1.8; P = 0.04) although this was a post hoc finding. As for the impact of n:p ratio on missed care, it was significantly associated with missed care in the univariable model, with OR of 1.3 (95% CI: 1.01–1.6; P = 0.037) and an OR of 1.3 (95% CI: 1.02–1.6; P = 0.032) in the multivariable model. When the categories of satisfaction were compared across different hospitals of KSMC, different age groups, and education, there were no differences in any of the Chi-square tests performed. Similarly, there were no statistically significant differences when the missed care was compared across the same subgroups; moreover, it was distinguished that p: n ratio was significantly higher in the maternity hospital. Conclusion: A higher p:n ratio negatively affects missed care opportunities. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate Knowledge, Attitude, and Practice (KAP) regarding deep margin elevation (DME) among dental practitioners in Riyadh city. Materials and Methodology: A cross-sectional study that comprised a total number of 535 dental practitioners: 255 (47.7%) were males and 280 (52.3%) females. A self-constructed 21 close-ended self-administered questionnaire was utilized in the study. The data were entered and analyzed by Chi-square test and descriptive analysis using Statistical Package for the Social Sciences (SPSS) software. Results: Although the majority of the respondents have heard about DME, only 30.4% have utilized this technique in their clinical practice by having general practitioners and specialists utilize this technique more often than consultants. Among the participants, 65.4% of them have agreed that adhesion by bonding to deep cervical dentin is predictable and related to the success of the final restoration. Conclusion: The knowledge level of DME among the study participants was adequate. The findings of this study revealed that the total number of dentists who utilize the technique in restoring large subgingival defects of posterior teeth with proximal caries is very minimal. Thus, it is recommended that dental practitioners have this technique introduced in their dental clinics as an alternative to surgical crown lengthening. Although years of experience and dentist rank may influence the clinical decision, in-depth factorial analysis with a greater sample size is necessary. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to measure the level of the stigma of medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus, towards mentally ill patients. Material and Methods: A cross-sectional survey was conducted in King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh. The data collection was started in July 2017 till March 2018. The students completed a self-administered questionnaire consisting of sociodemographic data and the Community Attitudes toward the Mentally Ill (CAMI) Scale. Results: The sample size was realized as 274 participants. There were no significant differences in all CAMI subscales for the different academic years except for Authoritarianism which showed a significant increase in the level of stigma (P-value = 0.04). Male gender, previous psychiatric treatment, and having a relative with psychiatric illness were associated with higher Authoritarianism and Social Restrictiveness scores and lower Benevolence and CMHI scores. Discussion: More stigma was observed among the 4th year students and it might be due to insufficient academic preparation as well as more exposure to psychiatric rotations. Conclusion: The results support the importance of implementing anti-stigma programs throughout the medical program to improve the healthcare provided to mentally ill patients. [ABSTRACT FROM AUTHOR]

Aim: To assess the efficacy of the antimicrobial properties of charcoal vs. noncharcoal toothbrushes and the level of bacterial contamination in the oral cavity using a charcoal toothbrush. Materials and Methods: This was a randomized, double-blind controlled study in which both male and female subjects aged from 18 to 35 were included (n = 30; 15 males and 15 females). The subjects were selected from (students) of Riyadh Elm University in Riyadh, Saudi Arabia. Subjects were informed about the study and signed the consent form before participation. From January to April 2019, subjects were given charcoal and non-charcoal toothbrushes. Results: The Wilcoxon signed rank test showed that there was a significant difference in bacterial counts between non-charcoal and charcoal toothbrushes (P = 0.000). Of the subjects, 70% showed a decrease in the number of bacterial counts while 30% showed no increase in bacterial counts. There was a statistically significant decrease in the number of bacteria in the gingival crevicular fluid (GCF) with charcoal treatment (P < 0.001). Of the subjects, 96.6% showed a decrease in the count of bacteria in GCF after using a charcoal toothbrush. Only 3.3% of the subjects had the similar counts of bacteria in GCF after using the charcoal toothbrush. Conclusion: The study demonstrates that charcoal toothbrushes reduce bacterial contamination and the poor effects on oral health after 1 week of use. [ABSTRACT FROM AUTHOR]

Background: Preventive oral health care (OHC) is an important part of preventive health care and needs to be started early in life. Family physicians are in a position where they can help to initiate preventive OHC. From previous literature, oral health has an impact on the general health and quality of life of individuals with a large burden on the health care system. In addition, pediatricians and family physicians lack knowledge in oral health and can be unwilling to participate in preventive OHC. We aim to increase family physicians' knowledge of oral health. Objectives: This study aimed to measure the level of knowledge about oral health and identify some of its determinants among family physicians working in Riyadh, Saudi Arabia. Methods: This is a cross-sectional study that included 187 family physicians to measure the knowledge of family doctors about oral health using a self-administered questionnaire. Results: The total mean score was 119.28 ± 11.26 out of 175, indicating a poor level of knowledge level about oral health. Conclusion: Family physicians in Riyadh, Saudi Arabia lack knowledge of oral health. These findings make it necessary to include oral health topics during residency and continuing medical education programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although unintentional childhood injuries are a major cause of morbidity, there is a dearth of literature on the issue in Saudi Arabia. The aim of this study was to assess the prevalence of unintentional childhood injuries in Saudi children, safety of their home environment, and the parents' attitude toward home safety measures. MATERIALS AND METHODS: A cross-sectional survey was conducted in a consecutive sample of parents accompanying children aged ≤12 years to the pediatric outpatient clinics of a tertiary care hospital in Riyadh, Saudi Arabia. A validated self-administered questionnaire was used for data collection. Data was analysed using SPSS; Chi-square test and t-test were used to identify variables associated with injury in the preceding 12 months. Logistic regression analysis performed to identify the significant variables associated with injury after contolling for other variables. RESULTS: A total of 283 participants were enrolled. The prevalence of unintentional childhood injuries was 24.7% in the past 12 months. The majority of these injuries occurred at home (74.3%). Accidental falls were the most reported (62.9%) cause of injury followed by burns (22.9%). Being a male child, attending a nursery or kindergarten, and having parents who kept hazardous objects within the reach of children were found to be significantly associated with higher odds of injury. CONCLUSION: The prevalence of unintentional childhood injuries was high in the study population. Significant gaps were found between parents' reported knowledge and practice. Focused educational programs to improve home safety will be valuable in reducing this burden. [ABSTRACT FROM AUTHOR]

Background: The consequences of physical inactivity during pregnancy are one of the major problems among pregnant women in Saudi. To explore the pattern of exercise and to know the beliefs and reasons for not doing physical activity (PA) emphasized the need for conducting this study. This study aimed to improve the level of knowledge and practice of PA among women during pregnancy. Methods: A cross-sectional study was performed using quota sampling Results: 41.62% of pregnant women had high level of physical activity (PA) awareness and practice and 58.37% had a low level of awareness and practice. Statistical difference was found between the two groups in terms of parity, education level, work status, and family income. Pregnant women preferred walking as exercise. They are aware about PA benefits during pregnancy, but perceived that tiredness was the greatest barrier for physical activity. Conclusion: This study recommends conducting well-designed intervention sessions to promote PA awareness and practice among pregnant women, especially those with low education, low income, and low number of children. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to estimate the awareness of Saudi population in Riyadh regarding cardiovascular diseases (CVDs) and their risk factors. Methods: This was a cross-sectional study that used self-administered questionnaires conducted in universities, primary care centers, and electronic copies distributed in social media websites. Results: Overall, 47.1% of the respondents had a good awareness of CVD and associated risk factors. However, awareness of the symptoms of stroke and heart attack was low. Pulmonary embolism and deep vein thrombosis were the most commonly identified types of CVD, with 39.2% aware of these conditions. The most well-known symptom of heart attack was shortness of breath (known by 54.4% of the respondents). In relation to stroke, the most commonly recognized symptom was "sudden dizziness, trouble walking, or loss of balance" (45.4%). Respondents' awareness of CVD risk factors was moderate. The most common factors—identified by over two-thirds of participants—were unhealthy diet, smoking, dyslipidemia, and physical inactivity. Independent predictors of good CVD awareness were age 35–44 years, living in the north of Riyadh and following a healthy diet. Conclusions: The awareness of CVD and associated risk factors is insufficient among Saudis in Riyadh City. This study emphasizes the necessity for effective education to increase the awareness about CVD in Saudi Arabia. High awareness may lead to early recognition of the risk factors and lead to early implementation of primary prevention which the cornerstone of family medicine practice. [ABSTRACT FROM AUTHOR]

Background: Healthcare is a substantial industry globally, where nurses comprise the largest percentage of the healthcare system. There is a global nursing shortage and nursing staff retention has become a major human resource challenge. One of the critical indicators of quality of care is nurse-to-patient ratio (n:p ratio), but due to the extreme shortage of nurses, the quality of nursing care may have been affected leading to low nurse engagement results and substantial missed on aspects of nursing care. Identifying these key areas among nurses in King Saud Medical City (KSMC) will contribute to the improvement of staffing conditions at any levels. Aim: The primary objectives were (1) to investigate the impact of patient-to-nurse ratio (p:n ratio) on satisfaction and (2) to explore the impact of p:n ratio on missed care. The secondary objectives were (1) to compare the nurses' satisfaction categories, missed care categories across different hospitals included in our medical city, different age categories, and different education levels and (2) n:p ratio will be compared across hospitals. Methods: This was a cross-sectional analytical study. Setting: This was conducted at KSMC, Riyadh, Saudi Arabia, specifically in areas of main general hospital, medical tower, pediatric and maternity hospital. Outcome Measures: (n:p ratio), nurse engagement/satisfaction, and missed nursing care. Results: Of the total of 384 responses (96% response rate), the majority of respondents were satisfied (n=155, 40.4%), followed by Neutral (n=124, 32.3%), very unsatisfied category included only 17 responses (4.4%) and very satisfied were 35 nurses (9.1%). While responses to the missed care section revealed that overall the majority of missed care opportunities were in the category of never missed (278, 72.4%). As for the p: n ratio, the average was 4.2 (patients) ± 1 (nurse). Furthermore, the ratio of patients-to-nurse was not found to significantly impact overall satisfaction, neither in the univariable model nor in the multivariable model adjusted for age, education, and experience. Interestingly, age category was a significant predictor of nurse satisfaction (higher odds of satisfaction category with higher age category) yielding an adjusted odds ratio (OR) of 1.4 (95% confidence interval [CI]: 1.01-1.8; P = 0.04) although this was a post hoc finding. As for the impact of n:p ratio on missed care, it was significantly associated with missed care in the univariable model, with OR of 1.3 (95% CI: 1.01-1.6; P = 0.037) and an OR of 1.3 (95% CI: 1.02-1.6; P = 0.032) in the multivariable model. When the categories of satisfaction were compared across different hospitals of KSMC, different age groups, and education, there were no differences in any of the Chi-square tests performed. Similarly, there were no statistically significant differences when the missed care was compared across the same subgroups; moreover, it was distinguished that p: n ratio was significantly higher in the maternity hospital. Conclusion: A higher p:n ratio negatively affects missed care opportunities. [ABSTRACT FROM AUTHOR]

Background: Cervical spine injury is the most common vertebral injury after major trauma, 20% of all cervical fractures happen to be odontoid fractures. In young adults, odontoid fracture usually happens as a result of high-energy trauma after a motor vehicle accident (MVA). MVA in Riyadh represents 38.4% of all trauma cases, in which the head-and-neck are the most injured body parts. This research aims to provide information about the incidence of odontoid process fracture post-MVA in Riyadh, Saudi Arabia. Methods: The design of this study was retrospective. A single level one trauma center database (trauma registry) was used to identify odontoid fractures post-MVA. All trauma cases from 2008 to the most recent were included, a total of 17,047 patients, to identify cervical spine fractures and further identify odontoid fracture incidence. The patients' radiographs were reviewed retrospectively, and odontoid fractures were classified by a board-certified spine surgeon. A descriptive analysis was carried out to report basic data distribution. Pearson's correlation was carried out to assess associations. Results: A total number of cervical spine fracture was 1195 patients (6.6% of the total sample). The incidence of odontoid fractures during the entire study period from 2008 to 2018 was 42 of 480 patients with C2 cervical trauma, constituting 8.75% C2 fractures, and 3.5% of cervical spine fractures. The mean age was 41.75 ± 18 years. There were three patients (onemale, two females) with type I odontoid fracture, 26 (all males) with type II, and 13 (11 males, 2 females) with type III. Most patients were managed conservatively (83.33%), whereas 16.67% underwent surgical management. Conclusion: The incidence of posttraumatic odontoid fractures is low, given the younger population of this study. This does not predict future incidence rates with the continued improvement of road traffic laws and awareness in the population. [ABSTRACT FROM AUTHOR]

Objectives: To assess patients’ awareness of the indications and complications of sleeve gastrectomy in King Khalid University Hospital, Riyadh, Saudi Arabia. Methods: The cross‑sectional study conducted from December 2017 to May 2018 in KKUH, Riyadh, Saudi Arabia included all patients aged 18 years and older. Data collection was conducted through self‑administered questionnaires. Chi‑square test was performed to determine the significant differences between variables. A P value of < 0.05 was considered statistically significant. Result: Of 480 participants, 247 (51.5%) of them were male. The educational level of most was bachelor’s degree (253; 52.7%). Most of the participants (326; 67.9%) are not aware about BMI. However, 80 (16.7%) participants knew the true answer to obese BMI. Of the total participants, 283 (59.0%) did not knew about sleeve gastrectomy indications; however, 311 (64.8%) of the participants had heard about the complications of sleeve gastrectomy. All these results are correlated with the educational level of the participants. Conclusion: Our study shows a lack of awareness of sleeve gastrectomy indications and complications among study population. We need to increase public awareness about sleeve gastrectomy indications and complication by proper scientific health education in the community [ABSTRACT FROM AUTHOR]

Objectives: Missing teeth are routinely replaced with fixed dental prostheses (FDPs); thus, knowing the patient's oral health–related quality of life (OHRQoL) after placement of FDP and factors affecting their quality of life in addition to their oral hygiene practices is important. This study aimed to measure OHRQoL with FDPs and oral hygiene practices of adults in Riyadh, Saudi Arabia. Materials and Methods: A survey was distributed in hard and soft copy forms. Target subjects were adults older than 18 years with FDP and living in Riyadh. The questionnaire contained four domains: demographic data, medical history, characteristics of the prostheses and oral hygiene practices, and Oral Health Impact Profile (OHIP)-14 questionnaire, which measures OHRQoL. Results: The study included 528 subjects. More than half of the participants (56.6%) had poor OHRQoL, which was associated with female gender, full-time employment, and low income. The presence of toothache, periodontal diseases, oral abscess, and broken teeth were all associated with poor OHRQoL. Participants with diabetes were also found to have poor OHRQoL. As for oral hygiene practices, 47% of subjects did not receive oral hygiene instructions after the placement of their FDP. It was also found that 53.4% of the study population brush only once daily. Conclusion: Many factors can have an influence on OHRQoL. Both dentist and patient awareness regarding postoperative oral hygiene instructions should be increased to ensure the durability of the prosthodontic appliances and improve patients' OHRQoL. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to evaluate the faculty members' attitude toward establishing a business center in the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Materials and Methods: A structured questionnaire comprised three sections: demographic variables such as gender and age, questions regarding the faculty's attitude toward a dental college business center, and a comparison between a business center and private clinics. Statistical analysis was performed to compare the groups with scale response variable; independent t-test, analysis of variance, and factor analysis were also conducted. Results: The study results show that 43 respondents were men and 26 were women. Twenty respondents were ranked in the position of assistant professor, whereas 38 were ranked as associate professors, and 11 as professors. In total, 88.5% of female faculty members supported the idea of establishing a business center at the dental college, whereas 65% of male faculty members supported the same idea. There is a statistically significant difference among them (P < 0.05). The factor analysis extracted three factors named as "treatment accessibility," "treatment effectiveness," and "treatment cost." The factor loading ranges from 0.652 to 0.867, and altogether they explain 79% of the total data variance. Conclusion: Our study proved that 65.1% of male and 88.5% of female dental faculty of the college supported the idea of establishing a business center at the dental college as funding is needed to invest in dental education and research programs in order to formulate the next generation of practitioners to serve the population. This study will add to the progress of establishing a business center in dental education and provides the patient with a treatment accessibility and effectiveness in a low-cost budget. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the relationship between dental caries and exposure to secondhand smoking in mixed teeth among Saudi children. Materials and Methods: A cross-sectional study was designed to target schoolchildren aged between 6 and 13 years in their mixed dentition stage. A cluster random sample of schools teaching first to sixth grades from different regions in Riyadh city was used. Data were obtained by self-reported questionnaires and clinical dental examinations. Questionnaires comprised sections related to sociodemographic, behavioral, health characteristics, and questions related to mother and father smoking status, type, and duration of smoking, and whether parents smoked inside homes or not. The clinical dental examination was based on the basic methods of the World Health Organization criteria for decayed, missing, and filled teeth (DMFT) (1997). Statistical analyses included descriptive statistics, t test, and one-way analysis of variance. Results: Of the 302 participating schoolchildren, 56% were females, 72% were Saudi nationals, and 84% were of normal weight. Of the total 3246 teeth examined, DMFT was found in 1922 teeth (mean DMFT = 6.36). Only eight mothers (2.7%) were smokers, seven of them smoked inside their homes. Majority of fathers were smokers (110, 37%) and 82% smoked inside their houses. It had been found that 26% of schoolchildren were exposed to secondhand smoking. The mean DMF scores were higher among schoolchildren with smoking fathers and mothers, and the difference was statistically significant (P = 0.05). Conclusion: The DMFT among Saudi schoolchildren was 6.36. Children, who are exposed to secondhand smoking by their family members, are more likely to have dental caries in their mixed dentitions. [ABSTRACT FROM AUTHOR]

Background/Aim: Hypertension (HBP) is a chronic disease that has become a public health problem, which has been attributed to numerous risk factors. However, despite numerous HBP management and behavioral treatment guidelines, HBP is poorly controlled among patients due to insufficient care. We conducted this study to identify the prevalence of self-management behaviors and to explore factors affecting self-management behaviors for controlling HBP among hypertensive patients. Methods: We conducted a survey using the Hypertension Self-Care Profile (HBP-SCP) and the Hill-Bone Adherence Scale among diagnosed HBP patients attending the Family Medicine clinics of King Saud Medical City in Riyadh, Saudi Arabia in January 2019. All patients of Saudi nationality aged 18 years and above were included in the study. Results: A total of 187 patients responded to the survey, 95 (50.8%) males and 92 (49.2%) females. Only 93 patients (49.7%) monitor their BP at home, and 68 (36.4%) always measure their BP. Ninety-one patients (48.7%) said that measuring their BP is not important. The most common reason for not taking the anti-HBP medications is they forget to take the medications in 87 (46.5%) of patients. Seventy-two patients (38.5%) did not restrict salt intake, and 51 patients (27.3%) had no time for exercise. More than half of the patients (51.3%) were not motivated to regularly exercise and 56.7% were motivated to limit salt-intake. Confidence to exercise, check BP at home, and eat low-salt foods were also low at 52.4–53.5%. Significant factors including gender, age, BMI, duration of HBP, and presence of cardiac disease were found to be related toward behavior, motivation, and confidence to self-care. Conclusion: Compliance, behavior, motivation, and self-care among hypertensive patients visiting the primary care clinics in our representative population are low. Various factors were found to be related to poor behavior, poor motivation, and less confidence to do home BP monitoring, to exercise more, restrict salt intake, and value the control of HBP. There is a need for health practitioners to assess self-care activities and blood pressure control, and educate patients the importance of HBP monitoring and teaching practical techniques to boost their confidence and motivation to achieve a better behavior, self-care, and compliance to management. [ABSTRACT FROM AUTHOR]

Background: Infected travelers returning from malaria endemic countries pose the threat of local outbreaks in nonendemic countries. Such outbreaks are becoming potential public health threats with increasing volume of international travels. Aims: This study aimed to assess the knowledge, attitude, and practices toward malaria, its prevention and treatment among Saudi air travelers visiting malaria-endemic countries. Methods: A cross-sectional survey was conducted among Saudi passengers who were waiting at the departure gates of the King Khalid International Airport, Riyadh to travel to five chosen malaria-endemic countries. Knowledge, attitude, practice, and health-seeking behavior for malaria were assessed using a self-administered questionnaire. Factors associated with favorable responses were identified by statistical tests. Results: Among 531 travelers, adequate knowledge, favorable attitude, and healthy practices pertaining to malaria were present in 42.7%, 80.2%, and 55.7%, respectively. Traveling to India, age >=30 years, tourists and traveling businessmen, previous visit to same country or region, seeking malaria-specific advice were significantly associated with adequate knowledge. Only 11.3% had sought pretravel health advice on malaria. Lack of knowledge about the existence and importance of pretravel consultation was the common reason for not seeking advice. Conclusion: Knowledge about malaria and practice of preventive measures were suboptimal among Saudi travelers. Public awareness about travel consultation and chemoprophylaxis should be a part of malaria elimination and prevention efforts. Primary care physicians should take into account the level of knowledge among prospective travelers and provide opportunistic travel health services or refer them appropriately. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients' perception of their physician's empathy influences their compliance with treatment and the resulting quality of life. We aimed to measure the patient-rated empathy of physicians and to determine patient-level factors associated with it. MATERIALS AND METHODS: This hospital-based cross-sectional study enrolled adult (≥18 years) patients attending the outpatient clinics of the departments of family medicine, internal medicine, and surgery. We measured patients' rating of their physician's empathy using the Jefferson Scale of Patient's Perception of Physician Empathy questionnaire. Data were analyzed using SPSS v 23.0; categorical variables were presented as frequencies and percentages, and all quantitative variables were presented as mean and SD. Associations were explored by Chi-square test and Student's t-test. Regression analysis was performed to identify factors significantly associated with the empathy score; P< 0.05 was considered statistically significant. RESULTS: Of a total of 390 patients with a mean (standard deviation [SD]) age of 40.5 (13.6) years, 189 (48.5%) were male. The mean (SD) total patient-rated physician empathy score was 26.6 (6.0). Multilevel linear regression modeling revealed that having a health professional in the family, suffering from an acute illness (as compared to chronic illness), consulting a physician recommended by relatives/friends, trusting the physicians' expertise, shorter (<10 min) waiting time, and perceived adequate consultation time were associated with higher empathy ratings. CONCLUSIONS: Patients' perception of physicians' empathy is indispensable for the success of a clinical consultation. It is influenced by patient-level social and clinical factors. On-the-job physician training in empathy, effective monitoring, and feedback mechanisms should be an integral component of the quality control of hospital services. [ABSTRACT FROM AUTHOR]

Background: Familial Hypercholesterolemia (FH) is an inherited and complex multifactorial disease that can lead to early onset of coronary artery disease (CAD). Diagnosis, treatment, and management of FH require a well-trained physician with high awareness of the disease and different risk factors to avoid complications. Materials and Methods: This cross-sectional study evaluated family physicians' awareness and knowledge of FH using self-administered questionnaires in governmental hospitals in Riyadh, Saudi Arabia, during 2018. Results: A total of 225 family physicians completed the questionnaire, with a response rate of 58.4%. The mean age of respondents was 31.3 years and more than 59.1% were men. Although 72.4% of physicians rated their familiarity with FH as average and above, 48.4% of all participants had poor FH knowledge, while only 51.6% had acceptable FH knowledge. About 65.8% of physicians reported that they routinely take a detailed family history, perform a physical examination, and screen close relatives. Awareness of various clinical algorithms for diagnosis of patients with FH was very low at 52.0%. The mean FH knowledge and familiarity scores were significantly higher (P < 0.001) among participants who were older, had higher training levels, or longer years in practice. Conclusions: The current study revealed significant deficits in FH familiarity, awareness, knowledge, and practice among Saudi physicians. FH educational programs directed at all physicians involved in FH patients' management are necessary to improve physicians' knowledge of all aspects of FH management, including the importance of a mechanism for identifying people at risk for a genetic condition by a process of systematic family tracing. [ABSTRACT FROM AUTHOR]

Context: Public awareness regarding cosmetic surgery. Aims: To assess the attitudes and acceptance of cosmetic surgery among patients in a tertiary care hospital in Riyadh, Saudi Arabia. Settings and Design: Single-center, cross-sectional study in the family medicine department at our institution. Methods and Material: Data were collected from 389 patients (age 15-50, 29.37 ± 9.25 years, male: female = 139:250) using the Acceptance of Cosmetic Surgery Scale (ACSS) modified for Arabic speakers. Statistical Analysis Used: SPSS 22 statistical package. Results: One hundred eighty-five (47.6%) patients were willing to undergo minor cosmetic surgery, whereas 144 (37.1%) were not. Additionally, 237 (60.9%) patients agreed that cosmetic surgery is good because it can help people feel better about themselves, whereas104 (26.8%) patients disagreed. Robust Cronbach α values were observed among all ACSS scales. Mean significant (P = 0.002) differences were observed between gender and the intrapersonal scale scores. The average intrapersonal scale score was greater among female patients (22.48 vs. 19.29). Similarly, the mean consider scale scores among female patients (20.92 vs. 17.45; P = 0.001). Mean significant (P = 0.001) differences were also observed between education and the intrapersonal scale. Conclusions: The results reveal important information regarding the acceptance of and attitudes toward cosmetic surgery in Saudi Arabia. There is an urgent need for regulatory intervention to ensure patient safety and satisfaction. [ABSTRACT FROM AUTHOR]

Background: Sepsis represents a huge burden for the health-care system. Septic patients presented by emergency medical services (EMS) are usually sicker in comparison to patients arriving by other means. Knowledge of sepsis is a key factor in recognizing and providing the appropriate care; it is not the only barrier as EMS providers do not have access to the proper diagnostic investigation. This work highlighted the level of knowledge, awareness, and attitude of EMS providers regarding prehospital care of sepsis in Riyadh, Saudi Arabia. Methods: This study was a cross-sectional study that conducted among EMS personnel of Saudi Red Crescent Authority and King Abdulaziz Medical City. One hundred and ninety-seven individuals were sampled (99 were technicians and 98 were paramedics). Results: Most participants (71%) were aware of the term "sepsis;" however, only 48% of participants correctly defined sepsis (30% between emergency medical technicians [EMTs] vs. 66% paramedics group,P < 0.01). Paramedics were noted to have a better understanding of signs, symptoms, and management of sepsis. Most of the participants thought that sepsis can be identified during prehospital care (55%) and 75% suggested that they should be involved in the management of septic patients. About 80% responded that their intervention would result in a better outcome for patients and would influence the behavior of emergency department medical care. Most of the participants (83%) were willing to be actively engaged in the prehospital care of septic patients. Conclusion: This study showed an insufficient level of knowledge and awareness regarding sepsis care in the EMS field in Saudi Arabia. Paramedics had more knowledge and awareness about sepsis care compared to EMT personnel. Future work should focus on exploring the reasons behind this, as well as implementing plans to improve education about sepsis for EMS personnel. [ABSTRACT FROM AUTHOR]

PURPOSE: The prevalence and determinants of dry eye disease (DED) among 40 years and older population of Riyadh (except capital), Saudi Arabia. SUBJECTS AND METHODS: A population-based survey was conducted in Riyadh district between 2013 and 2017. All Saudi aged >40 years attended at the Primary Health Center were the study population. McCarty Symptom Questionnaire was adopted. A representative sample was examined. The best-corrected visual acuity and anterior and posterior segment assessment were performed. DED was graded as absent, mild, moderate, and severe. RESULTS: We examined 890 participants. The age- and sex-adjusted prevalence of DED was 45.1% (95% confidence interval [CI] = 44.8–45.4). One-third of the participants had DED. However, two-third of DED cases were of mild grade. The prevalence of DED among females was significantly higher. The variation of DED by age group was not statistically significant (χ2 = 2.6, Degree of freedom = 3, and P = 0.1). Presence of glaucoma was significantly associated to DED (odds ratio [OR] = 2.6, [95% CI = 1.2–5.6], and P = 0.01). Use of topical glaucoma medication was significantly associated to DED (OR = 4.6 [95% CI = 1.8–11.8], and P = 0.001). However, severity of DED was not found to be associated with glaucoma medication (χ2 = 2.6, P = 0.1). Associations of diabetes and hypertension to DED were not statistically significant (OR = 0.97 [95% CI = 0.73–1.3], and P = 0.84) (OR = 1.1 [95% CI = 0.8–1.4], and P = 0.6). The severe visual impairment was not associated to the grade of DED (P = 0.55). CONCLUSION: The prevalence of DED among Saudi is high, but severe DED is found to be less. Association with female gender, glaucoma, and topical glaucoma medications was reported. Association with diabetes, hypertension, and age group variation was not significant. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a natural part of the female reproductive cycle in which periodic discharge of blood from the uterus exits through the vagina, it is the spontaneous onset of puberty. Aim: The study is to assess the level of knowledge, readiness, and myths about menstruation among young Saudi girls in the Princess Noura University, Riyadh. Materials and Methods: This cross‑sectional study of a convenient sample of 500 students from different colleges at the Princess Nora Bint Abdul Rahman University, Riyadh, Saudi Arabia was conducted between January 2016 and March 2016. A validated questionnaire assessing knowledge, readiness, and attitude of participants was used. Questions assessing beliefs and myths about menstruation were included. Results: About 500 students participated in the study, their average age was 21.1 ± 7.8 years and 25.8% of them were from the health colleges. The main source of information about menstruation was the mother in about 60%, whereas only 4% considered doctors and nurses as a source of information. The study shows that the knowledge, attitude, and readiness of participants about menstruation were really poor. The majority (73.4%) of the participants were not able to correctly recognize why girls get their period. Similarly, the percentage of students having a negative attitude about menstruation is 78.4% (370), and <23% were defined to be ready before their first menses. Conclusion: The results of the study depict that the respondents lack proper knowledge of information relevant to menstruation. This included the importance of increasing awareness and giving accurate information using scientific sources, such as schools, colleges, or health team members. [ABSTRACT FROM AUTHOR]