The visual status of adolescents in Riyadh, Saudi Arabia: a population study

Purpose

The visual status of adolescents in Saudi Arabia (SA) has not been well reported. To date, the prevalence and types of refractive errors (REs), amblyopia, strabismus, and correctable visual impairments have not been quantified. The aim of the study was to investigate the visual status in adolescents in Riyadh, SA.

Methods

This study was based on a population cross-sectional and random cluster design. After design and the sample calculations, 1,007 participants, 12–20 years of age, were screened during the study. Nine participants were excluded due to ocular disorders. The participants were assessed for REs, distance visual acuity logarithm of the minimum angle of resolution, contrast sensitivity, stereoacuity, pinhole test findings, and cover–uncover test findings.

Results

The results showed that 55.5% of the participants had some form of REs, while correctable visual impairment was found in one-fifth of the screened participants. Myopia was the dominant type (53.3%, ranged from −0.50 DS to −14.00 DS), whereas hyperopia was found in 2.2% (+2.00 DS to +5.50 DS) and astigmatism was present in 15% (−0.75 DC to −5.25 DC). Only 43% of the participants had corrected REs; however, the noncompliance for spectacle use was 20.25%.

Conclusion

This study was the first attempt to investigate the visual status in adolescents in SA. It provided estimations of the REs, amblyopia, and strabismus. The high prevalence of REs emphasizes the need to identify the best proactive strategies to detect and manage REs to reduce the incidence of visual impairment in SA. Increasing awareness about eye health and employing efficient screening programs could help to address the need for REs corrections.

Prevalence of subclinical hypothyroidism in adults visiting primary health-care setting in Riyadh

Background and objectives: Subclinical hypothyroidism is an asymptomatic condition with normal thyroxin and raised thyroid stimulating hormone (TSH) level. The objective of the study was to determine the prevalence of subclinical hypothyroidism in primary health care (PHC) settings in Riyadh and explore the relationship of TSH level with age, gender, family history, body mass index, and co-morbid conditions.

Subjects and methods: A cross-sectional study of adult visitors to nine satellites PHC clinics in military housing in Riyadh was carried out. TSH concentration and free T4 levels were measured. Data were collected by nurses and physicians during routine clinical practice in primary care. Descriptive analysis was performed on all variables in study, and relationships were explored using chi-square, t-test, analysis of variance, and linear regression.

Results: A total of 340 out of 394 participants in the study gave blood samples. Subclinical hyperthyroidism was identified in 2.1% (p = .001) and subclinical hypothyroidism in 10.3% (p = .001) of the PHC visitors. TSH levels were found to be significantly higher (p = .047) in elderly population of ≥60 years and those with family history of thyroid disease. Non-significant upward trends were noted in TSH levels with hyperlipidemia and increasing blood pressure. No overt hyperthyroidism or hypothyroidism was found in our study sample.

Conclusion: Subclinical hypothyroidism has a prevalence of 10% of adults visiting PHC’s. TSH levels are higher in the elderly, which warrants screening of those aged 60 years and above.

Improving patient safety culture in Saudi Arabia (2012-2015): trending, improvement and benchmarking

Background

Measuring patient safety culture can provide insight into areas for improvement and help monitor changes over time. This study details the findings of a re-assessment of patient safety culture in a multi-site Medical City in Riyadh, Kingdom of Saudi Arabia (KSA). Results were compared to an earlier assessment conducted in 2012 and benchmarked with regional and international studies. Such assessments can provide hospital leadership with insight on how their hospital is performing on patient safety culture composites as a result of quality improvement plans. This paper also explored the association between patient safety culture predictors and patient safety grade, perception of patient safety, frequency of events reported and number of events reported.

Methods

We utilized a customized version of the patient safety culture survey developed by the Agency for Healthcare Research and Quality. The Medical City is a tertiary care teaching facility composed of two sites (total capacity of 904 beds). Data was analyzed using SPSS 24 at a significance level of 0.05. A t-Test was used to compare results from the 2012 survey to that conducted in 2015. Two adopted Generalized Estimating Equations in addition to two linear models were used to assess the association between composites and patient safety culture outcomes. Results were also benchmarked against similar initiatives in Lebanon, Palestine and USA.

Results

Areas of strength in 2015 included Teamwork within units, and Organizational Learning—Continuous Improvement; areas requiring improvement included Non-Punitive Response to Error, and Staffing. Comparing results to the 2012 survey revealed improvement on some areas but non-punitive response to error and Staffing remained the lowest scoring composites in 2015. Regression highlighted significant association between managerial support, organizational learning and feedback and improved survey outcomes. Comparison to international benchmarks revealed that the hospital is performing at or better than benchmark on several composites.

Conclusion

The Medical City has made significant progress on several of the patient safety culture composites despite still having areas requiring additional improvement. Patient safety culture outcomes are evidently linked to better performance on specific composites. While results are comparable with regional and international benchmarks, findings confirm that regular assessment can allow hospitals to better understand and visualize changes in their performance and identify additional areas for improvement.

MERS-CoV infection: Mind the public knowledge gap

In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV.

In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information.

The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all <25%). In a multivariate logistic regression analysis age ≤30 years (Odds Ratio (OR) = 1.647, 95%CI 1.048–2.584, P = 0.030), male gender (OR = 1.536, 95%CI 1.105–2.134, P = 0.01), and no tertiary education (OR = 1.957, 95%CI 1.264–3.030, P = 0.003) were independent significant predictors of poor epidemiological knowledge.

This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted.

Satisfaction of Patients Attending in Primary Healthcare Centers in Riyadh, Saudi Arabia: A Random Cross-Sectional Study

This study aims to determine the level of satisfaction of patients who visit primary healthcare centers in Riyadh, Saudi Arabia. The investigation was a cross-sectional study conducted in twenty randomly selected primary healthcare centers in Riyadh, Saudi Arabia from October to December 2014. A descriptive data analysis was performed. Eligible participants had visited at least one of the selected primary healthcare centers within the past 12 months. A total of 1741 participants completed the survey, providing a response rate of 87 % (43 % male, 57 % female). The highest satisfaction rates were in the following areas: comprehensiveness and coordination 76.2 % (95 % CI 74.8 ± 77.5), communication 72.7 % (95 % CI 71.3 ± 74) and attitude of staff 73.4 % (95 % CI 72.1 ± 74.8) The areas of greatest concern expressed by the participants were the length of the wait and the quality of the facility 55.4 % (95 % CI 53.3 ± 57.5), 50.5 % (95 % CI 48.3 ± 52.7), respectively. The majority of the patients attending primary healthcare centers in Riyadh showed high levels of satisfaction; however, there are still some factors that need to be considered and improved upon. These include the accessibility of primary healthcare centers as well as waiting time of patients. The results of the current study showed relative improvement in other factors such as comprehensiveness and coordination, communication and attitude of staff. The level of satisfaction of patients and stakeholders shows the progress of the quality of care in healthcare facilities in Riyadh, Saudi Arabia.

Bilateral peritonsillar abscess: A case report and pertinent literature review

INTRODUCTION

The peritonsillar space is defined as the area between the palatine tonsillar capsule medially and the superior pharyngeal constrictor muscle laterally. Unilateral peritonsillar abscess (PTA) is more common than the bilateral condition. To the best of our knowledge, only 13 cases of bilateral PTA have been reported worldwide; this is the first case reported from Saudi Arabia.

PRESENTATION OF CASE

We present a case involving a 16-year-old boy who presented to the emergency department with a5-day history of sore throat, dysphagia, trismus, drooling, and a muffled "hot-potato" voice, but with no symptoms of airway compromise. After several examinations, we diagnosed bilateral PTA. We performed an incision and drained the pus from both sides, which was positive for Streptococcus pyogenes. Postoperatively, the patient improved dramatically, and tonsillectomy was scheduled for 6 weeks later.

DISCUSSION

The difficulty in diagnosing bilateral PTA stems from the fact that it does not present with the usual clinical characteristics as unilateral PTA. These symptoms include asymmetry of the tonsils and palate, deviation of the uvula, and unilateral otalgia. As these cases carry the risk of impending airway compromise, we recommend airway management as the first step in treating such cases.

CONCLUSION

Based on our case and literature review, we recommend airway management as the first step, followed by further examinations, especially contrast-enhanced computed tomography, in cases of bilateral PTA. This condition lacks the hallmark of unilateral disease and may mimic many conditions, which will have different management approaches.

Antibiotics and over the counter medication use and its correlates among Arab pregnant women visiting a tertiary care hospital in Riyadh, Saudi Arabia

BACKGROUND AND OBJECTIVE

The use of over the counter medications (OTCMs) is a common practice globally. OTCMs are of special concern among pregnant women as they pose risk to the mother and fetus. The objective was to assess the use of OTCMs by pregnant woman, and factors associated with it.

METHODS

A cross-sectional study, using a structured self-administrated questionnaire was conducted at the obstetric and antenatal clinics at King Khalid University hospital, Riyadh. 354 pregnant women were surveyed.

RESULT

About 32% of the study participants used OTCMs without prescription at least once during their last pregnancy. The most commonly used OTCM was Paracetamol (22%). Pharmacists were the main source of knowledge (53%) for the participants. Correct knowledge regarding the drugs was associated with the usage of OTCM drug.

CONCLUSION

Use of OTCMs and antibiotics during pregnancy is a common practice among Saudi pregnant women. General awareness regarding OTCMs use during pregnancy without prescription needs to be raised in the community. Pharmacists and media can help in providing accurate knowledge.

General Breast Cancer Awareness among Women in Riyadh City

Breast cancer is the most common cancer among women globally as well as in Saudi Arabia. Early diagnosis can improve prognosis and breast self-examination (BSE) may be a cost effective way to achieve this. In Saudi Arabia, only a few studies have been conducted to address breast cancer awareness. Most showed a suboptimal level of understanding. During the last few years, Saudi Arabia has established many national campaigns to increase awareness of the disease and facilitate learning about different diagnostic procedures. This cross-sectional survey study was conducted in accordance to assess the current knowledge and practices of women regarding breast self-examination and mammography screening in Riyadh, Saudi Arabia. The sample comprised of 137 females aged 18 and older. Data were collected using face-to-face interviews with a modified Arabic version of a validated questionnaire and analyzed using SPSS. Similar to previous studies’, the results were suboptimal. Out of the 137, about 54% claimed they are aware of breast cancer and BSE, however, only 62% of them knew how to conduct self-examination. Far fewer were aware of mammography screening (38%). When asked about the source of breast cancer information, most of the women answered awareness campaigns (39%) while school/university and TV (22% each) were the sources for others. This highlights the importance and urgent need for continued awareness campaigns. Moreover, special awareness sessions need to be conducted in institutions like colleges, universities, and hospitals where the proportion of females is higher.

Perceived stress and associated factors among medical students

Background:

Stress and its psychological manifestations are currently a major source of concern. Medical education poses challenging and potentially threatening demands for students throughout the world.

Objectives:

To determine the prevalence and factors associated with perceived stress in medical students in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia.

Materials and Methods:

This was a cross-sectional study on all medical students of batches 9, 10, and 11, which constituted all the enrolled students. Data were collected using a questionnaire based on the Kessler10 psychological distress instrument with a total score ranging from 10 to 50 points in addition to some sociodemographic characteristics. Appropriate statistical test procedures were used to study the magnitude of stress and its risk factors.

Results:

Mean stress score of the eighty participants was 26.03 ± 9.7. Students with severe stress constituted 33.8%, and 30% were well. Severe stress was significantly associated with female gender and junior level. Nervousness, feeling hopeless, feeling restless, and depressed were the most important factors affecting students’ stress scores. Factor analysis revealed three hidden factors for stress in this group, namely, depression, nervousness, and age.

Conclusion:

Stress in medical students is prevalent and significantly associated with the female gender and the junior level. Implementation of coping programs is necessary.

Differential Diptera Succession Patterns on Decomposed Rabbit Carcasses in Three Different Habitats

This study describes for the first time the necrophagous Diptera attracted to rabbit carcasses in three distinct habitats in Riyadh, Kingdom of Saudi Arabia (KSA). A mean number of 1,427 flies belonging to 8 families and 16 species were collected during the decomposition process of the rabbits at the three different sites. Carcasses in the agricultural habitat attracted 1,146 flies from 7 families and 14 species, compared to carcasses in the urban site, which attracted 249 flies from 5 families and 9 species. Carcasses in the desert site attracted the lowest number (28 flies from 4 families and 5 species). In the agricultural and desert sites, flies were represented at all decomposition stages. Also, in the urban site, flies were represented at all stages except the fresh and dry stages. Lucilia sericata Meigen was the most abundant species occurring in both the agricultural and desert sites, while Musca domestica L. was the most abundant species occurring in the urban site. The evidence presented here, therefore, suggests that L. sericata and M. domestica are potentially useful species for estimating minimal postmortem intervals in this region of KSA.

Self-perceived halitosis and related factors among adults residing in Riyadh, Saudi Arabia. A cross sectional study

Objectives

This cross-sectional observational study was conducted to determine the prevalence of self-perceived halitosis among adults in Riyadh, Saudi Arabia and to assess the relation of halitosis with some socio-demographic factors, oral habits and health practices.

Materials and methods

A questionnaire was distributed to randomly selected subjects including senior high school students, college students and employees working in governmental offices. High schools and governmental offices were selected using systematic random sampling from each of the main five regions of Riyadh. The college students were selected from the major universities in Riyadh. One hundred questionnaires were randomly distributed in each of the 15 locations for males and 15 for females (5 schools, 5 universities and 5 governmental offices for each gender) giving a total of 3000 questionnaires.

Results

The prevalence of self-perceived halitosis was 22.8% among the participants. The majority of the subjects with self-perceived halitosis experienced bad breath on waking up (83.5%). Nearly half of the sample with self-perceived halitosis was told by others that they had bad breath, 25.8% visited a doctor regarding that, 23.8% received treatment for their bad breath and 54.1% made trials to control their problem by using some aids. Self-perceived halitosis was found to be more prevalent among males compared to females (P < 0.000), whereas, no statistically significant differences were found among the different age groups (P = 0.317). A statistically significant relationship was found between self-perceived halitosis and times of mouth cleaning, use of tooth brush, use of tooth paste, tongue cleaning (P < 0.000), and the use of dental floss (P = 0.004). A statistically significant relationship was also found between self-perceived halitosis and shisha (P < 0.000) and cigarette smoking (P = 0.045).

Conclusion

The prevalence of self-perceived halitosis among the population in Riyadh is within the range reported in other countries. Self-perceived halitosis is related to gender, inadequate oral hygiene practices and cigarettes and shisha smoking however, it is not related to age.

Carrion beetles succession in three different habitats in Riyadh, Saudi Arabia

A main objective of the study is the establishment of a forensic entomological database for Riyadh, Saudi Arabia. Decomposition processes and beetle succession were analysed on rabbit carcasses in three different habitats (agricultural, desert and urban) in the period from May to July 2014. Due to the effects of the high temperature at the study sites, carrion reached the dry stage within 12 days in the agricultural habitat, and 6 days in the desert and urban habitats. A total of 125 beetles belonging to eight species and five families were collected during the decaying process, with their abundances increasing from the fresh to decay stages. The prevailing species belonged to the families of Dermestidae and Histeridae. It was not possible to confirm any definitive relationship between the occurrence of a single species and a particular stage of decomposition. The beetle communities were also not distinctively different between desert and urban habitats, but a distinct community was evident in the agriculture habitat. In addition, there were distinct beetle communities between the decay stage and the other stages. The dry stage recorded the lowest number of beetles. This study indicated that, the habitat type had an effect on the decay process and the abundance rate of the beetles.

Epidemiology of 11 respiratory RNA viruses in a cohort of hospitalized children in Riyadh, Saudi Arabia

Respiratory tract infections are a principal cause of illness and mortality in children worldwide and mostly caused by viruses. In this study, the epidemiology of 11 respiratory RNA viruses was investigated in a cohort of hospitalized children at a tertiary referral center in Riyadh from February 2008 to March 2009 using conventional and real‐time monoplex RT‐PCR assays. Among 174 nasopharyngeal aspirates, respiratory syncytial virus (RSV) was detected in 39 samples (22.41%), influenza A virus in 34 (19.54%), metapneumovirus (MPV) in 19 (10.92%), coronaviruses in 14 (8.05%), and parainfluenza viruses (PIVs) in 11 (6.32%). RSV, PIVs and coronaviruses were most prevalent in infants less than 6 months old, whereas MPV and influenza A virus were more prominent in children aged 7–24 and 25–60 months, respectively. The majority of the viruses were identified during winter with two peaks observed in March 2008 and January 2009. The presented data warrants further investigation to understand the epidemiology of respiratory viruses in Saudi Arabia on spatial and temporal basis. J. Med. Virol. 88:1086–1091, 2016. © 2015 Wiley Periodicals, Inc.

Two years' experience of implementing molecular screening of hepatitis B virus, hepatitis C virus and human immunodeficiency virus 1, 2 in Riyadh blood donors

Molecular screening technologies have improved blood safety by reducing the number of window-period transmissions relative to serological screening. In the two years following the introduction of molecular testing in King Khalid University Hospital, Saudi Arabia, 25,920 donor samples were screened in parallel by both serological and molecular techniques for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). No HCV or HIV NAT yields were detected. However, molecular screening enabled the interdiction of two confirmed HBV NAT yields. This is only the second report of confirmed HBV NAT yield in the Kingdom of Saudi Arabia, and amongst the few reports in the wider Middle East and North Africa region.

Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia

Diabetes mellitus substantially increases cardiovascular disease (CVD) risk. Among Saudi Arabian citizens with diabetes, little is known about the prevalence and control of other CVD risk factors.

We extracted data from medical records of a random selection of 422 patients seen between 2008 and 2012 at two diabetic clinics in Riyadh, Saudi Arabia. We calculated the proportion of patients who had additional CVD risk factors: obesity (body mass index ⩾ 30 kg/m²), hypertension (BP ⩾ 140/90 mmHg), elevated cholesterol fractions, and multiple risk factors). Further, we calculated the proportion of patients meeting the American Diabetes Association’s recommended care targets for each risk factor.

Of 422 patients (mean age, 52 years), half were women, 56% were obese, 45% had hypertension, and 77% had elevated LDL concentrations. In addition to diabetes, 70% had two or more CVD risk factors. Although 9% met both target HbA1c and BP values, only 3.5% had optimum HbA1c, BP, and lipid values.

In Saudi Arabia’s best diabetes clinics, most patients have poor control of their disease. This huge disease burden and related care gaps have important health and financial implications for the country.

Medical grand rounds in Riyadh, Saudi Arabia: Current attitudes and barriers

Background:

Medical grand rounds (MGRs) are considered key educational tools in most academic medical institutions. In this multi-center cross-sectional survey, we tried to determine the current attitudes of local medical practitioners to MGRs, as well as perceived barriers.

Methodology:

A total of 120 physicians from the National Guard Hospital, King Fahad Medical City, King Khalid University Hospital and King Faisal Specialist Hospital participated in the survey. The questionnaire consisted of statements on attitudes and perceived barriers against participating in MGRs, as well as participants’ levels of agreement.

Results:

Most participants attend MGRs regularly (94.2%), claiming that it is mandatory (88%). Participants also agreed that MGRs were important tools for continuing medical education (89.2%) and that they provided an opportunity to both present materials and interact with their colleagues in other divisions (86.7% and 81.6%, respectively). The vast majority of respondents agreed that “topic review/update” and “inviting guest speakers” were the two most preferred suggestions for improving MGRs (94.2% and 92.5%, respectively). Major barriers included constraints of time (43.3%) and topics that were not patient-related (40.8%).

Conclusion:

MGRs in the major Tertiary Hospitals in Riyadh are well attended, and the majority of the local practitioners believe in the positive effect of MGRs in delivering quality and up to date medical knowledge. Time and physician-specific issues were identified as major barriers that needed to be addressed in order to maximize participation of medical staff.

Erythraeid mites (Prostigmata, Erythraeidae) from Saudi Arabia, description of three new species and a new record

Three erythraeid genera Balaustium von Heyden, Charletonia Oudemans, and Erythraeus Latreille (Trombidiformes: Prostigmata) are reported for first time from Saudi Arabia based on three new larval species, Balaustiumyousifisp. n., Charletoniabahaensissp. n., and Erythraeus (Erythraeus) uhadisp. n. and one new record Erythraeus (Zaracarus) lancifer Southcott. All the three new species are described and illustrated from larvae.

Coping strategies for stress used by adolescent girls in Riyadh, Kingdom of Saudi Arabia

OBJECTIVES

Secondary school girls, ages 15 - 19 yrs were surveyed to find out the coping strategies they used when stressed. Adolescents, who are affected with stress and depression early in life, suffer from depression throughout their lives especially if they are utilizing improper ways to cope with it.

METHODS

A cross sectional school based survey among 1028 adolescent girls was conducted among the secondary schools in Riyadh city,Kingdom of Saudi Arabia.

RESULTS

About 25% stated that they cry, 19% listen to music, 15% start eating a lot, 12% sit alone/isolate themselves, 11% pray/read the Quran, 10% get into a verbal argument or a fight. Only a few, 3% exercise, and 2% stated that they find someone to discuss and talk to.

CONCLUSION

Majority of the adolescent girls in our survey, rely on emotion related coping mechanisms rather than problem solving mechanisms. This can cause long term implications in these adolescents as there is an increased probability to develop depression later on in life. Policy makers need to implement strategies for early identification of stress and depression. Talking to friends and family can serve as an effective way to cope with stress.

Traffic and industrial activities around Riyadh cause the accumulation of heavy metals in legumes: A case study

The objective of this study was to analyse the effect of the continuously increasing anthropogenic activities around Riyadh, Saudi Arabia on the accumulation of heavy metals in leguminous crops. This study determined whether four legume crops, Pisum sativum L., Vicia faba L., Glycine max and Vigna sinensis, could accumulate the heavy metals Cu, Mn, Pb and Zn in their leaves, pods and grains during the summer when grown under conditions with ambient air pollution from heavy traffic and industrial activities in Riyadh, Saudi Arabia. The effect of the air pollution was examined by quantifying the protein and trace element Cu, Mn, Pb and Zn concentrations in the leaves, pods and grains of the four plant species. Analysis of the results indicated that air pollution significantly increased the heavy metal concentrations in the leaves, pods and grains. Toxic concentrations of the heavy metals were found in the plants grown at L3, L4 and L5. In conclusion, the air pollution increases as the traffic, industrial activities and population density increase.

Fast food intake and prevalence of obesity in school children in Riyadh City

Childhood obesity has become a new challenge for healthcare providers. The issue is not limited to certain parts of the world; its prevalence is increasing worldwide. The causes of obesity are poorly understood and continue to be debated and studied. It is a multifactorial disorder which involves dietary, behavioral, environmental as well as genetic factors. The increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to high obesity rates among children. The aim of this study was to assess the effect of dietary intake on the occurrence of childhood obesity, and study other associated factors including the education, occupation and income of parents and the living status. Normal healthy school girls (n =196) and school boys (n = 85) between the age of 6- 15 were recruited for the study. We found that obesity among children in Riyadh City was significantly associated with fast food intake (p = 0.0280). It was also observed that 72.5% of the overweight or obese students consumed fast food at least 4 times/week, and the other 15.9% were taking fast food 1- 3 times/week, while only 11.6% of the same overweight or obese group did not consume any fast food/ week. Father's and mother's occupations were not significantly correlated to their children's body weight. The prevalence of childhood obesity is changing and increasing yearly and is attributed to the nutritional risk factors for the Saudi school-age children. It is interesting to know that most of overweight or obese school students belonged to the families of highincome. Parents must take necessary precautions for the diet of their children and should adopt healthy life style in order to prevent or manage obesity of their children.

Community pharmacists' knowledge, behaviors and experiences about adverse drug reaction reporting in Saudi Arabia

OBJECTIVE

To assess community pharmacists' knowledge, behaviors and experiences relating to Adverse Drug Reaction (ADR) reporting in Saudi Arabia.

METHODS

A cross-sectional study was conducted using a validated self-administered questionnaire. A convenience sample of 147 community pharmacists working in community pharmacies in Riyadh, Saudi Arabia.

RESULTS

The questionnaire was distributed to 147 pharmacists, of whom 104 responded to the survey, a 70.7% response rate. The mean age of participants was 29 years. The majority (n = 101, 98.1%) had graduated with a bachelorette degree and worked in chain pharmacies (n = 68, 66.7%). Only 23 (22.1%) said they were familiar with the ADR reporting process, and only 21 (20.2%) knew that pharmacists can submit ADR reports online. The majority of the participants (n = 90, 86.5%) had never reported ADRs. Reasons for not reporting ADRs most importantly included lack of awareness about the method of reporting (n = 22, 45.9%), misconception that reporting ADRs is the duty of physician and hospital pharmacist (n = 8, 16.6%) and ADRs in community pharmacies are simple and should not be reported (n = 8, 16.6%). The most common approach perceived by community pharmacists for managing patients suffering from ADRs was to refer him/her to a physician (n = 80, 76.9%).

CONCLUSION

The majority of community pharmacists in Riyadh have poor knowledge of the ADR reporting process. Pharmacovigilance authorities should take necessary steps to urgently design interventional programs in order to increase the knowledge and awareness of pharmacists regarding the ADR reporting process.

Antibiotic utilization pattern in a general medical ward of a tertiary medical center in Saudi Arabia

To assess the pattern of antibiotic utilization and outcome of patients with bacteremia in a General Medical Ward, all positive blood cultures (BC) over a 12-month period from January 1994 to December 1995 were retrospectively reviewed. Fifty-two positive BC were recorded in 43 patients (63% males, 37% females; mean age 65.9 ± 16.6). 72% of the patients received antibiotics before or soon after obtaining the BC, and ceftriaxone was the most frequently-prescribed antibiotic (41.93%), either alone or in combination with other antibiotics. The bacteremia was due to gram-positive cocci in 60.46% of cases, gram-negative rods in 30.23%, and gram-positive rods in 9.30%. Positive BC due to contamination were not included. The most common gram-positive cocci were Staphylococcus epidermidis, followed by S. aureus, while the most common gram-negative bacilli were Brucella species, Proteus mirabilis, and Klebsiella sp. The suspected sources of the bacteremia were respiratory (21.2%), urinary (19.2%), or skin (19.2%). A subsequent change in the antibiotics regimen was done in 69.76% cases after BC results became available with no apparent effect on the outcome. Adding vancomycin and clindamycin was the most frequent change done (19.4% for each equally). Complications developed in 69.76% of patients, with 88.66% of them suffering from sepsis/shock. 69.23% of the patients improved and 30.77% expired; death was related to infection in 87.5% of cases. In conclusion, most bacteremia in the medical ward of the hospital were due to gram-positive cocci, which should be considered in antibiotic selection prior to BC. Risk factors for acquiring Brucellosis should always be obtained.

Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia

OBJECTIVE

To determine the prevalence of smoking among medical students at the medical college at King Fahad Medical City in Riyadh, and assess the association between smoking and socio-demographical factors, smoking contacts, reasons for smoking and attempts to quit.

MATERIALS AND METHODS

Cross-sectional survey in which anonymous, self-administered questionnaire was used to survey the cigarette smoking habits of the first- and second-year medical students in the Faculty of Medicine, King Fahad Medical City in June 2009.

RESULTS

Overall 39.8 % of the investigated students (153) had smoked before, and 17.6% were current smokers. The mean age of initiating smoking was 15.8 (±3.3). There were significantly more males than females. The most important reasons for smoking were leisure, imitation of other people and a means of relieving psychological pressure. Reasons for not smoking were mostly health and religion-based. Smokers tended to have friends who smoked.

CONCLUSION

Cigarettes smoking is highly prevalent among medical students in the Faculty of Medicine, King Fahad Medical City. Contact with smokers particularly friends are the major risk factors for the initiation of the habit. Health and religious considerations are important motives for not smoking, quitting or attempting to quit. These findings can be of help in designing future intervention strategies.

Prevalence of smoking and its related behaviors and beliefs among secondary school students in riyadh, saudi arabia

OBJECTIVE

To estimate the prevalence of smoking among secondary school students in National Guard area of Riyadh, and explore the reasons for the smoking and the attitude of non-smoker toward smoking habit.

DESIGN

A cross-sectional study was conducted in June 2009. By random sampling technique 255 students were enrolled from secondary school of National Guard area, Riyadh, Saudi Arabia. A self-administered questionnaire was used for data collection.

RESULTS

Current smokers represented 28.6% of the students. The most common reasons for smoking were: having free time (81.6%), for the relief of stress (63.2%) and seeing some of their teachers smoking (61.8%). Most of the smokers started the habit before the age of 15 years old (89%). 84% of non-smokers suggested to ban smoking in public places. 42.2% of students were planning to start smoking in future. Religion was the most important reason for not smoking among non smokers.

CONCLUSION

The prevalence of smoking is big enough a problem to be considered as a warning for an impending epidemic Health education provision should have a greater role in schools Governmental commitment and social support are vital if health education and awareness and especially quit smoking programs are to be implemented and sustained.

Fluoride content of bottled drinking waters available in Riyadh, Saudi Arabia

AIMS

This study aimed to examine the fluoride concentration of commercially available bottled water products in Riyadh, Saudi Arabia, and to assess the accuracy of the labeling of fluoride concentration on the tested brands.

METHODS

Fifteen randomly selected commercial brands of bottled water were obtained from supermarkets in Riyadh, Saudi Arabia. Three bottles of each brand were purchased, and fluoride content was measured using a combination fluoride-ion-selective electrode. The average reading for each brand was estimated and also compared with the fluoride content printed on the label.

RESULTS

The mean (±SD) fluoride content of the 12 local bottled water samples was 0.79 (±0.09) mg/L with a range from 0.5 to 0.83 mg/L. The mean fluoride concentration of the three imported brands was 0.67 (±0.02) mg/L with a narrow range of fluoride content (0.65-0.69). All tested samples mention the fluoride content on the label except two imported brands. Five samples showed a significant difference between our evaluation and stated content of fluoride that ranged between +0.46 and -0.2 mg/L.

CONCLUSIONS

Bottled drinking waters available in Riyadh, Saudi Arabia contain differing concentration of fluoride, but within a safe range for use as a source of systemic fluoride. In addition, the manufactures' labeling of fluoride content may be inaccurate.

Puberty onset among boys in riyadh, saudi arabia

Background:

The ages of onset of pubertal characteristics are influenced by genetic, geographic, dietary and socioeconomic factors; however, due to lack of country-specific norms, clinicians in Saudi Arabia use Western estimates as standards of reference for local children.

Aims:

The aim of the Riyadh Puberty Study was to provide data on pubertal development to determine the average age of onset of pubertal characteristics among Saudi boys.

Methods:

Cross-sectional study among male school children in Riyadh, Saudi Arabia, in 2006, 542 schoolboys, aged 6 to 16 years old, from diverse socioeconomic levels were selected into the sample using a cluster sample design. Tanner stages were ascertained during physical examination by pediatric endocrine consultants, and also trained pediatric residents and fellows.

Results:

The mean age (standard deviation) at Tanner Stages 2, 3, 4, and 5 for pubic hair development of Saudi boys was 11.4 (1.6), 13.3 (1.3), 14.4 (1.0) and 15.1 (0.8) years old, respectively. For gonadal development, the mean age (standard deviation) at stages 2, 3, 4, and 5 were 11.4 (1.5), 13.3 (1.2), 14.3 (1.1) and 15.0 (0.9) years old, respectively.

Conclusion:

The ages of onset of pubertal characteristics, based on gonadal development, among Saudi boys are comparable to those reported in Western populations.

Microbial Safety and Quality and Protein Integrity of Shrimp Sold in Shops in Riyadh, Saudi Arabia

The microbial safety and quality were assessed of shrimp from fish shops located in five separate zones in Riyadh City, Saudi Arabia. Protein hydrolysis of the shrimp was determined as a function of microbial growth by using an isoelectric focusing technique. A resuscitation culture step also was assessed and compared with direct plating on selective media for detection of the coliform group and fecal enterococci. The results of this study indicated high (6.23 to 7.23), moderate (4.10 to 5.94), and low (3.49 to 3.94 log CFU/g) ranges of psychrotrophic counts in 23.3, 60, and 16.7% of the samples, respectively. Statistical analysis showed significant (P < 0.05) differences in the psychrotrophic counts among the zones tested, with the highest counts being in the western and central zones, and the lowest counts in the northern zone. Similar results were obtained with coliform, fecal enterococci, and staphylococci counts. Use of the resuscitation step resulted in significantly (P < 0.05) higher recovery of coliforms and fecal enterococci. Band intensities of the sarcoplasmic proteins, as shown in the gel electrophoresis, were faint in samples with higher counts and comparatively intense in the ones with lower counts, indicating a clear relationship between product degradation and microbial load.