The prevalence of medical violation claims and associated predictors at the Eastern Province in Saudi Arabia: A logistic regression analysis

Despite efforts to improve healthcare delivery and ensure patient safety, medicolegal claims in Saudi Arabia remain a concerning issue. This study investigated medical violation claims referred to the medical violation committee in the Eastern Province in Saudi Arabia. A retrospective study was conducted on medical violation claims from 2016 to 2019. Binary logistic regression was performed to examine the association between issued verdicts and a set of defendant, plaintiff and healthcare institution variables. During the study's period, the medical violation committee reached final verdicts against 1242 healthcare professionals in which 69% of them were found guilty. The majority of the defendants worked in private healthcare institutions (66%), were physicians (30%), male (53%), and non-Saudi (64%). Working at pharmacies, other healthcare settings, and the private sector were significantly associated with receiving a guilty verdict. Male healthcare professionals as well as pharmacists were found to have a higher likelihood to receive a guilty verdict than their respective counterparts. Medical violation claims filled by the Ministry of Health were more likely to receive guilty verdicts than those filled by patients or healthcare professionals. Findings of the study extend the literature on medicolegal claims and introduces implications for healthcare professionals and policymakers at institutional and national levels.     

Common medical ethics dilemmas: Few reflections from a Saudi perspective

Medical ethics plays a crucial role in physicians’ daily practice, as it reflects on themselves, their institution, and, most importantly, the outcome of the treatment they provide to their patients. Common medical ethics dilemmas faced in Saudi Arabia include: end-of-life care, patient rights, which comprise autonomy, informed consent, and confidentiality, reproductive ethics, and equity of resources. The identification of flaws within the healthcare system and the implementation of clear guidelines are important to overcome the risk of malpractice and flawed judgment, and ensure the delivery of the best possible care to patients.     

Solitary rectal ulcer syndrome in children and adolescents: a descriptive clinicopathologic study

Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of the rectum. While benign, it can cause concern for patients and affect quality of life. Reported studies on SRUS worldwide are scarce. The aim of this study is to describe the clinicopathologic characteristics of SRUS in a cohort of children based in Saudi Arabia. In this study, children with a confirmed diagnosis of SRUS at King Abdulaziz University Hospital (KAUH) were included, during the period November 2003 to November 2017. Data were collected from hospital medical records. The study comprised twenty-one patients: 17 males (81%) and 4 females (19%); the median age was 11.4 years (range, 5.43-17.9 years). The most common presenting symptoms were rectal bleeding in 21 patients (100%), passage of mucus in 16 (76.1%), abdominal pain in 14 (66.6%), constipation in 13 (61.9%), straining in 9 (42.9%), and rectal prolapse in 5 (23.8%). The most common finding at initial colonoscopy was a single ulcer in 7 patients (33.3%), multiple ulcers in 6 (28.5%), polypoid lesions in 5 (23.8%), and hyperemic mucosa in 3 (14.2%). All patients received medical treatment and 14 (81%) continued to manifest one or more of the symptoms following treatment, which required subsequent modification of the treatment course. None of the patients required surgery. In conclusion, the study found rectal bleeding to be the most common presentation, with a single ulcer being the most prevalent lesion in endoscopy. Treatment response was variable, but almost half of patients reported relief of symptoms following treatment.     

Periodontal risk assessment in a teaching hospital population in Saudi Arabia’s Eastern Province

ObjectiveWith this cross-sectional study, we aimed to evaluate factors associated with moderate and high risk of periodontal disease (PD) progression in the Saudi population.MethodsWe reviewed 281 patients’ clinical charts from predoctoral periodontal clinics at the dental teaching hospital in the College of Dentistry (COD) at Imam Abdulrahman Bin Faisal University (IAU) in Dammam, Saudi Arabia. After obtaining ethical approval, we determined the Periodontal Risk Assessment (PRA) of the included patients based on the modified criteria developed by Lang and Tonetti (2003). We used logistic regression on stratified data and divided the results into two categories (low-moderate and high risk) to assess the effect modifier for potential risk factors. We used SPSS version 22 for data analysis, and considered a P-value ≤ 0.05 to be statistically significant.ResultsOut of the 281 patients, 104 (37.0%) were male and 177 (63.0%) were female, with a mean age of 39.9 ± 14.0 years; 78.1% were Saudi nationals, 77% were married, and 44.6% were in the age group of 30 to 49. The PRA revealed 86 (30.5%) to represent high risk, 108 (38.3%) denoted moderate risk, and 88 (31.2%) signaled low risk for periodontitis. Logistic regression analysis showed that males were three times more likely to have high PRA (OR = 3.24) and to be married (OR = 2.77), as well as to be active smokers (OR = 8.87). The highest predictive factors of high PRA were 8 or more pockets ≥ 5 mm (OR = 29.0), those with active diabetes mellitus (DM; OR = 10.2), and those with 8 or more missing teeth (OR = 9.15).ConclusionSaudi males who are married and have residual periodontal pockets, are actively diabetic, and with missing teeth are at high risk of PD. Further research is needed with a larger sample size comparing the general population with and without PD.     

Prevalence of malocclusion among children of the Kingdom of Saudi Arabia – A systematic review and meta-analysis

ObjectiveSystematic review and meta-analysis are of a great tool in assessment of malocclusion, which is major public health concern. This study aims to explore the prevalence of malocclusion among the children of the Kingdom of Saudi Arabia through a meta-analysis and systematic review.Materials and methodsRegistered with PROSPERO as CRD42020198427, an authentic and global scale database search using relevant MeSH (Medical Subject Headings) terms was performed. Literature search and articles screening done following PRISMA guidelines.For the dichotomous variables, 95% confidence intervals (CIs) were set for statistical data analysis. The heterogeneity index between the studies was determined using indices Tau², Chi², df and I² and Test for overall effect as Z.ResultsA total of 7930 candidates were reported to have either one of the three malocclusions. Prevalence of Class I, Class II and Class III Malocclusions were found to be 66.51%, 17.70%, 15.79% respectively. Among the small subsample of these candidates, male children with Class I, Class II and Class III Malocclusion were 43.80%, 12.27% and 7.40% respectively whereas female children were 22.07%, 10.93 %, 3.52 % respectively.ConclusionsAccording to the 26 studies included in the systematic review, there were 72% of the candidates with malocclusion in Saudi Arabia. Prevalence of Class I, Class II and Class III malocclusion were 66.51%, 17.70%, and 15.79% respectively. In both male and female participants, the prevalence of Class I was the highest followed by class II and III malocclusion.     

Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review

ObjectivesMaxillofacial trauma (MFT) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents (RTAs). MFT commonly associated with injuries to the face, head, and jaws and may cause soft tissue lacerations and bruises. MFT can also cause fatal blood loss and airway obstruction. The objective of this review was to determine the prevalence of MFT, identify the major causative factors in males and females in the main cities of Saudi Arabia.Materials and methodsWe performed literature searches of all published studies describing MFT from KSA during the last 20 years.ResultsIn Saudi Arabia, males are more prone to MFT than females, although the male: female ratio of MFT varies between different cities. Specifically, Aseer has the highest male: female ratio (10:1), followed by AlHofuf (8.3:1) while AlQurayyat had the least gender ratios of MFT (2:1). Most cases of MFT are associated with RTAs, which accounted for (63%–90.3%) in Medina, (89.1%) in Aseer, (86.1% –87.1%) in Riyadh, (67%–73.1%) in Jeddah, (71%) in Khamis Mushait, (64.2%) in Makkah and (63.3%) in Al-Hofuf. The least percentage of RTA resulting into MFT was recorded in AlQurayyat (24%).ConclusionMaxillofacial trauma is a serious health problem in Saudi Arabia. RTAs remain the major cause of maxillofacial injuries especially among males, thus strict implementation of traffic rules is a must to minimize maxillofacial injuries and its physical and psychological impact.     

Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia

Medical terminology is the vocabulary used to describe the human body and its conditions; fluency in this language is essential for health care professionals. We examined the level of basic medical terminology understanding among 347 pharmacy students in four different colleges of pharmacy in Saudi Arabia using a newly developed test of 30 multiple choice questions. Students in the relatively new colleges of pharmacy were more likely to have a higher score in the medical terminology test compared to their counterparts from the old college of pharmacy (β = 1.23, 95% CI = 0.16–2.30, P-value = 0.02). Female gender (β = 1.72, 95% CI = 0.57–2.88, P-value = 0.003), and advanced class level (β = 0.84, 95% CI = 0.36–1.32, P-value < 0.001) were also positively associated with high medical terminology test scores. The findings of this study reveal a deficiency in the pharmacy students’ level of understanding of basic medical terms which may necessitate a reintroduction of the medical terminology course into the pharmacy curriculum.     

Adherence to prophylactic dual antiplatelet therapy in patients with acute coronary syndrome – A study conducted at a Saudi university hospital

ObjectivesThe aim of this study was to evaluate patients’ self-reported adherence to dual antiplatelet therapy (DAPT) and determine the factors associated with premature discontinuation of DAPT.MethodsThe cross-sectional interview-based study was conducted among adult outpatients who visited the outpatient department of King Khalid University Hospital, Cardiac Center in Riyadh, Saudi Arabia, over a period of 3 months from May to July of 2016. Medication adherence was assessed using the Self-efficacy for Appropriate Medication Use Scale (SEAMS), which is composed of 13 items with a 3-point Likert scale.ResultsA total of 192 patients participated in the study. The majority of the participants were male (82.1%), and the mean age was 55.66 ± 10.80 years. More than 84% (84.4%) of the patients reported that they were “confident” in taking several medications each day. The minimum and maximum SEAMS scores were 22 and 39, respectively, with the mean score being 30.8 ± 3.5. Almost all patients had moderate scores and adherence; only one patient got a score of 39. Among sociodemographic characteristics, only health insurance and income were significantly associated with the medication adherence score (p < 0.05).ConclusionsStudy results concluded that patients had a moderate level of adherence towards DAPT in Saudi Arabia, however Patient education on DAPT is essential to improve adherence to medication treatment. More effective intentions and education methods should be developed to improve long-term DAPT adherence.     

Prevalence of post-traumatic stress disorder during the COVID-19 pandemic in Saudi Arabia

BackgroundThe coronavirus diseases of 2019 (COVID-19) pandemic was classified as one of the worst pandemics in the 21st century. Its rapid transmission, unpredicted mortality rate, and the uncertainty surrounding its transmission method have evoked additional fear and anxiety. Nonetheless, to the best of our knowledge, no prior study has explored PTSD prevalence three months after the start of the quarantine procedures in Saudi Arabia nor has examined PTSD prevalence by three different methods.ObjectiveThis observational cross-sectional study aimed to identify the prevalence, severity, and influencing factors of PTSD in different regions of Saudi Arabia three months after the onset of the quarantine procedures related to the COVID-19 pandemic.MethodsThrough the month of June 2020, 1374 people (49.05% men and 50.95% women) completed a 35-item, 10-minute online. The prevalence of PTSD was measured using PCL-S (specific for COVID-19) that assesses the 17 symptoms of PTSD. Resilience was measured using 2-items Arabic version of the Connor-Davidson Resilience Scale 2 (CD-RISC 2).ResultsWe calculated the prevalence by three methods, namely, PTSD cut-off score, criteria, and combined, and the prevalence was 22.63%, 24.8%, and 19.6%, respectively. Female participants showed higher prevalence than male. As well, participants who were either tested positive or suspected of having been infected with COVID-19 showed higher PTSD prevalence. Higher resilience was associated with lower PTSD prevalence.ConclusionsThis was the first study to report PTSD prevalence by three differential methods three months after the onset of the quarantine procedures related to the COVID-19 pandemic in Saudi Arabia. We observed a significant impact of the COVID-19 pandemic in the Saudi population; therefore, great attention should be performed in implementing new procedures that deal with the highlighted risk factors, especially in vulnerable groups, to overcome the psychological impact of the COVID-19 pandemic.