The use of social media among Saudi residents for medicines related information

This study aimed to measure the use of social media applications for health information among residents in Saudi Arabia. A cross sectional study was adopted in this study between 20th of September to 1st of December 2017. A pre-validated questionnaire was either distributed through face to face to respondents in public areas or through online survey which was posted to main social media groups in Saudi Arabia. All data was analyzed through using SPSS version 22.0. All p-values of less than 0.05 were considered significant. A total of 751 valid responses were obtained out of 1200 invitations. WhatsApp was the main application frequently used among our respondents 83.8%. In addition, about 18% of respondents use social media to search on medicines related information on weekly basis. On the other hand, 12.6% of respondents receive medical related information on social media daily. Friends are the main source of medical related information on social media which is represented by 28.5% of responses. Whereas health specialists represent only 20.1% of health information on social media. One-third of our respondents either search or receive medical related information on social media on daily and weekly basis. More than 90% of respondents prefer to receive medical related information from trusted official sources. Health authorities have to frequently review the health information contents available in social media as well as educate patients on the importance of validating the medical information available on social media from their healthcare providers.     

Influenza vaccination among Saudi Hajj pilgrims: Revealing the uptake and vaccination barriers

BackgroundHajj is the world’s largest annual mass gathering that attracts two to three million Muslims from around the globe to a religious assemblage in Makkah, Saudi Arabia. The risk of acquisition and transmission of influenza among Hajj pilgrims is high. Therefore, influenza vaccination is recommended, and was monitored frequently among pilgrims from different countries. However, the vaccination uptake among Saudi pilgrims has not been assessed in recent years.ObjectiveThis analysis aims to evaluate influenza vaccine uptake among Saudi Hajj pilgrims, and identify the key barriers to vaccination.MethodData on influenza vaccination were obtained from Saudi pilgrims who took part in a large trial during the Hajj of 2013, 2014 and 2015. Pilgrims were met and recruited in Mina, Makkah during the peak period of Hajj and were asked to complete a baseline questionnaire that recorded their influenza vaccination history, including reason(s) for non-receipt of vaccine.ResultsA total of 6974 Saudi pilgrims aged between 18 and 95 (median 34) years were recruited; male to female ratio was 1:1.2. Of the total, 90.8% declared their influenza vaccination history, 51.3% of them reported receiving influenza vaccine before travel to Hajj. The vaccination rates for the years 2013, 2014 and 2015 were 21.4%, 48.2% and 58.1%, respectively (P < 0.001). Of 1,269 pilgrims who were at higher risk of severe disease, 54.5% received the vaccine. Lack of awareness (47.5%), reliance on natural immunity (15.8%) and being busy (15.5%) were the main reasons for non-receipt.ConclusionThese data from a convenience sample indicate that influenza vaccine uptake among Saudi Hajj pilgrims is increasing over years but still needs further improvement. Lack of awareness and misperceptions are the main barriers. Education of Saudi pilgrims and health professionals is required to raise awareness about influenza vaccination. Further studies are needed to understand pilgrims’ misperceptions.     

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.     

Use,attitudes and knowledge of medications among pregnant women: A Saudi study

Objective

Medication use during pregnancy is a major concern for most women. The aim of the present study was to assess medication use, knowledge and beliefs about medications among pregnant women in Saudi Arabia.

Methods

More than 760 pregnant women, attending the obstetric clinic, filled a semi-structured questionnaire. Data were collected about their sociodemographic background, medication use during pregnancy, medication/pregnancy risk awareness, sources of drug information and beliefs about medications.

Results

Most women had a positive attitude toward medications in general but they believed pregnant women should be more cautious regarding drug-use during pregnancy. A significant association was found between participants’ education and occupation, and beliefs about medications. In this context, well educated women and those working in a health-related career demonstrated more correct beliefs about medications. Women with health-related occupations were more knowledgeable about the life saving effect of drugs on unborn children. Women indicated inadequate provision of drug-related information from physician and pharmacist; they rely on medication pamphlet to get such information. The most frequently used drugs were paracetamol and vitamins (13.2%). Most pregnant women (59.2%) were able to identify drugs to-be avoided in pregnancy that agreed roughly with FDA categories with 23 hits out of 32. They indicated that newborn anomalies (6.5%) were not attributed to drug-use during pregnancy.

Conclusion

During pregnancy, women were more conservative and skeptic toward medication, health-care professionals should be aware of such attitudes when advising pregnant women to take medication.     

Epidemiology,Pathology and Treatment of Cutaneous Leishmaniasis in Taif Region of Saudi Arabia

Background

Cutaneous leishmaniasis is an annoying and disfiguring disease affecting around 1,500,000 individuals globally. There are endemic pockets of this disease in Taif region. In some patients, lesion often weeps and leads to scar formation. The study was conducted to see the efficacy of fluconazole and itraconazole in the patients of cutaneous leishmaniasis and the effect of these drugs on liver enzymes and kidney markers.

Methods

Positivity of Leishmania was recorded by microscopic examinations of smears. Specific diagnosis for Leishmania major and L. tropica was made with the help of nested polymerase chain reaction. Fluconazole was given at the rate of 200mg/day while itraconazole was given at 150mg/day for six weeks. AST, ALT, creatinine and urea were estimated during medication.

Results

Leishmania major and L. tropica were the species responsible for cutaneous leishmaniasis in Taif region. 81% patients had single lesions, mostly on face followed by hands and legs. 15% of the lesions had bacterial contamination. In terms of efficacy, fluconazole gave slightly better results compared to itraconazole. After 6 weeks of medications, slightly elevated values were recorded for liver enzymes and creatinine.

Conclusion

Transmission of leishmaniasis in Taif region is probably because of poor coverage of residual insecticides spraying at hiding places in pile-ups of rocks and abandoned houses from where sand flies visit nearby houses and cattle sheds during night. Fluconazole and itraconazole may be used for the treatment of cutaneous leishmaniasis with good recovery rate and fewer side effects.     

COVID-19 Precautionary Measures and Type 1 Diabetes Patients in Saudi Arabia

AimTo minimize the spread of COVID-19, the Kingdom of Saudi Arabia (KSA) enforced a nationwide lockdown. We aimed to explore whether the manner in which Saudi patients with type 1 diabetes (T1D) manage their disease has changed during this unparalleled lockdown.MethodsAn online survey exploring the effect of lockdown on T1D outcomes was distributed among T1D patients residing in KSA during lockdown.ResultsA total of 1010 patients responded to the survey. Around 40% reported communicating with their physicians during lockdown. Age, level of education, residence, previous visits to diabetes education clinics, last HbA1c value, and average monthly income were all significantly associated with communication with the treating physician (p = 0.008, p < 0.001, p < 0.001, p = 0.002, p < 0.001, and p < 0.001, respectively). Age, level of education, and average monthly income were significantly associated with experiencing severe hypoglycemia (p = 0.036, p = 0.03, and p < 0.001, respectively), while average monthly income and level of education were significantly associated with experiencing diabetic ketoacidosis (DKA) (p < 0.001 and p = 0.0039, respectively); during lockdown. Patients who communicated with their physicians reported lower rates of severe hypoglycemia compared to those who did not (25.2% vs 30.7%, respectively).ConclusionAge and level of education were significantly associated with communication with the treating physician, and experiencing severe hypoglycemia and DKA; in patients with T1D during the lockdown period in Saudi Arabia. Keeping two-way virtual communication channels between physicians and their T1D patients should be encouraged.     

Predicting in-hospital death among patients injured in traffic crashes in Saudi Arabia

IntroductionTraffic-related injuries are a major cause of premature death in developing countries. Saudi Arabia has struggled with high rates of traffic-related deaths for decades, yet little is known about health outcomes of motor vehicle victims seeking medical care. This study aims to develop and validate a model to predict in-hospital death among patients admitted to a large-urban trauma centre in Saudi Arabia for treatment following traffic-related crashes.MethodsThe analysis used data from King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. During the study period 2001–2010, 5325 patients met the inclusion criteria of being injured in traffic crashes and seen in the Emergency Department (ED) and/or admitted to the hospital. Backward stepwise logistic regression, with in-hospital death as the outcome, was performed. Variables with p < 0.05 were included in the final model. The Bayesian Information Criterion (BIC) was employed to identify the most parsimonious model. Model discrimination was evaluated by the C-statistic and calibration by the Hosmer–Lemeshow Goodness of Fit statistic. Bootstrapping was used to assess overestimation of model performance and obtain a corrected C-statistic.Results457 (8.5%) patients died at some time during their treatment in the ED or hospital. Older age, the Triage-Revised Trauma Scale (T-RTS), and Injury Severity Score were independent risk factors for in-hospital death: T-RTS was best modelled with linear and quadratic terms to capture a flattening of the relationship to death in the more severe range. The model showed excellent discrimination (C-statistic = 0.96) and calibration (H–L statistic 4.29 [p > 0.05]). Internal bootstrap validation gave similar results (C-statistic = 0.96).ConclusionsThe proposed model can predict in-hospital death accurately. It can facilitate the triage process among injured patients, and identify unexpected deaths in order to address potential pitfalls in the care process. Conversely, by identifying high-risk patients, strategies can be developed to improve trauma care for these patients and reduce case-fatality. This is the first study to develop and validate a model to predict traffic-related mortality in a developing country. Future studies from developing countries can use this study as a reference for case fatality achievable for different risk profiles at a well-equipped trauma centre.     

Predictors of diabetes foot complications among patients with diabetes in Saudi Arabia

AimsTo identify risk factors and clinical biomarkers of prevalent diabetes foot complications, including foot ulcers, gangrene and amputations among patients with diabetes in Jeddah, Saudi Arabia.Methods598 diabetes patients from Jeddah participated in the current study. Patients were considered to have diabetes foot complications if they reported diagnosis of foot ulcers or gangrene or amputations in a questionnaire administered by a physician and confirmed by clinical exams. Information on socio-demographic and lifestyle variables was self-reported by patients, and several clinical markers were assessed following standard procedures.ResultsThe prevalence of diabetes foot complications in this population was 11.4%. In the multivariable model without adjustment for PAD (peripheral artery disease) and DPN (diabetes peripheral neuropathy), non-Saudi nationality, longer diabetes duration and insulin use was significantly associated with higher diabetes foot complications prevalence. Each 1 g/L increase of hemoglobin was associated with 2.8% lower prevalence of diabetes foot complications. In the multivariable model adjusting for PAD and DPN, the previously observed associations except for nationality were no longer significant. Patients with both DPN and PAD had 9.73 times the odds of diabetes foot complications compared to the patients with neither condition.ConclusionIn this population, longer diabetes duration, insulin use, lower hemoglobin levels and non-Saudi nationality were associated with higher prevalence of foot complications. These associations were largely explained by the presence of DPN and PAD except for non-Saudi nationality. Diabetes patients with both DPN and PAD had nearly 10-fold increased risk of foot complications than those with neither condition.     

Efficacy of acetaminophen versus ibuprofen for the management of rotator cuff-related shoulder pain: Randomized open-label study

BackgroundShoulder pain related to the rotator cuff (RC) is one of the most common and bothersome musculoskeletal complaints. Pharmacologic treatment most often includes acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. However, data allowing comparison of the efficacy of these two drugs are very limited. We compared the therapeutic outcomes of acetaminophen and ibuprofen in the management of RC-related pain.MethodsThis was an open-label, two-center, active-control, prospective randomized clinical trial. Participants were assigned randomly to acetaminophen or ibuprofen treatment groups. The acetaminophen dose was 500 mg every 6–8 h, and it was 400–800 mg every 6–8 h for ibuprofen. The impact of the treatment was measured by Shoulder Pain and Disability Index (SPADI), Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaires at baseline and after 6 weeks of therapy.ResultsThirty-three patients completed the study; 20 treated with ibuprofen and 13 with acetaminophen. Patients in both groups were comparable at baseline with regard to SPADI, Quick-DASH, and WHOQOL-BREF scores. After 6 weeks of treatment, patients receiving ibuprofen, but not acetaminophen, reported an improvement in pain severity and functional activity (as measured by SPADI and Quick-DASH). Patients taking acetaminophen, but not ibuprofen, reported improvement in the physical and environmental domains of WHOQOL-BREF scores.ConclusionsIbuprofen and acetaminophen provide benefits to patients suffering from RC-related pain. However, the type of improvement perceived by patients differed between these two medications.     

Synthesis,characterization and cytotoxic activity of naturally isolated naringin-metal complexes

High-purity naringin was isolated from the fruit peels of Citrus maxima and characterized by various spectroscopic methods like UV and NMR. The isolated compound ligand (HL) was used as ligand-metal complexes synthesis after using Ag (I), Y (III) and Ru (III) metals. These ligand-metal complexes were characterized by elemental analysis, FT-IR, UV–VIS, TGA, molar conductance and magnetic properties. Cytotoxic activity of the isolated naringin and its metal complexes were investigated against two human cancer cell lines namely, white breast Adenocarcinoma (MCF7) and Lung carcinoma (A549) using cell viability assay. Transition metal increased the cytotoxic activity of naringin when they were conjugated. LC50 of Ag ligand complex demonstrated strong cytotoxicity against MCF-7 and A549 cell line that was found higher active more than three and four times the strength, respectively when compared to LC50 of Adriamycin. While LC50 of Adriamycin compound was slightly more active only about 30% and twice the strength of the Ru ligand complex against MCF-7 and A549 cell line, respectively.