Livestock-owning households of Kazakstan part 2: Food patterns and health- seasonal and regional analysis

Six Saudi Arabian dishes based on cereals or legumes were analyzed for nine mineral elements and vitamins. Results indicated the following concentrations (mg/ 100 g): sodium 14–590, potassium 24–215, calcium 21–37, phosphorus 61–123, magnesium 22–31, iron 0.25–2.22, zinc 0.26–0.94, copper 0.23–0.47, and manganese 0.36–1.14. The concentration of the vitamins were: vitamind A 5–16 Retinol Equivalents/100 g, thiamine 0.031–0.106 mg/100 g, riboflavin, 0.013–0.114 mg/100 g, pyridoxine 0.021–0.078 mg/100 g, niacin0.667–1.749 mg/100 g, folacin 3–37 μg/100 g and pantothenic acid 0.100–0.366 mg/100 g. These results are discussed in relation to the Recommended Dietary Allowances for U.S. population set by the Food and Nutrition Board, National Research Council, National Academy of Sciences.     

Gender differences in cardiovascular risk factors among adolescents in Aseer Region,southwestern Saudi Arabia

ObjectiveThe objective of this study was to explore gender differences in the prevalence of silent and clinical apparent cardiovascular risk factors among adolescents in Aseer Region, southwestern Saudi Arabia.Materials and methodsA cross-sectional study on a stratified sample of 1869 adolescents was carried out. They were interviewed and examined for weight and height, systolic and diastolic blood pressure using standardized techniques.ResultsThe study revealed high prevalence of some potential behavioral and biological cardiovascular diseases (CVD) risk factors among adolescent males and females in the study area. Behavioral risk factors included inadequate low consumption of fruits and vegetables, physical inactivity, and smoking. Physical inactivity was significantly more prevalent among females than males (42.9% and 25.7%, respectively). Smoking was significantly more among females than males (11.8% and 1.3%, respectively). Biological risk factors found were family history of CVD, obesity and high blood pressure. Obesity was significantly prevalent among females (29.4%) compared to males (20.6%). Males had significantly more high blood pressure than females. In logistic regression analysis, being male (aOR = 2.992, 95% CI = 1.933–4.742) and obesity (aOR = 2.995, 95% CI = 2.342–3.991) were found to be significant risk factors in developing high blood pressure among adolescents in the region.ConclusionsPresence of cardiovascular risk factors among adolescents is a public health problem in the region. There is a need for a national program in the country to prevent and control cardiovascular risk factors among adolescents.     

Antimicrobial resistance of <Emphasis Type="Italic">Klebsiella pneumoniae</Emphasis> in a Saudi Arabian hospital: results of a 6-year surveillance study, 1998–2003

There are few data regarding the prevalence and trends of antibiotic resistance to Klebsiella pneumoniae in Saudi Arabia over time. Thus, we evaluated the prevalence and the trends in antibiotic resistance of K. pneumoniae at the Saudi Aramco Medical Services Organization over a 6-year period. This was a retrospective study of the in vitro pattern and trends of antibiotic resistance of K. pneumoniae from 1998 to 2003. A total of 3070 distinct isolates of K. pneumoniae were analyzed. Hospital-acquired isolates were more resistant to the tested antibiotics than the outpatient isolates. The resistance rates to cefazolin, trimethoprim-sulfamethoxazole, and ciprofloxacin were 10.8% (n = 79/730), 5% (n = 103/2093), and 15.8% (n = 93/586) for hospital-acquired isolates; and 11% (n = 216/1964), 9.6% (n = 60/624), and 4.4% (n = 68/1526) for outpatient isolates. Resistance to ceftriaxone and ceftazidime was detected in 5.6% (n = 37/659) and 13.8% (n = 24/174) of hospital-acquired isolates and in 1% (n = 17/1713) and 2.7% (n = 6/219) of outpatient isolates, respectively. All tested isolates were susceptible to imipenem. Resistance to three or more classes of antibiotics was present in 1.7% (n = 8/468) of the hospital-acquired isolates and in 0.6% (n = 9/1389) of the outpatient isolates. The data showed increased resistance rates of hospital-acquired isolates of K. pneumoniae to ceftriaxone, gentamicin, and ciprofloxacin; the data also showed that hospital-acquired, rather than outpatient isolates, were more likely to be resistant to multiple antibiotics.     

The influence of COVID-19 related psychological and demographic variables on the effectiveness of e-learning among health care students in the southern region of Saudi Arabia

BackgroundE-learning is a modern and flexible mode of education and is being used as an alternative to conventional mode of education during the ongoing COVID-19 pandemic. However evidence suggests that effectiveness of e-learning is influenced by many prevailing factors.MethodsA cross sectional study aimed to evaluate health care students’ perception towards implementation of e-learning was conducted for a period of 4 months, from April 2020 to July 2020. Research instrument consisted of a self-designed, qualitative questionnaire with three domains was validated using field pretest method and administered among health care students of King Khalid University using social media platforms. Chi square test was used to estimate the effect of e-learning on various domains whereas linear regression analysis was used to find the association between subjects’ characteristics to overall domain scores. P value < 0.05 was considered significant.ResultsAmong 254 respondents 59.8% were males and 96.5% respondents were staying with their families.10.2% reported medically imposed quarantine for one or more family members. 59.8% reported that the online classes were commenced too early. 63.4% of the respondents reported that they had no previous experience. Poor network connectivity (32.3%) and unawareness about online platforms (29.9%), poor audio/video qualities (26.3%) were found as major barriers. Psychological stress, discipline of study, living status and quarantine history had a remarkable impact on the effectiveness of online education.ConclusionHealth care students are still cynical and are yet to embrace e-learning fully. Psychological distress, technical issues in association with accessibility, inexperience and unpreparedness were found to be main barriers that limited student acceptance of e-learning.     

Methylene Tetrahydrofolate Reductase and Angiotensin Converting Enzyme Gene Polymorphisms Related to Overweight/Obesity among Saudi Subjects from Qassim Region

Background: This work was planned to check for the association of polymorphisms related to methylenetetrahydrofolate reductase (MTHFR) and angiotensin converting enzyme (ACE) genes with overweight/obesity among Saudi subjects from Qassim region. Methods: This work included 130 subjects having overweight or obesity and 111 normal controls. Their age mean ± SD was 27 ± 9.8 and 24 ± 8.8 years respectively. Their DNA was analyzed for polymorphisms of MTHFR; 677C/T and 1298 A/C and ACE; I/D genes using real-time PCR. Results: Genotype and allele frequencies of studied polymorphisms in cases of overweight/obesity showed no significant statistical difference compared to that of controls. However, on analysis of body mass index (BMI), cases showed slightly higher but statistically nonsignificant mean ± SD values among those carrying the mutant MTHFR 677 T allele (CT + TT vs. CC, 30.7 ± 4.5 vs. 29.9 ± 4.9), 1298 C allele (AC + CC vs. AA, 29.9 ± 4.1 vs. 29.7 ± 5.5) and ACE D allele (ID + DD vs. II, 30.0 ± 5.1 vs. 29.1 ± 2.8). In addition controls having the DD and ID genotypes showed higher statistically significant values of BMI than those of the II genotype (22.0 ± 1.9, 21.7 ± 2.6 and 19.5 ± 2.3 respectively, p < 0.05). Conclusion: There is no solid association of polymorphisms related to MTHFR and ACE genes with non-complicated overweight or obesity among Saudi subjects from Qassim Region.     

The impact of using pictorial aids in caregivers’ understanding of patient information leaflets of pediatric pain medications: A quasi-experimental study

IntroductionPatient information leaflets (PILs) are one of the main sources of information for over-the-counter medications (OTCs). This study aimed to assess caregivers' understanding of instructions in PILs provided with paracetamol medications and the impact of pictograms use.MethodsA quasi-experimental study was conducted among caregivers of children aged < 13 years recruited in pediatric outpatient clinics at University Medical City in Riyadh. The calculated sample size was 128; at least 64 participants were needed in each group (the text-only group and the text-plus pictograms group). Caregivers' health literacy was assessed using a validated Arabic version of the Newest Vital Sign scale. Participants’ understanding of PILs instructions was assessed using eight questions on the route of administration, minimal hours between doses, max daily dose, shake medication before use, storage, and reporting adverse events; and was rated based on the number of questions correctly understood. Characteristics of participants were compared by Pearson X² and t-test was used to assess the significance of mean score differences between groups.ResultsA total of 130 caregivers participated in the study; almost half of them were mothers (47%, [n = 61]) and 43% (n = 56) have “a possibility of limited health literacy”. The mean number of correct answers to questions assessing the understanding of PILs instructions was significantly higher among the text-plus pictograms group compared to the text-only group (5.25 ± 1.85 vs. 4.38 ± 1.27; p < 0.001). When results were controlled for age and gender, better health literacy was found to be associated with a better understanding of instructions (B = 0.39, 95 %CI 0.23–0.54).ConclusionLimited comprehension of medications instructions was observed; adding pictorial aids to PILs might enhance the comprehension. Differences in health literacy levels of caregivers should be considered when designing PILs.     

Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study

BackgroundThere is limited information describing the presenting features and treatment outcomes of intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) in Saudi Arabia.ObjectiveTo investigates the clinical, epidemiological, laboratory, radiological, vital signs and treatment characteristics/outcomes of severe (ICU) COVID-19 patients in Albaha region, Saudi Arabia.MethodsA retrospective cohort study was conducted from 01 April 2020 to 31 August 2020 involving files review of 171 patients admitted to the ICU of a COVID-19 treatment centre as a result of severe symptoms.ResultsAround a third of the ICU patients admitted were over 66 years of age, 59.6% males, 45% diabetics, 39% hypertensive, 25.7% smokers. Patients had symptoms such as 79% fever, 78% cough, 75% headache, 59% sore throat, 57% runny nose, and 75% cough. More than half of the patients had <90% oxygen saturation. Bilateral infiltration was present in about 43% of patients. 85.4% lymphopenia, and 70.8% D-dimer (>0.5 u/ml) were the most significant laboratory results. The median stay in the hospital ranged from 4 to 15.6 days, and the ICU time ranged from 4 to 12.7 days. Approximately 29% of patients received antiviral, antimalarial, and antibiotic treatment, while 27.5% of patients received antibiotics and antimalarial therapy alone. Incorporating hydroxychloroquine in treatment protocols did not improve patients’ outcomes.ConclusionsOlder age and cardio-metabolic comorbidities increase the risks of sever COVID-19. Different treatment protocols fail to improve mortality rates and urgent efforts are required to prevent the disease and reduce its severity.     

A survey of root canal treatment of molar teeth by general dental practitioners in private practice in Saudi Arabia

The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment.     

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.     

Current dietetic practices of obesity management in Saudi Arabia and comparison with Australian practices and best practice criteria

Aim:  To describe the dietetic practices of the treatment of obesity in Saudi Arabia and compare this with best practice criteria and the practice in Australia.
Methods:  Anonymous questionnaires were completed by dietitians in Saudi Arabia. The topics included barriers to obesity management, demand and level of service and strategies and approaches used for weight management. Best practice scores were based on those used to assess Australian dietitians.
Results:  A total of 253 dietitians participated in the survey. Of these, 175 (69%) were involved in the management of obesity. The best practice score for Australian dietitians was slightly greater than the scores of Saudi dietitians (median 43 vs 39). There was also a significant correlation between the best practice score and years of experience (r = 0.26, P < 0.001). The most common assessment approaches were assessment of body mass index (87%) and exercise habits (81%), while the most common strategies for obesity management were: dietary total fat reduction (92%) and increase incidental daily activity (92%). The major barrier for establishment of a weight management clinic reported by 49% of participants was inadequate resources.
Conclusion:  Saudi Arabian dietetic practice for the management of obesity does incorporate most best practice recommendations, but some specific elements are rarely used.