Prevalence and determinants of distress among oncology patients at a tertiary care medical city in Riyadh,Saudi Arabia

Objectives:To estimate the prevalence of distress in patients with cancer in Saudi Arabia and to identify common psychosocial stressors in these patients. We also looked for associations between distress and psychological, sociodemographic, and medical factors.Methods:This cross-sectional study was performed in the oncology outpatient clinic at King Saud University Medical City, Riyadh, Saudi Arabia, from January 2018 to December 2019. It included 280 patients with breast cancer, colorectal cancer, or lymphoma. Sociodemographic information was collected using questionnaire, along with information on medical history and any psychiatric history. Distress was assessed using the Distress Thermometer and Problem List. Satisfaction with social support was rated using the visual analog scale. All patients were screened for depression using the Patient Health Questionnaire 9-item depression scale and anxiety using the Generalized Anxiety Disorder 7-item scale.Results:The prevalence of distress in our study population was found to be 46%. Distress was associated with several practical, family, emotional, and physical stressors in the problem list. Logistic regression identified predictors of distress to be anxiety (odds ratio [OR] 8.7, confidence interval [CI] 1.98-38.24, p=0.002) and receiving radiotherapy (OR 3.6, CI 1.33-9.99, p=0.009), while Saudi nationality (OR 0.22, CI 0.05-0.95, p=0.037) and stage I cancer (OR 0.18, CI 0.05-1.40, p=0.002) were associated with low distress.Conclusion:Approximately half of cancer patients were found to have distress. Anxiety, advanced cancer stage, and radiotherapy were independently associated with distress.     

The prevalence of cardiovascular disease in adults with type 2 diabetes mellitus in Saudi Arabia - CAPTURE study

Objectives:To investigate cardiovascular disease (CVD) prevalence in adult patients with type 2 diabetes mellitus (T2DM) in Saudi Arabia using data from the CAPTURE cross-sectional study.Methods:CAPTURE was a non-interventional, multinational study carried out between December 2018 and September 2019. In Saudi Arabia, clinical (including medication) and demographic data were collected across 7 sites (Alhada Armed Forces Hospital, Taif; King Saud University Medical City, King Saud University, Riyadh; Specialized Medical Centre Hospital, Riyadh; King Abdulaziz University Hospital, Jeddah; King Abdulaziz Hospital for National Guard, Al Ahsa; Diabetes and Endocrinology Center, Buraidah; and Dallah Hospital, Riyadh, Saudi Arabia) from adults aged ≥18 years. The prevalence of CVD was estimated and weighted according to care setting, with data between groups not statistically compared.Results:Among the 883 adults enrolled in this study (566 from primary care, 317 from secondary care), 158 had established CVD, making the weighted prevalence of 18% (95% CI: [15.5-20.5]). The weighted prevalence of atherosclerotic CVD was 15.1% (95% CI: [12.8-17.5]), accounting for 82.4% of the CVD cases. Coronary heart disease was the most common subtype of CVD (13.4%), followed by cerebrovascular disease (1.7%). A total of 23.6% of patients were treated with glucose-lowering agents with proven cardiovascular benefit.Conclusion:In Saudi Arabia, approximately one in 5 adults with T2DM had established CVD, lower than the global prevalence, possibly because of disparities in patient characteristics, potential genetic predispositions, or a lack of accurate documentation due to poor coordination between care settings.     

Utilizing diabetes registry for exploring sociodemographic and clinical characteristics of type II diabetic patients in Saudi Arabia

Objectives:To explore the sociodemographic and clinical characteristics as the process and outcomes of diabetic individuals.Methods:Hospital Saudi registry at Prince Sultan Military Medical city, Chronic Illness Clinics (Family and Community Medicine), Riyadh, Saudi Arabia database was started in February 2019 and data were collected until February 2020. The data were collected by trained diabetes nurse specialists. The registry includes all patients with type II diabetes mellitus (DM) and excluded patients with type I DM.Results:A total of 8,209 patients were enrolled in the registry with a higher proportion of females than males. The mean age was 59.3 years, BMI 32.5kg/m², and HBA1c levels was 8.2%. Significant gender differences for BMI, duration of diabetes, blood pressure, LDL, smoking status, and medication intake. From the first to the third visit, BMI was raised; however, LDL, diastolic blood pressure, and albumin creatinine ratio were reduced. The mean HBA1c values plummeted for all patients and 33% of the patients had a reduction in the HbA1c levels. However, HbA1c levels increased for 24.7% of the patients’ from baseline to the last visit.Conclusion:This registry provides great insights into the sociodemographic and clinical characteristics of diabetic patients in Saudi Arabia. This registry data can be used to investigate the associations between sociodemographic or clinical characteristics and glycemic control among T2DM patients in Saudi Arabia.     

奥美拉唑对胃食管反流病患者胃电图的影响

目的 质子泵抑制荆用于胃食管反流病(GEILD)的治疗,观察这些药物是否影响GERD患者的胃电活动.方法 21例经内镜检查确诊为GERD的患者和20例健康对照组接受胃电图(electrogastrography,EGG)检查,对GERD患者的症状进行评分,奥美拉唑治疗4周后,再次对症状进行评分,记录EGG,并行胃镜检查评价糜烂性食管炎的程度.结果 GERD患者奥美拉唑治疗后烧心、反酸和胸痛症状评分显著减低(P＜0.01),GERD患者治疗前后与对照组的主频差异无显著性(P＞0.05),GERD组治疗前后与对照组进餐前后主功率相比显著增高(P＜0.01).GERD患者较正常对照的正常慢波节律显著减少,空腹时2组分别为(41.5±14.4)%和(65.8±23.5)%,餐后分别为(47.5±23.3)%和(76.8±16.7)%,差异有显著性(P＜0.05).奥美拉唑治疗后,15例(71.4%)患者内镜检查证实愈合,进餐前后正常慢波节律分别为(47.5±23.3)%和(66.2±21.8)%,显著增多(P＜0.01).结论 GERD患者奥美拉唑治疗可以改善烧心、反酸和胸痛症状.GERD患者正常慢波节律减少,奥美拉唑治疗可能增加餐后胃电正常慢波百分比,改善胃排空.     

Primary lymphoma of the kidney: Pathology experience from 2 tertiary hospitals in Western Saudi Arabia

Objectives:To document the clinicopathological features of primary renal lymphoma (PRL) at 2 tertiary hospitals in the western region of the Kingdom of Saudi Arabia.Methods:Data were retrieved from all PRLs that were diagnosed at King Abdulaziz University Hospital and King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia, between January 2002 and April 2022. Histopathological and immunohistochemical slides were reviewed, and additional immunohistochemistry stains were carried out in selected cases. Follow-up data were also collected.Results:There were 17 identified cases of PRL. The age of the patients ranged from 4-76 years (median: 50.5 years and mean: 46.8 years), 11 (64.7%) were males, and 6 (35.3%) were females. There were 12 cases of diffuse large B-cell lymphoma, 3 cases of Burkitt’s lymphoma, and 2 cases of post-transplant lymphoproliferative disorder. The median follow-up duration was 22 months. The one-year overall survival rate was 71% and the 2-year overall survival rate was 43% during follow-up.Conclusion:Primary renal lymphomas in Saudi patients are more common in males and seen in a relatively younger age group compared to the available worldwide data. The diagnosis of PRL is important to avoid tumor dissemination and unnecessary nephrectomy. Diffuse large B-cell lymphoma is the most common pathological type and non-germinal center B-cell is the most common subtype.     

Prevalence of microvascular complications among patients with type 2 diabetes mellitus who visited diabetes clinics in Saudi Arabia

Objectives:To determine the microvascular complications prevalence in patients with type 2 diabetes mellitus (DM) in the eastern province of the Kingdom of Saudi Arabia.Methods:The participants in this retrospective, cross-sectional study included patients with type 2 DM who visited the diabetes clinics of primary health care centers of 2 National Guard Hospitals, Eastern Province, Saudi Arabia.Results:This study included 935 patients with type 2 diabetes (54.1% women versus 45.9% men). Oral hypoglycemic medication was the most common treatment (90.3%). Overall, 55.1% of patients visited the ophthalmology clinic for retinopathy screening. The last glycated hemoglobin A1c result (mean: 8.04%) was higher than the second-to-last result (mean: 8.03%), or the third-to-last result (mean: 7.99%). The prevalence of microvascular complications of DM was 55.1%. Independent significant factors linked with a higher risk of microvascular issues of DM were higher age, visits to an ophthalmology clinic, and the use of injection therapy. The most typical complications that our patients experienced was nephropathy (80.2%), followed by retinopathy (32.7%), and neuropathy (8.4%).Conclusion:Microvascular complications were extremely common in type 2 DM patients in our region. Being older, regularly visiting an ophthalmologist, and using injection therapy were predictive factors correlated with a higher chance of experiencing these complications.     

Clinical and epidemiological characteristics of COVID-19 mortality in Saudi Arabia

Objectives:To analyze the clinical and epidemiological characteristics for 224 of in-hospital coronavirus disease 2019 (COVID-19) mortality cases. This study’s clinical implications provide insight into the significant death indicators among COVID-19 patients and the outbreak burden on the healthcare system in the Kingdom of Saudi Arabia (KSA).Methods:A multi-center retrospective cross-sectional study conducted among all COVID-19 mortality cases admitted to 15 Armed Forces hospitals across KSA, from March to July 2020. Demographic data, clinical presentations, laboratory investigations, and complications of COVID-19 mortality cases were collected and analyzed.Results:The mean age was 69.66±14.68 years, and 142 (63.4%) of the cases were male. Overall, 30% of the COVID-19 mortalities occurred in the first 24 hours of hospital admission, while 50% occurred on day 10. The most prevalent comorbidities were diabetes mellitus (DM, 73.7%), followed by hypertension (HTN, 69.6%). Logistic regression for risk factors in all mortality cases revealed that direct mortality cases from COVID-19 were more likely to develop acute respiratory distress syndrome (odds ratio [OR]: 1.75, confidence intervel [CI: 0.89-3.43]; p=0.102) and acute kidney injury (OR: 1.01, CI: [0.54-1.90]; p=0.960).Conclusion:Aging, male gender and the high prevalence of the underlying diseases such as, DM and HTN were a significant death indicators among COVID-19 mortality cases in KSA. Increases in serum ferritin, procalcitonin, C-reactive protein (CRP), and D-dimer levels can be used as indicators of disease progression.     

SARS-CoV-2 seroprevalence among healthcare workers from a tertiary care center in Riyadh,Saudi Arabia

Objectives:To calculate the seroprevalence of asymptomatic healthcare workers (HCWs) in our institution.Methods:We conducted a cross-sectional study among asymptomatic HCWs in a large hospital during the peak of the pandemic (from July to August 2020 and followed them up until February 2021) in Riyadh, Saudi Arabia. We collected the data in a Microsoft Word document after collecting a single serum sample for detection of antibodies from each participant then we compared the results statically in Microsoft Excel tables.Results:We enrolled 188 participants and measured their IgG antibodies from venous blood samples using CLIA. Six (3.2%) had positive antibodies despite being asymptomatic. Most of these were from non-COVID-19 working areas (4 out of 6), but all had an exposure with a positive COVID-19 patient at some point in the preceding 2 months.Conclusions:Our results are consistent with similar local studies showing low seroprevalence among HCWs while most positive cases are from non-COVID-19 areas. Despite this low seroprevalence, HCWs are still considered a high-risk group; hence, there is a need to encourage strict implementation and adherence to infection control measures and vaccination among HCWs, especially when these measures are relaxed on the national level.     

Translation,cultural adaptation,and evaluation of the psychometric properties of an Arabic diabetes distress scale: A cross sectional study from Saudi Arabia

Objectives:To translate, validate, and adapt the diabetes distress scale (DDS)-17 to a Saudi Arabian (SA) DDS (SADDS-17). Also, to evaluate the psychometric properties of the newly adapted SADDS-17.Methods:This was a cross-sectional study evaluating the psychometric properties of the DDS. The DDS was translated using the forward-backward translation from English to Arabic at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in January 2016. Statistical analyses included exploratory factor analysis, internal consistency, testretest reliability, and construct validity. Moreover, contingent validity was evaluated using hospital anxiety and depression scale, visual analogue scale, and the World Health Organization quality of life assessment instrument.Results:A total of 109 participants were included in this study. The exploratory factor analysis of our Arabic scale supported the original DDS with 4 sub-scales. Correlations ranged from 0.376 to 0.718 for items in regimen-related distress, 0.327 to 0.533 for items in emotional burden, 0.413 to 0.722 for items in physician-related distress, and 0.492 to 0.556 for items in interpersonal distress. The Cronbach’s alpha value of the SADDS was 0.848 for the total scale. The test-retest reliability value was 0.78.Conclusion:Our SADDS is a valid and reliable instrument for detecting diabetes distress among Saudi Arabian patients with type 2 diabetes.     

Evaluation of COVID-19 myths in Saudi Arabia

Objectives:To examine the awareness level of COVID-19 and to highlight the frequency of myths and misconceptions among Saudi Arabia’s population.Methods:We conducted a cross-sectional study from June 13 to 20, 2020 by distributing a 16-item online Google forms questionnaire among adults (18-65 years old) living in Saudi Arabia. We utilized the convenience sampling. Data analysis was performed using Chi-square and multiple regression analysis on Jamovi.Results:A total of 1436 responses were analyzed with 43.5% males and 56.5% females. Most respondents (89.1%) thought that only the elderly above 60 years old are considered at high risk of contracting COVID-19. Most respondents (86.5%) agreed that people with other health conditions could be more affected by COVID-19. Approximately 97.2% agreed that wearing a mask and avoiding touching eyes, nose, and mouth with unwashed hands was the leading preventive action. Most participants (99.4%) chose fever as an associated symptom. Respondents from the healthcare sector presented statistically higher scores than those in non-healthcare sectors (p<0.001). Higher education and higher salary were important predictors of better COVID-19 knowledge.Conclusion:Public health officials need to increase awareness measures on COVID-19 to limit myths and misconceptions and reduce psychological distress associated with it.     

Prevalence and determinants of burnout syndrome and depression among medical students at Qassim University,Saudi Arabia

Objectives:To investigate the prevalence and determinants of burnout syndrome and depression among medical students at Unaizah College of Medicine (UCM), Qassim University, Qassim, Kingdom of Saudi Arabia (KSA).Methods:A cross-sectional study of all Saudi medical students studying at UCM, Qassim University, Al Qassim, KSA, between February to March 2020.Results:Of the total 305 students sampled, 153 (50.2%) fit the category of depression. Concerning burnout, only 5.6% of the total population met the Maslach Burnout Inventory diagnostic criteria for burnout, with those determined to have burnout having ranked high on the emotional exhaustion and cynicism subscales, and low on the academic efficacy subscale. Male was strongly associated with burnout, while female gender and raising children were strongly associated with the presence of depression. Emotional exhaustion and high cynicism as determinants of burnout elevate the risk of depression.Conclusion:Our results highlight the high rate of depression and burnout, as well as the need for psychological intervention programs at medical schools to prevent the deterioration of student’s mental health that has been associated with advancement in medical school.     

Quality of life in vitiligo patients in central Saudi Arabia

Objectives:To assess the quality of life (QoL) in patients with vitiligo in central Saudi Arabia using the dermatology life quality index (DLQI).Methods:A cross-sectional study spanning over 6 months was conducted on 253 adult patients with vitiligo at the outpatient dermatology clinics of the National Center of Vitiligo (Light Clinics) and King Khalid University Hospital, Riyadh, Saudi Arabia. The patients were asked to complete a self-administered questionnaire using an Arabic version of the DLQI to measure the impact of vitiligo on their QoL. The association between the demographic and diseases characteristic to the median DLQI scores was investigated using binary logistic regression.Results:The median DLQI score was 4, the range 25, min 0 - max 25 and percentiles 2-8. The unadjusted odds ratio (95%CI) showed the median DLQI score was significantly higher in married subjects 2.29 (1.33-3.94) (p<0.01), non-segmental vitiligo 2.10 (1.16-3.79) (p<0.01), and the progressive vitiligo 1.87 (1.09-3.18) (p<0.02) than their counterparts. However, after adjustment only married status predicted the high DLQI score 2.08 (1.11-3.61) (p<0.01).Conclusion:The QoL in vitiligo patients in Saudi Arabia is adverse than those with lighter skin, in other countries. Therefore, in Saudi Arabia, better management modalities to improve patients’ QoL and prevent subsequent mental distress are needed.     

Clinical profiles and outcomes of acute ST-segment elevation myocardial infarction in young adults in a tertiary care center in Saudi Arabia

Objectives:To investigate the clinical profiles and outcomes of young adults presenting with ST-segment elevation myocardial infarction (STEMI).Methods:We retrospectively reviewed King Saud Medical City, Riyadh, Saudi Arabia, registry between January 2016 and November 2017 for all patients younger than 45 years old who were admitted with STEMI. We compared this study population to a control group of patients aged 45 years and older who were enrolled in the same period.Results:In total, 402 patients were enrolled; 197 were younger than 45 years. The incidence of newly diagnosed dyslipidemia was higher in younger patients (44% vs. 32%, p=0.01). Smoking was significantly more prevalent in the younger group (52% vs. 35%, p=0.001). The prevalence of pulmonary edema and cardiogenic shock on presentation was significantly higher in the older group (3% vs. 10; odds ratio, 4.43; 95% confidence interval, 1.750-10.94; p=0.002). Hospital stay was also longer in the older group (4±2 vs. 5±2 days, p=0.03).Conclusion:ST-segment elevation myocardial infarction in young patients has a favorable outcome. Smoking and dyslipidemia are the main risk factors for STEMI in young individuals. The majority of young patients with dyslipidemia were not aware of their pre-existing condition. Our findings recommend local adaptation and implementation of screening programs for dyslipidemia in the young and the reinforcement of smoking prevention programs.     

Clinical characteristics and in-hospital mortality of COVID-19 adult patients in Saudi Arabia

Objectives:To provide a detailed study of demographic, baseline comorbidities, clinical features, and outcome for Coronavirus disease 2019 (COVID-19) patients.Methods:A record-based case-series study conducted from March 23 to June 15, 2020 in King Saud Medical City, Riyadh, Saudi Arabia. Demographic data, clinical presentation, laboratory investigations, complications, and in-hospital outcome of COVID-19 patients collected with analysis of the clinical characteristics for survivors and deceased.Results:A total of 768 patients were included. The mean age was 46.36±13.7 years and 76.7% were men. Approximately 96.3% reported more than one comorbidity; diabetes mellitus was the most frequent (46.4%). Fever (84.5%), cough (82.3%), and shortness of breath (79.8%) were the main presenting symptoms. During the follow-up, pneumonia reported in 68.6%, acute respiratory distress syndrome in 32.7%, septic shock in 20.7%, respiratory failure in 20.3%, and acute kidney injury in 19.3%. Approximately 45.8% of enrolled patients required intensive care unit admission. Lung disease (odd ratio [OR]=3.862 with 95% confident interval [CI] (2.455-6.074), obesity (OR=3.732, CI=2.511-5.546), smoking (OR=2.991, CI=2.072-4.317), chronic kidney disease (OR=2.296. CI=1.497-3.521), and diabetes mellitus (OR=2.291, CI=1.714-3.063) are predictors of ICU admission. Fatality ratio was 89/2084 (4.27%). Men were more prevalent in dead group.Conclusion:Coronavirus disease 2019 places a huge burden on healthcare facilities, particularly in patients with comorbidity. Coronavirus disease 2019 patients who are obese and smokers with history of diabetes mellitus have a high risk of death.     

Evaluation of hematological parameters in dyspepsia patients infected with Helicobacter pylori : A retrospective study from the Central Region of Saudi Arabia

Objectives:To evaluate the hematological parameters in dyspepsia patients infected with Helicobacter pylori (H. pylori) infection from Al Qassim province of Kingdom of Saudi Arabia (KSA).Methods:This retrospective study was carried out in Dr. Sulaiman Al-Habib Hospital, Al Qassim, KSA. The data of dyspepsia and epigastric pain patients were derived from the hospital based registration system between 2020-2021. Logistic regression models were used to investigate the correlation between the onset of H. pylori infection and anemia.Results:Among 810 enrolled patients, there were 202 (24.9%) patients with H. pylori infection and 144 (17.8%) with anemia. The prevalence of anemia in the H. pylori (+) group was not statistically higher than the H. pylori (-) group after adjusting age, red blood cell count, serum ferritin, mean corpuscular volume, platelet count, and mean corpuscular hemoglobin (p>0.05). The level of hemoglobin was almost identical in both the H. pylori (+) group and the H. pylori (-) group (p>0.05).Conclusion:The findings show that H. pylori infection may not be related to anemia in dyspepsia patients from the Central region of KSA.     

膈脚屏障及食管体部清除功能在胃食管反流中的作用

目的探讨胃食管反流病(GERD)患者膈脚屏障功能及食管体部的清除功能在胃食管反流中的作用。方法GERD组和健康(HS)对照组同步进行餐前1h和餐后2h食管pH值和食管动力监测。结果(1)pH监测结果:GERD组8例,餐后pH<4的百分比中位数为11.2%;而HS组8例,餐后pH<4的百分比中位数为0.45%,两组相比差异有显著性(P<0.05)。(2)GERD组和HS组餐后下食管括约肌压力(LESP)均较餐前下降(P<0.001);GERD组及HS组餐前或餐后LESP两组比较差异无显著性(P>0.05)。(3)GERD组餐前及餐后与吞咽相关的下食管括约肌松弛后蠕动收缩波幅(Post-LESRA)明显低于HS组,两组比较差异有显著性(P<0.001)。(4)与HS组比较GERD组餐前及餐后静息膈脚张力(Dia-A0)均明显降低,差异有显著性(P<0.05)。(5)餐前及餐后深吸气时膈脚张力(Dia-AM),在GERD和HS两组间比较,差异无显著性(P>0.05),两组深吸气时膈脚张力可使胃食管交界处(EGJ)压力升高3～4倍。(5)GERD组餐前及餐后食管远端蠕动收缩波幅明显低于HS组,两组比较差异有显著性(P<0.001)。结论(1)静息膈脚张力、食管远端蠕动清除功能及与吞咽相关的下食管括约肌(LES)松弛后蠕动清除能力在GERD发病中起重要的作用。(2)深吸气时GERD组和HS组膈脚张力均可使EGJ区域压力增高数倍。     

The incidence and predictors of pneumothorax among trauma patients in Saudi Arabia: Findings from a level-I trauma center

ABSTRACTObjectives:To investigate the incidence and predictors of traumatic pneumothorax using data from a Level-I trauma center in Riyadh, Saudi Arabia.Methods:This is a retrospective chart-review study carried out in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Data were extracted from the hospital’s trauma registry (2016-2018). A total of 2,109 trauma patients were included. Inclusion criteria were patients ≥16 years old admitted for a traumatic injury. Variables included patient demographics, transport mode, trauma team activation, mechanism of injury, mortality rate, Glasgow Coma Scale and Injury Severity Scores. A logistic regression analysis was constructed to evaluate potential predictors of pneumothorax.Results:Of 2,109 patients included from the trauma registry, 236 (11.2%) were diagnosed with pneumothorax. The majority of the study population was young (19-49 years) (60.7%) and male (79.4%.) Injury mechanism was significantly associated with the presence of pneumothorax (p<0.001). Regression analysis indicated that the odds of having pneumothorax among intentional injury victims was 15 times higher than fall injury victims (OR=15.3, 95% CI= 7.2-32.9). Participants who sustained motor vehicle collision injuries had 3 times higher odds of developing pneumothorax than those who suffered fall injuries (OR=3.1, 95% CI= 1.5-6.1).Conclusion:The incidence of traumatic pneumothorax is sizable and highly associated with the mechanism of injury. Efforts to reduce motor vehicle collision burden should be directly associated with decreasing the burden of traumatic pneumothorax.     

Assessment of dermatologists’ perception of utilizing teledermatology during COVID-19 pandemic in Saudi Arabia

Objectives:To assess teledermatology (TD) perception among dermatologists in the Kingdom of Saudi Arabia during the COVID-19 pandemic and to identify the most common advantages and disadvantages of TD.Methods:We conducted a cross-sectional survey-based study to address Saudi dermatologist perceptions of TD from July 2020 to December 2020, during Covid-19 pandemic.Results:Out of 664 emails sent, 107 complete responses were returned. Approximately 40.2% used TD through phone calls, followed by those who used a virtual clinic (32.7%). Also, the best way to use TD, according to respondents, was for triage before inpatient and outpatient visits. When we compared the use of TD in the outpatient and inpatient settings, outpatient responses always had more positive attitudes than inpatients. The most important benefit of TD is to reduce the risk of pandemic infections (69%). More than half of the participants sometimes used TD for diagnosis (n=63, 58.9%) and management (n=59, 55.1%), and 69 (64.5%) considered using it in the future.Conclusion:Our survey-based study indicates that TD is an important part in the future dermatology because our participants agreed that TD decreases cost, increases access to dermatology care, and reduces the risk of pandemic infections. And it is necessary to establish an infrastructure for TD that protects patient’s privacy and ensures accurate diagnosis.     

Clinicopathological features and prevalence of prostate cancer in Aseer,Saudi Arabia

Objectives:To determine the prevalence and characterize prostate cancer (PC) cases in Aseer, Saudi Arabia.Methods:This study involved 883 patients who consulted physicians in Aseer Central Hospital, Abha, Saudi Arabia, for prostate issues between the years 2008-2018. All patients underwent digital rectal examination and measurement of their serum prostate-specific antigen levels. For patients who presented abnormal digital rectal examination findings and elevated prostate-specific antigen levels, prostate biopsies were recommended. Specimens were histopathologically examined to differentiate between malignant and benign tumors.Results:Among the 883 included patients, 132 (15%) underwent a prostate biopsy and were found to have a tumor. Histopathological examination confirmed malignancy (PC) in 77 (8.7%) patients. The absolute majority of the patients diagnosed with PC (96%) were aged >60 years and almost all of them (92%) were found to have a high prostate-specific antigen level of >4 ng/ml.Conclusion:Prostate cancer appears to be a serious disease in Aseer, Saudi Arabia. Further studies aimed at determining the causes of this type of cancer and understanding its mechanisms are warranted.