Screening for body dysmorphic disorder among patients pursuing cosmetic surgeries in Saudi Arabia

Objectives:To determine the prevalence of positive screening of body dysmorphic disorder (BDD) among patients seeking cosmetic surgeries in plastic surgery and oculoplastic surgery clinics.Methods:The survey of this cross-sectional study was self-administrated and distributed among adults pursuing cosmetic surgeries in plastic surgery and oculoplastic surgery clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between March 2019 and March 2020. The BDD questionnaire was validated, and a highly sensitive and specific tool was used to identify patients with BDD. Ethical approval was granted by the Research Ethics Committee. All analytic studies were performed using IBM SPSS, version 24.Results:A total of 344 patients participated in this study with a mean age of 39.66 ± 13.76 years. Of these, 296 (86%) were women and 298 (86.6%) were Saudi. The prevalence of positive screening for BDD was 19.2%. The most commonly requested procedures were abdominoplasty (21.2%) and skin lesion removal (21.2%). Smoking was found to be significantly associated with BDD with 21.2% of smokers having it (p<0.010).Conclusion:Body dysmorphic disorder was unrecognized among patients pursuing cosmetic surgeries. One-fifth of patients requesting cosmetic procedures are potential cases of BDD requiring psychiatric evaluation and treatment. We recommend implementing screening protocols to identify cases before surgical plans.     

Prevalence and predictors of habitual snoring in a sample of Saudi middle-aged adults

Objectives:

To determine the prevalence of habitual snoring among a sample of middle-aged Saudi adults, and its potential predictors.

Methods:

A cross-sectional study was conducted from March 2013 until June 2013 in randomly selected Saudi Schools in Jeddah, Kingdom of Saudi Arabia. The enrolled subjects were 2682 school employees (aged 30-60 years, 52.1% females) who were randomly selected and interviewed. The questionnaire used for the interview included: the Wisconsin Sleep Questionnaire to assess for snoring, medical history, and socio-demographic data. Anthropometric measurements and blood pressure readings were recorded using standard methods.

Results:

Forty percent of the 2682 enrolled subjects were snorers: 23.5% were habitual snorers, 16.6% were moderate snorers, and 59.9%, were non-snorers. A multivariate analysis revealed that independent predictors of snoring were ageing, male gender, daytime sleepiness, hypertension, family history of both snoring and obstructive sleep apnea, water-pipe smoking, and consanguinity.

Conclusion:

This study shows that snoring is a common condition among the Saudi population. Previously reported risk factors were reemphasized but consanguinity was identified as a new independent predictive risk factor of snoring. Exploring snoring history should be part of the clinical evaluation.Snoring is defined as a harsh buzzing noise produced by vibration of the soft palate and pillars of the oropharyngeal inlet, primarily with inspiration during sleep. Habitual snoring (HS) is defined as the presence of loud snoring at least 3 nights per week, and is strongly associated with obstructive sleep apnea (OSA).1,2 Even in the absence of OSA, HS is associated with health and social consequences including sleep fragmentation, family discord, excessive daytime sleepiness, and more seriously, the development of systemic hypertension in individuals aged <50 years.3 However, many individuals regard HS as a benign and a common behavior; moreover, physicians often disregard snoring as a disorder in their clinical practice. Such denial may lead to delayed recognition and management of OSA.1 Loud snorers have a 40% greater chance of developing hypertension, 34% greater chance of developing heart attack, and 67% greater chance of developing stroke, compared to non-snorers after adjustments for age, gender, body mass index, diabetes, level of education, smoking, and alcohol consumption.4 More recently, heavy snoring has been independently associated with carotid atherosclerosis and treating it was suggested as an important goal in prevention of stroke.5 There have been many international epidemiological studies to establish the prevalence of habitual snoring. Habitual snoring was reported to affect 35.7% of American,2 37.2% of Polish,6 35% of Spanish,7 19.6% of Chinese,8,9 17.3% of Korean,10 and 25.6% of Indian populations.20 The main reported risk factors were aging, male gender, obesity, and smoking. However, very limited data is available on the prevalence and impact of HS in the Middle Eastern countries. A limited study on Saudi health care workers reported HS in only 5.4%.11 Another primary health care clinics based study found a snoring prevalence of 52.3% in Saudi males, and 40.8% in Saudi females.12,13 Therefore, we conducted the current study to assess the actual prevalence and risk factors predictive of HS in a cohort of subjects in Saudi Arabia. Our results will be used to assess the size of the problem and increase awareness of this health disorder among health care professions, so that sleep disordered breathing can be effectively diagnosed and treated.     

Primary hyperparathyroidism in Saudi Arabia: a review of 46 cases

Records of 46 patients who were treated for primary hyperparathyroidism at King Khalid University Hospital, Riyadh Saudi Arabia from 1st July 2000 to 30th June 2006 were reviewed. Mean age at diagnosis was 44 years (range 13-70 years) and average duration of symptoms was 39 months (1 month to 11 years). There were 35 females and 11 males with a ratio of 3.2:1. Bone pains were the major symptoms at presentation in 45.7% followed by no symptom in 23.9%, renal stones in 15.2%, polyuria in 6.5%, while 4.3% each presented with depression, and constipation. Males had significantly more severe disease with higher serum calcium, higher urinary calcium excretion, and higher serum creatinine. Ninety six percent of patients had successful surgery and 4% (two patients) each had recurrence and hungry bone syndrome. It is concluded that PHPT in Saudi Arabia continues to be a symptomatic disorder with skeletal and renal manifestations occurring at a younger age and males having more severe disease. Further prospective studies are needed to verify our findings.     

Primary hyperparathyroidism in Saudi Arabia: a review of 46 cases

Records of 46 patients who were treated for primary hyperparathyroidism at King Khalid University Hospital, Riyadh Saudi Arabia from 1st July 2000 to 30th June 2006 were reviewed. Mean age at diagnosis was 44 years (range 13 - 70 years) and average duration of symptoms was 39 months (1 month to 11 years). There were 35 females and 11 males with a ratio of 3.2:1. Bone pains were the major symptoms at presentation in 45.7% followed by no symptom in 23.9%, renal stones in 15.2%, polyuria in 6.5%, while 4.3% each presented with depression, and constipation. Males had significantly more severe disease with higher serum calcium, higher urinary calcium excretion, and higher serum creatinine. Ninety six percent of patients had successful surgery and 4% (two patients) each had recurrence and hungry bone syndrome. It is concluded that PHPT in Saudi Arabia continues to be a symptomatic disorder with skeletal and renal manifestations occurring at a younger age and males having more severe disease. Further prospective studies are needed to verify our findings.     

Prevalence and risks of habitual snoring and obstructive sleep apnea symptoms in adult dental patients

Objectives:

To determine the prevalence of habitual snoring and risk of obstructive sleep apnea (OSA) among dental patients and investigate factors associated with high-risk OSA.

Methods:

This cross-sectional study was performed at the Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Kingdom of Saudi Arabia, between October and December 2014. A total of 200 consecutive female and male dental patients were included in this study. Subjective and objective assessments were carried out. Habitual snoring and risk of OSA were assessed using the Arabic version of the Berlin questionnaire. Two trained investigators carried out the objective measurements of anthropometric data, blood pressure, oxygen saturation, pulse rate, and clinical examination of upper-airway, and dental occlusion.

Results:

Habitual snoring was present in 18.2% of the females and 81.8% of the males (p<0.05). Breathing pauses during sleep of more than once a week occurred in 9% (n=17) of the sample. Of the males, 78.3% were at high risk of OSA compared with 21.7% of the females. Multivariate analysis for risk of OSA revealed that obese patients were almost 10 times more likely to report OSA symptoms than their non-obese counterparts (odds ratio: 9.9, 95% confidence intervals: 4.4-22.1). Tongue indentations, tonsil size, and a high Epworth Sleepiness Scale score were also independent risks of OSA.

Conclusion:

Tongue indentations and tonsil grades III and IV were significantly associated with risk of OSA. This validates the important role of dentists in the recognition of the signs and symptoms of OSA.Obstructive sleep apnea (OSA) is a repetitive complete or partial obstruction of the upper airway during sleep.1 It is characterized by snoring, hypoxia, hypercapnia, and arousals from sleep.2 Obstructive sleep apnea is found in 24% of male and 9% of female adults.3 Data from the Canadian Community Health Survey4 showed that approximately 26% of adult Canadians were at high risk of developing OSA. Two studies5,6 in Saudi Arabian population reported a 39% prevalence of OSA in females and 33.3% in males. Obstructive sleep apnea can cause tiredness, anxiety, depression, and is associated with diminished motor and cognitive functions, and reduced quality of life.7 The individuals with OSA have 2-10 times increased risk of motor vehicle accidents than those without OSA.8 Untreated OSA has been linked to systemic complications such as coronary artery disease,9 heart failure,2 impaired glucose tolerance, insulin resistance, and dyslipidemia10 among other conditions. Unfortunately, most of the OSA cases (85%) remain undiagnosed,11 partly due to lack of information to patients and health professionals as well as the high costs of diagnostic tests. Several factors contribute to the development of OSA, which includes obesity, older age,12 male gender, menopause, hereditary, smoking, alcohol, craniofacial abnormalities,13 and periodontal disease.14 Orofacial anatomical abnormalities such as mandibular micrognathia or retrognathia, large tongue, hypertrophy of palatine tonsils, enlarged uvula, and deep palatal arch are craniofacial risks for developing OSA.15 Habitual snoring is one of the symptoms of sleep disordered breathing. A population based longitudinal study found that 13% of adults developed habitual snoring over 14 years. The factors associated with habitual snoring include male gender, obesity, smoking, and asthma.16 In addition, snoring is strongly associated with increased all-cause mortality.17 Dentists play a major role in the recognition of the signs and symptoms and the overall management of OSA.18 No data exist on the epidemiology or risks of OSA symptoms among dental patients in Saudi Arabia. This study aims to determine the prevalence of habitual snoring and OSA risk in adult dental patients and investigate the factors associated with high risk of OSA.     

The distribution and classification of clefts in patients attending a cleft lip and palate clinic in Riyadh, Saudi Arabia

OBJECTIVE: To evaluate and discuss the etiology, distribution, and classification of cleft lip and palate (CLP) patients in one of the most active CLP clinics in Riyadh, Saudi Arabia. METHODS: The records of all 171 CLP patients attending the CLP clinic at the College of Dentistry, King Saud University in Riyadh, Saudi Arabia, were collected in November and December 2006. Variables such as etiology, age, gender, type of cleft, and location of cleft were statistically analyzed. Proportional Z test (p<0.05) was used. RESULTS: The patients age range was 0.5-30 years with an average of 11.1 (standard deviation 5.87) years. Attending male patients (63.7%) were more than females (36.6%) (p=0.000). The unknown environmental factor was the most reported etiological factor (79.5%) (p=0.000). The cleft lip and palate were the most prevalent type (78.3%) (p=0.000). In the different types of cleft, as well as within the same cleft type, the cleft lip and palate type were significantly higher in males (49.1%) (62.7%), than females (29.1%) (37.3%) with (p=0.038) (p=0.008). There were no statistical differences between the right and left cleft sides. CONCLUSION: The average age and range of CLP patients at first visit were high. Attending male patients was more than females. The environmental etiological factor was not identifiable. Males were dominant in the cleft lip and palate type. The cleft lip and palate type were the highest among oral clefts.     

Epidemiology of hepatitis E virus in male blood donors in Jeddah, Saudi Arabia

To our knowledge, only a few epidemiological reports on the prevalence of hepatitis E antibodies in Saudi blood donors have been published. Men of several nationalities, donating blood at King Khalid National Guard Hospital (Jeddah, Saudi Arabia) were selected (n = 593) for this study examining the seroprevalence of hepatitis E virus (HEV) in the local male donor population and testing the relationship of the antibody to HEV (anti-HEV) to donor characteristics using Odds Ratio (OR) and Chi-square statistic. The prevalence of anti-HEV in the group examined was 16.9 per cent (100/593). The seroprevalence for Saudi donors was 14.8 per cent compared with 33.3 per cent for non-Saudis of Middle Eastern origin. Donors who were 40 yr and over had significantly higher seroprevalence than those donors who were 30 yr or younger (OR =2.5, p = 0.006). There was a significant association between anti-HEV and anti-HCV with donors who were positive to anti-HCV having about 5 times the risk of HEV than those who were anti-HCV negative (p = 0.02). These findings demonstrate the high seroprevalence rate of anti-HEV among male blood donors in Saudi Arabia.     

Patterns of breast cancer radiotherapy practices among Saudi radiation oncologists

Objectives:To identify practice patterns among radiation oncologists in Saudi Arabia.Methods:A questionnaire comprising 27 scientific questions and 6 demographic questions was created in 2019 by a faculty member at King Abdulaziz University, Jeddah, Saudi Arabia, and distributed among radiation oncologists in Saudi Arabia between February and April 2019.Results:Twenty-four responses were received. Regarding chest wall treatment after mastectomy, 100% of the respondents offered postmastectomy radiotherapy (PMRT) for tumor stage 3 node 1 (T3N1) or T4 disease, while 87.5% offered PMRT for T2N1, and 83.3% offered PMRT for T3N0 disease. In contrast, there was a lack of consensus regarding treatment planning and coverage criteria for internal mammary lymph nodes and contouring.Conclusion:Variations in breast radiotherapy practices in Saudi Arabia exist due to the lack of clinical evidence and national guidelines, as well as potential variations in health resources allocation. Resource allocations and the establishment of national guidelines are recommended to decrease this variation and allow for data exchange and the development of national research collaborations.     

Prevalence of gastro-esophageal reflux in diabetic patients at a tertiary hospital in Central Saudi Arabia

Objectives:To estimate the prevalence of gastro-esophageal reflux disease (GERD) among diabetic patients and to investigate GERD’s potential association with diabetic complications, and patients’ sociodemographic and clinical characteristics.Methods:This cross-sectional study used the GERD questionnaire (GerdQ) in 403 diabetic patients attending the outpatient clinics at King Khalid University Hospital, King Saud University Medical City, King Saud University; a tertiary hospital in Riyadh, Saudi Arabia, between January and February 2019. On the basis of a cutoff GerdQ score of 8, we distinguished GERD and non-GERD groups.Results:Gastro-esophageal reflux disease prevalence was 44.9%. Of the diabetic patients with GERD, 76.8% were female (p<0.001). Gastro-esophageal reflux disease patients were older (mean age: 55.27, p=0.038) and had a slightly higher body mass index (BMI) than non-GERD (32.04 versus, 30.20 p=0.006), respectively. Smokers in the GERD group were 1.7% versus 7.2% in the non-GERD group (p=0.007). Peripheral numbness (p=0.023) and nephropathy (p=0.041) were more prevalent in patients with GERD, while myocardial infarction was more prevalent in non-GERD subjects (p=0.038). On multi variable analysis, the only independent GERD risk factors were female gender (p=0.013) and age >65 years (p=0.007).Conclusion:Gastro-esophageal reflux disease prevalence in diabetic patients was 45%. Diabetic patients with GERD were more often female and older >65 years. None of the other tested factors (BMI, smoking status, diabetes mellitus duration, therapeutic plan, or diabetic complications) showed significant difference between GERD and non-GERD groups.     

Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors

Background:

Snoring remains under diagnosed in general population. It however has significant morbidity and mortality risk factors with multiple effects on the cardiovascular system. The Berlin questionnaire is a worldwide validated instrument to identify those at increased risk for obstructive sleep apnoea (OSA).

Materials and Methods:

In all, 206 workers of LAUTECH were invited to participate in the study. The Berlin questionnaire was used for this study. It was a cross-sectional study. Socio-demographic and clinical data were taken with a data form. Statistical Package for the Social Sciences software (SPSS 17.0) was used for statistical analysis. P < 0.05 was taken as statistically significant value.

Results:

The study participants consisted of 96 males (46.6%) and 110 (53.4%) females. The mean age was 45.3 ± 7.9 years. The mean body mass index was 28.5 ± 6.0 kg/m². The frequency of occurrence of snoring was 91 (44.2%) including 50 males (54.9% and 41 females (37.3 %, P <0.05). Using the Berlin score, 63 (30.6%) including 34 females (30.9%) were assessed to be at high risk for OSA. Snorers were more likely to be at higher risk of OSA compared to non snorers: odd risk was 113.8, relative risk was 3.3. Snoring was most likely to be associated with obesity, elevated blood pressure and male gender in this study.

Conclusion:

We concluded that snoring and high risk for sleep apnoea is common among this unselected University population and they are closely related to many conventional cardiovascular risk factors. Appropriate interventional strategies are indicated to reduce the burden of the increased morbidity and mortality associated with sleep apnoea in our population.     

Prevalence and predictors of obstructive sleep apnea syndrome in a sample of patients with type 2 Diabetes Mellitus in Nigeria

Introduction:

Obstructive sleep apnea (OSA) and Diabetes Mellitus (DM) are growing health challenges worldwide. However, the relation of OSA with type 2 diabetes is not well understood in developing countries. This study described the prevalence and predictors of OSA in type 2 DM patients using a screening questionnaire.

Materials and Methods:

Patients aged 40years and above with type 2 diabetes mellitus were recruited into the study consecutively from the outpatient clinics of a university hospital. They were all administered the Berlin questionnaire and the Epworth sleepiness scale (ESS) to assess the risk of OSA and the tendency to doze off, respectively. Anthropometric details like height, weight and body mass index (BMI) were measured and short-term glycaemic control was determined using fasting blood glucose.

Results:

A total of 117 patients with type 2 diabetes mellitus were recruited into the study. The mean (SD) age, height and BMI was 63 years (11), 160 cm (9) and 27.5 kg/ m² (5.7), respectively. Twenty-seven percent of the respondents had a high risk for OSA and 22% had excessive daytime sleepiness denoted by ESS score above 10. In addition, the regression model showed that for every 1 cm increase in neck circumference, there is a 56% independent increase in the likelihood of high risk of OSA after adjusting for age, sex, BMI, waist, hip circumferences and blood glucose.

Conclusion:

Our study shows a substantial proportion of patients with type 2 diabetes may have OSA, the key predictor being neck circumference after controlling for obesity.     

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.     

The prevalence of internet gaming disorder among medical students at King Saud University,Riyadh, Saudi Arabia: A cross-sectional study

Objectives:To estimate the prevalence of internet gaming disorder (IGD) among King Saud University (KSU), Riyadh, Saudi Arabia medical students and to determine the association of IGD with gender, age, academic achievement, amount of sleep, and accommodation.Methods:We conducted a cross-sectional study between October 2019 and April 2020 on KSU medical students with a sample size of 281 medical students currently studying at KSU chosen by a stratified proportionate random sampling. The questionnaire contained the IGD short scale and questions eliciting demographic data.Results:The sample comprised of 228 responses. The prevalence of IGD was 8.8% (n=20), while 19.3% (n=44) of the participants were risky gamers. There was a significant association (p=0.0040) between IGD and gender, with 10.1% (n = 15) of males having IGD compared to 6.3% (n=5) of females. Additionally, 25% (n = 37) of males were risky gamers, as compared to 8.8% (n=7) of females.Conclusion:There is a high prevalence of internet gaming disorder among KSU medical students, with higher frequency among males. However, there was no significant association between this disorder and age, sleep, academic achievement, or accommodation.     

Long-term compliance with continuous positive airway pressure in Saudi patients with obstructive sleep apnea: A prospective cohort study

Objectives:

To evaluate continuous positive airway pressure (CPAP) compliance and define predictors of CPAP compliance among Saudi patients with obstructive sleep apnea (OSA) after applying an educational program.

Methods:

This prospective cohort study included consecutive patients diagnosed to have OSA based on polysomnography between January 2012 and January 2014 in King Saud University, Riyadh, Kingdom of Saudi Arabia. All patients had educational sessions on OSA and CPAP therapy before sleep study, and formal hands-on training on CPAP machines on day one, day 7, and day 14 after diagnosis. The follow-up in the clinic was carried out at one, 4, and 10 months after initiating CPAP therapy. Continuous positive airway pressure compliance was assessed objectively. Logistic regression model was used to assess the predictors of CPAP adherence.

Results:

The study comprised 156 patients with a mean age of 51.9±12.1 years, body mass index of 38.4±10.6 kg/m², and apnea hypopnea index of 63.7±39.3 events/hour. All patients were using CPAP at month one, 89.7% at month 4, and 83% at month 10. The persistence of CPAP-related side effects and comorbid bronchial asthma remained as independent predictors of CPAP compliance at the end of the study.

Conclusion:

With intensive education, support, and close monitoring, more than 80% of Saudi patients with OSA continued to use CPAP after 10 months of initiating CPAP therapy.Continuous positive airway pressure (CPAP) is a standard, safe, and efficacious treatment for obstructive sleep apnea (OSA), a common disorder with established harm to quality of life and adverse consequences for cardiovascular health.1 Obstructive sleep apnea is characterized by recurrent partial (hypopnea) or complete (apnea) upper airway obstruction during sleep. These recurrent respiratory events usually cause intermittent hypoxemia and sleep fragmentation.2 Recent data demonstrated that the estimated prevalence of moderate to severe OSA ranges from 10-17% in middle-aged and elderly men.3 In Saudi Arabia, 3 out of 10 middle-aged Saudi men and 4 out of 10 middle-aged Saudi women are at high risk of having OSA.4,5 The mainstay medical treatment for OSA is CPAP therapy.6 Among various available therapeutic modalities for OSA, CPAP remains the most effective treatment.6 Continuous positive airway pressure is a machine that applies positive airway pressure to the upper air passages via a mask fitted on the mouth or nose to keep the throat open.6 Previous studies in Western countries showed that OSA patients on CPAP therapy use their machines on average from 4.5 to 5.5 hours per night with compliance rates ranging from 30-85%.7,8 Several studies have been conducted to define factors that influence, or predict CPAP use and adherence, and reported conflicting results.6 Moreover, several studies reported that race might influence CPAP adherence. For example, available data suggest lower CPAP adherence among African Americans than Caucasians.9 An earlier study that assessed CPAP compliance subjectively (self-reports) among Saudi patients with OSA after 3 months of initiation of CPAP therapy revealed an overall compliance rate of 39%.10 However, self-reports have been shown to overestimate CPAP use by approximately one hour/night when compared with objectively measured CPAP use.11 In general, there are very few data on objectively assessed long-term CPAP compliance in the literature. Moreover, there is a lack of previous study objectively addressing the rate of CPAP compliance, the predictors of good compliance, and the side effects of CPAP treatment in Saudi OSA patients. Therefore, we established in our center an educational program for patients with OSA and easily accessible medical support, and close follow-up of CPAP compliance. This study was conducted to evaluate CPAP compliance and to define predictors of CPAP compliance among Saudi patients with OSA after applying the new educational program.     

Regional variations in the prevalence of consanguinity in Saudi Arabia

OBJECTIVE: To report on the prevalence of consanguinity in each region of the Kingdom of Saudi Arabia including the variation in prevalence between urban and rural settlements. METHODS: The study was conducted over 2 years (2004-2005). A cross-sectional sample determined by multistage random probability sampling of Saudi households from each of the 13 regions of the Kingdom. As part of survey questionnaire, the mother of each household was asked on the relationship to her husband to choose one of 3 answers: first-degree cousin, more distant relationship, or no relation. RESULTS: The overall prevalence of consanguinity was 56% with the first-degree cousin (33.6%) being more common than all other relations (22.4%). The overall prevalence was significantly more common in rural (59.5%) than in urban settlements (54.7%) (p=0.000). There are regions with high prevalence of 67.2% such as Madina, and regions with significantly lower prevalence of 42.1% such as Al-Baha (p=0.000). CONCLUSION: The national prevalence of consanguinity in the Kingdom of Saudi Arabia remains high. In addition, there are significant variations in the prevalence of consanguinity between certain regions as well as between rural and urban settlements that should be taken into consideration in further studies.     

Childhood anxiety disorders prevalence in Saudi Arabia

Objectives:To investigate the prevalence of childhood anxiety disorders in Saudi Arabia.Methods:We conducted a cross-sectional study, between September and November 2019, in Saudi Arabia. The study group included the parents of 468 primary school children, aged 6-12 years. Parents completed the Screen for Child Anxiety Related Disorders (SCARED) screening instrument, translated to Arabic. The measured outcome was the prevalence of childhood anxiety disorders, determined from the scores on the SCARED instrument.Results:Childhood anxiety disorders prevalence were as follows: 32.7% had one anxiety, 18.4% had 2, 10.9% had 3, 8.1% had 4, and 7.7% had 5. Of note, 22.2% of children did not have an anxiety disorder.Conclusion:Our results reveal a high prevalence of childhood anxiety disorders among primary school age children in Saudi Arabia. Based on these findings, conducting awareness campaigns and providing educational programs on childhood anxiety disorders might be important to improve the health outcomes of children.     

Outcomes of a type 2 diabetes education program adapted to the cultural contexts of Saudi women: A pilot study

Objective:

To explore the outcomes of a pilot intervention of a type 2 diabetes (T2D) education program, based on international standards, and adapted to the cultural and religious contexts of Saudi women.

Methods:

This study is an experiment of a pilot intervention carried out between August 2011 and January 2012 at the primary health clinics in Dammam. Women at risk of or diagnosed with T2D (N=35 including dropouts) were assigned to one of 2 groups; an intervention group participated in a pilot intervention of T2D education program, based on international standards and tailored to their cultural and religious contexts; and a usual care group received the usual care for diabetes in Saudi Arabia. Outcomes included blood glucose, body composition, 6-minute walk distance, life satisfaction, quality of life, and diabetes knowledge. The intervention group participated in a focus group of their program experience. Data analysis was based on mixed methods.

Results:

Based on 95% confidence interval comparisons, improvements were noted in blood sugar, 6-minute walk distance, quality of life, and diabetes knowledge in participants of the intervention group. They also reported improvements in lifestyle-related health behaviors after the education program.

Conclusion:

Saudi women may benefit from a T2D education program based on international standards and adapted to their cultural and religious contexts.Saudi women have a higher prevalence of obesity than men, which increases their risk of type 2 diabetes (T2D).1 The reporting of diabetes is higher in women compared to men in all provinces of Saudi Arabia.1 Diabetes education programs in Saudi Arabia do not target people at risk of diabetes with emphasis on diabetes prevention and feasible changes to lifestyle behaviors.2 Scientific evidence suggests that diabetes education programs based on international standards of lifestyle behaviors, are more effective when tailored to the cultures and religions of targeted groups.3-6 The aim of this study was to explore the outcomes of a pilot intervention of a T2D education program based on international standards and adapted to the cultural and religious contexts of Saudi women. Specifically, whether such a program can impact health outcomes (for example, physical health measures, diabetes knowledge, life satisfaction, and health-related quality of life, diabetes knowledge) in comparison with the usual care of T2D in Saudi Arabia.     

Vitamin B12 deficiency in patients with type 2 diabetes mellitus using metformin and the associated factors in Saudi Arabia

Objectives:To assess the presence of vitamin B12 deficiency among metformin users and associated factors in patients with type 2 diabetes mellitus.Methods:An observational cross-sectional study was conducted with 307 diabetic patients in the primary health care centers at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia between October 2017 and January 2018. Face-to-face interviews were conducted with the participants, using a designed checklist.Results:The prevalence of vitamin B12 deficiency was (3.6%) and the majority of the sample had borderline B12 levels (66.1%). The vitamin B12 deficiency and borderline levels were strongly associated with the dose of metformin. Patients taking doses of metformin more than 1000 mg had lower levels of vitamin B12. The use of multivitamin and vitamin B complex was assessed, and it was found that there was a marked decrease in the prevalence of vitamin B12 deficiency in patients using vitamin B complex containing more than 200 mcg vitamin B12.Conclusion:Our findings show a low prevalence of vitamin B12 deficiency in type 2 diabetic patients taking metformin. The majority of the sample had borderline deficiency; therefore, additional investigation and management are required.     

Blood pressure control among type 2 diabetics

OBJECTIVE: To assess blood pressure (BP) control in patients with diabetes mellitus type 2 (DM type 2) treated in primary health care. METHODS: A cross-sectional study was conducted in primary health care at King Fahad Military Complex Hospital in Dhahran, Kingdom of Saudi Arabia, between August 2003 and February 2004, to assess blood pressure control in type 2 diabetics. A sample of 403 medical records of type 2 diabetic patients was selected using systematic random sampling after ordering the medical record numbers. The data were collected through a pre-coded checklist. RESULTS: Hypertension was found in 57.8% of diabetic patients with no statistically significant difference between males and females. The mean age of diabetic patients was significantly higher in hypertensives than non-hypertensives (p=0.001). The mean duration of hypertension was significantly higher in females (p=0.02). There were only 14.2% of hypertensive diabetic patients in whom blood pressure was controlled. Poor control was significantly associated with obesity, and a higher rate of complications. Blood pressure control correlated positively and significantly with the age of patients, and negatively with duration of diabetes and hypertension. The most commonly prescribed antihypertensive were angiotensin converting enzyme inhibitors in 29.3%, followed by angiotensin receptors blockers in 24.1%, and the least prescribed drug was thiazide diuretic. CONCLUSION: Blood pressure in diabetic patients needs to be given particular attention from all health care professionals, especially primary care family physicians, who should follow the new guidelines for better control of blood pressure, and fewer complications. Patient's awareness should be increased, through continuous health education with different modalities.     

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.