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

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

Academic advising and student support: Help-seeking behaviors among Saudi dental undergraduate students

Objective

The purpose of this study was to assess the use of and satisfaction with the academic-advising and student-support systems available to undergraduate students in the College of Dentistry at the University of Dammam. In addition, the study aimed to also identify factors that explained the help-seeking behavior of students which they used to solve academic issues.

Materials and methods

Students enrolled in the five-year Bachelor of Dental Surgery (BDS) program in 2012–13 and 2013–14 first-year students were invited to respond to a self-administered questionnaire.

Results

The results showed that 66.2% of students had discussed academic issues with their advisor at least once, with a frequency ranging from zero to six times. Most students reported that their advisors were readily available, listened intently to their needs and questions, and helped them solve their problems. However, only 7.6% of students relied primarily on advisors for help with academic issues, whereas 51% depended first on colleagues and 13.8% did not seek help and relied on themselves. In total, 17.2% of students were very or somewhat satisfied with the academic advising system. Males had lower odds of discussing issues with their advisors, and the odds were higher with advisors who were more available (OR = 0.25 and 3.74, respectively). Alerting students to important dates in the academic calendar significantly increased the odds that a student would depend primarily on academic advisors for advice related to academic issues (OR = 6.53).

Conclusions

Few students were satisfied with the academic support system. We need to train advisors to help them develop their skills and knowledge and to enable them to provide the support needed by the students.     

Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia

Objectives:

To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA).

Methods:

In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 (Phase 1). From the case files, we obtained information related to patients’ age, gender, weight, presenting complaints, serum biochemical profile, and management.

Results:

This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]:8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p<0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR:2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours.

Conclusion:

The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies.Diabetes mellitus (DM) is an endocrine disease affecting millions of children worldwide.1-3 Diabetic ketoacidosis (DKA) is one of the serious complication of diabetes in the pediatric population,4 and its prevalence increases by an annual rate of 3% worldwide.3 It is associated with significant risk of life threatening complications.5-8 The criteria for diagnosis of DKA in children by the International Society for Pediatric and Adolescent Diabetes describes DKA as blood glucose >11 mmol/L, venous pH <7.3, or bicarbonate <15 mmol/L, and ketonemia with ketonuria.9 Previous studies1,2 have reported characteristics of DKA patients based on different geographical areas. Overall, there is a paucity of literature on this particular aspect. The aim of this study was to assess pediatric patients presenting with DKA regarding aspects of demographics, presentation, investigations, and management in the Kingdom of Saudi Arabia (KSA).     

Preoperative duplex ultrasound parameters predicting male fertility after successful varicocelectomy

Objectives:

To assess duplex ultrasound (DUS) parameters, and predicti the outcome of varicocele ligation in male infertility.

Methods:

This retrospective and follow up study was conducted at Dr. Sulaiman Al Habib Hospital, AlQassim, Saudi Arabia between January 2011 and December 2012. Eighty-two patients were selected, who presented with clinical/subclinical varicocele and male infertility. All these patients had DUS of the scrotum and underwent for low ligation varicocelectomy. These patients were followed for a period of 12-24 months after surgery for the occurrence of paternity. We reviewed pre-operative scrotal DUS of these 82 patients for the testicular size and volume, pampiniform veins caliber and duration of reflux in the dilated veins at rest, and after valsalva maneuver. These DUS parameters were correlated with the postoperative paternity rate.

Results:

Postoperative paternity was achieved in 18 patients (31.6%) with normal-sized testes, and in 3 patients (12%) with small size testes. The positive paternity rate was higher (38.5%) in patients with clinically detected varicocele, compared with only 16.7% of patients with subclinical varicocele (detected by ultrasound only). In addition, postoperative paternity was significantly higher in patients with bilateral varicocele (70.6%), with shunt-type varicocele (71.4%), and patients with a permanent grade of venous reflux (62.5%).

Conclusion:

Selection of patients for the successful paternity after varicocele repair depends mainly on DUS parameters, which includes normal size testicles with shunt type of bilateral varicocele and continuous reflux.Varicocele is defined as dilatation of the pampiniform venous plexus draining the testes. It is much more common on the left side compared with the right side, owing to long length of left testicular vein, the acute angle of insertion of left testicular vein into the left renal vein, lack of effective anti-reflux valves, which may transmit the high pressure of renal vein, making left testicular vein more vulnerable to varicocele.1,2 Varicocele is the most frequently identified male factor for infertility, present in up to 40% of cases. Long duration persistent varicocele is associated with adverse effects on sperm count, sperm motility and morphology, decrease testicular size, abnormal testosterone hormone level and decrease pregnancy rates.3-5 Scrotal physical examination is the preferred method for the diagnosis of varicocele. The Dubin grading system classifies the varicocele into 3 grades. Grade 1: varicocele is visible and palpable at rest; Grade 2: varicocele is palpable, but not visible; and Grade 3: varicocele is palpable only during valsalva maneuver. Duplex ultrasound (DUS) allows accurate diagnosis of varicoceles, even subclinical varicocele, which is not apparent on physical examination. Duplex ultrasound is performed at rest and during Valsalva maneuver.6,7 The scrotal vessels are assessed for the degree of dilatation, augmentation and direction of flow during Valsalva and duration of reflux. In this way, CDU is helpful to select the patient for varicocele repair.8-11 Many studies following varicocelectomy have reported approximately 66-70% improvement in semen parameters and 40-60% of patients have increased conception rates.12-15 Although, the outcome and prognosis after varicocelectomy are still controversial, and there are many preoperative parameters that determine the probability of success of the operation.16-18 There is a great need for research to improve preoperative selection of patients with varicocele. This study was carried out to assess the DUS (DUS includes grey scale ultrasound and color doppler ultrasound) parameters including the testicular size, degree of varicocele, type, and duration of reflux that could predict the outcome of varicocele repair in terms of paternity.     

Ultra-fast,low dose high-pitch (FLASH) versus prospectively-gated coronary computed tomography angiography: Comparison of image quality and patient radiation exposure

Background

Coronary computed tomography angiography (CCTA) is increasingly being used for the evaluation of coronary artery disease; however, radiation exposure remains a major limitation of its use.

Antipyretic,anti-inflammatory and analgesic activity of <Emphasis Type="Italic">Acacia hydaspica</Emphasis> R. Parker and its phytochemical analysis

Background

Inflammation and pain underlies several pathological conditions. Synthetic drugs used for the management of these conditions carry severe toxic effects. Globally efforts are ongoing to introduce novel medicinal plants to develop effective, economic and innocuous drugs. The current study was aimed at investigating the antipyretic, anti-inflammatory and analgesic activity of methanol extract of A. hydaspica aerial parts (AHM) and its active fraction. Furthermore identification and isolation of polyphenolic compounds was carried out to identify the active principles.

Methods

Yeast induced pyrexia, Paw edema, acetic acid-induced writhing and hot plate test were carried out in vivo. HPLC-DAD analysis and combination of different chromatographic techniques, involving vacuum liquid chromatography (VLC) and flash chromatography (FC) were carried out for chemical characterization. The structural heterogeneity of flavanols was characterized by ESI- MS, ¹H NMR, ¹³C NMR and ²D NMR spectroscopic analyses, and also by comparison with reported literature.

Results

Oral administration of A. hydaspica methanol extract (AHM) and A. hydaspica ethyl acetate fraction (AHE), showed dose and time dependent decrease in body temperature in yeast induced pyrexia, comparable to standard, Paracetamol. AHM and AHE (150 mg/kg) significantly (p?<?0.001) inhibit pain sensation in various pain models, i.e. acetic acid induced writhing and hot plate test. Similarly AHM and AHE demonstrated an anti-inflammatory effect in carrageenan-induced paw edema in rats and 150 mg/kg dose being distinctly more effective (91.92% inhibition). When studied on prostaglandin E₂ (PGE₂) induced edema in rats, AHM and AHE showed maximum inhibition of edema at 150 mg/kg after 4 h. HPLC chromatogram of AHM revealed the presence of gallic acid, catechin, rutin and caffeic acid. Chromatographic separation and structure characterization of AHE, has led to the identification of three flavan-3-ol derivative including 7-O-galloyl catechin, +catechin and methyl gallate, which have been reported for the first time in A. hydaspica.

Conclusion

These results revealed that the presence of bioactive compounds in A. hydaspica might be responsible for the pharmacological activities, confirming the indigenous utility of A. hydaspica against inflammatory disorders.

     

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.Key words: Acute stroke, Mirror therapy, Upper extremity     

Association of Help-seeking Behavior with Depression and Anxiety Disorders among Gastroenterological Patients in Saudi Arabia

Background/Aims:

There is a high prevalence of depression and anxiety disorders among gastroenterological outpatients. Relatively few studies have been done on the help-seeking behavior among those who suffer from gastrointestinal symptoms with or without psychiatric disorders. We aimed to characterize the help-seeking behavior of gastroenterological outpatients and to evaluate if this behavior is linked to the presence of depression and anxiety.

Patients and Methods:

A cross-sectional study was carried out in gastroenterology clinics in four hospitals in Riyadh between February and September 2013. A self-administrated questionnaire was developed and administered to patients. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to diagnose depression and anxiety, respectively.

Results:

A total of 440 patients completed the study questionnaire. The average age was 36.0 ± 12.8 years and 69% of the patients were males. Complaints included abdominal pain (58%), heartburn (29%), diarrhea or constipation (25%), appetite or weight changes (22%), and nausea or vomiting (16%). Depression was diagnosed in 36%, while anxiety was diagnosed in 28% of the patients. The first intervention was use of medications (68%) and undergoing endoscopy (16%), while few patients initially used herbs or Islamic incantation (7.5%). This first intervention was done primarily (59%) in private sector hospitals rather than government sector hospitals (36%). The rates of depression and anxiety in our patients were higher among those who suffered from multiple complaints for longer durations and with less satisfaction with the offered services.

Conclusion:

Depression and anxiety are common comorbidities in gastroenterological outpatient population, especially those who have a chronic course of multiple gastrointestinal complaints.