Original Article--Surgical site infections following pediatric cardiac surgery in a tertiary care hospital: Rate and risk factors

BackgroundSurgical site infections [SSIs] are the second most common type of healthcare-associated infections and leading cause of postoperative morbidity and mortality in pediatric cardiac surgery. This study aims to determine the rate of, risk factors for, and most common pathogen associated with the development of SSIs after pediatric cardiac surgery.MethodsPatients aged ≤14 years who underwent cardiac surgery at our tertiary care hospital between January 2010 and December 2015 were retrospectively reviewed.ResultsThe SSI rate was 7.8% among the 1510 pediatric patients reviewed. Catheter-associated urinary tract infection [CAUTI] [odds ratio [OR] 5.7; 95% confidence interval [CI] 2.3–13.8; P < 0.001], ventilator-associated pneumonia [VAP] [OR 3.2; 95% CI 1.4–7.2; P = 0.005], longer postoperative stay [≥25 days] [OR 4.1; 95% CI 2.1–8.1; P < 0.001], and a risk adjustment in congenital heart surgery [RACHS-1] score of ≥2 [OR 2.4; 95% CI 1.2–5.6; P = 0.034] were identified as risk factors for SSIs. Staphylococcus aureus was the most common pathogen [32.2%].ConclusionsSSI risk factors were longer postoperative stay, CAUTI, VAP, and RACHS-1 score of ≥2. Identification and confirmation of risk factors in this study is important in order to reduce the rate of SSIs following cardiac surgery.     

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.     

Relationships among consanguinity,family history,and the onset of type 1 diabetes in children from Saudi Arabia

AimsWe aimed to demonstrate the relationship between parental consanguinity and positive family histories of type 1 diabetes mellitus (T1DM) and autoimmune disease and the development of T1DM among children in Saudi Arabia.MethodsThis was a cross-sectional case-control study. In total, 192 patients and 188 healthy controls were enrolled from the Pediatric Diabetes Clinic at King Salman Military Hospital between January 2000 and December 2010. Detailed patients’ data recorded while distributing questionnaires to control samples included various gradations of consanguinity and family histories of T1DM and autoimmune disease.ResultsParental consanguinity was not significantly associated with T1DM; however, children of first-cousin parents showed a higher risk of developing T1DM than did children of second-cousin parents. The presence of a family history of T1DM significantly differed between those with and without T1DM (p < 0.05). No association was observed between a family history of autoimmune disorders and the development of T1DM.ConclusionsParental consanguinity and family history of autoimmunity were not clearly linked to T1DM development in children, indicating that T1DM is a multifactorial disease. A history of affected first-cousin parents increases the risk of T1DM.     

Prevalence of impacted third molars and the reason for extraction in Saudi Arabia

PurposeThis study aims to record the current pattern of third molar impactions and relevant reasons for extraction in Riyadh, Saudi Arabia. We hypothesized that the principal reason for extraction was elective.Material and MethodsOrthopantomograms (OPG) radiographs and electronic files relating to 4000 patients were retrospectively collected from patients between the ages of 21 and 50 years old. Of these, 1014 were included in this study (514 females, 500 males). The classification was determined according to the Winter, Pell, and Gregory classification. The analysis was done using the chi-square (χ²) test, with SPSS version 25 (IBM, Inc, Chicago, IL). A p-value of < 0.05 was considered statistically significant.ResultsA total of 2240 impacted third molars were found with no gender predilection. Impaction was more commonly found in the mandible (58.5%) than the maxilla (41.5%). The most common reason for extraction was ‘asymptomatic; prophylactic indication’ (66.8%), followed by ‘symptomatic’ (33.2%). Vertical angulation was most common in the maxilla (56.5%), and mesioangular impaction in the mandible (40.5%).ConclusionThere is a high rate of third molar impaction in the central region of Saudi Arabia. It is more likely to occur in the mandible than the maxilla with no gender predilection. The majority of the patients were referred for elective asymptomatic reasons. Mesio-angular impaction is mostly found in the mandible and vertical angulation in the maxilla. Both arches had a C level depth and Class I Ramus relationship. Further studies should be conducted with the wider Kingdom of Saudi Arabia so that the population can be more accurately represented.     

Prevalence of primary dysmenorrhea and its effect on the quality of life amongst female medical students at King Saud University,Riyadh, Saudi Arabia: A cross-sectional study

Objectives:To quantify the prevalence of primary dysmenorrhea, study its associated factors, and to assess its effect on the quality of life of female medical students.Methods:A cross-sectional study was conducted among 376 female medical students at King Saud University student campus and King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, between September 2017 and May 2018. The study was conducted using a consecutive, non-random sampling technique.Results:The prevalence of primary dysmenorrhea among female medical students was 80.1%; most of the participants (n=134) reported moderate pain (49.8%). Primary dysmenorrhea was significantly associated with caffeine consumption (p<0.05) and did not show an association with factors, body mass index, diet, lack of physical activity, and smoking. Among the SF-36 domains, the 4 domains physical health (p<0.001) and emotional health (p=0.01) including health changes (p=0.033) and pain (p<0.001) were statistically significantly affected by dysmenorrhea. Primary dysmenorrhea also had a significant impact on the students’ academic performance where a higher proportion of students suffering from primary dysmenorrhea showed negative effects on their attendance, concentration, study time, and participation in class.Conclusion:Most female medical students suffer from primary dysmenorrhea, which adversely affects their quality of life and academic performance. Caffeine consumption demonstrated a significant association with primary dysmenorrhea. Periodical awareness programs to minimize the consequences of primary dysmenorrhea should be introduced.