Tooth loss among Saudi adolescents: social and behavioural risk factors

OBJECTIVES: To examine the prevalence of tooth loss in Saudi adolescents, to investigate the reasons behind such loss and to identify any associated social and behavioural factors. METHODS: A cross-sectional study was carried out in the Eastern Province of Saudi Arabia, from March 2006 through January 2007. A total of 484 subjects, aged 14-19-years of age, were included in the study. The subjects had a clinical examination and completed a self-administered questionnaire regarding their demographic, social, oral and general health attitudes. The prevalence and mean tooth loss were calculated, and a binary regression model was used to construct a risk prediction model. RESULTS: A 90% response rate was achieved. The prevalence of tooth loss was 40.9% (n=198). Permanent first molars were the most frequently missing teeth (57.1%). The overall mean tooth loss was 0.83 +/- 1.18. Both the proportion and mean tooth loss were significantly associated with sweet consumption, smoking, tooth brushing, dental flossing, dental visiting pattern and self-rated oral health. In logistic regression analysis, five social and behavioural factors had significant independent effects. CONCLUSIONS: Several socio-behavioural characteristics have been related to the high prevalence of tooth loss among Saudi adolescents. Tooth loss should be urgently addressed through implementation of community preventive programmes in Saudi Arabia.     

The distinguishing anthropometric features of the Saudi Arabian eyes

Purpose

Identifying the peri-ocular anthropometric measurements characteristic of Saudi Arabian eyes.

Methods

A prospective, cohort, hospital-based study.

Results

Measurements were made on 668 subjects (mean age 33.8 years; 58.7% female). The horizontal palpebral aperture was 30.1 ± 2.9 mm (mean ± SD), vertical palpebral aperture was 10.1 ± 0.85 mm, upper lid skin fold height was 3.6 ± 1.9 mm, upper lid crease height was 9.6 ± 0.8 mm, eyebrow height was 10.2 ± 2.7 mm, and intercanthal distance was 32 ± 2.7 mm. There was a statistically significant correlation between gender and eyebrow height (P = 0.001) and gender and horizontal palpebral aperture (P = 0.016), but no significant correlations were noted between any measurement and age.

Conclusions

Saudi Arabian eyes are unique in exhibiting a higher upper lid skin fold, higher lid crease.     

Solitary rectal ulcer syndrome presenting as polypoid mass lesions in a young girl

Solitary rectal ulcer syndrome (SRUS) is a rare condition in children. We report a case of SRUS in an 8-year old Saudi girl who presented with recurrent rectal bleeding, intermittent mucosal prolapse, and passage of mucus per rectum. Colonoscopy revealed multiple polypoid mass lesions with histopathological features of SRUS. The polypoid variant of SRUS is very rare in children and may be confused with rectal malignant or inflammatory conditions.     

Value drivers for pharmaceutical products in health technology assessment (HTA) in Saudi Arabia: Results from a capacity Building,Multi-Stakeholder workshop

ObjectivesCapacity building exercises are important to increase understanding of healthcare processes by key stakeholders, and to facilitate open discussions to build consensus. This study explored the views of a multi-stakeholder group of local Saudi experts on possible value elements that could be important for health technology assessment (HTA) processes and methods regarding pharmaceutical products in Saudi Arabia (‘value drivers’).MethodsA diversified group of local experts were invited to a two-day capacity building workshop from 18 to 19 December 2019 in Riyadh, Saudi Arabia. Information regarding the participants’ demographic and educational/professional background, along with their self-assessed knowledge and experience of HTAs and the concept of value in the pharmaceutical market was collected. For each of 22 value drivers identified during a targeted literature search, participants were asked either to ‘opt out’ of its consideration for future HTA assessments, or rate it from 1 to 10 (low–high) on feasibility and acceptability.ResultsEfficacy and safety were the highest rated value drivers for acceptability and feasibility. Explicit cost-effectiveness thresholds had the lowest ratings for acceptability and feasibility. Participants highlighted data availability and accuracy as a potential challenge to HTA implementation in Saudi Arabia.ConclusionsParticipants valued a pharmaceutical product’s efficacy and safety alongside the consideration of disease characteristics for HTA processes. Participants also valued a binding HTA recommendation and the use of local real-world evidence, where available, to support HTA submissions.     

Clinical pharmacy definition,required education,training and practice in Saudi Arabia: A position statement by the Saudi society of clinical pharmacy

The Saudi Society of Clinical Pharmacy (SSCP) is a scientific and professional society in the field of clinical pharmacy that operates under the Saudi Commission for Health Specialties governance. The SSCP believes that there is a need to define and describe many aspects related to the clinical pharmacy profession in Saudi Arabia. Moreover, there is an increasing demand for promoting the concept of clinical pharmacy and developing a consensus regarding the scope of practice and clinical pharmacist's required postgraduate education and training in Saudi Arabia. This paper is intended to present several position statements by the SSCP that define the concept of clinical pharmacy, describe the required education and training, and highlight clinical pharmacists' scope of practice in Saudi Arabia. This paper calls for further investigations that examine the impact of clinical pharmacists on individual and population health levels.     

Reference values for the Modified Timed Up and Go Test in Saudi children aged 4–12 years old in Riyadh city: cross-sectional study

PurposeThe study aimed to report within-session reliability, estimate the reference values for the Modified Timed Up and Go (mTUG) test in typically developing (TD) Saudi children aged 4–12 years old, develop a reference equation for the estimated mTUG, and compare the measured mTUG in the present study with the predicted mTUG obtained from the previous regression equation.MethodsIn this cross-sectional observational study, anthropometric measurements and mTUG test were investigated in 805 child. The association between the mTUG test and predictive variables was studied.ResultsAverage mTUG speed was 4.63 ± 0.68 s. Within-session reliability was excellent with intraclass correlation coefficient of 0.90. The test was significantly and negatively correlated with age, height, and weight (r = −0.66, p = .00), (r = −0.54, p = .01), and (r = −0.33, p = .01) respectively. According to the stepwise regression analysis, age and weight were the predictors and explained 47% of total variance of mTUG scores.ConclusionThis study provided the mTUG reference values that can be used clinically to evaluate functional mobility and dynamic balance in TD Saudi children aged 4–12 years. The mTUG scores can be predicted as a function of age and weight.

KEY MESSAGES

• Modified Timed Up and Go test used to assess the functional mobility and dynamic balance for children with or without developmental abnormalities.
• Availability of reference values according to age is helpful to compare the performance of children at same ages.

     

Prevalence of malocclusion among children of the Kingdom of Saudi Arabia – A systematic review and meta-analysis

ObjectiveSystematic review and meta-analysis are of a great tool in assessment of malocclusion, which is major public health concern. This study aims to explore the prevalence of malocclusion among the children of the Kingdom of Saudi Arabia through a meta-analysis and systematic review.Materials and methodsRegistered with PROSPERO as CRD42020198427, an authentic and global scale database search using relevant MeSH (Medical Subject Headings) terms was performed. Literature search and articles screening done following PRISMA guidelines.For the dichotomous variables, 95% confidence intervals (CIs) were set for statistical data analysis. The heterogeneity index between the studies was determined using indices Tau², Chi², df and I² and Test for overall effect as Z.ResultsA total of 7930 candidates were reported to have either one of the three malocclusions. Prevalence of Class I, Class II and Class III Malocclusions were found to be 66.51%, 17.70%, 15.79% respectively. Among the small subsample of these candidates, male children with Class I, Class II and Class III Malocclusion were 43.80%, 12.27% and 7.40% respectively whereas female children were 22.07%, 10.93 %, 3.52 % respectively.ConclusionsAccording to the 26 studies included in the systematic review, there were 72% of the candidates with malocclusion in Saudi Arabia. Prevalence of Class I, Class II and Class III malocclusion were 66.51%, 17.70%, and 15.79% respectively. In both male and female participants, the prevalence of Class I was the highest followed by class II and III malocclusion.     

The Potential Role of PTPN-22 C1858T Gene Polymorphism in the Pathogenesis of Type 1 Diabetes in Saudi Population

Background: Recent investigations have reported an association between protein tyrosine phosphatase non-receptor type-22 (PTPN-22) gene polymorphism and susceptibility to the development of type 1 diabetes (T1D) in some populations and not in others. In this study, we aimed to investigate the association of PTPN-22 C1858T polymorphism with T1D in Saudi children.

Methods: A cohort of 372 type 1 diabetic children and 372 diabetes-free subjects was enrolled in the current investigation. The PTPN-22 C1858T polymorphism was identified using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

Results: Our data showed that the frequency of CT and TT genotypes of PTPN-22 C1858T was higher in T1D children (17.7% and 4.3%, respectively) compared to healthy controls (4.8% and 1.6%, respectively), and both genotypes were statistically associated with T1D patients (OR = 4.4, 95% CI: 2.55–7.58, p < 0.001; and OR = 3.2, 95% CI: 1.23–8.28, p = 0.017, respectively). Moreover, the 1858T allele was significantly associated with T1D patients compared to the C allele (OR = 3.2, 95% CI: 1.59–6.88, p < 0.001). In addition, the T allele was significantly associated with elevated levels of HbA1c, anti-GAD, and anti-insulin antibodies (p < 0.001) and a lower concentration of C-peptide (p < 0.001) in T1D children.

Conclusion: The data presented here suggests that the T allele of PTPN-22 C1858T polymorphism might be a risk factor for T1D development in Saudi children.     

Rates,levels, and determinants of electronic health record system adoption: A study of hospitals in Riyadh,Saudi Arabia

ObjectiveOutside a small number of OECD countries, little information exists regarding the rates, levels, and determinants of hospital electronic health record (EHR) system adoption. This study examines EHR system adoption in Riyadh, Saudi Arabia.Materials and methodsRespondents from 22 hospitals were surveyed regarding the implementation, maintenance, and improvement phases of EHR system adoption. Thirty-seven items were graded on a three-point scale of preparedness/completion. Measured determinants included hospital size, level of care, ownership, and EHR system development team composition.ResultsEleven of the hospitals had implemented fully functioning EHR systems, eight had systems in progress, and three had not adopted a system. Sixteen different systems were being used across the 19 adopting hospitals. Differential adoption levels were positively related to hospital size and negatively to the level of care (secondary versus tertiary). Hospital ownership (nonprofit versus private) and development team composition showed mixed effects depending on the particular adoption phase being considered.DiscussionAdoption rates compare favourably with those reported from other countries and other districts in Saudi Arabia, but wide variations exist among hospitals in the levels of adoption of individual items. General weaknesses in the implementation phase concern the legacy of paper data systems, including document scanning and data conversion; in the maintenance phase concern updating/maintaining software; and in the improvement phase concern the communication and exchange of health information.ConclusionThis study is the first to investigate the level and determinants of EHR system adoption for public, other nonprofit, and private hospitals in Saudi Arabia. Wide interhospital variations in adoption bear implications for policy-making and funding intervention. Identified areas of weakness require action to increase the degree of adoption and usefulness of EHR systems.     

Identification of Two Homozygous Sequence Variants in the COL7A1 Gene Underlying Dystrophic Epidermolysis Bullosa by Whole‐Exome Analysis in a Consanguineous Family

Dystrophic epidermolysis bullosa (DEB) is an inherited skin disorder with variable severity and heterogeneous genetic involvement. Diagnostic approaches for this condition include clinical evaluations and electron microscopy of patients’ skin biopsies, followed by Sanger sequencing (SS) of a large gene (118 exons) that encodes the alpha chain of type VII collagen (COL7A1) located on Chromosome 3p21.1. However, the use of SS may hinder diagnostic efficiency and lead to delays because it is costly and time‐consuming. We evaluated a 5‐generation consanguineous family with 3 affected individuals presenting the severe generalised DEB phenotype. Human whole‐exome sequencing (WES) revealed 2 homozygous sequence variants: the previously reported variant p.Arg578* in exon 13 and a novel variant p.Arg2063Gln in exon 74 of the COL7A1 gene. Validation by SS, performed on all family members, confirmed the cosegregation of the 2 variants with the disease phenotype. To the best of our knowledge, 2 homozygous COL7A1 variants have never been simultaneously reported in DEB patients; however, the upstream protein truncation variant is more likely to be disease‐causing than the novel missense variant. WES can be used as an efficient molecular diagnostic tool for evaluating autosomal recessive forms of DEB.