Zohair Al aseri - Academia.edu (original) (raw)

Papers by Zohair Al aseri

BioMed Research International

Objective. This study was aimed at evaluating the knowledge and behavior toward venous thromboemb... more Objective. This study was aimed at evaluating the knowledge and behavior toward venous thromboembolism (VTE) prophylaxis among medical interns. Methods. This is a questionnaire-based cross-sectional observational cohort study of medical interns that used a validated questionnaire. The questionnaire comprised of items that assessed behavior, knowledge, and self-assessment of VTE risk factors, diagnosis, and prophylaxis. The study was conducted in Riyadh, Saudi Arabia, from October 2020 till September 2021. Results. The respondents were 246 medical interns. The overall rate of correct responses to behavior items was 41.82%. The overall rate of correct responses to knowledge items was 47.35%. A total of 61.8% responded negatively to the use of VTE risk assessment guidelines ( p < 0.0001 ). For the self-assessment of knowledge of VTE, more than 70% believed they did not have appropriate knowledge, were not prepared to establish the risk of VTE, and were not prepared to provide adequa...

Trials, 2022

Background Noninvasive respiratory support is frequently needed for patients with acute hypoxemic... more Background Noninvasive respiratory support is frequently needed for patients with acute hypoxemic respiratory failure due to coronavirus disease 19 (COVID-19). Helmet noninvasive ventilation has multiple advantages over other oxygen support modalities but data about effectiveness are limited. Methods In this multicenter randomized trial of helmet noninvasive ventilation for COVID-19 patients, 320 adult ICU patients (aged ≥14 years or as per local standards) with suspected or confirmed COVID-19 and acute hypoxemic respiratory failure (ratio of arterial oxygen partial pressure to fraction of inspired oxygen < 200 despite supplemental oxygen with a partial/non-rebreathing mask at a flow rate of 10 L/min or higher) will be randomized to helmet noninvasive ventilation with usual care or usual care alone, which may include mask noninvasive ventilation, high-flow nasal oxygen, or standard oxygen therapy. The primary outcome is death from any cause within 28 days after randomization. The...

Neurosciences, 2021

The data were analyzed using SPSS version 21.0. Appropriate statistical tests)chi-square and Fish... more The data were analyzed using SPSS version 21.0. Appropriate statistical tests)chi-square and Fisher's exact test(were used for bivariate analyses. Results: A total of 3932 stroke patient visits were recorded in 37 hospitals in the central region of Saudi Arabia. The most common limitations of acute stroke services were that 25)67.57%(of the hospitals had no stroke unit and 21)56.76%(had inadequate clinical staff. Magnetic resonance imaging and computed tomography were available in 32)86.49%(and 36)97.30%(hospitals, respectively. Only two-thirds of hospitals 25)67.57%(followed protocols for rapid Emergency Department)ED(triage. Conclusion: We found that most of our hospitals were not fully prepared to address acute stroke management in a manner that was reasonably consistent with international guidelines. We recommend raising the hospital's requirements a higher level to be in line with the stroke guidelines.

BMC Public Health, 2021

Background The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged initially in ... more Background The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged initially in China in December 2019 causing the COVID-19 disease, which quickly spread worldwide. Iran was one of the first countries outside China to be affected in a major way and is now under the spell of a fourth wave. This study aims to investigate the epidemiological characteristics of COVID-19 cases in north-eastern Iran through mapping the spatiotemporal trend of the disease. Methods The study comprises data of 4000 patients diagnosed by laboratory assays or clinical investigation from the beginning of the disease on Feb 14, 2020, until May 11, 2020. Epidemiological features and spatiotemporal trends of the disease in the study area were explored by classical statistical approaches and Geographic Information Systems. Results Most common symptoms were dyspnoea (69.4%), cough (59.4%), fever (54.4%) and weakness (19.5%). Approximately 82% of those who did not survive suffered from dyspnoea. The ...

Journal of Affective Disorders, 2007

Background: We examined the performance the Beck Depression Inventory (BDI) and its short form (B... more Background: We examined the performance the Beck Depression Inventory (BDI) and its short form (BDI-FS) and the Hospital Anxiety and Depression Scale depression (HADS-D) and anxiety (HADS-A) subscales in detecting depression in a group of patients with hepatitis C. Methods: SCID-CV was used to establish DSM-IV diagnosis. Sensitivity, specificity, positive and negative predictive values were used to assess test performance and Cohen's Kappa to measure agreement with DSM diagnosis. Results: Twenty-five of 88 participants had a DSM-IV depressive diagnosis. There was considerable non-overlap between 'caseness' on the BDI and HADS (Kappa = 0.44). The HADS depression subscale had poor sensitivity (52%) and poor agreement with clinical diagnosis (Kappa = 0.35). The full BDI had a sensitivity of 88% and a Kappa of 0.54 against a sensitivity of 84% and Kappa of 0.42 for the short form. The HADS anxiety subscale predicted depression as well as the depression subscale (sensitivity 88%, Kappa 0.47). Conclusions: Neither the BDI nor the HADS agrees well with the clinical diagnosis of depressive disorder, nor do they agree well with one another. The anxiety subscale of the HADS appears to measure depression at least as well as the depressive subscale.

European Heart Journal, 2007

To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term ... more To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. Methods and results We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with STEMI onset ,12 h and hs-C-reactive protein determination on admission. Patients were classified into four groups [I (hs-C-reactive protein , 0.48 mg/dL), II (hs-C-reactive protein ! 0.48 to ,1.2 mg/dL), III (hs-C-reactive protein ! 1.2 to ,3.1 mg/dL), IV (hs-C-reactive protein ! 3.1 mg/dL)] according to quartiles of hs-C-reactive protein serum level. The IV quartile hs-C-reactive protein group had a higher incidence of in-hospital mortality and cumulative adverse events. At a mean follow-up of 724 + 376 days (range 0-1393), the IV quartile hs-C-reactive protein group showed lower estimated survival, lower estimated myocardial infarction-free survival and lower estimated event-free survival. At multivariable analysis hs-C-reactive protein appeared to be an independent predictor of long-term mortality (HR: 1.04, 95% CI: 1.01-1.07, P ¼ 0.003), long-term mortality and re-infarction (HR: 1.03, 95% CI: 1.01-1.06, P ¼ 0.008) and adverse events (HR: 1.03, 95% CI: 1.01-1.05, P ¼ 0.03). Conclusion Evaluation of hs-C-reactive protein on admission in STEMI patients undergoing primary PCI allows reliable risk stratification of these patients.

Depression and Anxiety, 2013

Saudi Critical Care Journal, 2017

Healthcare organizations around the globe are increasingly turning to multicenter quality improve... more Healthcare organizations around the globe are increasingly turning to multicenter quality improvement collaboratives (QICs) to improve patient care and outcomes. Despite the increase in demand and popularity of establishing multi-organizational QICs, there is limited evidence of these collaboratives in Saudi Arabia and in the Middle Eastern region. This article highlights the main components of successful QICs, recommendations to ensure successful QICs, and implications for establishing future collaboratives in Saudi Arabia.

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2011

ST segment elevation of more than 1 mm from the baseline is an electrocardiographic presentation ... more ST segment elevation of more than 1 mm from the baseline is an electrocardiographic presentation of acute myocardial injury. This phenomenon is not confined only to ischemic injury, and various other etiological factors have been described in relation to ST segment elevation. We report the case of a young man who presented in the emergency department complaining of loin pain. He was subsequently found to have transient ST segment elevation, but a thorough evaluation showed no evidence of coronary artery disease. ST segment elevation is one of the best tools for diagnosing acute myocardial infarction, of which reperfusion therapy is the treatment of choice thus making it important to make the diagnosis as quickly as possible. It is equally important, however, not to misdiagnose acute myocardial infarction, as there are other causes of ST segment elevation. Therefore, we report this unique case of renal pain due to stone causing ST segment elevation.

Saudi Critical Care Journal, 2020

Preparedness for coronavirus disease 2019 (COVID-19) started early in the Kingdom of Saudi Arabia... more Preparedness for coronavirus disease 2019 (COVID-19) started early in the Kingdom of Saudi Arabia before the World Health Organization declared COVID-19 as a pandemic. In this article, we narratively describe critical care surge planning in Saudi Arabia from an organizational perspective. In Saudi Arabia, the surge capacity response focused on seven domains, critical care surge capacity codes, communications, staff, space structure, supply, and strategies.

OBJECTIVE To determine high sensitivity C-reactive protein (hsCRP) levels in patients with acute ... more OBJECTIVE To determine high sensitivity C-reactive protein (hsCRP) levels in patients with acute myocardial infarction (AMI) and its correlation with classical enzyme markers of myocardial damage. STUDY DESIGN Observational study. PLACE AND DURATION OF STUDY Department of Emergency Medicine at King Khalid University Hospital, King Saud University, Riyadh and Department of Physiology, from August 2010 to December 2011. METHODOLOGY Consecutive eligible patients with either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI) who were admitted to the Emergency Department of King Khalid University Hospital were recruited. A total of 71 subjects were finally selected for the study. The hsCRP, Troponin I (Trop I), creatine kinase myocardial bound (CK-MB), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) concentrations of all patients with an acute myocardial infarction (AMI) were measured. RESULTS Among all patients 34 (47.9%) patie...

Background: There is intense interest in the use of high-sensitivity C-reactive protein (hsCRP) f... more Background: There is intense interest in the use of high-sensitivity C-reactive protein (hsCRP) for risk assessment. Elevated hsCRP concentrations early in acute coronary syndrome (ACS), prior to the tissue necrosis, may be a surrogate marker for cardiovascular co-morbidities. Objective: Therefore we aimed to study different follow up measurements of hsCRP levels in acute coronary syndrome patients and to compare the difference between non-ST elevation myocardial infarction (NSTEMI) and ST myocardial infarction (STEMI) patients. Methods: This is an observational study. Of the 89 patients recruited 60 patients had acute myocardial infarction (AMI). Three serial hsCRP levels at baseline on admission to hospital before 12 hours of symptom onset, peak levels at 36-48 hours and follow up levels after 4-6 weeks were analyzed and compared between non-ST elevation AMI and ST elevation AMI. Results: STEMI patients had significantly higher BMI compared to NSTEMI patients. Creatine kinase myoc...

High-flow nasal cannula (HFNC) is a noninvasive oxygenation modality that delivers heated and hum... more High-flow nasal cannula (HFNC) is a noninvasive oxygenation modality that delivers heated and humidified oxygen. It possesses several advantages due to the unique physiological effects on the lung and ventilation mechanics compared to other modes of oxygen therapy. The use of HFNC is tolerable, comfortable, and easy to set up. Current evidence indicates that the use of HFNC in critically ill patients with coronavirus disease 2019 (COVID-19)-acute hypoxemic respiratory failure (AHRF) is noninferior to noninvasive ventilation in the reduction of endotracheal intubation rate. Early identification of HFNC failure is vital to avoid delaying intubation. However, multiple knowledge gaps exist, and unpowered observational studies limit HFNC incorporation into strong recommendations. The low dispersion of particles demonstrates the feasibility of HFNC; yet, an appropriate setting and precautions should be maximized. Here, we review the recent evidence of HFNC implications in the management o...

Background Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary... more Background Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary resuscitation being performed. We aimed to assess knowledge of cardiopulmonary resuscitation among individuals in Riyadh City, Saudi Arabia, who are not involved in health care. Methods A community-based cross-sectional study was conducted between January and February 2020 in 4 different areas in Riyadh City: North, South, East, and West. The participants were surveyed using a validated self-administered questionnaire. The Statistical Package for Social Sciences version 25.0 was used for inferential statistics and binary logistic regression analysis. Results A total of 856 participants completed the questionnaire, 51.8% were unaware of cardiopulmonary resuscitation. Only 4.4% of the participants had attended a formal cardiopulmonary resuscitation training course, 5.1% were campaign attendees, and 38.7% acquired their experience through the media. Having a higher level of education was p...

Critical Care Explorations

Supplemental Digital Content is available in the text. Objectives: Given the numerous recent chan... more Supplemental Digital Content is available in the text. Objectives: Given the numerous recent changes in ICU practices and protocols, we sought to confirm whether favorable effects of telemedicine ICU interventions on ICU mortality and length of stay can be replicated by a more recent telemedicine ICU intervention. Design, Setting and Patients: Observational before-after telemedicine ICU intervention study in seven adult ICUs in two hospitals. The study included 1,403 patients in the preintervention period (October 2014 to September 2015) and 14,874 patients in the postintervention period (January 2016 to December 2018). Intervention: Telemedicine ICU implementation. Measurements and Main Results: ICU and hospital mortality and length of stay, best practice adherence rates, and telemedicine ICU performance metrics. Unadjusted ICU and hospital mortality and lengths of stay were not statistically significantly different. Adjustment for Acute Physiology and Chronic Health Evaluation Version IVa score, ICU type, and ICU admission time via logistic regression yielded significantly lower ICU and hospital mortality odds ratios of 0.58 (95% CI, 0.45–0.74) and 0.66 (95% CI, 0.54–0.80), respectively. When adjusting for acuity by comparing observed-over-expected length of stay ratios through Acute Physiology and Chronic Health Evaluation IVa methodology, we found significantly lower ICU and hospital length of stay in the postintervention group. ICU mortality improvements were driven by nighttime ICU admissions (odds ratio 0.45 [95% CI, 0.33–0.61]) as compared to daytime ICU admissions (odds ratio 0.81 [95% CI, 0.55–1.20]), whereas hospital mortality improvements were seen in both subgroups but more prominently in nighttime ICU admissions (odds ratio 0.57 [95% CI, 0.44–0.74]) as compared to daytime ICU admissions (odds ratio 0.73 [95% CI, 0.55–0.97]), suggesting that telemedicine ICU intervention can effectively supplement low intensity bedside staffing hours (nighttime). Conclusions: In this pre-post observational study, telemedicine ICU intervention was associated with improvements in care standardization and decreases in ICU and hospital mortality and length of stay. The mortality benefits were mediated in part through telemedicine ICU supplementation of low intensity bedside staffing hours.

Background and objective Noninvasive respiratory support is frequently needed for patients with a... more Background and objective Noninvasive respiratory support is frequently needed for patients with acute hypoxemic respiratory failure due to coronavirus disease 19 (COVID-19). Helmet noninvasive ventilation having multiple advantages over other support modalities but data about effectiveness are limited. Methods In this multicenter randomized trial of helmet non-invasive ventilation for COVID-19 patients (Helmet-COVID), 320 adult ICU patients with suspected or confirmed COVID-19 and acute hypoxemic respiratory failure (with a ratio of arterial oxygen partial pressure to fraction (percent) of inspired oxygen (PaO2/FiO2) <200 despite supplemental oxygen with a partial/non-rebreathing mask at a flow rate >10 L/min or above) will be randomized to helmet-noninvasive ventilation with usual care or usual care alone. The primary outcome is death from any cause within 28 days after randomization. The trial has 80% power to detect a 15% absolute risk reduction from 40% to 25%. Conclusion ...

Infections and Sepsis Development

Diagnosis of organ hypoperfusion in patient with sepsis is not always straightforward which makes... more Diagnosis of organ hypoperfusion in patient with sepsis is not always straightforward which makes septic shock definition, diagnosis, and early treatment are major challenges that emergency physicians and intensivist must deal with in their daily practice. Normal blood pressure does not always mean good organ perfusion, which means patient might develop septic shock, yet they are not hypotensive. There are several indices that could be used in combination to diagnose and manage hypoperfusion in patients with septic shock. Fluid resuscitation and vasopressor administration along with infection sources control are the cornerstones in septic shock management. This chapter will cover indices that can be used to diagnose hypoperfusion, type and amount of fluid and vasopressor that can be used in resuscitating septic shock patients.

BMJ Open

IntroductionNon-invasive ventilation (NIV) delivered by helmet has been used for respiratory supp... more IntroductionNon-invasive ventilation (NIV) delivered by helmet has been used for respiratory support of patients with acute hypoxaemic respiratory failure due to COVID-19 pneumonia. The aim of this study was to compare helmet NIV with usual care versus usual care alone to reduce mortality.Methods and analysisThis is a multicentre, pragmatic, parallel randomised controlled trial that compares helmet NIV with usual care to usual care alone in a 1:1 ratio. A total of 320 patients will be enrolled in this study. The primary outcome is 28-day all-cause mortality. The primary outcome will be compared between the two study groups in the intention-to-treat and per-protocol cohorts. An interim analysis will be conducted for both safety and effectiveness.Ethics and disseminationApprovals are obtained from the institutional review boards of each participating institution. Our findings will be published in peer-reviewed journals and presented at relevant conferences and meetings.Trial registrat...

Background: Coronavirus disease of 2019 (COVID-19) created a major public health emergency and an... more Background: Coronavirus disease of 2019 (COVID-19) created a major public health emergency and an international concern. It is an infectious respiratory illness caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The international mortality rates due to COVID-19 reached 2,748,763 on March 24, 2021. We describe the prevalence, case fatality rate, and epidemiological trends of COVID-19 mortality in Saudi Arabia in this paper.Method: A systematic approach of evaluating COVID-19 related mortalities was established in Saudi Arabia. A scientific committee that evaluated all reported cases with suspicious or confirmed COVID-19 disease using a standardized electronic form. A data registry of all deaths with all clinical parameters was built based on active reporting from all healthcare facilities in Saudi Arabia. Analysis of data using national and regional crude case fatality rate (cCFR) and death per 100,000 population was carried. Descriptive analysis of age, gender, nationa...