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Papers by waleed Albuali

International Journal of General Medicine, Jul 1, 2022

Background: Organophosphate (OP) poisoning is one of the most common etiologies of poisoning in t... more Background: Organophosphate (OP) poisoning is one of the most common etiologies of poisoning in the pediatric age group. Objective: This study aimed to evaluate the demographic characteristics, clinical features, clinical course, and outcomes of children with toxicity from organophosphates admitted to the pediatric intensive care unit. Methods: A retrospective review of hospital medical records of all children aged 14 years and younger who were admitted to the PICU with a provisional diagnosis of organophosphate poisoning at King Fahad Hospital of the University (KFHU), Alkhobar, Saudi Arabia, between January 1, 2008, and December 31, 2018, was conducted. Patients with incomplete medical record information or with suspicion or evidence of one or more agents other than organophosphate were excluded from the study. Results: Thirty-one patients were enrolled in the study. The median age of the study population was 2 years, and 19 (61%) were males. The majority of patients (68%) had more than one route of organophosphate exposure. Skin exposure was reported in 26 patients (84%). Only three patients (10%) had suicidal organophosphate exposure from organophosphates, while the majority (28 patients; 90%) had accidental poisoning. Bronchorrhea was the most prevalent presenting feature, reported in 28 patients (90%). 17 patients (55%) were treated with intravenous atropine and (45%) were used a combination of pralidoxime with atropine for treatment. Five patients (16%) developed acute respiratory distress syndrome. Twelve patients (39%) needed endotracheal intubation and mechanical ventilation secondary to respiratory failure. Conclusion: The presenting features of organophosphate poisoning differ widely in children. Risk factors for mortality for PICU patients with organophosphate poisoning include delayed hospital arrival by more than 1 hour, inhalational route of exposure, need for mechanical ventilation, and high lactate levels in the first 24 hours post-exposure.

International Journal of General Medicine

The Objective Structured Clinical Examination (OSCE) is a standard academic assessment tool in th... more The Objective Structured Clinical Examination (OSCE) is a standard academic assessment tool in the field of medical education. This study presents an innovative method for digitizing OSCE evaluation system for medical students and explores its efficacy compared to the traditional paper-based system, through the analysis of a User Satisfaction Survey. Methods: A cross-sectional, questionnaire-based study involving a User Satisfaction Survey to evaluate assessors' attitudes toward and acceptance of the Computerized Web-based OSCE Evaluation System (COES) was used. Fifth-year medical students at a College of Medicine were assessed clinically through their 2019 end-of-year OSCE examination by 30 examiners in five different OSCE stations. The traditional paper-based stations were converted into an online electronic version using QuestionPro software. Answers were filled in using smart tablets (iPads). QR codes were used for students' identification at each station to fully digitize the process and save time. After the completion of the exam, a User Satisfaction Survey was sent electronically to all examiners to evaluate their experiences with the new system. Results: The response rate for the survey was 100% with an internal consistency of 0.83. Almost all the examiners (29, 97%) were satisfied with the application of the COES. Further, 72% of the examiners indicated that the electronic system facilitated the evaluation of the students' skills, and 84% found using a smart device (iPad) was easier than using a paper form. All examiners expressed their preference for using the electronic system in the future. Conclusion: Users were satisfied with the utilization of the customized COES. This concept of fully digitizing the OSCE assessment process shortened the time needed for both the analysis of results and providing students with feedback. Further observational studies are needed to assess examiners' behaviors when using this methodology.

Current Pediatric Reviews

Background: The biomarker procalcitonin (PCT) PCT is a good in detecting sepsis in postoperative ... more Background: The biomarker procalcitonin (PCT) PCT is a good in detecting sepsis in postoperative pediatric trauma patients, especially those with a high suspicion of sepsis, and formulate a quick treatment. Its use is still limited to surgical pediatric patients, particularly those in intensive care units (ICUs), who are more susceptible to sepsis. The purpose of this study was to see if procalcitonin could be used as a reliable and quick biomarker for sepsis in postoperative pediatric trauma patients and were brought to the PICU. Methods: This retrospective longitudinal study was conducted from January 2017 to December 2019. Postoperative pediatric trauma patients aged > 2 weeks old who were hospitalized at the PICU of King Fahd Hospital of the University due to serious trauma or post-acute surgical events were included. Within 24 hours of admission, PCT levels were measured, and again 48–72 hours later. Results: In our study, 31% of severely ill children developed post-surgical...

Global Journal of Health Science, 2019

INTRODUCTION: The variations in the physiological properties of female platelets during menstrual... more INTRODUCTION: The variations in the physiological properties of female platelets during menstrual cycle phases, pregnancy and postmenopausal women to interactions with platelet CD49b, CD42b, CD41a and CD61 expression glycoprotein receptors were not well understood. Therefore, the aim of the present study was to evaluate the expression of these glycoprotein receptors during menstruation and ovulatory phase of menstrual cycle in reproductive age women. METHODS: It is across section study including 44 healthy young non‑hormonal contraceptives taking women aged between 19-44 years to determine the effect of estrogen on the expression level of platelet glycoprotein receptors (GPIb, GPIIa, GPIIb and GPIIIa) in its resting state in women in reproductive age. RESULTS: No significant difference in the expression of CD42b, CD41a and CD61 between menstruation and ovulatory phases in resting platelets in all subjects. However, this study showed a significant difference in CD49b expression in no...

Corporación Universitaria Minuto de Dios, 2018

III DEDICATORIA Agradezco a Dios primero que todo por su ayuda y por llevarme de su mano en esta ... more III DEDICATORIA Agradezco a Dios primero que todo por su ayuda y por llevarme de su mano en esta etapa profesional, a Angela, Ciro y Natalia, mi familia quienes me apoyaron en este camino desde el principio, aún con obstáculos, ellos siempre depositaron su confianza en mí, en que podría culminar mis estudios con mucha sabiduría y éxitos.

BMJ Open, 2022

ObjectiveTo describe the risk factors, clinical profile and outcomes of COVID-19 in the paediatri... more ObjectiveTo describe the risk factors, clinical profile and outcomes of COVID-19 in the paediatric population.DesignMulticentre, retrospective observational study.SettingFour tertiary hospitals in Saudi Arabia.PatientsWe recruited 390 paediatric patients aged 0–18 years who presented from March to December 2020 and tested positive for COVID-19 on PCR.Main outcome measuresWe retrospectively analysed medical records for sociodemographics, health indicators, clinical presentations, laboratory findings, clinical complications, and outcomes.ResultsThe mean participant age was 5.66±4.90 years, and the mean hospital stay was 2.17±3.48 days. Forty patients, mostly school-aged children (16, 40.00%; p=0.005) and children with comorbidities (25, 62.50%; p<0.001), received more than just supportive care. Complications were seen in 15 (3.9%) patients, bacterial infection being the most common (6, 40.00%). Patients presented with dyspnoea (OR 6.89; 95% CI 2.89 to 20.72), abnormal chest radiogr...

Higher Education Studies, Feb 5, 2018

Tremendous changes have taken place in medical curricula in the last two decades; these changes h... more Tremendous changes have taken place in medical curricula in the last two decades; these changes have arguably created some imbalances in the quality of medical graduates around the globe, which may be partly due to the number of resources often demanded by the design of the newer curricula. Therefore, resource-poor countries are often unable to adopt these newer models of training in their entirety and are thus compelled to follow the socalled "Subject-Based Curriculum". The authors have discussed and prepared some guidelines to provide direction for the adaptation and implementation of Problem-Based Learning Curriculum (PBLC) in countries with different cultures and limited resources. This article addresses the issues and concerns raised by medical educationists on the implementation of PBLC especially in developing countries. These pointers include practical solutions for such common problems as staff, cost, infrastructure and training.

American Journal of Hematology, 2013

Independently of its African roots, the HbS gene is also indigenous to the Middle East and India ... more Independently of its African roots, the HbS gene is also indigenous to the Middle East and India where it can be on an Arab-Indian (AI) HBB haplotype. This haplotype is associated with high levels of fetal hemoglobin (HbF) and increased HbF improves many complications of sickle cell disease [1]. Polymorphisms in BCL11A (chr 2p) and HBS1L-MYB (chr 6q) and in elements linked to HBB (chr 11p) are associated with HbF level. In AI haplotype HbS homozygotes, SNPs in BCL11A and HBS1L-MYB accounted for 8.8% of HbF variance. We studied 61 patients with HbS-b thalassemia, aged 12 years and not taking hydroxyurea at the time HbF was measured by high performance liquid chromatography (HPLC). HbS-b thalassemia was determined by the presence of the HbSF phenotype by HPLC, heterozygosity for the HbS mutation and microcytosis. The b-thalassemia mutation was not genotyped. The HbS mutation was ascertained using ARMS (amplification refractory mutation system) analysis. The AI haplotype was determined by genotyping the 50 HBG2 Xmn1 C>T restriction site (rs7482144) and a Hinc2 site 50 to HBE1 (rs3834466), and confirmed by the presence of a C>T polymorphism 68 bp 50 to HBD [2]. Single nucleotide polymorphism (SNP)s studied are shown in Table I and were detected by TaqMan assays (Applied Bio systems) or by Sanger di-deoxy sequencing. Linear regression was performed on HbF for each genetic locus, adjusting for gender. The analysis was performed using an additive genetic model whereby the total number of minor alleles present was counted for each subject. b-Thalassemia is common in Al-Ahsa. The four most prevalent mutations are: codon 39 C-T (25%); IVSII-1 G-A (22.2%); IVSI-5 G-C (13.3%); and IVSI 25 bp deletion (13.0%). a-Thalassemia has little effect on HbF in other haplotypes of sickle cell anemia [3,4]. More than 40% of AI haplotype HbS homozygotes had some form of a-thalassemia. HbS-b thalassemia patients had a mean HbF of 17.7%, a level similar to that found in HbS homozygotes and similar to those previously reported in AI haplotype HbS-b thalassemia but distinct from HbS-b thalassemia with African haplotypes. Their HbF distribution is not significantly different from that in AI haplotype HbS homozygotes (Fig. 1). There was no association of SNPs in BCL11A or the HBS1L-MYB intergenic region with HbF (Table I). The number of patients we studied was small. To have 80% power to detect associations of SNPs in BCL11A (rs766432) with HbF 140 cases would be needed; 1,640 cased are required to detect an association with rs9399137 in HBS1L-MYB. Given the results in sickle cell anemia and the AI haplotype, the effects of these SNPs on HbF in Saudi patients with HbS-b thalassemia are likely to be small. Along with interactions of cis-acting elements of the AI haplotype with trans-acting factors prevalent in the Saudi Arab population that remain to be discovered, reduced or abnormal b-globin mRNA caused by b thalassemia and stress erythropoiesis might contribute to increasing HbF expression [5]. Less b-globin mRNA might enhance the stability of g-globin RNA by reducing post-transcriptional competition for the translational machinery [6]. Sickle cell trait carriers with the AI haplotype and Saudi Arab heterozygotes with b thalassemia had nearly normal HbF levels. The absence of hemolytic anemia or suppression of HBB expression trans to the HbS gene might account for their normal HbF.

Children

Acute chest syndrome (ACS) is a common cause of death in sickle cell disease (SCD) patients. Mult... more Acute chest syndrome (ACS) is a common cause of death in sickle cell disease (SCD) patients. Multiple studies investigated the risk factors of developing ACS; however, predictors of recurrent ACS episodes have not been thoroughly investigated. We aim to examine the clinical and laboratory predictors of recurrent ACS in pediatric patients with SCD. A retrospective case-control study included pediatric patients with SCD (˂14 years) admitted with ACS or developed ACS during admission for another indication. Patients were classified into recurrent ACS episodes (≥2 episodes) and a single ACS episode groups. Ninety-one ACS episodes (42 patients) were included, with a mean age at diagnosis of 7.18 ± 3.38 years. Twenty-two (52.4%) patients were male, and twenty-five (59.5%) patients had recurrent ACS. Younger age at first ACS was significantly associated with recurrence (p = 0.003), with an optimal cutoff at 7.5 years (area under the receiver operating characteristic curve [AUROC] = 0.833; ...

Background Procalcitonin (PCT) levels are elevated in pediatric patients with systemic inflammati... more Background Procalcitonin (PCT) levels are elevated in pediatric patients with systemic inflammation. This study was aimed to evaluate the use of Procalcitonin as a single biomarker in the prediction of mortality in pediatric patients after acute traumatic events or post-surgical infection.MethodsThis retrospective longitudinal study involved pediatric patients aged more than two weeks who were admitted to Pediatric Intensive Care Unit (PICU) of King Fahd Hospital of the University from January 2017 to December 2019 due to post-surgical infection. The data includes age, gender, comorbidity, severity of trauma, Pediatric Risk of Mortality Score (PRISM III) score in 24h of admission, PCT level at 24h and 48-72h, day-5 admission, blood culture, PICU stay, multi-organ failure, number of inotropes and intubation requirement were retrieved.ResultsThe mortalities after surgical infection was of 15.9%. Significantly, the elevated mean levels including PRISM III score, PCT level at 24h, 48-72...

World Academy of Science, Engineering and Technology, International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering, 2013

The possible therapeutic effect of cannabidiol, the major non-psychotropic Cannabis constituent, ... more The possible therapeutic effect of cannabidiol, the major non-psychotropic Cannabis constituent, was investigated against acute hepatotoxicity induced by a single oral dose of acetaminophen (500mg/kg) in mice. Cannabidiol (two intraperitoneal injections, 5mg/kg, each) was given 1 hour and 12 hours following acetaminophen administration. Acetaminophen administration caused significant elevations of serum alanine aminotransferase, and hepatic malondialdehyde, and nitric oxide levels, and a significant decrease in hepatic reduced glutathione. Cannabidiol significantly attenuated the deterioration in the measured biochemical parameters resulted from acetaminophen administration. Also, histopathological examination showed that cannabidiol markedly attenuated ameliorated acetaminophen-induced liver tissue damage. These results emphasize that cannabidiol represents a potential therapeutic option to protect against acetaminophen hepartotoxicity which is a common clinical problem. Keywords—c...

Saudi medical journal, 2005

The administration of drotrecogin alfa (activated) improves outcome in adult patients with severe... more The administration of drotrecogin alfa (activated) improves outcome in adult patients with severe sepsis. Since the published pediatric experience with this drug is limited, the role of drotrecogin alfa (activated) in children, and especially in newborns is not well established. We describe a 3-day-old neonate with septic shock and multiorgan system failure, including circulatory, respiratory, renal failure, and disseminated intravascular coagulation, refractory to intensive fluid resuscitation and inotrope support. Within hours of drotrecogin alfa (activated) administration, the neonate experienced dramatic improvement in hemodynamic parameters. The infusion was discontinued after 48 hours, without clinical deterioration. Aside from transient thrombocytopenia, no significant side effects were observed. A brain MRI performed on day 18 after discontinuation of treatment was normal. The positive hemodynamic effect and outcome of treatment in this patient, indicates that drotrecogin al...

World Academy of Science, Engineering and Technology, International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering, 2014

The protective effect of thymoquinone (TQ) was investigated in rats exposed to testicular injury ... more The protective effect of thymoquinone (TQ) was investigated in rats exposed to testicular injury induced by sodium arsenite (10mg/kg/day, orally, for two days). TQ treatment (10mg/kg/day, intraperitoneal injection) was applied for five days, starting three day before arsenic administration. TQ significantly attenuated the arsenic-induced decreases of serum testosterone, and testicular reduced glutathione level, and significantly decreased the elevations of testicular malondialdehyde and nitric oxide levels resulted from arsenic administration. Also, TQ ameliorated the arsenic-induced testicular tissue injury observed by histopathological examination. In addition, TQ decreased the arsenic-induced expression of inducible nitric oxide synthase and caspase-3 in testicular tissue. It was concluded that TQ may represent a potential candidate to protect against arsenic-induced testicular injury. Keywords—Thymoquinone, arsenic, testes, rats.

American Journal of Hematology

proteasome inhibitor bortezomib by the pediatric preclinical testing program. Pediatr Blood Cance... more proteasome inhibitor bortezomib by the pediatric preclinical testing program. Pediatr Blood Cancer. 2008;50(1):37-45. 7. Romaguera JE, Fayad LE, McLaughlin P, et al. Phase I trial of bortezomib in combination with rituximab-HyperCVAD alternating with rituximab, methotrexate and cytarabine for untreated aggressive mantle cell lymphoma. Br J Haematol. 2010;151(1):47-53. 8. Messinger Y, Gaynon P, Raetz E, et al. Phase I study of bortezomib combined with chemotherapy in children with relapsed childhood acute lymphoblastic leukemia (ALL): a report from the therapeutic advances in childhood leukemia (TACL) consortium. Pediatr Blood Cancer. 2010;55(2):254-259. 9. Saraceni MM, Scott E, Maziarz RT, et al. Modified HyperCVAD versus Bortezomib-HyperCAD in patients with relapsed/refractory multiple myeloma. Clin Lymphoma Myeloma Leuk. 2018;18(1): e77-e84. 10. Niewerth D, Franke NE, Jansen G, et al. Higher ratio immune versus constitutive proteasome level as novel indicator of sensitivity of pediatric acute leukemia cells to proteasome inhibitors. Haematologica. 2013;98(12):1896-1904. 11. Takahashi K, Inukai T, Imamura T, et al. Anti-leukemic activity of bortezomib and carfilzomib on B-cell precursor ALL cell lines. PLoS One. 2017;12(12):e0188680. 12. Brown PA, Wieduwilt M, Logan A, et al. Guidelines insights: acute lymphoblastic leukemia, version 1.2019. J Natl Compr Canc Netw. 2019;17(5):414-423. 13. Campana D. Minimal residual disease in acute lymphoblastic leukemia. Hematol Am Soc Hematol Educ Prog. 2010;2010:7-12. 14. Kantarjian HM, O'Brien S, Smith TL, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. 2000;18(3):547-561. 15. Holowiecki J, Krawczyk-Kulis M, Giebel S, et al. Status of minimal residual disease after induction predicts outcome in both standard and high-risk Ph-negative adult acute lymphoblastic leukaemia. The polish adult leukemia group ALL 4-2002 MRD study. Br J Haematol. 2008;142(2):227-237.

Saudi Medical Journal

To identify ribosome protein L5 gene variants and the risk of hepatic vein thrombosis in Saudi pa... more To identify ribosome protein L5 gene variants and the risk of hepatic vein thrombosis in Saudi patients. Methods: A case-control study was conducted during the period of May 2018 to September 2019. Sixty-five patient cases of hepatic vein thrombosis (HVT) were chosen, and 50 healthy individuals of the same ages and both gender were set as a control group. The genotype of the gene RPL5 was determined by PCR please provide abbreviation in full and capillary electrophoresis. Sanger sequencing for genetically screened variants was applied for the RPL5 gene. Results: Alleles A at variant rs182018447 and T allele at variant rs559377519 were strongly corelated (p=0.009 and p=0.037, respectively) with the risk of HVT. The genotype frequencies of the RPL5 gene, the A/A Original Article genotypes at rs182018447 and T/T at rs559377519 were associated with HVT (p=0.000 and p=0.004; respectively) and an increase in risk for HVT among these patients. Please rephrase the highlighted text without using the word respectively. Conclusion: Our findings indicate that the 5 genetic novel variants examined in the RPL5 gene were associated with a risk of HVT in all our Saudi cases. Additionally, the A/A at rs182018447 and T/T at rs559377519 genotypes were substantially susceptible to HVT in all these patients.

Journal of Multidisciplinary Healthcare

Purpose: Currently, several scoring systems for predicting mortality in severely ill children who... more Purpose: Currently, several scoring systems for predicting mortality in severely ill children who require treatment in a pediatric intensive care unit (PICU) have been established. However, despite providing high-quality care, children might develop complications that can cause rapid deterioration in health status and can lead to death. Hence, this study aimed to establish a simple early predictive mortality (SEPM) model with high specificity in identifying severely ill children who would possibly benefit from extensive mechanical ventilation during PICU admission. Patients and Methods: This is a retrospective longitudinal study that included pediatric patients aged older than two weeks who were on mechanical ventilation and were admitted to the PICU of King Fahd Hospital of the University from January 2015 to December 2019. Results: In total, 400 pediatric patients were included in this study. The mortality rate of children on mechanical ventilation was 28.90%, and most deaths were associated with respiratory (n = 124 [31%]), cardiovascular (n = 76 [19%]), and neurological (n = 68 [17%]) causes. The SEPM model was reported to be effective in predicting mortality, with an accuracy, specificity, and sensitivity of 92.5%, 97.31%, and 66.15%, respectively. Moreover, the accuracy, specificity, and sensitivity of the Pediatric Risk of Mortality (PRISM) III score in predicting mortality was 95.25%, 98.51%, and 78.46%, respectively. Conclusion: The SEPM model had a high specificity for mortality prediction. In this model, only six clinical predictors were used, which might be easily obtained in the early period of PICU admission. The ability of the SEPM model and the PRISM III score in predicting mortality in severely ill children was comparable. However, the accuracy of the newly established model in other settings should be validated, and a prospective longitudinal study that considers the effect of the treatment on the model's predictive ability must be conducted.

BMC Emergency Medicine

Background The Emergency Room (ER) is one of the most used areas in healthcare institutions. Prob... more Background The Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4%...

Bangladesh Journal of Medical Science

Background: Quality of life of medical students may influenced by different socio-demographic com... more Background: Quality of life of medical students may influenced by different socio-demographic components and disrupt their capability to study medicine. An in-depth exploration of these elements may encourage enhancement in learning and retention of medical students. Aim: This study was designed to identify the role of socio-demographic factors in quality of life in undergraduate medical students. Material and Method: A cross-sectional study was conducted among 223 undergraduate medical students (male = 125, females = 98) at King Faisal University, Saudi Arabia between February and September 2019. An Arabic version of WHOQOL-BREF was used to explore the QOL of medical students. Regression analysis were employed to evaluate association between QOL and socio-demographic factors including age, sex, academic year, family type, area of residence, monthly income, parental education and housing status. Result: The results showed a significant relationship between various socio-demographic ...

Biomedicine & Pharmacotherapy