Prof. Mostafa Kofi | Suez Canal University (original) (raw)
Papers by Prof. Mostafa Kofi
Background: Falls injuries remain the major cause of hospitalization and disability among childre... more Background: Falls injuries remain the major cause of hospitalization and disability among children and are the fifth leading cause of death among infants. Objective: To assess the knowledge, attitude and barriers of parents regarding falls prevention and management in children under 5 years of age. Material and Methods: A cross-sectional descriptive study was done in Prince Sultan Military Medical City (PSMMC) outpatient clinics and primary health care centers, Riyadh, Saudi Arabia among a convenience sample of parents of children aged 5 years or less. Data were collected through a validated self-administrated questionnaire contained 4 main parts: Socio demographic characteristics of parents, detailed description of the children`s falls, knowledge about child falls prevention and management (14 statements) and attitude of parents towards child falls prevention and management (5 statements). Results: The study included 360 out of 384 targeted parents with a response rate of 93.75%. Almost two-thirds (65%) of the respondents were mothers and 47.5% aged between 25 and 34 years. The total parental knowledge score was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 12 out of a possible maximum of 14 and its IQR was 12-14. Mothers were more knowledgeable about child falls prevention and management than fathers, p = 0.012. Parents aged between 25 and 34 years has the highest knowledge score, p < 0.001. Parents with Bachelor degree expressed the highest score, p = 0.011. Unemployed were more knowledgeable than employed parents, p = 0.004. Parents live in extended families had the highest score, p < 0.001. There was a statistically significant positive correlation between number of family members and total knowledge score (r "Spearman`s coefficient of correlation" = 0.106, p = 0.045). Parents who had history of receiving any training courses in first aid were more knowledgeable, p = 0.001. Overall, total parental attitude score towards fall prevention and management was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 9 out of a possible maximum of 10 and its IQR was 8-10. The highest attitude score towards child fall prevention and management was observed among parents with lowest educational level, p = 0.030. Students expressed higher score of attitude score, p = 0.002. Divorced parents expressed higher attitude score than widowed parents, p < 0.001. There was a statistically significant positive correlation between number of rooms and total attitude score (r = 0.148, p = 0.005). Parents who had history of receiving any training courses in first aid were more likely to have better attitude compared to their counterparts, p < 0.001. Conclusion: Parental knowledge of and attitude towards child fall prevention and management were good in general. However, lack of their training in first aid represented the main barrier affecting their knowledge and attitude.
QJM: An International Journal of Medicine, 2021
Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia... more Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia. Diabetes causes many complications like diabetic retinopathy (DR) which affects up to 80 percent of all patients who have diabetes for more than 10 years or more. Objectives To estimate the prevalence rate of diabetic retinopathy among type 2 diabetic (T2D) patients in some Arab countries and to compare the difference in the prevalence rate according to different patient’s characteristics. Patients and Methods In recent years, several studies have indicated occurrence of peripapillary retinal nerve fiber layer (RNFL) thinning in the retina of diabetic patient. We reviewed the full articles of the extracted 17 different studies across 10 Arab countries that were captured through our search strategy. Through 25 years (1991– 2016), most of the studies re-ported were carried, we captured 17 studies through our systematic search. Results The prevalence rate of diabetic retinopathy among typ...
Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly... more Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly increase the risk of diabetes, cardiovascular disease, and stroke. It is characterized by obesity, hyperglycemia, dyslipidemia, and hypertension. Multiple definitions and criteria of MS exist. The most widely used set of criteria are the US National Cholesterol Education Program (NCEP) ATP III and the International Diabetes Federation (IDF), both of which are used in this study. Due to different defining criteria and population demographics, the prevalence of MS varies widely across countries, regions, and continents. Objective: This study investigates the prevalence and risk factors of metabolic syndrome among primary healthcare attendees in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted over 12 months at the Prince Sultan Military Medical City (PSMMC) Wazzarat Center in Riyadh, Saudi Arabia, involving 262 participants. The study aimed to determine the prevalence and predictors of MS among primary healthcare attendees using ATP III and IDF criteria. Participants were assessed for sociodemographic features, comorbidities, vital signs, and laboratory data related to MS. Statistical analysis utilized R v 4.3 for descriptive statistics, Pearson correlation, Chi-square tests for categorical variables, and the Mann-Whitney test for continuous variables. Results: Among the study participants, 20.2% met the criteria for MS according to ATP III, and 19.9% according to IDF criteria, with a strong concordance between the two (Kappa statistic = 0.92, P < 0.001). The median age of individuals with MS was significantly higher (45 years) than those without (35 years, P < 0.001). Significant predictors included age, with BMI and fasting blood glucose showing a strong positive correlation (r > 0.5, P < 0.001). Notably, 60.7% of the cohort were medically free from conditions contributing to MS. Conclusion: The prevalence of MS among primary healthcare attendees in Riyadh, as defined by ATP III and IDF criteria, underscores the importance of age and lifestyle factors as predictors. The findings advocate for targeted preventive strategies focusing on lifestyle modifications to mitigate the risk of MS. Further research is suggested to explore the long-term impact of these interventions.
Background: Patients, professionals, and health care systems are faced with a serious problem of ... more Background: Patients, professionals, and health care systems are faced with a serious problem of pressure ulcers. They represent a significant occurrence and prevalence throughout the world. Their character iatrogenic states that its appearance is preventable, and its incidence is an indicator of scientific and technical quality both in primary care and specialized care. Surgery may be necessary to accelerate the healing process, although most pressure ulcers are usually treated with debridement and conservative therapy. Their reported incidence and prevalence are significant worldwide. Objectives: The study's objectives are to identify the pressure ulcer risk factors in patients getting home health care, as well as to look at the quantity, type, and characteristics of pressure ulcers as well as patient comorbidities. Methods: Cross-sectional study, Home Care Nursing personnel questionnaire to determine the Risk Factors of Pressure Ulcers, patient comorbidities, and the number, and characteristics of pressure ulcers among patients receiving home care in Riyadh, Saudi Arabia. Results: PU is prevalent among the studied participants in Saudi Arabia, about 55% of these ulcers showed noticeable distraction of skin and/or deeper soft tissue against a bony prominence. We have also found a significant relationship between PU and gender, diabetes mellitus, hypertension, incontinence issues, nutritional status, and physical status, cerebrovascular accidents, trauma, and chronic kidney disease. Conclusion: Different risk factors are associated with PU such as diabetes mellitus, hypertension, and nutritional, and physical status. To monitor and promote best practices in skin care for highly dependent patients, continued measurement and evaluation of PU incidence, it is recommended more research of risk factors of PU development be assessed at home Health care Centers.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Type 2 diabetes mellitus is a common health problem in Saudi Arabia. Awareness of patients about ... more Type 2 diabetes mellitus is a common health problem in Saudi Arabia. Awareness of patients about the disease, its complications, preventive measures, and management modalities will play a vital role in its better control and avoidance of hazardous complications. The objective was to assess type 2 diabetic patients` awareness of DM, its complications, preventive measures, and treatment modalities. A cross-sectional study was conducted among a sample of adult type 2 diabetic patients attending the chronic diseases clinic at Alwazarat primary healthcare center in Riyadh City, Saudi Arabia. Data were collected by interviewing patients using a valid questionnaire consisting of four main sections: socio-demographic characteristics of patients, diabetes-related characteristics, awareness about diabetic complications, and knowledge about different aspects of diabetes. The study included 252 type 2 diabetic patients. The age of 29.4% of them ranged between 50 and 59 years and males represented 58.7% of the patients. The majority of patients (92.5%) were aware of the development of diabetic complications in case of uncontrolled blood sugar levels. Among those patients, the most reported source of information was diabetologists (54.1%). The overall level of diabetic patients` knowledge about diabetes mellitus, its complications, and prevention and management modalities was good among 21% of patients whereas, it was poor among 31% of them. Patients aged between 30 and 49 years, females, housewives, university graduated patients (p<0.001) and married patients (p=0.001) were more knowledgeable about diabetes compared to their peers. Additionally, patients with a longer duration of diabetes (>5 years) (p=0.001), patients who reported nonadherence to anti-diabetic medications (p<0.001), those with a family history of diabetes (p<0.001), those having their information from diabetologists (p<0.001), and reported previous clinical examination for diabetic complications (p<0.001) were more knowledgeable about diabetes than their counterparts. The majority of type 2 diabetic patients were aware of the development of diabetic complications in case of uncontrolled blood sugar levels. However, the overall level of diabetic patients` knowledge about diabetes mellitus, its complications, prevention and management modalities was good among almost fifth of patients.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
During the pandemic of covid-19, many physicians got anxiety, depression, and insomnia that affec... more During the pandemic of covid-19, many physicians got anxiety, depression, and insomnia that affected their performance at work and daily life. According to the psychiatry department of Imperial College in London, they reported that it is necessary to assess the mental health of the health workers who were on the frontline during the COVID-19 pandemic and to evaluate the pattern of sleep and other issues that may affect their mental status. The aim of the study is to assess and analyze the existing evidence on the prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 outbreak. A cross-sectional study will be conducted in PSMMC, Riyadh. Assessing the psychosocial effect of COVID-19 among health care workers. sampling size and sampling procedure: 380 HCWs will be included in the estimated proportion of anxiety and depression. All doctors and nurses who met the criteria will be included in the study. Data collection form: Data will be utilized by conducting an online survey to decrease the risk of spreading infection through papers. The following variables will be collected and entered into Microsoft Excel 2010 x demographics x Medical characteristics x Job title and location x The psychosocial effects. The characteristics of the study participants are shown in Table (1). The mean age of the participants was 31.81(±7.64) years, and more than half of the participants were males at 52.15%, and 61.9% were single. Most of the participants were doctors at 76.7%, the vast majority (97.9%) were working during COVID-19, and 94.9% managed suspected COVID-19 cases, with a 73.3% high exposure level. For depression, more than half (59.32%) of the participants reported a loss of interest or feeling low, 39.41% and 33.90% agreed that the COVID-19 pandemic affected their daily life routine including feeling locked down and loss of interest in fun activities. For anxiety, the majority of the respondents reported experiencing anxiety at 83.9%, and almost half of them reported stigma thoughts and somatization at 49.58%, and 50.42%, respectively. Almost half and even more than half of the participants agree that the COVID-19 pandemic affected their daily life routine. In regards to insomnia, 61.44% said that their sleep pattern was affectedCOVID-19D 19 Pandemic, 75.85% has their social life negatively affected, and 82.20% had their work performance modified to follow the standard operating procedure. Data is shown in Table (2). The mean score of anxiety by the characteristics of the participants is shown in Table (3). The mean of the total anxiety score was 16.77(±3.98). Females showed a significantly higher mean score of anxiety compared to males at 17.55(±3.82) vs. 16.16(±4.01), with a p-value of <0.001. The anxiety score was the highest among doctors at 16.38(±3.93), with a significant p-value (0.003). The anxiety score was also significantly higher among those who were working during the pandemic, managing suspected cases, and with a high level of exposure to COVID-19. The mean of the total depression score was 7.37(±2.69), and it differed significantly (p <0.05) by gender, marital status, number of children, job title, working during the pandemic, and exposure level. Females score was higher at 8.06(±2.48) whilethe males one was 6.73(±2.73). Nurses showed the highest depression score at 8.26(±2.63), and those with high exposure levels showed a higher score at 7.91(2.59) compared to moderate exposure at 5.89(±2.40). Data is shown in Table (4) For insomnia, the mean total score was 2.19(±1). It was also significantly higher among females at 2.36(0.96), and nurses at 2.44(±0.96). Similarly, those who worked during the pandemic, managed suspected cases, and were at high exposure levels showed significantly higher insomnia scores as shownTablee (5). This study explored the prevalence of anxiety, depression, and insomnia and their associated factors among COVID-19 HCWs in Saudi Arabia. The results highlighted that the prevalence of anxiety, depression, and insomnia are concerning, and considered far higher compared to what was reported globally in this regard.
Acta Scientific Nutritional Health, Jul 1, 2023
Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of... more Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of both gender and all ages. Primary care physicians are key health personnel that encounters obese patients regularly. However, few physicians are knowledgeable about the management of morbid obesity, especially surgical treatment and procedures. Objective: To provide information contributing to the improvement of the knowledge and perception among primary care physicians about bariatric surgery, and their ability to care for patients who suffer from morbid obesity. Methods: The study design was cross-sectional. The study population was Primary care physicians working at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. A questionnaire developed by researchers of the university health network-Toronto adapted and modified to fit the setting of practice in the study population. The questionnaire was distributed among the physicians over 3 waves until 170 completed questionnaires were collected. Results: Of the total 170 respondents, Most of the participants (64.1%) reported measuring their patient's weight on each clinic visit. The majority (97.6%) used BMI to assess the weight of a patient (88.8%) of respondents had referred obese patients for bariatric surgery. The majority of responses admits the lack of knowledge for all types of surgery in question. Regarding the questions in the survey, a significant difference in the comparison between those who referred versus who did not refer patients to bariatric surgery is obvious in the percentage of morbidly obese patients seen in the last 12 months (p-value 0.015) and the ideal bariatric procedure in average patients (p-value 0.043). Conclusions and Recommendations: The study conclude that the knowledge of physicians in the bariatric surgical treatment of morbid obesity is insufficient. More guidelines and continuing education should be emphasized regularly to the physicians in order to improve their knowledge on management of obesity.
Acta Scientific Medical Sciences, Jul 1, 2023
Introduction: Flipped class learning is an innovative method for Health professional education, t... more Introduction: Flipped class learning is an innovative method for Health professional education, that yields active learning, interactive group learning, and more retained knowledge by trainees. Flipped Classroom (FC) has been approved by our training department in to be applied widely within the Saudi Family Medicine Residency Program (SFMR), especially for junior residents. Junior trainers are encouraged to take their part of responsibility in applying this new technique and gaining benefit from expert staff under their observation. Methods: From this study, we are looking at the perception of junior trainers in the Family Medicine training Program at PSMMC, Riyadh, Saudi Arabia towards the benefits and drawbacks of using FC in FM training. A mixed methods study in which opinions of junior trainers were compiled by three senior trainers in the FM training program. So, A Qualitative study design using a mixed method of data collection tools: Narrative survey and direct observation. Results: A non-random comprehensive sample of 8 junior staff involved in Family medicine training and 2 senior trainers were included. All participants affirmed the positive attitude towards FC in FM training, basically, it encourages the engagement of residents, improves attention, it provides trainees with a sense of ownership of the Class activity. Conclusion: Wide use of FC is recommended, and introduction of the concept of the FC early in the training program. Flipped class learning is an innovative method for Health professional education, that yields active learning, interactive group learning, and more retained knowledge by trainees, yet it's not short of challenges such as the need for huge time and efforts resources by instructors, needs to think as students and needs for strong organizational skills and the fact that there is always a need to ensure students have prepared prior to class.
Zenodo (CERN European Organization for Nuclear Research), Jul 2, 2023
The prevalence of patients' satisfaction has been evaluated in several studies globally with diff... more The prevalence of patients' satisfaction has been evaluated in several studies globally with different conclusions. Few local studies evaluate the prevalence of patients' satisfaction in Primary Health Care centers in Saudi Arabia. Study of satisfaction among patients with factors related to the clinical consultation plays a key role in assessing the quality of health care. The objective of this study is to determine the prevalence of satisfaction among patients in primary health care center in Riyadh, Saudi Arabia and to explore the factors that could affect patients' satisfaction with the medical consultations. A cross-sectional study has been conducted between January and July 2019 among patients of Alwazarat health care center. The data were collected using face to face interview method. 340 patients were interviewed. The mean age was 35.43 ± 10.76 years. Both age and educational level had significant relationships with patients' overall satisfaction. Overall satisfaction in both gender was as follow: 48.5% very satisfied, 44.7% satisfied, 3.8% not sure, 2.9% upset, zero very upset. The overall patient satisfaction is high among all ages of patients who require health care services and also among all patients' educational levels.
International journal of advanced community medicine, Oct 1, 2020
Background: Later childbearing trend is seen worldwide. Primary health care physicians are at the... more Background: Later childbearing trend is seen worldwide. Primary health care physicians are at the heart of all issues relating to infertility, and they continue to be the first line of contact with couples struggling to conceive. We conducted this study aiming to assess family physicians perceptions about their practice in infertility management at primary care centers, PSMMC, Riyadh, Saudi Arabia 2020. Methods: This was a cross-sectional survey study among family physicians working at PSMMC health care centers. Data was collected using a questionnaire that has been developed and validated by the study authors. It was self-administered, to 165 family physicians working at PSMM primary care centers. The questionnaire consisted of 5 sections: the socio-demographic data, exposure to infertility cases, perception about Practice in the evaluation of an infertile couple, perception about Practice in the treatment of an infertile couple, and the perception about practice in the diagnosis and referral of an infertile couple. Results: A total of 150 family physicians participated in the study, the vast majority (94%) has previously dealt with infertile couples, and 87.3% reported starting to investigate newly married couple with a minimum of at least one year after marriage. More than three-quarters of the participants were either strongly agree or agree (33.3%, and 48.7%, respectively) that they feel comfortable initiating the diagnostic evaluation of patients that present with infertility. Semen analysis was the first step in the evaluation of infertile couples by 51.3%, but 42% reported that they start with both semen analysis and blood work for females. Only 12% of the participants performed ovulation induction with clomiphene citrate. The highest frequent causes of referral were either infertility >2 years among subjects aged <35, or those aged>35 years with infertility of>1 year at 57.3%, and 56.7%, respectively Conclusion: family physicians participated in the current study showed Positive attitude, perception, and practice in infertility management. However, still there is a need for evidence-based training regarding infertility management to improve family physicians' practice and management of infertility.
Family medicine and primary care, Nov 26, 2021
Background: Pregnancy is a diabetogenic condition, with Gestational Diabetes Mellitus (GDM) devel... more Background: Pregnancy is a diabetogenic condition, with Gestational Diabetes Mellitus (GDM) developing in 3 to 25% of all pregnancies. GDM has unfavorable short-and long-term consequences for both mothers and their children. We conducted this study aiming to assess the prevalence of gestational diabetes and associated risk factors during pregnancy in Riyadh, Saudi Arabia. Methods: This was a retrospective cross-sectional survey study. GDM diagnosis was based on the universal two-hour 75 g OGTT. GDM cases were defined using the 75 g OGTT with at least one value of plasma glucose concentration equals to or exceeds the thresholds of 92 mg/dl, 180 mg/dl, and 153 mg/dl for fasting one-hour, and 2-hour post glucose, respectively. The data was collected by the study authors from patients' files using a data collection form that included the oral glucose tolerance test results in addition to the participants' socio-demographic data. Results: A total of 384 pregnant women were recruited, the highest percentage (29.7%) of them aged 26 to 30 years old, 35% were overweight and 24.5% were obese, and 72.4% were multi-parity. Based on the 2h OGTT, the prevalence of GDM was 32.6%. The univariate logistic regression analysis showed that old age, low educational level, higher BMI, family history of DM, higher rates of multi-parity, abortions, C-sections, and hypothyroidism were significant risk factors for GDM. On the other hand, there were no significant associations between occupational status, PCOS, preeclampsia, hypertension, asthma, and GDM. Conclusion: GDM diagnosed on basis of the OGTT criteria was very common among pregnant women in Saudi Arabia. Overweight and obesity as well as older age were associated with an increased risk of GDM. Also, low educational level, family history of DM, GDM history, history of abortion, and C-section were all significant risk factors of GDM.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Acceptance of mandatory influenza vaccination requires an understanding of knowledge, and attitud... more Acceptance of mandatory influenza vaccination requires an understanding of knowledge, and attitudes (KA). This study explored the KA and other co-variables influencing the acceptance of mandatory influenza vaccination among Saudi physicians working in primary care. A Cross-sectional study among Saudi physicians working at Wazarat primary health care center in Riyadh was conducted from Nov 2022throughJan 2023. A convenience sample of 162 physicians was recruited and surveyed using a validated questionnaire. A total of 138 responded and completed the study. Univariate and multivariate analyses using SPSS version 22 were performed to assess associations between sociodemographic factors, KA, and acceptance of mandatory influenza vaccination. The response rate was 85%. While the age of 92% of the participants was < 36 years, 73.2% were males, and 34.1% were smokers. Only 67.4% of the participants accepted mandatory vaccination. Youngers, females, singles, postgraduates, and staff with no chronic disease had higher odds to accept the mandatory flu vaccine. On univariate analysis, physicians with better knowledge and good attitudes were more likely to accept the mandatory flu vaccination. On multivariate analysis, physicians with higher knowledge and attitude scores were more likely to accept the mandatory vaccination (adjusted odds ratio (aOR): 1.17; (95%CI 1.05, 1.31)). Acceptance of mandatory vaccination was negatively correlated with a declination of flu vaccination (r=-0.237, P=0.005) and positively with actual vaccination (r= 0.203, P=0.017). High levels ofgood attitudes towards and knowledge of influenza vaccination were associated with a high level of acceptance of mandatory flu vaccination. This study paves the way for more targeted initiatives including risk communication approaches to be implemented to improve acceptance of mandatory influenza vaccination rates.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Research activities carried by postgraduate medical residents are very important in promoting bet... more Research activities carried by postgraduate medical residents are very important in promoting better clinical care, critical reasoning and writing, keeping updated with local, regional and international guidelines as well as lifelong education. However, some barriers were identified to prevent residents from conducting of high-quality research during residency. The research objective was to determine the barriers that can prevent family medicine residents to conduct high-quality research during residency and to make publication by the residents during residency. A cross-sectional survey was conducted among family medicine residents enrolled in the residency program the of seven largest hospitals in Riyadh City, Kingdom of Saudi Arabia. A self-reported survey instrument was used for data collection. It included questions regarding personal and academicrelated characteristics of physicians, history of taking research during residency, confidence and motivation in seeking publication of research and barriers and existing resources conducting research. A total of 254 family medicine residents responded out of targeted 286, giving a response rate of 88.8%. The majority of them (85%) aged between 26 and 29 years. Males represented 53.9% of them. Regarding their future choice after completion of the residency program, 33.1% chose practice as family medicine specialists whereas 24% chose to pursue a graduate degree. Majority of the respondents (91.3%) reported taking a research course during residency training and 85% reported presence of a mandatory research course during residency training. The commonest reported barriers mentioned by family medicine residents to complete their research were lack of overall interest in research project (40.2), lack of interest in completing research (38.6%), limited knowledge of the processes associated with research (36.2%) and lack of time available to complete research activities (24.4%). Regarding the resources currently available to assist the family medicine residents in the pursuit of research, the most frequently reported were mentorship from a preceptor or colleague with extensive research experience (59.1%) and mentorship from preceptors with extensive family medicine practice experience (49.6%). Barriers are existing regarding the conduction of research projects among family medicine resident physicians. Thus, people in charge should implement measures in order to create effective solutions to these barriers.
Acta Scientific Nutritional Health, Apr 1, 2023
Objectives: This systematic review studied current updates to the literature on patients with ost... more Objectives: This systematic review studied current updates to the literature on patients with osteoarthritis (OA) who underwent total hip arthroplasty (THA) to improve their quality of life (QoL). We also looked into the reported interventions that could enhance postoperative recovery. Methodology: PubMed, Web of Science, Science Direct, EBSCO, Wiley, and Cochrane Library were searched. Study articles were screened by title and abstract using Rayyan QCRI then a full-text assessment was implemented. Results: A total of Twenty-nine studies with 74664 patients were included in this review. The follow-up duration ranged from 3 months to 96 months. All of the included studies reported improved QoL of OA patients following THA. One study reported that underweight, overweight, or obese (classes I to III) experienced more hip pain after THA. Two other studies reported that continuous nursing (CN) counted on the WeChat platform and IARA intervention significantly enhanced the QoL among patients. Conclusion: enhancing patients' physical and mental health after THA is essential for improving recovery and patient QoL. Underweight, overweight, or obese experienced more hip pain after THA. Interventions such as CN counted on WeChat and IARA were found to greatly impact patients' recovery and well-being after discharge.
Acta Scientific Nutritional Health, Jun 1, 2023
Background: Obstructive sleep apnea (OSA) is a chronic sleep-related disorder that afflicts a maj... more Background: Obstructive sleep apnea (OSA) is a chronic sleep-related disorder that afflicts a majority of obese patients. The current study aimed to evaluate the prevalence of OSA in obese patients with other comorbidities and to identify factors that may be associated with its progression. Methods: A cross-sectional, observational study was conducted at the Alwazarat health care center (PSMMC) in Riyadh, Saudi Arabia. Participants were recruited from the center's chronic diseases clinic who were 18 years or older. All participants completed a questionnaire that included questions about their medical history, sleeping habits, and impact on routine functionality. Results: A total of 337 participants were included in the study, with the majority of participants between the ages of 35 to 49 years (29.6%). The most common BMI range was 26-31, which was found in 111 individuals (32.9%) whereas 24.3% of participants had a 32-36 BMI range. The results showed that a total of 82 (24.3%) had at least one of the listed conditions including asthma, dyslipidemia, diabetes, heart disease, and thyroid disease. The most common comorbidity was diabetes which was diagnosed in 108 individuals (32.0%). The incidence of multiple conditions, with the most common combination being diabetes and asthma, was diagnosed in 18 individuals (5.3%). In response to snoring, 263 (78%) answered yes, 68 (20.2%) answered no, and 6 (1.8%) responded that they don't know. Concerning the extent of snoring, 70 (20.8%) reported their snoring as loud as talking, 14 (4.2%) responded that it was louder than talking, and 188 (55.8%) felt it was slightly louder than breathing. The majority of participants reported rarely or never experiencing instances of interrupted breathing during sleep. A high proportion of participants reported having high blood pressure (50.1%). Conclusions: The results of this study suggest a significantly high prevalence of OSA in obese patients with multiple comorbidities.
Journal of Family Medicine and Primary Care
Introduction: Early detection and prevention of diseases can reduce morbidity, mortality, and eco... more Introduction: Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services. Materials and Methods: This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening f...
Family medicine and primary care, Feb 22, 2022
Background: Potentially Inappropriate Medications (PIMs) are drugs in which the adverse risks exc... more Background: Potentially Inappropriate Medications (PIMs) are drugs in which the adverse risks exceed the clinical benefits, lacking evidence-based indications, potentially interact with other medications. PIM use is common in older adults who are frequently treated with multiple medications. PIM use in older adults is associated with many complications. Aim: To critically appraise and systematically evaluate the existing studies on the effectiveness of pharmacist-led deprescribing in health service utilization, clinical effectiveness, cost effectiveness and cost utility. In nursing home and ambulatory care settings and patients aged 65 years and above. Methods: PubMed, Medline, CINAHL, Embase, and Cochrane Library were searched between 1st to 2nd July 2021 and updated on 25 th December 2021 to select studies that compare pharmacist-led deprescribing in nursing home and ambulatory care settings with usual care. Outcomes related to health service utilization, clinical effectiveness, cost effectiveness and cost utility were evaluated. Results: A total of 3944 relevant records were identified through database searching. A further ten records were identified by following up citations and reference lists of the selected studies. After assessment, nine studies were included in the review. Four of the included studies reported outcomes relating to both health service utilization and clinical effectiveness, three studies reported only health service utilization, and the two economic studies reported cost effectiveness and cost utility respectively. Six out of seven studies that reported health service utilization outcomes found improvement in health service utilization after the implementation of the pharmacist-led deprescribing. However, there is no positive clinical effectiveness outcomes, and no worldwide studies for the economic outcomes. Conclusion: This evidence of moderate to high quality. Pharmacist-led deprescribing was effective only in reducing PIMs usage and medication burden for older adults in nursing home and ambulatory care setting, but with no clinical effectiveness outcomes. It is essential to evaluate the economic outcomes in different countries other than Canada (high-income county).
Acta Scientific Medical Sciences
Introduction: Worldwide obesity has become one of the most common public health concerns. In addi... more Introduction: Worldwide obesity has become one of the most common public health concerns. In addition to being an increased mortality risk factor, it also contributes to type 2 diabetes, hypertension, heart disease, and some types of cancer. On aiming to reduce body mass index multiple measures are scientifically investigated such as lifestyle modification, pharmacological and surgical therapy. This review took a critical look on evaluating the scientific evidence of GLP-1 Vs bariatric surgery and the outcome of cardiovascular events. Methods: PubMed, Google Scholar and Research Gate were searched for recent studies published in the period between 2010 and 2021. Results: A total of 16 studies with 283983 patients were included in this review. Of these, 77316 patients were in the intervention groups representing 27.2% of the overall studied population. Around 9% of patients were in the bariatric surgery group, while 18% were in the GLP-1 group. Nine studies used bariatric surgery as their primary intervention, while seven used GLP-1. The mean age of participants ranged from 32.4 to 66 years. Conclusion: In conclusion, GLP-1 showed similar event rates to the control group for MI and CVD but better stroke outcomes. Moreover, bariatric surgery, across studies demonstrated a significant reduction in the risk of the studied events. Thus, we recommend conducting high-quality trials comparing the two interventions to safely apply the results in everyday practice.
Acta Scientifci Nutritional Health
Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of... more Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of both gender and all ages. Primary care physicians are key health personnel that encounters obese patients regularly. However, few physicians are knowledgeable about the management of morbid obesity, especially surgical treatment and procedures. Objective: To provide information contributing to the improvement of the knowledge and perception among primary care physicians about bariatric surgery, and their ability to care for patients who suffer from morbid obesity. Methods: The study design was cross-sectional. The study population was Primary care physicians working at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. A questionnaire developed by researchers of the university health network-Toronto adapted and modified to fit the setting of practice in the study population. The questionnaire was distributed among the physicians over 3 waves until 170 completed questionnaires were collected. Results: Of the total 170 respondents, Most of the participants (64.1%) reported measuring their patient's weight on each clinic visit. The majority (97.6%) used BMI to assess the weight of a patient (88.8%) of respondents had referred obese patients for bariatric surgery. The majority of responses admits the lack of knowledge for all types of surgery in question. Regarding the questions in the survey, a significant difference in the comparison between those who referred versus who did not refer patients to bariatric surgery is obvious in the percentage of morbidly obese patients seen in the last 12 months (p-value 0.015) and the ideal bariatric procedure in average patients (p-value 0.043). Conclusions and Recommendations: The study conclude that the knowledge of physicians in the bariatric surgical treatment of morbid obesity is insufficient. More guidelines and continuing education should be emphasized regularly to the physicians in order to improve their knowledge on management of obesity.
Background: Falls injuries remain the major cause of hospitalization and disability among childre... more Background: Falls injuries remain the major cause of hospitalization and disability among children and are the fifth leading cause of death among infants. Objective: To assess the knowledge, attitude and barriers of parents regarding falls prevention and management in children under 5 years of age. Material and Methods: A cross-sectional descriptive study was done in Prince Sultan Military Medical City (PSMMC) outpatient clinics and primary health care centers, Riyadh, Saudi Arabia among a convenience sample of parents of children aged 5 years or less. Data were collected through a validated self-administrated questionnaire contained 4 main parts: Socio demographic characteristics of parents, detailed description of the children`s falls, knowledge about child falls prevention and management (14 statements) and attitude of parents towards child falls prevention and management (5 statements). Results: The study included 360 out of 384 targeted parents with a response rate of 93.75%. Almost two-thirds (65%) of the respondents were mothers and 47.5% aged between 25 and 34 years. The total parental knowledge score was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 12 out of a possible maximum of 14 and its IQR was 12-14. Mothers were more knowledgeable about child falls prevention and management than fathers, p = 0.012. Parents aged between 25 and 34 years has the highest knowledge score, p < 0.001. Parents with Bachelor degree expressed the highest score, p = 0.011. Unemployed were more knowledgeable than employed parents, p = 0.004. Parents live in extended families had the highest score, p < 0.001. There was a statistically significant positive correlation between number of family members and total knowledge score (r "Spearman`s coefficient of correlation" = 0.106, p = 0.045). Parents who had history of receiving any training courses in first aid were more knowledgeable, p = 0.001. Overall, total parental attitude score towards fall prevention and management was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 9 out of a possible maximum of 10 and its IQR was 8-10. The highest attitude score towards child fall prevention and management was observed among parents with lowest educational level, p = 0.030. Students expressed higher score of attitude score, p = 0.002. Divorced parents expressed higher attitude score than widowed parents, p < 0.001. There was a statistically significant positive correlation between number of rooms and total attitude score (r = 0.148, p = 0.005). Parents who had history of receiving any training courses in first aid were more likely to have better attitude compared to their counterparts, p < 0.001. Conclusion: Parental knowledge of and attitude towards child fall prevention and management were good in general. However, lack of their training in first aid represented the main barrier affecting their knowledge and attitude.
QJM: An International Journal of Medicine, 2021
Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia... more Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia. Diabetes causes many complications like diabetic retinopathy (DR) which affects up to 80 percent of all patients who have diabetes for more than 10 years or more. Objectives To estimate the prevalence rate of diabetic retinopathy among type 2 diabetic (T2D) patients in some Arab countries and to compare the difference in the prevalence rate according to different patient’s characteristics. Patients and Methods In recent years, several studies have indicated occurrence of peripapillary retinal nerve fiber layer (RNFL) thinning in the retina of diabetic patient. We reviewed the full articles of the extracted 17 different studies across 10 Arab countries that were captured through our search strategy. Through 25 years (1991– 2016), most of the studies re-ported were carried, we captured 17 studies through our systematic search. Results The prevalence rate of diabetic retinopathy among typ...
Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly... more Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly increase the risk of diabetes, cardiovascular disease, and stroke. It is characterized by obesity, hyperglycemia, dyslipidemia, and hypertension. Multiple definitions and criteria of MS exist. The most widely used set of criteria are the US National Cholesterol Education Program (NCEP) ATP III and the International Diabetes Federation (IDF), both of which are used in this study. Due to different defining criteria and population demographics, the prevalence of MS varies widely across countries, regions, and continents. Objective: This study investigates the prevalence and risk factors of metabolic syndrome among primary healthcare attendees in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted over 12 months at the Prince Sultan Military Medical City (PSMMC) Wazzarat Center in Riyadh, Saudi Arabia, involving 262 participants. The study aimed to determine the prevalence and predictors of MS among primary healthcare attendees using ATP III and IDF criteria. Participants were assessed for sociodemographic features, comorbidities, vital signs, and laboratory data related to MS. Statistical analysis utilized R v 4.3 for descriptive statistics, Pearson correlation, Chi-square tests for categorical variables, and the Mann-Whitney test for continuous variables. Results: Among the study participants, 20.2% met the criteria for MS according to ATP III, and 19.9% according to IDF criteria, with a strong concordance between the two (Kappa statistic = 0.92, P < 0.001). The median age of individuals with MS was significantly higher (45 years) than those without (35 years, P < 0.001). Significant predictors included age, with BMI and fasting blood glucose showing a strong positive correlation (r > 0.5, P < 0.001). Notably, 60.7% of the cohort were medically free from conditions contributing to MS. Conclusion: The prevalence of MS among primary healthcare attendees in Riyadh, as defined by ATP III and IDF criteria, underscores the importance of age and lifestyle factors as predictors. The findings advocate for targeted preventive strategies focusing on lifestyle modifications to mitigate the risk of MS. Further research is suggested to explore the long-term impact of these interventions.
Background: Patients, professionals, and health care systems are faced with a serious problem of ... more Background: Patients, professionals, and health care systems are faced with a serious problem of pressure ulcers. They represent a significant occurrence and prevalence throughout the world. Their character iatrogenic states that its appearance is preventable, and its incidence is an indicator of scientific and technical quality both in primary care and specialized care. Surgery may be necessary to accelerate the healing process, although most pressure ulcers are usually treated with debridement and conservative therapy. Their reported incidence and prevalence are significant worldwide. Objectives: The study's objectives are to identify the pressure ulcer risk factors in patients getting home health care, as well as to look at the quantity, type, and characteristics of pressure ulcers as well as patient comorbidities. Methods: Cross-sectional study, Home Care Nursing personnel questionnaire to determine the Risk Factors of Pressure Ulcers, patient comorbidities, and the number, and characteristics of pressure ulcers among patients receiving home care in Riyadh, Saudi Arabia. Results: PU is prevalent among the studied participants in Saudi Arabia, about 55% of these ulcers showed noticeable distraction of skin and/or deeper soft tissue against a bony prominence. We have also found a significant relationship between PU and gender, diabetes mellitus, hypertension, incontinence issues, nutritional status, and physical status, cerebrovascular accidents, trauma, and chronic kidney disease. Conclusion: Different risk factors are associated with PU such as diabetes mellitus, hypertension, and nutritional, and physical status. To monitor and promote best practices in skin care for highly dependent patients, continued measurement and evaluation of PU incidence, it is recommended more research of risk factors of PU development be assessed at home Health care Centers.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Type 2 diabetes mellitus is a common health problem in Saudi Arabia. Awareness of patients about ... more Type 2 diabetes mellitus is a common health problem in Saudi Arabia. Awareness of patients about the disease, its complications, preventive measures, and management modalities will play a vital role in its better control and avoidance of hazardous complications. The objective was to assess type 2 diabetic patients` awareness of DM, its complications, preventive measures, and treatment modalities. A cross-sectional study was conducted among a sample of adult type 2 diabetic patients attending the chronic diseases clinic at Alwazarat primary healthcare center in Riyadh City, Saudi Arabia. Data were collected by interviewing patients using a valid questionnaire consisting of four main sections: socio-demographic characteristics of patients, diabetes-related characteristics, awareness about diabetic complications, and knowledge about different aspects of diabetes. The study included 252 type 2 diabetic patients. The age of 29.4% of them ranged between 50 and 59 years and males represented 58.7% of the patients. The majority of patients (92.5%) were aware of the development of diabetic complications in case of uncontrolled blood sugar levels. Among those patients, the most reported source of information was diabetologists (54.1%). The overall level of diabetic patients` knowledge about diabetes mellitus, its complications, and prevention and management modalities was good among 21% of patients whereas, it was poor among 31% of them. Patients aged between 30 and 49 years, females, housewives, university graduated patients (p<0.001) and married patients (p=0.001) were more knowledgeable about diabetes compared to their peers. Additionally, patients with a longer duration of diabetes (>5 years) (p=0.001), patients who reported nonadherence to anti-diabetic medications (p<0.001), those with a family history of diabetes (p<0.001), those having their information from diabetologists (p<0.001), and reported previous clinical examination for diabetic complications (p<0.001) were more knowledgeable about diabetes than their counterparts. The majority of type 2 diabetic patients were aware of the development of diabetic complications in case of uncontrolled blood sugar levels. However, the overall level of diabetic patients` knowledge about diabetes mellitus, its complications, prevention and management modalities was good among almost fifth of patients.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
During the pandemic of covid-19, many physicians got anxiety, depression, and insomnia that affec... more During the pandemic of covid-19, many physicians got anxiety, depression, and insomnia that affected their performance at work and daily life. According to the psychiatry department of Imperial College in London, they reported that it is necessary to assess the mental health of the health workers who were on the frontline during the COVID-19 pandemic and to evaluate the pattern of sleep and other issues that may affect their mental status. The aim of the study is to assess and analyze the existing evidence on the prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 outbreak. A cross-sectional study will be conducted in PSMMC, Riyadh. Assessing the psychosocial effect of COVID-19 among health care workers. sampling size and sampling procedure: 380 HCWs will be included in the estimated proportion of anxiety and depression. All doctors and nurses who met the criteria will be included in the study. Data collection form: Data will be utilized by conducting an online survey to decrease the risk of spreading infection through papers. The following variables will be collected and entered into Microsoft Excel 2010 x demographics x Medical characteristics x Job title and location x The psychosocial effects. The characteristics of the study participants are shown in Table (1). The mean age of the participants was 31.81(±7.64) years, and more than half of the participants were males at 52.15%, and 61.9% were single. Most of the participants were doctors at 76.7%, the vast majority (97.9%) were working during COVID-19, and 94.9% managed suspected COVID-19 cases, with a 73.3% high exposure level. For depression, more than half (59.32%) of the participants reported a loss of interest or feeling low, 39.41% and 33.90% agreed that the COVID-19 pandemic affected their daily life routine including feeling locked down and loss of interest in fun activities. For anxiety, the majority of the respondents reported experiencing anxiety at 83.9%, and almost half of them reported stigma thoughts and somatization at 49.58%, and 50.42%, respectively. Almost half and even more than half of the participants agree that the COVID-19 pandemic affected their daily life routine. In regards to insomnia, 61.44% said that their sleep pattern was affectedCOVID-19D 19 Pandemic, 75.85% has their social life negatively affected, and 82.20% had their work performance modified to follow the standard operating procedure. Data is shown in Table (2). The mean score of anxiety by the characteristics of the participants is shown in Table (3). The mean of the total anxiety score was 16.77(±3.98). Females showed a significantly higher mean score of anxiety compared to males at 17.55(±3.82) vs. 16.16(±4.01), with a p-value of <0.001. The anxiety score was the highest among doctors at 16.38(±3.93), with a significant p-value (0.003). The anxiety score was also significantly higher among those who were working during the pandemic, managing suspected cases, and with a high level of exposure to COVID-19. The mean of the total depression score was 7.37(±2.69), and it differed significantly (p <0.05) by gender, marital status, number of children, job title, working during the pandemic, and exposure level. Females score was higher at 8.06(±2.48) whilethe males one was 6.73(±2.73). Nurses showed the highest depression score at 8.26(±2.63), and those with high exposure levels showed a higher score at 7.91(2.59) compared to moderate exposure at 5.89(±2.40). Data is shown in Table (4) For insomnia, the mean total score was 2.19(±1). It was also significantly higher among females at 2.36(0.96), and nurses at 2.44(±0.96). Similarly, those who worked during the pandemic, managed suspected cases, and were at high exposure levels showed significantly higher insomnia scores as shownTablee (5). This study explored the prevalence of anxiety, depression, and insomnia and their associated factors among COVID-19 HCWs in Saudi Arabia. The results highlighted that the prevalence of anxiety, depression, and insomnia are concerning, and considered far higher compared to what was reported globally in this regard.
Acta Scientific Nutritional Health, Jul 1, 2023
Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of... more Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of both gender and all ages. Primary care physicians are key health personnel that encounters obese patients regularly. However, few physicians are knowledgeable about the management of morbid obesity, especially surgical treatment and procedures. Objective: To provide information contributing to the improvement of the knowledge and perception among primary care physicians about bariatric surgery, and their ability to care for patients who suffer from morbid obesity. Methods: The study design was cross-sectional. The study population was Primary care physicians working at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. A questionnaire developed by researchers of the university health network-Toronto adapted and modified to fit the setting of practice in the study population. The questionnaire was distributed among the physicians over 3 waves until 170 completed questionnaires were collected. Results: Of the total 170 respondents, Most of the participants (64.1%) reported measuring their patient's weight on each clinic visit. The majority (97.6%) used BMI to assess the weight of a patient (88.8%) of respondents had referred obese patients for bariatric surgery. The majority of responses admits the lack of knowledge for all types of surgery in question. Regarding the questions in the survey, a significant difference in the comparison between those who referred versus who did not refer patients to bariatric surgery is obvious in the percentage of morbidly obese patients seen in the last 12 months (p-value 0.015) and the ideal bariatric procedure in average patients (p-value 0.043). Conclusions and Recommendations: The study conclude that the knowledge of physicians in the bariatric surgical treatment of morbid obesity is insufficient. More guidelines and continuing education should be emphasized regularly to the physicians in order to improve their knowledge on management of obesity.
Acta Scientific Medical Sciences, Jul 1, 2023
Introduction: Flipped class learning is an innovative method for Health professional education, t... more Introduction: Flipped class learning is an innovative method for Health professional education, that yields active learning, interactive group learning, and more retained knowledge by trainees. Flipped Classroom (FC) has been approved by our training department in to be applied widely within the Saudi Family Medicine Residency Program (SFMR), especially for junior residents. Junior trainers are encouraged to take their part of responsibility in applying this new technique and gaining benefit from expert staff under their observation. Methods: From this study, we are looking at the perception of junior trainers in the Family Medicine training Program at PSMMC, Riyadh, Saudi Arabia towards the benefits and drawbacks of using FC in FM training. A mixed methods study in which opinions of junior trainers were compiled by three senior trainers in the FM training program. So, A Qualitative study design using a mixed method of data collection tools: Narrative survey and direct observation. Results: A non-random comprehensive sample of 8 junior staff involved in Family medicine training and 2 senior trainers were included. All participants affirmed the positive attitude towards FC in FM training, basically, it encourages the engagement of residents, improves attention, it provides trainees with a sense of ownership of the Class activity. Conclusion: Wide use of FC is recommended, and introduction of the concept of the FC early in the training program. Flipped class learning is an innovative method for Health professional education, that yields active learning, interactive group learning, and more retained knowledge by trainees, yet it's not short of challenges such as the need for huge time and efforts resources by instructors, needs to think as students and needs for strong organizational skills and the fact that there is always a need to ensure students have prepared prior to class.
Zenodo (CERN European Organization for Nuclear Research), Jul 2, 2023
The prevalence of patients' satisfaction has been evaluated in several studies globally with diff... more The prevalence of patients' satisfaction has been evaluated in several studies globally with different conclusions. Few local studies evaluate the prevalence of patients' satisfaction in Primary Health Care centers in Saudi Arabia. Study of satisfaction among patients with factors related to the clinical consultation plays a key role in assessing the quality of health care. The objective of this study is to determine the prevalence of satisfaction among patients in primary health care center in Riyadh, Saudi Arabia and to explore the factors that could affect patients' satisfaction with the medical consultations. A cross-sectional study has been conducted between January and July 2019 among patients of Alwazarat health care center. The data were collected using face to face interview method. 340 patients were interviewed. The mean age was 35.43 ± 10.76 years. Both age and educational level had significant relationships with patients' overall satisfaction. Overall satisfaction in both gender was as follow: 48.5% very satisfied, 44.7% satisfied, 3.8% not sure, 2.9% upset, zero very upset. The overall patient satisfaction is high among all ages of patients who require health care services and also among all patients' educational levels.
International journal of advanced community medicine, Oct 1, 2020
Background: Later childbearing trend is seen worldwide. Primary health care physicians are at the... more Background: Later childbearing trend is seen worldwide. Primary health care physicians are at the heart of all issues relating to infertility, and they continue to be the first line of contact with couples struggling to conceive. We conducted this study aiming to assess family physicians perceptions about their practice in infertility management at primary care centers, PSMMC, Riyadh, Saudi Arabia 2020. Methods: This was a cross-sectional survey study among family physicians working at PSMMC health care centers. Data was collected using a questionnaire that has been developed and validated by the study authors. It was self-administered, to 165 family physicians working at PSMM primary care centers. The questionnaire consisted of 5 sections: the socio-demographic data, exposure to infertility cases, perception about Practice in the evaluation of an infertile couple, perception about Practice in the treatment of an infertile couple, and the perception about practice in the diagnosis and referral of an infertile couple. Results: A total of 150 family physicians participated in the study, the vast majority (94%) has previously dealt with infertile couples, and 87.3% reported starting to investigate newly married couple with a minimum of at least one year after marriage. More than three-quarters of the participants were either strongly agree or agree (33.3%, and 48.7%, respectively) that they feel comfortable initiating the diagnostic evaluation of patients that present with infertility. Semen analysis was the first step in the evaluation of infertile couples by 51.3%, but 42% reported that they start with both semen analysis and blood work for females. Only 12% of the participants performed ovulation induction with clomiphene citrate. The highest frequent causes of referral were either infertility >2 years among subjects aged <35, or those aged>35 years with infertility of>1 year at 57.3%, and 56.7%, respectively Conclusion: family physicians participated in the current study showed Positive attitude, perception, and practice in infertility management. However, still there is a need for evidence-based training regarding infertility management to improve family physicians' practice and management of infertility.
Family medicine and primary care, Nov 26, 2021
Background: Pregnancy is a diabetogenic condition, with Gestational Diabetes Mellitus (GDM) devel... more Background: Pregnancy is a diabetogenic condition, with Gestational Diabetes Mellitus (GDM) developing in 3 to 25% of all pregnancies. GDM has unfavorable short-and long-term consequences for both mothers and their children. We conducted this study aiming to assess the prevalence of gestational diabetes and associated risk factors during pregnancy in Riyadh, Saudi Arabia. Methods: This was a retrospective cross-sectional survey study. GDM diagnosis was based on the universal two-hour 75 g OGTT. GDM cases were defined using the 75 g OGTT with at least one value of plasma glucose concentration equals to or exceeds the thresholds of 92 mg/dl, 180 mg/dl, and 153 mg/dl for fasting one-hour, and 2-hour post glucose, respectively. The data was collected by the study authors from patients' files using a data collection form that included the oral glucose tolerance test results in addition to the participants' socio-demographic data. Results: A total of 384 pregnant women were recruited, the highest percentage (29.7%) of them aged 26 to 30 years old, 35% were overweight and 24.5% were obese, and 72.4% were multi-parity. Based on the 2h OGTT, the prevalence of GDM was 32.6%. The univariate logistic regression analysis showed that old age, low educational level, higher BMI, family history of DM, higher rates of multi-parity, abortions, C-sections, and hypothyroidism were significant risk factors for GDM. On the other hand, there were no significant associations between occupational status, PCOS, preeclampsia, hypertension, asthma, and GDM. Conclusion: GDM diagnosed on basis of the OGTT criteria was very common among pregnant women in Saudi Arabia. Overweight and obesity as well as older age were associated with an increased risk of GDM. Also, low educational level, family history of DM, GDM history, history of abortion, and C-section were all significant risk factors of GDM.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Acceptance of mandatory influenza vaccination requires an understanding of knowledge, and attitud... more Acceptance of mandatory influenza vaccination requires an understanding of knowledge, and attitudes (KA). This study explored the KA and other co-variables influencing the acceptance of mandatory influenza vaccination among Saudi physicians working in primary care. A Cross-sectional study among Saudi physicians working at Wazarat primary health care center in Riyadh was conducted from Nov 2022throughJan 2023. A convenience sample of 162 physicians was recruited and surveyed using a validated questionnaire. A total of 138 responded and completed the study. Univariate and multivariate analyses using SPSS version 22 were performed to assess associations between sociodemographic factors, KA, and acceptance of mandatory influenza vaccination. The response rate was 85%. While the age of 92% of the participants was < 36 years, 73.2% were males, and 34.1% were smokers. Only 67.4% of the participants accepted mandatory vaccination. Youngers, females, singles, postgraduates, and staff with no chronic disease had higher odds to accept the mandatory flu vaccine. On univariate analysis, physicians with better knowledge and good attitudes were more likely to accept the mandatory flu vaccination. On multivariate analysis, physicians with higher knowledge and attitude scores were more likely to accept the mandatory vaccination (adjusted odds ratio (aOR): 1.17; (95%CI 1.05, 1.31)). Acceptance of mandatory vaccination was negatively correlated with a declination of flu vaccination (r=-0.237, P=0.005) and positively with actual vaccination (r= 0.203, P=0.017). High levels ofgood attitudes towards and knowledge of influenza vaccination were associated with a high level of acceptance of mandatory flu vaccination. This study paves the way for more targeted initiatives including risk communication approaches to be implemented to improve acceptance of mandatory influenza vaccination rates.
Zenodo (CERN European Organization for Nuclear Research), May 26, 2023
Research activities carried by postgraduate medical residents are very important in promoting bet... more Research activities carried by postgraduate medical residents are very important in promoting better clinical care, critical reasoning and writing, keeping updated with local, regional and international guidelines as well as lifelong education. However, some barriers were identified to prevent residents from conducting of high-quality research during residency. The research objective was to determine the barriers that can prevent family medicine residents to conduct high-quality research during residency and to make publication by the residents during residency. A cross-sectional survey was conducted among family medicine residents enrolled in the residency program the of seven largest hospitals in Riyadh City, Kingdom of Saudi Arabia. A self-reported survey instrument was used for data collection. It included questions regarding personal and academicrelated characteristics of physicians, history of taking research during residency, confidence and motivation in seeking publication of research and barriers and existing resources conducting research. A total of 254 family medicine residents responded out of targeted 286, giving a response rate of 88.8%. The majority of them (85%) aged between 26 and 29 years. Males represented 53.9% of them. Regarding their future choice after completion of the residency program, 33.1% chose practice as family medicine specialists whereas 24% chose to pursue a graduate degree. Majority of the respondents (91.3%) reported taking a research course during residency training and 85% reported presence of a mandatory research course during residency training. The commonest reported barriers mentioned by family medicine residents to complete their research were lack of overall interest in research project (40.2), lack of interest in completing research (38.6%), limited knowledge of the processes associated with research (36.2%) and lack of time available to complete research activities (24.4%). Regarding the resources currently available to assist the family medicine residents in the pursuit of research, the most frequently reported were mentorship from a preceptor or colleague with extensive research experience (59.1%) and mentorship from preceptors with extensive family medicine practice experience (49.6%). Barriers are existing regarding the conduction of research projects among family medicine resident physicians. Thus, people in charge should implement measures in order to create effective solutions to these barriers.
Acta Scientific Nutritional Health, Apr 1, 2023
Objectives: This systematic review studied current updates to the literature on patients with ost... more Objectives: This systematic review studied current updates to the literature on patients with osteoarthritis (OA) who underwent total hip arthroplasty (THA) to improve their quality of life (QoL). We also looked into the reported interventions that could enhance postoperative recovery. Methodology: PubMed, Web of Science, Science Direct, EBSCO, Wiley, and Cochrane Library were searched. Study articles were screened by title and abstract using Rayyan QCRI then a full-text assessment was implemented. Results: A total of Twenty-nine studies with 74664 patients were included in this review. The follow-up duration ranged from 3 months to 96 months. All of the included studies reported improved QoL of OA patients following THA. One study reported that underweight, overweight, or obese (classes I to III) experienced more hip pain after THA. Two other studies reported that continuous nursing (CN) counted on the WeChat platform and IARA intervention significantly enhanced the QoL among patients. Conclusion: enhancing patients' physical and mental health after THA is essential for improving recovery and patient QoL. Underweight, overweight, or obese experienced more hip pain after THA. Interventions such as CN counted on WeChat and IARA were found to greatly impact patients' recovery and well-being after discharge.
Acta Scientific Nutritional Health, Jun 1, 2023
Background: Obstructive sleep apnea (OSA) is a chronic sleep-related disorder that afflicts a maj... more Background: Obstructive sleep apnea (OSA) is a chronic sleep-related disorder that afflicts a majority of obese patients. The current study aimed to evaluate the prevalence of OSA in obese patients with other comorbidities and to identify factors that may be associated with its progression. Methods: A cross-sectional, observational study was conducted at the Alwazarat health care center (PSMMC) in Riyadh, Saudi Arabia. Participants were recruited from the center's chronic diseases clinic who were 18 years or older. All participants completed a questionnaire that included questions about their medical history, sleeping habits, and impact on routine functionality. Results: A total of 337 participants were included in the study, with the majority of participants between the ages of 35 to 49 years (29.6%). The most common BMI range was 26-31, which was found in 111 individuals (32.9%) whereas 24.3% of participants had a 32-36 BMI range. The results showed that a total of 82 (24.3%) had at least one of the listed conditions including asthma, dyslipidemia, diabetes, heart disease, and thyroid disease. The most common comorbidity was diabetes which was diagnosed in 108 individuals (32.0%). The incidence of multiple conditions, with the most common combination being diabetes and asthma, was diagnosed in 18 individuals (5.3%). In response to snoring, 263 (78%) answered yes, 68 (20.2%) answered no, and 6 (1.8%) responded that they don't know. Concerning the extent of snoring, 70 (20.8%) reported their snoring as loud as talking, 14 (4.2%) responded that it was louder than talking, and 188 (55.8%) felt it was slightly louder than breathing. The majority of participants reported rarely or never experiencing instances of interrupted breathing during sleep. A high proportion of participants reported having high blood pressure (50.1%). Conclusions: The results of this study suggest a significantly high prevalence of OSA in obese patients with multiple comorbidities.
Journal of Family Medicine and Primary Care
Introduction: Early detection and prevention of diseases can reduce morbidity, mortality, and eco... more Introduction: Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services. Materials and Methods: This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening f...
Family medicine and primary care, Feb 22, 2022
Background: Potentially Inappropriate Medications (PIMs) are drugs in which the adverse risks exc... more Background: Potentially Inappropriate Medications (PIMs) are drugs in which the adverse risks exceed the clinical benefits, lacking evidence-based indications, potentially interact with other medications. PIM use is common in older adults who are frequently treated with multiple medications. PIM use in older adults is associated with many complications. Aim: To critically appraise and systematically evaluate the existing studies on the effectiveness of pharmacist-led deprescribing in health service utilization, clinical effectiveness, cost effectiveness and cost utility. In nursing home and ambulatory care settings and patients aged 65 years and above. Methods: PubMed, Medline, CINAHL, Embase, and Cochrane Library were searched between 1st to 2nd July 2021 and updated on 25 th December 2021 to select studies that compare pharmacist-led deprescribing in nursing home and ambulatory care settings with usual care. Outcomes related to health service utilization, clinical effectiveness, cost effectiveness and cost utility were evaluated. Results: A total of 3944 relevant records were identified through database searching. A further ten records were identified by following up citations and reference lists of the selected studies. After assessment, nine studies were included in the review. Four of the included studies reported outcomes relating to both health service utilization and clinical effectiveness, three studies reported only health service utilization, and the two economic studies reported cost effectiveness and cost utility respectively. Six out of seven studies that reported health service utilization outcomes found improvement in health service utilization after the implementation of the pharmacist-led deprescribing. However, there is no positive clinical effectiveness outcomes, and no worldwide studies for the economic outcomes. Conclusion: This evidence of moderate to high quality. Pharmacist-led deprescribing was effective only in reducing PIMs usage and medication burden for older adults in nursing home and ambulatory care setting, but with no clinical effectiveness outcomes. It is essential to evaluate the economic outcomes in different countries other than Canada (high-income county).
Acta Scientific Medical Sciences
Introduction: Worldwide obesity has become one of the most common public health concerns. In addi... more Introduction: Worldwide obesity has become one of the most common public health concerns. In addition to being an increased mortality risk factor, it also contributes to type 2 diabetes, hypertension, heart disease, and some types of cancer. On aiming to reduce body mass index multiple measures are scientifically investigated such as lifestyle modification, pharmacological and surgical therapy. This review took a critical look on evaluating the scientific evidence of GLP-1 Vs bariatric surgery and the outcome of cardiovascular events. Methods: PubMed, Google Scholar and Research Gate were searched for recent studies published in the period between 2010 and 2021. Results: A total of 16 studies with 283983 patients were included in this review. Of these, 77316 patients were in the intervention groups representing 27.2% of the overall studied population. Around 9% of patients were in the bariatric surgery group, while 18% were in the GLP-1 group. Nine studies used bariatric surgery as their primary intervention, while seven used GLP-1. The mean age of participants ranged from 32.4 to 66 years. Conclusion: In conclusion, GLP-1 showed similar event rates to the control group for MI and CVD but better stroke outcomes. Moreover, bariatric surgery, across studies demonstrated a significant reduction in the risk of the studied events. Thus, we recommend conducting high-quality trials comparing the two interventions to safely apply the results in everyday practice.
Acta Scientifci Nutritional Health
Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of... more Background: Obesity is one of the most common health problems in Saudi Arabia affecting people of both gender and all ages. Primary care physicians are key health personnel that encounters obese patients regularly. However, few physicians are knowledgeable about the management of morbid obesity, especially surgical treatment and procedures. Objective: To provide information contributing to the improvement of the knowledge and perception among primary care physicians about bariatric surgery, and their ability to care for patients who suffer from morbid obesity. Methods: The study design was cross-sectional. The study population was Primary care physicians working at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. A questionnaire developed by researchers of the university health network-Toronto adapted and modified to fit the setting of practice in the study population. The questionnaire was distributed among the physicians over 3 waves until 170 completed questionnaires were collected. Results: Of the total 170 respondents, Most of the participants (64.1%) reported measuring their patient's weight on each clinic visit. The majority (97.6%) used BMI to assess the weight of a patient (88.8%) of respondents had referred obese patients for bariatric surgery. The majority of responses admits the lack of knowledge for all types of surgery in question. Regarding the questions in the survey, a significant difference in the comparison between those who referred versus who did not refer patients to bariatric surgery is obvious in the percentage of morbidly obese patients seen in the last 12 months (p-value 0.015) and the ideal bariatric procedure in average patients (p-value 0.043). Conclusions and Recommendations: The study conclude that the knowledge of physicians in the bariatric surgical treatment of morbid obesity is insufficient. More guidelines and continuing education should be emphasized regularly to the physicians in order to improve their knowledge on management of obesity.