Project description:To date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were reviewed. In addition, liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was utilized to determine the 6-monoacetylmorphine (6-MAM), 6-acetylcodeine (6-AC), morphine (MOR), and codeine contents in unhydrolyzed postmortem specimens. Ninety-seven heroin-related deaths were assessed in this study, and they represented 2% of the total postmortem cases at the JPCC (median age, 38; 98% male). In the blood, urine, vitreous humor, and bile samples, the median morphine concentrations were 280 ng/mL, 1400 ng/mL, 90 ng/mL, and 2200 ng/mL, respectively; 6-MAM was detected in 60%, 100%, 99%, and 59% of the samples, respectively; and 6-AC was detected in 24%, 68%, 50%, and 30% of the samples, respectively. The highest number of deaths (33% of total cases) was observed in the 21-30 age group. In addition, 61% of cases were classified as "rapid deaths," while 24% were classified as "delayed deaths." The majority (76%) of deaths were accidental; 7% were from suicide; 5% were from homicide; and 11% were undetermined. This is the first epidemiological study to investigate heroin-related fatalities in Saudi Arabia and the Middle East and North African region. The rate of heroin-related deaths in Jeddah remained stable but increased slightly at the end of the study period. Most patients were heroin-dependent abusers and from the middle-aged group. The availability of urine, vitreous humor, and bile specimens provided valuable information regarding the opioids that were administered and the survival time following heroin injection.
Project description:BackgroundProviding basic life support (BLS) at the site of an accident is crucial to increase the survival rates of the injured people. It is especially relevant when health care is far away.ObjectiveThe aim of our study is to assess the BLS knowledge level of the Saudi Arabian population and identify influencing factors associated with level of knowledge about BLS.MethodsOur study is a cross-sectional descriptive study, which was conducted using a self-administered online questionnaire derived from the BLS practice test. The Saudi population was the target population. The questionnaire was divided into two parts: one contained demographic data and the second part contained questions to test the population's perception about how to perform BLS techniques properly. The data were collected between July and August 2017. Statistically significant differences were defined as those with a P value <.05, and a score of five or more was considered a passing score on the second part. We used SPSS version 21 for data analysis.ResultsOur study included 301 participants. Our participants' BLS online exam scores ranged from 0 to 10, with a mean of 4.1 (SD 1.7). Only 39.2% (118/301) of the participants passed the test. The percentage of bachelor's degree or higher holders constituted 60.1% (181/301) of the study population. In addition, higher income was significantly associated with higher scores on the test (P=.04).ConclusionsThis study demonstrated that the theoretical knowledge level of BLS among the general population in Jeddah was below average. There is a critical need to increase the public's exposure to BLS education through raising awareness campaigns and government-funded training programs that aim to curb the incidence of out-of-hospital cardiac arrest mortalities in the Saudi community.
Project description:BackgroundPediatric sepsis remains a significant cause of morbidity and mortality worldwide. This study aimed to identify the incidence of sepsis and septic shock among patients admitted to the pediatric intensive care unit (PICU) of a tertiary center in Saudi Arabia. Patients' demographics and risk factors associated with sepsis-related mortality were also investigated.MethodsA retrospective cohort study was conducted in the PICU of King Abdulaziz Medical City, Jeddah (KAMC-J). KAMC-J is a tertiary care hospital in the western region of Saudi Arabia. A total of 2389 patients admitted to the PICU of KAMC-J between January 1, 2013 and December 31, 2017 were screened and evaluated for sepsis using The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).ResultsOf the 2389 total admissions to the PICU, 113 patients (4.9%) met the definition of Sepsis-3; 50.4% of the 113 patients met the definition of septic shock. Most patients (66.3%) were less than 6 years old, and 52.2% were male. Eight-five patients (75.2%) had underlying comorbidities. The respiratory system was the most common primary site of infection (57.5%). Bacterial and viral infections were the most common infectious etiology with reported rates of 29.2 and 21.2%, respectively. The median duration of PICU stay was 8 days and the 28-day PICU mortality rate was 23.9%. A Pediatric Sequential Organ Failure Assessment (pSOFA) Score greater than four and a pre-existing percutaneous central venous catheter were associated with a significant increase in mortality, with adjusted odds ratios of 3.6 (95% confidence interval: 1.30-9.93) and 9.27 (95% confidence interval: 1.28-67.29), respectively.ConclusionsThe incidence of sepsis in our institution is comparable to that reported internationally; however, the mortality rate is higher than that of developed countries. Nationwide studies identifying sepsis epidemiology are needed to improve the outcome of pediatric sepsis. Following international guidelines for central-line insertion and maintenance is of paramount importance.
Project description:ObjectivesThe objective of this study was to determine whether female genital mutilation/cutting (FGM/C) exists in Jeddah, Saudi Arabia.DesignA cross-sectional study.SettingKing Abdulaziz University Hospital, Jeddah, Saudi Arabia.ParticipantsBetween December 2016 and August 2017, women attending the obstetrics and gynaecology clinics were asked to participate in a cross-sectional survey. This included questions on demographics, FGM/C status and type and attitudes towards the practice.ResultsIn a convenience sample of 963 women aged 18 to 75 years, 175 (18.2%) had undergone FGM/C. Compared with women without FGM/C, women with FGM/C were older, married, non-Saudi and had a lower monthly income. Thirty-seven (21.1%) women had had FGM/C with some cutting of body parts (type I or II), 11 (6.3%) with suturing (type III), 46 (26.3%) with no cutting of body parts (type IV) and 81 (46.3%) did not know their type of FGM/C. There was also a significant association between nationality and age at which FGM/C was performed, with Saudi women undergoing the procedure earlier than Egyptian, Somali, Yemeni and Sudanese women.ConclusionsFGM/C is prevalent in Jeddah, Saudi Arabia, among immigrant women from other countries, and it is practised among Saudi women. Further research is needed to determine its prevalence.
Project description:Background Cardiovascular disease (CVD) remains the major cause of global mortality. Applying a comprehensive interventional program may reduce the incidence of cardiovascular disease and its complications. Objective This study compared the effects of a three-month intervention involving lifestyle modification and physical activity with standard care in women ≥30 years having a moderate to high risk of CVD, with respect to improving physical activity and cardiovascular disease risk factors at the National Guard Residential City in Jeddah, Saudi Arabia, in 2015. Methods The effects of this community-based lifestyle program were assessed through a randomized controlled trial from January 1st to September 6th, 2015. Women in the intervention group (n = 31) received health education, exercise training, and diet counselling as individuals and in groups according to the participant's risk. Women in the control group (n = 28) received one health education session at the screening site. The primary outcome was the proportion of women with moderate Framingham risk scores (FRS) reducing their risk by 10% and the proportion of women with high FRS reducing their risk by 25%. The secondary outcome was the proportion of women reducing their risk by ≥1 risk category. Results The mean participant age was 42 ± 8 years. At three-month's follow-up, reductions were greater in the intervention group and the difference between groups was statistically significant (p < 0.05). Lifestyle intervention program significantly reduced systolic blood pressure (-9.2 mmHg), blood glucose (-45 mg/dL) and Framingham risk score (-13.6). Linear regression analysis revealed a significant improvement in the Framingham risk score (p < 0.01). Conclusion In a population of women with moderate-to-high risk of CVD, a personalized lifestyle modification program showed positive association in improving the 10-year cardiovascular Framingham risk score after three months.
Project description:ObjectivesThis study evaluates awareness of folic acid and neural tube defects, use of folic acid and knowledge of folic acid usage among female university students in Saudi Arabia.MethodsAn analytical cross-sectional survey was conducted in the Jeddah branch of Saudi Electronic University. A total of 400 female students in the 19-45 years age group were contacted to participate in the study using a convenience sampling method. Eighty-eight students refused to participate, so 312 students were included in the study. Demographic characteristics of participants and their awareness, usage and knowledge of folic acid are presented as frequencies and percentages. Logistic regression analysis was used to compute crude odds ratios to show the association between demographic factors and knowledge of folic acid supplementation. A further adjusted odds ratio was calculated to control for other cofactors. A p-value < 0.05 was considered significant.ResultsOverall, 81.1% (253/312) of respondents had heard of folic acid, 30.4% knew about neural tube defects, and 47.1% of respondents reported using folic acid supplements. Marriage was found to be associated with awareness of folic acid (adjusted odds ratio (95% confidence interval) = 2.64 (1.01-6.91)). Health sciences specialization and experience of pregnancy were associated with the usage of folic acid (adjusted odds ratio (95% confidence interval) = 3.46 (1.73-6.91) and adjusted odds ratio (95% confidence interval) = 6.70 (3.09-14.53), respectively). A bachelor's and above education level was found to be associated with knowledge of folic acid deficiency leading to neural tube defects (adjusted odds ratio (95% confidence interval) = 2.03 (1.17-3.52)), and health sciences specialization was found to be associated with knowledge of natural sources of folic acid (adjusted odds ratio (95% confidence interval) = 2.33 (1.25-4.36)). Similarly, marriage was found to be associated with knowledge of the correct dosage of folic acid and timing of folic acid to prevent neural tube defects (adjusted odds ratio (95% confidence interval) = 6.34 (3.50-11.48) and adjusted odds ratio (95% confidence interval) = 3.45 (1.93-6.16), respectively). Experience of pregnancy was found to be an associated with good total knowledge of folic acid (adjusted odds ratio (95% confidence interval) = 3.05 (1.65-5.63); p = 0.0001).ConclusionThe study findings highlight the lack of awareness among female university students about the importance of folic acid usage in the prevention of neural tube defects. There is a need for interventional programs in universities to create awareness.
Project description:Background:Peripheral artery disease (PAD) is a major health problem in Saudi Arabia with considerable implications for morbidity and mortality. Many risk factors have been established for developing PAD, but the prevalence of these risk factors is variable from one country to another. Aim:To identify the risk factors for PAD and study their prevalence in Jeddah, Saudi Arabia. Methods:A retrospective chart review study was conducted in a tertiary center in Jeddah from July 2012 to September 2015. All patients with PAD were recruited into this study, and their data were analyzed using IBM SPSS. Correlation between PAD and various risk factors was studied using Spearman's coefficient. Results:A total of 261 patients were recruited, of which 55% were males. Hypertension, diabetes type 2, and obesity were found among 34.2%, 33.3%, and 29.2% of the patients, respectively. About 45% had a history of previous vascular surgery, and amputation was performed in 6.9% particularly in legs. Hypertension and metabolic syndrome were the only risk factors that showed a significant correlation with PAD (P=0.039 and 0.040, respectively). Conclusion:The most prevalent risk factors for PAD in Jeddah were hypertension, diabetes, obesity, and smoking. Hypertension and metabolic syndrome were the only risk factors significantly associated with PAD. Males were often more affected by PAD than females. The most commonly affected site was the lower limbs.
Project description:The promotion of physical activity (PA) in various subgroups of the population such as people with physical disabilities has been spotlighted in the revised guidelines of The World Health Organization (WHO), Geneva, Switzerland. In order to update public health interventions, there is a need to identify factors that may promote or prevent engagement in PA for special subgroups of the population. This study aims to calculate the PA levels of individuals with and without physical disabilities in Saudi Arabia, their assessment of the environmental (EQoL), and the predictive role of EQoL in PA. The International Physical Activity Questionnaire (IPAQ) and the EQoL domain in standardized WHOQoL Questionnaire were administered on both groups of the population. The study sample comprised 116 individuals with physical disabilities and 243 individuals without any form of disability as a control group. A regression analysis was performed to analyze the predictors of PA in both groups. Findings showed that among the individuals with disabilities, older people were more likely to engage in PA as compared to the younger age group (p < 0.05) and males were significantly less likely to meet the PA criteria. Some of the EQoL features such as safety increased the likelihood of PA up to 2.3 times (p < 0.05) in individuals with physical disabilities. In addition, opportunities for leisure activities were a significant predictor of PA among both groups of individuals with and without physical disabilities (p < 0.05). Our findings suggest that upcoming public health interventions should focus on improving various dimensions of EQoL for the promotion of physical activity among individuals with physical disabilities. Additional studies are needed to further explore various sociodemographic and environmental factors which can affect the PA status of disabled groups.
Project description:Tumor protein 53 (TP53) is a tumor-suppressor gene and plays an essential role in apoptosis, cell cycle arrest, genomic stability, and DNA repair. Although it is the most often mutated gene in human cancer, it has respectively low frequency in hematological malignancy but is significantly linked with complex karyotype, poor prognosis, and chemotherapeutic response. Nevertheless, the prevalence and prognostic role of TP53 mutations in hematological malignancy in Saudi patients are not well reported. We, therefore, aim to assess the frequency of TP53 mutations in hematological malignancies in Saudi Arabia. 20 different hematological malignancy samples were tested using fluorescence in situ hybridization (FISH) technique for TP53 deletion detection and next-generation sequencing (NGS) targeted panel was applied on 10 samples for mutations identification specifically TP53 mutation. TP53 deletion was detected in 6 of 20 samples by FISH. Most of the 6 patients with TP53 deletion had acute lymphoblastic leukemia (ALL), and majority of them were child. NGS result revealed one heterozygous missense mutation in exon 5 of the TP53 gene (c. G9963A, p.H175R). To the best of our knowledge, the TP53 mutation is novel variant, and the first time we are reporting their association with myelodysplastic syndromic individual with complex karyotype. This study recommends further analysis of genomic mutations on bigger cohorts, utilizing high throughput technologies.
Project description:Wolbachia (Hertig 1936) (Rickettsiales: Ehrlichiaceae) has emerged as a valuable biocontrol tool in the fight against dengue by suppressing the transmission of the virus through mosquitoes. Monitoring the dynamics of Wolbachia is crucial for evaluating the effectiveness of release programs. Mitochondrial (mtDNA) markers serve as important tools for molecular tracking of infected mitochondrial backgrounds over time but require an understanding of the variation in release sites. In this study, we investigated the mitochondrial lineages of Aedes aegypti (Linnaeus 1762) in Jeddah, Saudi Arabia, which is a prospective release site for the "wAlbBQ" Wolbachia-infected strain of this mosquito species. We employed a combination of comprehensive mitogenomic analysis (including all protein-coding genes) and mtDNA marker analysis (cox1 and nad5) using data collected from Jeddah. We combined our mitogenome and mtDNA marker data with those from previous studies to place mitochondrial variation in Saudi Arabia into a broader global context. Our findings revealed the presence of 4 subclades that can be broadly categorized into 2 major mitochondrial lineages. Ae. aegypti mosquitoes from Jeddah belonged to both major lineages. Whilst mitogenomic data offered a higher resolution for distinguishing Jeddah mosquitoes from the wAlbBQ strain, the combination of cox1 and nad5 mtDNA markers alone proved to be sufficient. This study provides the first important characterization of Ae. aegypti mitochondrial lineages in Saudi Arabia and offers essential baseline information for planning future molecular monitoring efforts during the release of Wolbachia-infected mosquitoes.