Abdullah A Yousef

Lack of MERS Coronavirus Neutralizing Antibodies in Humans, Eastern Province, Saudi Arabia

We used a lentiviral vector bearing the viral spike protein to detect neutralizing antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV) in persons from the Eastern Province of Saudi Arabia. None of the 268 samples tested displayed neutralizing activity, which suggests that MERS-CoV infections in humans are infrequent in this province.

The Saudi initiative for asthma - 2012 update: Guidelines for the diagnosis and management of asthma in adults and children

This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.

Assessing the construct validity and reliability of the parental perception on antibiotics (PAPA) scales

BackgroundThe overuse of antibiotics is becoming an increasing concern. Antibiotic resistance, which increases both the burden of disease, and the cost of health services, is perhaps the most profound impact of antibiotics overuse. Attempts have been made to develop instruments to measure the psychosocial constructs underlying antibiotics use, however, none of these instruments have undergone thorough psychometric validation. This study evaluates the psychometric properties of the Parental Perceptions on Antibiotics (PAPA) scales. The PAPA scales attempt to measure the factors influencing parental use of antibiotics in children.Methods1111 parents of children younger than 12 years old were recruited from primary schools’ parental meetings in the Eastern Province of Saudi Arabia from September 2012 to January 2013. The structure of the PAPA instrument was validated using Confirmatory Factor Analysis (CFA) with measurement model fit evaluated using the raw and scaled χ2, Goodness of Fit Index, and Root Mean Square Error of Approximation.ResultsA five-factor model was confirmed with the model showing good fit. Constructs in the model include: Knowledge and Beliefs, Behaviors, Sources of information, Adherence, and Awareness about antibiotics resistance. The instrument was shown to have good internal consistency, and good discriminant and convergent validity.ConclusionThe availability of an instrument able to measure the psychosocial factors underlying antibiotics usage allows the risk factors underlying antibiotic use and overuse to now be investigated.

The continuous glucose monitoring system (CGMS) in patients with beta-thalassemia major

Background: Blood transfusion-dependent beta Thalassemia Major (BTM) patients are at risk of hemosiderosis. Hemosiderosis of pancreas results in impaired glucose homeostasis tolerance and diabetes mellitus (DM). Since glycosylated hemoglobin has limited role in patients with hemoglobinopathies, this study was conducted as a first attempt worldwide to understand glucose homeostasis and evaluate efficacy of Continuous Glucose Monitoring (CGM) system as a diagnostic tool of abnormal glucose homeostasis in these patients. Materials and Methods: A case series study of six non-diabetic, transfusion-dependent beta-thalassemia patients aged 9-13-year-old. Clinical and laboratory data were collected on admission for their monthly transfusion. Patients were connected to CGM systems for one day. Findings: Using CGM and based on American Diabetes Association guidelines, three patients were found to have abnormal glucose levels of diabetic range. The other three showed impaired glucose tolerance. Among all patients, glycosylated hemoglobin (HbA1C) readings have an inverse relationship to CGM and calibration readings. Conclusion: CGM could be a promising tool for evaluating BTM patients. Larger studies are recommended.

Clinical description of human bocavirus viremia in children with LRTI, Eastern Province, Saudi Arabia

Human bocavirus (HBoV) is a major etiology of lower respiratory tract infection (LRTI) in young children. We tested 149 patients admitted to King Fahd Hospital of the University with diagnosis of LRTI. Viremia caused by the different studied viruses was detected in 31.5% of the total cases by Real-time Polymerase chain reaction. We report five patients who were positive for HBoV in serum samples. Clinical presentation ranged from mild to severe disease as one of them required admission to intensive care unit. Wheezing was a striking feature in most of our patients, but fever was not a consistent finding.

A Review of Nonfatal Drowning in the Pediatric-age Group: A 10-year Experience at a University Hospital in Saudi Arabia

Objective The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. Methods Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient’s outcome analyzed. Patients’ outcomes were classified into either full recovery, moderate to severe neurological damage, or brain death. Results Fifty-one subjects were included in the study; 66.7% were males, 57% were younger than 6 years, and 80% were Saudi citizens. Of the total cases, 94% recovered fully, and 6% were diagnosed as having brain death or discharged from the intensive care unit with severe neurological injury. Submersion time of more than 5 minutes, Glasgow Coma Scale of 4 or less, pH of less than 7.1, temperature of 35°C or less, and blood sugar of 180 mg/dL or greater were found to correlate with bad outcomes with great statistical significance. Conclusions The findings of this study were in line with results of most of the international and local studies on the subject. Significant defects have been concluded in prehospital medical care and cardiopulmonary resuscitation. Adequate swimming safety regulations, assignments of lifeguards, and parental education should be taken into consideration by media and involved authorities.

Epidemiological aspects of prematurity in the Eastern region of Saudi Arabia

Objectives: To assess the epidemiological characteristics of prematurity and survival rate in preterm infants diagnosed at a university hospital in the Eastern province of Saudi Arabia. Methods: A retrospective study was carried out of 476 preterm infants who were admitted with the diagnosis of prematurity to King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, between June 2008 and 2013. Demographics, birth weight, and neonatal survival rate were analyzed. Results: Four hundred and seventy-six preterm infants were admitted with a total prevalence of 7.5%. Descriptive analysis revealed 55% were males. Extremely preterm infants (<28 weeks’ gestation) comprised 9% and very preterm infants (28 to <32 weeks’ gestation) comprised 20%. Extremely low-birth-weight (ELBW) infants (<1000 g) comprised 11%. One hundred and fifty-seven (32%) infants were small for gestational age. Out of the total number of ELBW infants, 58% of them were discharged. The overall mortality was 7.6%. The mortality rate of male infants was 53%. The survival to discharge according to gestational age ranged from 30-97.6%. Conclusion: The estimated prevalence of preterm births in a university hospital in eastern province of Saudi Arabia, is consistent with various studies from different parts of the world.

The Parental Use of Antibiotics in Children in Saudi Arabia

Background: The overuse of antibiotics especially in children is becoming one of the most important public health issues worldwide. This study aims to assess the factors underlying the parental use of antibiotics for children in Saudi Arabia. Methods: This is a cross-sectional study design. The study included 1104 Parents (52% were mothers) of children younger than 12 years old recruited from schools parental meetings in the Eastern Province of Saudi Arabia. Ordinal logistic regression was used to identify the factors influencing the parental use of antibiotics in children. Risk factors considered included parents’ demographic information, child health-related information, along with the validated Parents Perceptions on Antibiotics (PAPA) scales, an instrument that measures parents’ knowledge and beliefs, behaviors, adherence, seeking information, and awareness about antibiotic resistance. Results: There is a high association between the frequency of cold episodes and the number of antibiotics used for the youngest child in the family during the previous year. Three parent-related psychosocial aspects appeared to be significantly associated with the parents’ tendency to use an antibiotic in their children: Knowledge and beliefs, behaviors, and seeking health-related information. Also, parent’s geographical background is associated with their use of antibiotics. Conclusion: The strong association between the number of cold incidence and the amount of antibiotics used suggests an evidence for antibiotic misuse in Saudi Arabia. In addition, to stronger regulations relating to dispensing antibiotics, the Saudi government should implement public health interventions aimed at advocating parents to appropriate use of antibiotics, and the potential dangers in their misuse.

Pediatric pulmonary services in Saudi Arabia

OBJECTIVE: The purpose of this study was to assess the available pediatric pulmonary services, in terms of workforce, resources, and distribution across Saudi Arabia. This would help in proper utilization of resources and direct future planning. METHODS: A cross-sectional survey among pediatric pulmonologists registered in the Saudi Thoracic Society. RESULTS: Among 43 practicing pediatric pulmonologist in Saudi Arabia, 29 have responded to the survey (response rate of 67.4%). The majority of practicing pediatric pulmonologists were young graduates with less than 5 years’ experience (44.8%) and were North American training programs graduates (69%). The majority of the respondents (51%) were located in Riyadh, 27% in Jeddah, 14% in the Eastern region and 3% in Madinah and Al-Majma’a. Most of the respondents had access to basic diagnostic tools required in the subspecialty, a majority of them (85%) lack dedicated pediatric pulmonary function laboratories. Nearly, 80% of the hospitals performed less than 50 flexible bronchoscopies/year. CONCLUSION: Pediatric pulmonology is a growing subspecialty in Saudi Arabia with well-trained and experienced physicians. Our study represents an overview of the available pediatric pulmonology services in Saudi Arabia, which would help in future planning and better utilization of the available resources.

Bronchial atresia in a neonate with congenital cytomegalovirus infection

Bronchial atresia (BA) is characterized by a mucus-filled bronchocele in a blind-ending segmental or lobar bronchus with hyperinflation of the obstructed segment of the lung. We describe a neonate who presented on his 9th day of life with respiratory distress. Chest computed tomography showed a soft tissue density involving the right middle lobe (RML). RML lobectomy confirmed the diagnosis of BA. Cytomegalovirus was detected by polymerase chain reaction in blood, urine, and tracheal aspirates which may provide further insight into the pathogenesis of BA.