Emad Masuadi

Is the Saudi public aware of Middle East respiratory syndrome

Summary To limit the spread of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, the Ministry of Health tried to raise public awareness using different public campaigns. We aimed to measure public awareness of MERS in Saudi Arabia. A cross-sectional study was conducted between May and June 2014 using a newly designed Arabic questionnaire that was distributed and completed online. We analyzed the response of 1149 respondents across Saudi Arabia. We found that 97% of the participants were aware of MERS. In addition, 72% realized that coughing and sneezing could spread the infection. Furthermore, 83% thought that some patients with MERS could be cured. Moreover, 62% knew that no vaccine can prevent the disease. However, only 36% realized that taking antibiotics will not stop the infection, and only 41% recognized that no medication has yet been manufactured to treat it. Regarding protection measures, 74% used hand sanitizers, 43% avoided crowded places, and 11% wore masks in public places. Moreover, only 47% knew that bats and camels are the primary source of the virus. As anticipated, this level of awareness varied between the different categories of the studied population. Female, married, older, and more educated participants were significantly more knowledgeable about the disease. Public awareness of MERS is generally sufficient. However, some false beliefs about treatment were fairly common. In addition, almost half of the population remains unaware that bats and camels are the most likely sources of the virus.

The prevalence and association of stress with sleep quality among medical students

Introduction: Medical students tend to reduce their sleep, in an effort to adjust and cope with their workload and stressful environment. This study estimated the prevalence of and the relationship between poor sleep quality and stress among medical students. Methods: This cross-sectional study was conducted using a stratified random sample of male and female medical students in King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index, and the stress level by using the Kessler Psychological Distress Scale. Results: A high prevalence of poor sleep quality (76%) and stress (53%) were found, with a statistically significant association (p < 0.001). Logistic regression indicated that students who are not suffering from stress are less likely to have poor sleep quality (OR = 0.28, p < 0.001), and the risk of having poor sleep quality is almost four times higher in students whose cumulative grade point average (GPA) is less than 4.25 (OR = 3.83, p = 0.01). Conclusion: The study documents a statistically significant association between stress and poor sleep quality. A recommendation for the management of medical college is to establish academic counseling centers focusing in promoting good sleep hygiene and strengthening students’ study skills and coping with their stressful environment.

Knowledge and attitude towards total knee arthroplasty among the public in Saudi Arabia: a nationwide population-based study

PurposeStudies on total knee arthroplasty (TKA) in Saudi Arabia are scarce, and none have reported the knowledge and attitude of the procedure in Saudi Arabia. Our study aims to measure the knowledge and attitude of TKA among the adult Saudi population.MethodsTo encompass a representative sample of this cross-sectional survey, all 13 administrative areas were used as ready-made geographical clusters. For each cluster, stratified random sampling was performed to maximize participation in the study. In each area, random samples of mobile phone numbers were selected with a probability proportional to the administrative area population size. Sample size calculation was based on the assumption that 50% of the participants would have some level of knowledge, with a 2% margin of error and 95% confidence level. To reach our intended sample size of 1540, we contacted 1722 participants with a response rate of 89.4%.ResultsThe expected percentage of public knowledge was 50%; however, the actual percentage revealed by this study was much lower (29.7%). A stepwise multiple logistic regression was used to assess the factors that positively affected the knowledge score regarding TKA. Age [P = 0.016 with OR of 0.47], higher income [P = 0.001 with OR of 0.52] and participants with a positive history of TKA or that have known someone who underwent the surgery [P < 0.001 with OR of 0.15] had a positive impact on the total knowledge score.ConclusionsThere are still misconceptions among the public in Saudi Arabia concerning TKA, its indications and results. We recommend that doctors use the results of our survey to assess their conversations with their patients, and to determine whether the results of the procedure are adequately clarified.

Burnout and its association with extracurricular activities among medical students in Saudi Arabia

Objectives To assess levels of burnout in medical students, and to explore the influence of extracurricular activities on burnout at a medical school in Saudi Arabia. Methods This cross-sectional study was conducted with first to fourth year medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia. Socio-demographic, burnout level (the Maslach Burnout Inventory-Student Survey, MBI-SS) and participation in extracurricular activities data were collected using a self-administered questionnaire. Statistical analyses were performed using the Pearson’s chi-square test and binary logistic regression. Results From the 306 medical students approached, 249 (81.4%) completed the questionnaire. The level of high burnout was 67.1% (n=167). The study revealed that the majority (62.3%, n=155) of students had high levels of cynicism, 58.6% (n=146) had high levels of emotional exhaustion, and 60.2% (n=150) had low levels of professional efficacy. Most of the students (73.5%, n=183) participated in extracurricular activities, and 112 (45%) students were organizers of extracurricular activities. No significant association was found between burnout levels and the frequency of involvement in extracurricular activities (χ2=2.2, df=2, p=0.333). However, students who were organizing extracurricular activities were less likely to have low professional efficacy (OR=0.51, 95% CI: 0.27- 0.96). Conclusions High levels of burnout were reported at this medical school. Although the burnout level is not significantly associated with the frequency of involvement in extracurricular activities, leading and organizing extracurricular activities might result in lower levels of burnout. Therefore, improving the students’ leadership skills should be considered in curriculum planning, and greater emphasis should be placed on the quality of involvement in extracurricular activities rather than the quantity.

Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study

Objectives Studies have shown that dentists have a higher incidence of work-related musculoskeletal (MSK) pain than those in other occupations. The risk factors contributing to MSK pain among Saudi dentists has not been fully studied so this study aims to estimate the prevalence of MSK pain and investigate its associated risk factors among dentists in Saudi Arabia. Setting and participants A cross-sectional survey was carried out in the capital city Riyadh, Saudi Arabia, using random cluster sampling. 224 surveys were distributed among dentists with a 91.1% response rate (101 women and 103 men). Outcomes The prevalence of MSK pain and its associated risk factors were investigated. Results 184 (90.2%) respondents reported having MSK pain. Lower back pain was the most commonly reported MSK pain (68.1%). Gender and age were reported to be predictors for at least one type of MSK pain. Older age was associated with lower back pain (OR 1.23; 95% CI 1.00 to 1.50) and women had double the risk of shoulder pain (OR 2.52; 95% CI 1.12 to 5.68). In addition, lower back pain was related to the time the dentist spent with patients (OR 0.28; 95% CI 0.14 to 0.54), while shoulder pain (OR 1.03; 95% CI 1.00 to 1.06) and lower back pain (OR 1.06; 95% CI 1.03 to 1.10) were significantly related to years of experience. Conclusions MSK pain is common among older and female Saudi dentists. Research on the impact of exercise and the ergonomics of the workplace on the intensity of MSK pain and the timing of its onset is required.

Kidney cancer in Saudi Arabia. A 25-year analysis of epidemiology and risk factors in a tertiary center

Objectives To evaluate available epidemiological data and risk factors for kidney cancer in a tertiary care center in Riyadh, Saudi Arabia, over a period of 25 years. Methods This retrospective study conducted in a tertiary care center included all adult patients with primary kidney cancer who presented and were managed between 1990 and 2015. Based on this information, we forecast the incidence of the disease in our center over the next 5 years (2016 to 2020). Results In total, 371 patients were included in the study. The mean age of the patients was 56.3 years and the majority were male (61%). Among the patients, 55.8% were diagnosed incidentally. At the time of diagnosis, 53.2% were hypertensive, 46.2% were diabetic, 39.1% had dyslipidemia, and 25% were smokers. In addition, most patients were obese (42.3%) or overweight (30%). The most frequent histopathological variants were clear cell and chromophobe. Most patients presented with Stage 1. Minimally invasive surgery (laparoscopic, robotic) was performed in 55% of cases. Based on these data, we predicted that 172 new cases will present at our tertiary care center in 5 years from 2016 to 2020. Conclusion The incidence in kidney cancer is increasing and is associated with an alarming increase in the prevalence of associated risk factors.

Perceptions of mental illness etiology and treatment in Saudi Arabian healthcare students: A cross-sectional study

Objectives: Cultural beliefs often affect people’s attitude toward mental illness and their help-seeking behavior. Belief in superstitious causes of mental illness can lead to seeking help from non-medical practitioners, which might hinder treatment. This study aimed to explore the perception of mental illness and help-seeking behavior among healthcare students. Methods: A cross-sectional study carried out on a sample of 400 randomly selected undergraduate health professional students in Riyadh. Data collection involved two self-administered questionnaires: the causes and treatment routes for a female vignette with psychosis and the General Health Questionnaire-28. Results: The mean age of participants was 20.9 years, and 68.2% were male. Although participants reported a lack of personal history of mental illness (81.9%), female participants were more likely to disclose psychological distress as measured by General Health Questionnaire-28 (67.6%). Mental illness (47.2%) was chosen as the main reason for the problem depicted by the female vignette. General Health Questionnaire-28 scores for “caseness” did not affect perception about psychosis versus non-caseness. Factor analysis produced four dimensions for causes of psychosis: “social,” “psychobiological,” “superstitious,” and “socially undesirable”; and two treatment routes: “clinical” versus “social interventions.” Male participants leaned toward social factors for the cause of psychosis and were more likely to endorse social interventions for treatment. Conclusion: Healthcare students in Riyadh remained supportive of a biomedical approach toward the causation and treatment of mental illness. The use of religious practices as an adjunct was apparent. Students, especially females, were prone to experience more psychological distress.

Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study

Objectives Approximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls. Setting and participants A cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women). Results The 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned ‘not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly. Conclusion 49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed.

Indications, retrieval rate, and complications of inferior vena cava filters: Single-center experience in Saudi Arabia

BACKGROUND: Inferior vena cava (IVC) filter is indicated in patients with acute venous thromboembolism (VTE) in whom therapeutic anticoagulation is contraindicated. While prophylactic insertion of an IVC filter may be considered for patients at high risk of VTE, there are significant differences between clinical guidelines on the role of IVC filters. These discrepancies have arisen predominantly because of the paucity of data on the efficacy and safety of IVC filters. We, therefore, evaluated the indications for filter insertion, the rate of filter retrieval and complications in patients who received IVC filters at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. METHODS: A descriptive, retrospective review of electronic- and paper-based medical records was performed. Consecutive sampling was used to study all adult patients who received an IVC filter at KAMC between 2007 and 2016 and met the inclusion criteria. RESULTS: A total of 382 IVC filters were inserted. 113 patients (30%) had an acute VTE and a contraindication to anticoagulation while 53 patients (14%) received an IVC filter in the absence of VTE (i.e., prophylactic). Only 124 (32.5%) IVC filters were eventually retrieved. The most common reason for nonretrieval was the need for permanent filtration (155, 60%). Thrombotic complications developed in 72 (19%) patients; nine patients had fatal pulmonary embolism. CONCLUSION: The insertion of IVC filters in this cohort was associated with low retrieval rate and relatively high incidence of thrombotic complications. Follow-up of patients is required to detect IVC filter-related complications and to increase retrieval rate.

Attitudes of dental professional staff and auxiliaries in Riyadh, Saudi Arabia, toward disclosure of medical errors

Aim To collect empirical data on the attitudes of dental professionals and dental auxiliaries in Riyadh, Saudi Arabia, regarding the disclosure of medical errors. Methods A cross-sectional study was conducted, involving the administration of a questionnaire to a sample of 586 participants recruited from over 10 government and private dental institutions in Riyadh between August 2015 and January 2016. The questionnaire collected information regarding participant opinions on (a) personal beliefs, norms, and practices regarding medical errors, (b) the nature of errors that should be disclosed, and (c) who should disclose errors. Results Most (94.4%) participants preferred that medical errors should be disclosed. However, personal preferences, perceptions of the norm and current practices with respect to which type (seriousness) of error should be disclosed were inconsistent. Only 17.9% of participants perceived that it was the current practice to disclose errors resulting in “Major harm”. Over 68% of respondents reported a personal belief, a perception of the norm and a perception of current practice that errors should be disclosed by the erring dentist. Participants at government institutions were more likely to disclose errors than those at private institutions. There were also significant differences in the responses with respect to gender, age, and nationality. The implications for the development of guidelines to help Saudi dentists adopt ethical courses of action for the disclosure of errors are considered. Conclusions (1) The majority of participants personally believed that errors should be disclosed, (2) there was little agreement between participant personal beliefs and perceptions of the norm and practice with respect to which type of errors should be disclosed, (3) there was strong agreement that the erring dentist is responsible for reporting errors, and (4) the attitudes of the participants varied with respect to type of institution, age, gender, and nationality.