Ibrahim M. Gosadi

Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia

Metabolic syndrome (MS) is a combination of factors that increases the risk of cardiovascular atherosclerotic diseases including diabetes, obesity, dyslipidemia, and high blood pressure. Cardiovascular diseases are one of the leading causes of death in the adult Saudi population where the increase in cardiovascular-related mortality is augmented by the rise in the prevalence of MS. Metabolic syndrome is a multi-factorial disorder influenced by interactions between genetic and environmental components. This review aims to provide a comprehensive assessment of studied environmental and genetic factors explaining the prevalence of MS in the Kingdom of Saudi Arabia. Additionally, this review aims to illustrate factors related to the population genetics of Saudi Arabia, which might explain a proportion of the prevalence of MS.

Asthma quality of life in Saudi Arabia: Gender differences

Abstract Objectives: To explore potential gender differences in the factors associated with asthma-specific quality of life (AQL). Methods: A cross-sectional study of consecutive series of adult patients attending primary care centers at three major hospitals in Riyadh, Saudi Arabia, was performed. AQL was measured using a standardized version of the AQL questionnaire (min = 1, max = 7), with higher scores indicating a better AQL. Multiple linear regression analysis was performed. Results: The mean AQL was 4.3 (standard deviation [SD] = 1.5) for males and 4.0 (SD = 1.3) for females (p = 0.113). With each unit increase in asthma control, the AQL improved by 0.19 points (95% confidence interval [CI] = 0.14–0.23) in men and by 0.21 points (95% CI = 0.16–0.25) in women. Daily tobacco smoking was associated with a 0.72 point (95% CI = 0.14–1.30) decrease in the AQL among males. Women who had a household member who smoked inside the house had a significantly lower AQL (B = −0.59, 95% CI = −1.0 – −0.19). A monthly household income of 25,000 Saudi Riyals or more was associated with a better AQL among men (B = 0.51, 95% CI = 0.01–1.01), whereas being employed exhibited a protective effect in women (B = 0.48, 95% CI = 0.11–0.84). Higher levels of perceived asthma severity were associated with better AQL in women (B = 0.82, 95% CI = 0.36–1.28). Conclusions: Our findings revealed gender-specific differences in the correlates of AQL in Saudi Arabia, particularly in tobacco exposure, socio-economic factors and perceived asthma severity.

Do healthier foods cost more in Saudi Arabia than less healthier options

Objectives: To investigate whether healthy foods in Saudi Arabia cost more compared with less healthy options. Method: This is a cross-sectional study conducted in Riyadh, Saudi Arabia during June and July 2015. The study targeted well-known market chains in the city of Riyadh. The selection of food items was purposive to include healthy and less healthy food items in each category. Price, caloric value, salt, fat, sugar, and fiber contents for each food item were collected. To test for the correlation between nutritional contents and average price, Spearman’s correlation coefficients were calculated. The Mann-Whitney U test was used to test for the presence of average price difference between healthy and less healthy food items. Results: A total of 162 food items were collected. Sixty-six food items were classified as healthy compared with 96 less healthier options. The calculated correlation coefficients indicate an association between increased cost of food with increased caloric values (0.649 p=0.0000001), increased fat content (0.610 p=0.0000003), and increased salt contents (0.273 p=0.001). Prices of food items with higher fiber contents showed a weaker association (0.191 p=0.015). The overall average cost of healthy food was approximately 10 Saudi riyals cheaper than less healthy food (p=0.000001). Conclusion: The findings of the study suggest that the cost of healthy food is lower than that of less healthy items in the Saudi market.

Adherence to Brain Trauma Foundation guidelines for management of traumatic brain injury patients: study protocol for a systematic review and meta-analysis

BackgroundTraumatic brain injury (TBI) is a leading cause of death and disability around the world. Management based on Brain Trauma Foundation (BTF) guidelines is widely accepted and thought to improve outcome. The objectives of this systematic review are to give an overview of adherence to the BTF guidelines, describe factors influencing adherence, and study the effect of guideline-based management on outcome.Methods/designWe will search electronic bibliographic databases: PROSPERO, Medline, EMBASE, SCOPUS, NHS, CINAHL, Cochrane Database, and ProQuest Dissertations and Theses Global. Two investigators will independently screen all titles, abstracts, and articles and select Randomized Controlled Trial (RCT), cohort studies, case-control studies, and case series reporting the adherence rate, factors influencing adherence, and mortality or morbidity. These investigators will also independently extract data using a pre-designed and pilot-tested standardized electronic data extraction form and assess the risk of bias. We will exclude pediatric and military-related TBI studies, studies that included fewer than ten patients or addressed adherence to pre-hospital guidelines. Narrative synthesis and if appropriate, quantitative meta-analysis clustered by type of recommendation will be reported.DiscussionThis study is expected to demonstrate the current level of professionals’ adherence to BTF guidelines in patients with severe traumatic brain injury, it will describe the factors influencing adherence, which may provide valuable input for development of strategies to successfully increase adherence. In addition, if the studies are sufficiently homogenous, it will describe the effect of these guidelines on patient outcome.Systematic review registrationPROSPERO CRD42015017794

Burgeoning Rise In Smartphone Usage among School Children In Saudi Arabia: Baseline Assessment of Recognition and Attention Skills Among Users and Non-Users Using CANTAB Tests

Background: The use of smartphones and other Internet-based smart devices by children is on the rise. The aim of the present study was to determine the prevalence and pattern of smart device use and to conduct the baseline assessment of speed, memory and accuracy skills of the users. Method: A cross-sectional study was done on 177 school children aged between 12 to 16 years studying in the intermediate schools of Riyadh city. The survey tool was interviewer administered and cognitive function assessment was done by CANTAB battery testing. Results: The most common smart device used by children was a smartphone (85%). Boys showed a higher prevalence of usage of the smartphone compared to girls (93% vs 74%; p

The importance of hand hygiene education on primary schoolgirls’ absence due to upper respiratory infections in Saudi Arabia. A cluster randomized controlled trial

Objectives: To quantify the reduction in absence due to upper respiratory infections (URIs) among primary schoolgirls attending Riyadh’s schools after delivering a hand hygiene workshop intervention over a period of 5 weeks. Methods: A cluster randomized trial was conducted among girls attending 4 primary schools between January and March 2018. The participants attended a hand hygiene workshop. The schoolgirls’ absences were followed up for 5 weeks. Incidence rate, percentage of absence days, and absence rate were calculated for total and URIs absences. Result: Total number of participating schoolgirls was 496. Upper respiratory infections accounted for 15.3% of absence episodes. Schoolgirls lost 521 days of school and 19.4% of them were URIs-related. Absence rate due to URIs were 12.4 and 23.4 as well as 5.62 and 11.72 per 100 schoolgirls in the control (CG) and experimental (EG) groups, respectively. Percentage of absence days were lower in the experimental group (CG: 0.86% and 1.39% versus EG: 0.39% and 0.72%). Incidence rates of absence due to URIs were 0.54 and 1.02 in CG versus 0.24 and 0.51 in EG per 100 schoolgirls per day. Conclusion: There could be further reduction in school absences if education was accompanied by hand soap dissemination. The study could serve as a pilot for major studies in the future. Sustainability of the intervention can be tested in studies with longer durations.

Depression among sickle cell anemia patients in the Eastern Province of Saudi Arabia

Objectives: To determine the prevalence of, and factors associated with, depression among sickle cell anemia adult patients in the Eastern Province of Saudi Arabia. Materials and Methods: A cross-sectional study was conducted between December 2014 and May 2015 among sickle cell anemia patients aged 16–70 years from the outpatient hematology clinics at Qatif Central Hospital. A total of 110 successive participants consented and answered an anonymous, self-administered, questionnaire and the Arabic version of the Beck Depression Inventory-II. Individuals were considered depressed if they scored ≥14 in Beck Depression Inventory-II. Simple logistic regression was used to compare differences between the depressed and nondepressed groups. Odds ratios (ORs) with 95% confidence intervals (95% CI) were reported. Results: Depression was detected in 53 participants (48.2%). Bivariate analysis showed that lower educational qualification (OR = 2.5; 95% CI = 1.1–5.3; P = 0.021), higher frequency of vaso-occlusive crises (OR = 3.4; 95% CI = 1.3–8.7; P = 0.008) and frequent visits to the hematology clinic (OR = 5.3; 95% CI = 1.4–19.9; P = 0.008) were significantly associated with depression. Conclusion: This study revealed that there is high prevalence of depression among sickle cell anemia patients in the Eastern Province of Saudi Arabia.

Assessment by WHO’s My 5 moments of Hand Hygiene Shows Inadequate Knowledge and its Translation into Practices for Hand Washing Behavior Among Saudi Medical Students

Introduction: Nosocomial infections are one of the greatest challenges faced by medical fraternity. The simplest and most effective form of control is by adoption of hand hygiene measures. Methodology: The current study examined knowledge, attitude and compliance of medical students towards hand hygiene guidelines using a validated questionnaire from World Health Organization’s ‘My 5 moments for Hand Hygiene’ on 269 medical students from clinical years of study. Scores were computed for all correct answers and analyzed using SPSS ver 21.0. Results: The highest attainable computed score was 12. Only 47% of the students achieved the highest score for questions on both knowledge and attitude while no more than 35 % attained full score for practice indicating inadequacy in comprehensiveness. The study showed significant gender differences in all the mean scores where females scored higher than males for knowledge, attitude and practices for hand hygiene practices(p<0.015). A weak correlation was found between increasing knowledge scores and practice (r = 0.466) while a moderate positive correlation was shown for attitude (r = 0.756). Participating in previous formal training programs did not show any significant effect on the overall scores. Conclusions: The findings necessitate call for revision of curriculum guidelines and formulation of sustained and innovative reinforcement methods for effective implementation of the highly recommended preventive strategy.

Development of a Saudi Food Frequency Questionnaire and testing its reliability and validity

Objectives: To create a food frequency questionnaire specifically designed to capture the dietary habits of Saudis and test its validity and reliability. Methods: This investigation is a longitudinal, test-retest study conducted in King Saud University, Riyadh, Kingdom of Saudi Arabia between December 2015 and March 2016. A list of 140 food items was included in the questionnaire where a closed-ended and open-ended approach was used. Regarding past year food frequency consumption and 24 hours dietary recall, body weight and height were collected. Internal consistency, test-retest reliability, completeness of the food list, and criterion validity were assessed. Results: One-hundred and thirty eight participants were interviewed to complete the 24 hours dietary recall and the constructed questionnaire. Approximately 85% of the food items reported in the dietary recall were covered in the food frequency questionnaire. The association of body mass index with meats (regression coefficients: 2.28) and dairy products consumption frequency was statistically significant (regression coefficients: 2.31). A high overall reproducibility rate of the questionnaire was detected (Pearsons’ correlation coefficient: 0.78 p<0.001). Conclusion: The developed questionnaire has a high reliability and reasonable validity, and suitable for use in nutritional epidemiological investigations in Saudi Arabia.

Uptake of influenza vaccination, awareness and its associated barriers among medical students of a University Hospital in Central Saudi Arabia

Outbreaks of influenza epidemics are common but influenza vaccination is sub-optimal among the healthcare staff including the medical students. The study aims to assess the rate of vaccine uptake among medical students, its associated barriers and levels of awareness. A cross sectional study was done at a University Hospital in Saudi Arabia on 421 medical students by self administered questionnaire from February to March 2015. The immunization rate of seasonal influenza vaccine was just 20.7% in 2015, while it was 57% for cumulative of previous three-year period. The intended uptake among those offered vaccination was 68%. The significant determinants of vaccine uptake were clinical years of medical study (p<0.05) and previous history of vaccination (p<0.0001). The major sources influencing vaccine uptake decision were health department guidelines, medical training, social and media influence. Barriers of vaccination constituted, assumption of not being at risk of influenza (37.9%), vaccine side effects (28.9%), questioned effectiveness of the vaccine (14.5%), and inability to allocate time (11%). Knowledge levels were unsatisfactory and males scored lower (5.4±1.7) than females (6.5±1.4) out of total score of 9. Both knowledge and uptake of annual influenza vaccination was inadequate. Policy makers can formulate strategies with a focus on larger coverage of medical students.