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Al-Moamary MS, Alhaider SA, Allehebi R, Idrees MM, Zeitouni MO, Al Ghobain MO, Alanazi AF, Al-Harbi AS, Yousef AA, Alorainy HS, Al-Hajjaj MS. The Saudi initiative for asthma - 2024 update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2024; 19:1-55. [PMID: 38444991 PMCID: PMC10911239 DOI: 10.4103/atm.atm_248_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/31/2023] [Indexed: 03/07/2024] Open
Abstract
The Saudi Initiative for Asthma 2024 (SINA-2024) is the sixth version of asthma guidelines for the diagnosis and management of asthma for adults and children that was developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up-to-date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA Panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5-12 years, and children aged <5 years. SINA guidelines have focused more on personalized approaches reflecting a better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient-doctor partnership in the management that also includes a self-management plan.
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Affiliation(s)
- Mohamed Saad Al-Moamary
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A. Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Riyad Allehebi
- Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Majdy M. Idrees
- Department of Medicine, Respiratory Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed O. Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed O. Al Ghobain
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah F. Alanazi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Adel S. Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan S. Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed S. Al-Hajjaj
- Department of Paediatrics, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Al-Shamrani A, Al-Shamrani K, Al-Otaibi M, Alenazi A, Aldosaimani H, Aldhalaan Z, Alalkami H, Yousef AA, Kobeisy S, Alharbi S. Residual Cough and Asthma-like Symptoms Post-COVID-19 in Children. Children (Basel) 2023; 10:1031. [PMID: 37371263 DOI: 10.3390/children10061031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide and is characterized by different presentations ranging from asymptomatic to severe pneumonia. COVID-19 affects all age groups, including pediatric patients. We observed numerous children complaining of a cough post-COVID-19, even if it was trivial. The most reported persistent symptoms after recovery from COVID-19 were insomnia, coughing, fatigue, dyspnea, loss of taste and/or smell, and headache. To date, residual cough post-COVID-19 has been reported in pediatrics and adolescents. METHOD we conducted a retrospective study, with a self-administered questionnaire by the patient or caregiver, 12 months post-COVID-19-infection. RESULT A total of 94.8% of patients were Saudi citizens and were mainly from the southern region of Saudi Arabia (50.0%). Mothers (64.4%) submitted most of the results. The ages were as follows: 6-14 years (51.0%), 3-5 years (32.3%), and younger than 2 years of age (only 16.7%). Females accounted for 41.7% of those studied. Nearly half of the patients (48.5%) had had a previous COVID-19 infection in 2022, with only 2.1% infected in 2019. Only 27/194 (13.9%) patients required hospital admission, and 7 of them (4.2%) required intensive care treatment. A total of 179 (92.2%) patients still reported persistent symptoms 4 weeks post-COVID-19-infection. A cough was reported in 69.8% of patients, followed by cough and wheezing in 12.3%. The cough was described as dry in 78.0% and nocturnal in 54.1%, while 42.5% did not notice any diurnal variation. For those reporting residual cough, 39.3% found that it affected school attendance and daily activities, 31.1% reported associated chest pain, 51.9% associated it with wheezing, and 27.1% associated it with shortness of breath. For 54.4%, the residual cough lasted less than one month, while 31.4% reported a 1-2 month duration. Only 1.0% had a duration of cough of more than 3 months. For cough relief, 28.2% used bronchodilators, 19.9% used cough syrup, 16.6% used a combination of bronchodilators and steroid inhalers, and 1.7% used antibiotics. Surprisingly, 33% attempted herbal remedies for cough relief. Sesame oil was used the most (40.0%), followed by a mixture of olive oil and sesame oil (25.0%), and 21.7% used male frankincense. The majority (78.4%) sought medical advice for their post-infection cough, either from general pediatricians (39.5%) or via specialist pediatric pulmonology consultations (30.9%). A total of 11.0% with a residual cough reported having pets at home, while 27.2% reported secondhand smoke exposure in the household. Before infection with COVID-19, only 32.6% were diagnosed with asthma, while 68.2% reported a diagnosis of atopic skin. CONCLUSIONS There was a high prevalence of residual cough post-COVID-19, extended for a minimum of two months, and the characteristics of the cough were very similar to those of asthmatic patients. There was still a high prevalence of using cough syrup and herbal remedies, especially olive oil, sesame oil, and male frankincense. A residual cough adversely affected school attendance in daily activities, and there was a high prevalence of other siblings in the family being affected. The study showed that a minority of patients were seen by the pulmonologist; luckily, long COVID was rare in our study, and so further studies are highly needed to confirm the association with asthma. More educational programs are highly needed regarding herbal remedies and cough syrup.
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Affiliation(s)
- Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military Medical City, Al Faisal University, P.O. Box 7897, Riyadh 11159, Saudi Arabia
| | - Khalid Al-Shamrani
- College of Medicine, Al Marifah University, P.O. Box 92882, Riyadh 11663, Saudi Arabia
| | - Maram Al-Otaibi
- Department of Pediatrics, Prince Sultan Military Medical City, P.O. Box 26523, Riyadh 12841, Saudi Arabia
| | - Ayed Alenazi
- Respiratory Division, Department of Pediatrics, Prince Sultan Military Medical City, P.O. Box 7456, Riyadh 13326, Saudi Arabia
| | - Hareth Aldosaimani
- Department of Emergency, Prince Sultan Military Medical City, P.O. Box 282236, Riyadh 11392, Saudi Arabia
| | - Zeyad Aldhalaan
- Department of Infectious Disease, Prince Sultan Military Medical City, P.O. Box 106383, Riyadh 11666, Saudi Arabia
| | - Haleimah Alalkami
- Department of Pediatrics, Abha Maternity & Children Hospital, P.O. Box 62521, Abha 3613, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, King Fahd Hospital of the University, P.O. Box 2208, Al-Khobar 31952, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia
| | - Sumayyah Kobeisy
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
| | - Saleh Alharbi
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
- Department of Pediatrics, Umm Al-Qura University, P.O. Box 715, Mecca 24382, Saudi Arabia
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Albuali WH, Yousef AA, Al-Qahtani MH, AlQurashi FO, Albuali HW, Yousef HA, Aldajani AA, Ghamdi MAA, AlBassam BN. A Clinical and Biochemical Comparative Study Of Diabetic Ketoacidosis (DKA) in Newly Diagnosed Vs Known Cases of Type 1 Diabetic Children. Rev Diabet Stud 2023; 19:28-33. [PMID: 37185051 PMCID: PMC10082331 DOI: 10.1900/rds.2023.19.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Objectives: We aimed to study the characterizing clinical and biochemical profiles of Diabetic Ketoacidosis (DKA) in children with newly diagnosed Type 1 Diabetes Mellitus (Type 1DM) compared to children with established diagnosis of Type 1DM presenting with DKA admitted to the pediatric intensive care unit of a large university hospital in the eastern region of Saudi Arabia. Methods: We retrospectively reviewed the medical records of 211 patients who were admitted to the pediatric intensive care unit with diabetic ketoacidosis between 2010 and 2019. The diagnosis of diabetic ketoacidosis was based on symptoms of polydipsia, polyurea, weight loss, vomiting, dehydration, abdominal pain, breathing problems, lethargy or coma, biochemical hyperglycemia (blood glucose level of >200 mg/dL), venous pH of <7.3, serum bicarbonate level of ≤15 mEq/L, and ketonemia (blood β -hydroxybutyrate concentration of ≥3 mM) or moderate or severe ketonuria (diagnosed as newly acquired type 1 diabetes). Results: The rate of newly diagnosed Type 1 DM with DKA was 41.7%, out of them who got severe and moderate diabetic ketoacidosis were 61.6% and 38.4%, respectively. We observed significantly increased heart and respiratory rates in patients newly diagnosed with diabetic ketoacidosis and in those with severe diabetic ketoacidosis (p<0.001) compared to known cases with Type 1DM presenting with DKA. We also identified significantly increased biochemical indices including HbA1c, random blood sugar, serum osmolality, blood urea nitrogen, creatinine, chloride, lactate, and anion gap in relation to severe diabetic ketoacidosis and newly diagnosed type 1 diabetes (p ≤ 0.05). Conclusions: We found that the clinical and biochemical profiles of patients with newly diagnosed Type 1 DM children were significantly affected compared to children who were known Type 1DM presenting with DKA.
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Affiliation(s)
- Waleed H Albuali
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hamad W Albuali
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Haneen A Yousef
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ala'a A Aldajani
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed A Al Ghamdi
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bassam N AlBassam
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Al-Qahtani MH, ElYahia SA, AlQahtani AS, AlQahtani AJ, Alamer AA, AlQahtani SM, Yousef AA, Albuali WH, Awary BH, Aldajani AA, Al Ghamdi MA. Thyroid Disorders Spectrum in Pediatric Endocrine Clinic; Seven-Year Experience of a Teaching Hospital in Saudi Arabia. Children (Basel) 2023; 10:children10020390. [PMID: 36832519 PMCID: PMC9955412 DOI: 10.3390/children10020390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Thyroid disorders constitute one of the major endocrine disorders in pediatric service. It includes a range of congenital versus acquired anatomic and/or functional thyroid diseases in growing children that has a spectrum of severity from severe intellectual disability effect to subclinical mild pathologies. This study was designed to analyze the demographic characteristics, clinical pattern, and severity of thyroid disorders in the pediatric endocrine clinic patients at the teaching hospital of the university over a 7-year duration. A total number of 148 patients with thyroid disorders were seen in pediatric Endocrine clinic during the time between January 2015 and December 2021. Female patients constitute 64% of them. Acquired Hypothyroidism was the commonest disorder; 34% of the cases followed by the congenital hypothyroidism (CH), then Hashimoto's thyroiditis, and 5.8% for others. While a very small percentage was acquired hyperthyroidism. The majority of referrals were from dermatology and other service for the screening of thyroid disease as association with other autoimmune diseases with percentage of 28.3%. Next was neck swelling manifestation in 22.6%. Thyroid disorders in children, both congenital and acquired, constitute an important medical issue for pediatricians to be aware of its variable presentations, and its potential serious health consequences on the affected children if not diagnosed and treated earlier. Acquired hypothyroidism constitutes more percentage of the thyroid disorders followed in the pediatric endocrinology outpatient clinics. Congenital hypothyroidism is the second most common thyroid disorder in the outpatient unit, having the most potential complications. These results support the international studies with the female predominance in most of thyroid disorders.
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Affiliation(s)
- Mohammad H. Al-Qahtani
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
- Correspondence:
| | - Sufian A. ElYahia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | | | | | - Abdulaziz A. Alamer
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Sultan M. AlQahtani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Waleed H. Albuali
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Bassam H. Awary
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Ala’a A. Aldajani
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Mohammed A. Al Ghamdi
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
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Yousef AA, Al Qahtani MH, Al-Mutairi AK, AlQurashi FO, AlOmar RS, AlShamlan NA, Al Shammari MA, Yousef HA. Factors Affecting Length of Stay in Pediatric Emergency Department in a Teaching Hospital in Saudi Arabia. Med Arch 2023; 77:268-275. [PMID: 37876560 PMCID: PMC10591245 DOI: 10.5455/medarh.2023.77.268-275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/24/2023] [Indexed: 10/26/2023] Open
Abstract
Background Decreasing the number of Emergency Department patient visits for treatment, especially in non-urgent cases, is an international healthcare goal. The same applies for pediatric emergency rooms where the utilization of ED is much more than adults. Objective We aim to measure the length of stay for all pediatric patients and examine the factors influencing it. Methods A retrospective chart review study was conducted at the pediatric ED of King Fahd Hospital in the Eastern Province of Saudi Arabia. The study included all patients presented to the pediatric ED, between January 1, 2018, and December 31, 2018, aged from 1 day to < 14 years old. Data included patient's age, sex, season in which the patient presented in, chief complaint, time of presentation, and whether admission to the hospital ward was collected. Results The total number of patients was 37,613. The median LOS was 100, interquartile range (IQR) = 53 - 272 minutes. Male pediatric patients were (55.12%). Among all patients, (32.04%) were toddlers, followed by school aged children (25.05%). The ER received more patients during the winter months followed by summer (32.92% and 24.72%, respectively). Fever was the most common complaint for all patients combined. For prolonged LOS patients, the most common complaints were respiratory related (23.44%). Pre-school children and school aged children were found to have a 5.49% and a 7.93% increased LOS when compared to toddlers (95% CI = 2.52 - 8.53, and 95% CI = 5.01 - 10.93, respectively). Summer was associated with a statistically significant increased LOS (% change = 28.92, 95% CI = 25.53 - 32.40). Morning shift was found to have a 7.89% increased LOS when compared to the evening shift. The highest increase in LOS was attributed to haematology related complaints (% change = 108.32, 95% CI = 85.69 - 133.71). Conclusion Several pediatric LOS predicting factors have been identified; morning arrival, and presentation during summertime. Systemic factors such as staffing, and infrastructure can be modified and may affect the length of stay of patients. The implementation of these strategies and the evaluation of their impact on the length of stay in the pediatric emergency department require further investigation.
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Affiliation(s)
- Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Mohammed H. Al Qahtani
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Abdullah K. Al-Mutairi
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Faisal O. AlQurashi
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Reem S. AlOmar
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf A. AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malak A. Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hannen A. Yousef
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Al-Shamrani A, Alharbi S, Kobeisy S, AlKhater SA, Alalkami H, Alahmadi T, Almutairi A, Alharbi AS, Yousef AA. Adverse Drug Reactions (ADRs) of Montelukast in Children. Children (Basel) 2022; 9:1783. [PMID: 36421233 PMCID: PMC9688958 DOI: 10.3390/children9111783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2023]
Abstract
UNLABELLED Montelukast is a leukotriene receptor antagonist (LTRA) commonly prescribed for asthma, allergic rhinitis and sleep-related breathing disorders. Recently, some studies have reported several adverse events, such as neuropsychiatric disorders and sleep disturbances, among children. OBJECTIVE To obtain more insight into the safety profile of montelukast for children with asthma, allergic rhinitis and sleep-related breathing disorders. METHOD AND RESULTS We retrospectively studied all adverse drug reactions to montelukast among 385 children 6 months or older in six tertiary centers over a two-year period. A total of 89.6% were asthmatic, 50% had allergic rhinitis and 13.6% had sleep-related breathing disorders; Singulair was the most common type of montelukast used (67.9%). This study reported a high prevalence of adverse drug reactions among 123 patients (31.9%), predominantly in those aged 4-9 years (52.8%), followed by adolescents (24.4%) and toddlers (22.8%). Two (ADRs) were reported in 9.8% of the children, while three or more were reported in 5.5%. Sleep disturbance was the most common (ADRs), affecting 15.1% of participants (overlap was common; 5.5% of children experienced sleep difficulties, 4.4% experienced sleep interruption and decreased sleep, and 1.82% experienced nightmares), followed by agitation (10.4%), pain (9.4%) and hyperactivity (6.8%). No serious (ADRs) were reported. Eleven percent of families faced difficulties in purchasing montelukast, and only 57% of families had insurance. Misconceptions were common (9.8% reported it to be a steroid, while 30.6% believed it to be a bronchodilator). Although 81% of the families believed it was an effective and preventive medication, 5.3% stopped the drug due to concern about side effects, especially agitation (3%) and nightmares (0.6%). CONCLUSION These data demonstrate that montelukast is effective, but the associated adverse neuropsychiatric drug reactions are more prevalent than those reported in the literature. In particular, sleep disturbance, agitation, pain and hyperactivity were observed. Pediatricians should be aware of such (ADRs). Misconceptions about montelukast are still common, and parental counseling and urgent epidemiological studies are needed to quantify the risk for management plans.
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Affiliation(s)
- Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military Medical City, AL Faisal University, P.O. Box 7897, Riyadh 11159, Saudi Arabia
| | - Saleh Alharbi
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
- Department of Paediatrics, Umm Al-Qura University, Mecca 24382, Saudi Arabia
| | - Sumayyah Kobeisy
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
| | - Suzan A. AlKhater
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Pediatrics, King Fahd Hospital of the University, Al-Khobar 31952, Saudi Arabia
| | - Haleimah Alalkami
- Department of Pediatrics, Abha Maternity & Children Hospital, P.O. Box 62521, Abha 1650, Saudi Arabia
| | - Turki Alahmadi
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Aisha Almutairi
- Department of Pediatrics, College of Medicine, Qassim University, P.O. Box 7897, Buraidah 51452, Saudi Arabia
| | - Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, AL Faisal University, P.O. Box 7897, Riyadh 11159, Saudi Arabia
| | - Abdullah A. Yousef
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Pediatrics, King Fahd Hospital of the University, Al-Khobar 31952, Saudi Arabia
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Yousef HA, Abdel Wahab MM, Alsheikh S, Alghamdi R, Alghamdi R, Alkanaan N, Al-Qahtani M, Albuali WH, Almakhaita H, Aldossari M, Yousef AA. Characteristics of Pediatric Primary Healthcare Visits in a University-Based Primary Healthcare Center in Saudi Arabia. Children (Basel) 2022; 9:1743. [PMID: 36421192 PMCID: PMC9688705 DOI: 10.3390/children9111743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 10/03/2023]
Abstract
This study aimed to identify the characteristics of pediatric primary health care (PHC) visits and evaluate the outcomes of patients presenting with complaints along with their referral and consultation capabilities. This was a retrospective medical record-based study. The study population included any pediatric patient (≤14 years old), including females and males, Saudis, and non-Saudis. Research data were gathered for visits from 2016-2021. Sampling was performed using a stratified random sample based on age groups, followed by simple random sampling with proportional allocation to different age groups. The number of pediatric visits included was 1439 (males, 52.2%). The most common age group was toddlers, and 60% of the total sample was from Saudi Arabia. The most common cause of visits was vaccination (32%), followed by general checkups and/or a well-baby visit (25.4%), and fever (11.2%). Approximately 10% of visits needed referral to other subspecialties. Approximately 50% of visits with complaints concerning ophthalmology, cardiology, and surgical intervention were referred to a specialized department. More awareness needs to be raised about the important role of PHC services in the pediatric age group, as it was capable of handling approximately 90% of their cases.
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Affiliation(s)
- Haneen A. Yousef
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Moataza M. Abdel Wahab
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Shahad Alsheikh
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Rizam Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Raghad Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Najla Alkanaan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Mohammad Al-Qahtani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Paediatrics, King Fahd Hospital of the University, Shura Street, Al Aqrabiyah, Al Khobar 34445, Saudi Arabia
| | - Waleed H. Albuali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Paediatrics, King Fahd Hospital of the University, Shura Street, Al Aqrabiyah, Al Khobar 34445, Saudi Arabia
| | - Huda Almakhaita
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Mae Aldossari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Abdullah A. Yousef
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
- Department of Paediatrics, King Fahd Hospital of the University, Shura Street, Al Aqrabiyah, Al Khobar 34445, Saudi Arabia
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Albuali WH, Al-Qahtani MH, Yousef AA, Al Ghamdi MA, AlQurashi FO, Lardhi AA. Myocarditis in Children: Impact of Early Presentation on Disease Outcomes at a Single Tertiary Center in Saudi Arabia. Int J Gen Med 2022; 15:5627-5633. [PMID: 35726274 PMCID: PMC9206454 DOI: 10.2147/ijgm.s369088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Myocarditis is the inflammation of the heart muscle and can be caused by a variety of infections, incendiary diseases, and pollutants. It is challenging for an emergency pediatrician to have a sufficiently high degree of suspicion for myocarditis to avoid diagnostic delay given the broad overlap of myocarditis symptoms with other disease processes. The study aimed to evaluate the impact of early presentation and diagnosis on the outcomes of acute myocarditis in children. Patients and Methods We performed a retrospective analysis of the complete records of 80 pediatric patients diagnosed with acute myocarditis between 2015 and 2019 at a single tertiary center in Saudi Arabia. Patients were two weeks to 14 years of age and were admitted to the pediatric intensive care unit (PICU) for various sequelae of myocarditis. Data from routine clinical and laboratory investigations were collected. Results The incidence of delayed presentation at the hospital after the onset of symptoms of myocarditis was 42.5%. A total of 22 (27.5%) patients expired during their hospital stay. There was marginally significant association of earlier presentation with in-hospital survival (80.4% vs 61.8%) and delayed presentation with higher proportion of in-hospital mortality (38.2% vs 19.6%, p=0.064). The rate of mechanical ventilator was also marginally significant in delayed presentation (p=0.068). Shock and multisystem organ failure were the significantly associated manifestations of delayed acute myocarditis presentations. Length of stay in PICU was also significant in delayed presentation group. The impact of presenting symptoms, ECG findings, and use of mechanical ventilator was not significantly associated with delayed presentation. Conclusion An earlier presentation may have a substantial impact on overall prognosis and length of PICU stay and may lead to comparatively lesser frequency of mechanical ventilation use.
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Affiliation(s)
- Waleed H Albuali
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
| | - Mohammad A Al Ghamdi
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
| | - Amer A Lardhi
- Department of Pediatrics, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia
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9
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Alharbi AS, Yousef AA, Alharbi SA, Almaghamsi TM, Al Qwaiee MM, Al-Somali FM, Alahmadi TS, Alhaider SA, Alotaibi WH, Albalawi MA, Alotaibi FN, Alenizi AS, Alsaadi MM, Said YS. Severe asthma in children: An official statement from Saudi Pediatric Pulmonology Association. Saudi Med J 2022; 43:329-340. [PMID: 35414610 PMCID: PMC9998054 DOI: 10.15537/smj.2022.4.43.20210756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
In Saudi Arabia, the prevalence of pediatric asthma ranges between 8% and 25%. However, there are no sufficient data regarding severe asthma in childhood in Saudi Arabia. Therefore, a task force has been formed by the Saudi Pediatric Pulmonology Association which is a subsidiary group of the Saudi Thoracic Society and consists of Saudi experts with well-respected academic and clinical backgrounds in the fields of pediatric asthma as well as other respiratory diseases to write a consensus on definitions, phenotypes, and pathophysiology, evaluation, and management. To achieve this, the subject was divided into various sections, each of which was assigned to at least 2 experts. Without a central literature review, the authors searched the literature using their own strategies. To reach an agreement, the entire panel reviewed and voted on proposed findings and recommendations.
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Affiliation(s)
- Adel S. Alharbi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Abdullah A. Yousef
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Saleh A. Alharbi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Talal M. Almaghamsi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Mansour M. Al Qwaiee
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Faisal M. Al-Somali
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Turki S. Alahmadi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Sami A. Alhaider
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Wadha H. Alotaibi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Mona A. Albalawi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Faisal N. Alotaibi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Ahmed S. Alenizi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Muslim M. Alsaadi
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| | - Yazan S. Said
- From the Department of Pediatrics (A. Alharbi, Alotaibi), Pediatric Pulmonology Division and Pediatric Sleep Center, from the Department of Pediatrics (Al-Somali), Pediatric Pulmonary Division, Prince Sultan Military City, from the Departments of Pediatric Pulmonology & Sleep Medicine (Albalawi), King Fahad Medical City, from the Pediatric Pulmonology And Sleep Medicine Department (Alenizi), Children’s Hospital, King Saud Medical City, from the Department of Pediatrics (Alenizi), College of Medicine and King Khalid University Hospital, King Saud University, From the Pediatric Department (Said), Security Forces Hospital, Riyadh; from the Department of Pediatrics (Yousef), Imam Abdulrahman Bin Faisal University, College of Medicine; from the Department of Pediatrics (Almaghamsi, Alhaider), King Fahad Specialist Hospital, Dammam; King Fahd Hospital of the University (Yousef), from the Department of Pediatrics (Alahmadi), Dr. Sulaiman Al Habib Hospital, Al-Khobar; Department of Pediatrics (S. Alharbi), Faculty of Medicine, Umm Alqura University, Mecca; from the Department of Pediatrics (S. Alharbi), Dr. Soliman Fakeeh Hospital; from the Pediatric Department (Al Qwaiee), King Faisal specialist hospital & Research Center, from the Department of Pediatrics (Alotaibi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Albuali WH, AlGhamdi AA, Aldossary SJ, AlHarbi SA, Al Majed SI, Alenizi A, Al-Qahtani MH, Lardhi AA, Al-Turki SA, AlSanea AS, Bubshait DK, Kobeisy SA, Herzallah NH, Alqarni WA, AlHarbi AH, Albuali HW, Aldossary BJ, AlQurashi FO, Yousef AA. Clinical profile, risk factors and outcomes of ric COVID-19: a retrospective cohort multicentre study in Saudi Arabia. BMJ Open 2022; 12:e053722. [PMID: 35277403 PMCID: PMC8919130 DOI: 10.1136/bmjopen-2021-053722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To describe the risk factors, clinical profile and outcomes of COVID-19 in the paediatric population. DESIGN Multicentre, retrospective observational study. SETTING Four tertiary hospitals in Saudi Arabia. PATIENTS We recruited 390 paediatric patients aged 0-18 years who presented from March to December 2020 and tested positive for COVID-19 on PCR. MAIN OUTCOME MEASURES We retrospectively analysed medical records for sociodemographics, health indicators, clinical presentations, laboratory findings, clinical complications, and outcomes. RESULTS The mean participant age was 5.66±4.90 years, and the mean hospital stay was 2.17±3.48 days. Forty patients, mostly school-aged children (16, 40.00%; p=0.005) and children with comorbidities (25, 62.50%; p<0.001), received more than just supportive care. Complications were seen in 15 (3.9%) patients, bacterial infection being the most common (6, 40.00%). Patients presented with dyspnoea (OR 6.89; 95% CI 2.89 to 20.72), abnormal chest radiographs (OR 6.11; 95% CI 1.26 to 29.38), lethargy (OR 9.04; 95% CI 2.91 to 28.06) and elevated ferritin (OR 14.21; 95% CI 4.18 to 48.37) and D-dimer (OR 48.40; 95% CI 14.32 to 163.62), with higher odds of developing complications. The odds of paediatric intensive care unit (ICU) admission were higher for patients with dyspnoea (adjusted OR 4.66; 95% CI 1.24 to 17.50) and elevated white blood cell count (adjusted OR 3.54; 95% CI 1.02 to 12.30). CONCLUSIONS COVID-19 complications were limited among our patients. However, dyspnoea, abnormal chest radiographs, lethargy and elevated ferritin and D-dimer were associated with an increased risk of complications. Dyspnoea, leucocytosis, comorbidities and abnormal chest radiographs at presentation increased the risk of ICU admission.
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Affiliation(s)
- Waleed H Albuali
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal A AlGhamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shaikha J Aldossary
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saleh A AlHarbi
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Pediatrics, Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Sami I Al Majed
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ahmed Alenizi
- Pediatric Pulmonology and Sleep Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Saudi Arabia
| | - Amer A Lardhi
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shams A Al-Turki
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz S AlSanea
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dalal K Bubshait
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sumayyah A Kobeisy
- Department of Pediatrics, Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Noor H Herzallah
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Wejdan A Alqarni
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Abeer H AlHarbi
- Pediatric Pulmonology and Sleep Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Hamad W Albuali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bader J Aldossary
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Yousef AA, Awary BH, AlQurashi FO, Albuali WH, Al-Qahtani MH, Husain SI, Sharif O. Innovative Method to Digitize a Web-Based OSCE Evaluation System for Medical Students: A Cross-Sectional Study in University Hospital in Saudi Arabia. Int J Gen Med 2022; 15:1085-1095. [PMID: 35140510 PMCID: PMC8820456 DOI: 10.2147/ijgm.s351052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Abdullah A Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Vice Deanship for e-learning, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bassam H Awary
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Correspondence: Faisal O AlQurashi, Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O Box: 11286, Dammam, 31453, Saudi Arabia, Tel +966555078804, Fax +966138955088, Email
| | - Waleed H Albuali
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Syed I Husain
- Vice Deanship for e-learning, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omair Sharif
- Vice Deanship for e-learning, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Chiang CY, Ellwood P, Ellwood E, García-Marcos L, Masekela R, Asher I, Badellino H, Sanz AB, Douros K, El Sony A, Diaz CG, Rodríguez MA, Moreno-Salvador A, Pérez-Martini LF, Filho NR, Shpakou A, Sulaimanov S, Tavakol M, Valverde-Molina J, Yousef AA, Pearce N. Infection with SARS-CoV-2 among children with asthma: evidence from Global Asthma Network. Pediatr Allergy Immunol 2022; 33:e13709. [PMID: 34856034 DOI: 10.1111/pai.13709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/12/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Clinical presentations of coronavirus disease 2019 (COVID-19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID-19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. METHODS The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021. RESULTS Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty-eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3-16). Those who had moderate or more severe COVID-19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID-19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23-12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02-5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID-19, asthma exacerbation, and hospitalization. CONCLUSIONS Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID-19.
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Affiliation(s)
- Chen-Yuan Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France.,Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Philippa Ellwood
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eamon Ellwood
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Luis García-Marcos
- Pediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bioresearch Institute, Murcia, Spain.,ARADyAL Allergy Network, Edificio Departamental-Laib, El Palmar, Murcia, Spain
| | - Refiloe Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Innes Asher
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Héctor Badellino
- Pediatric Respiratory Medicine Department, UCES University and Clínica Regional del Este, Corrientes, San Francisco, Argentina
| | - Alberto Bercedo Sanz
- Cantabrian Health Service, Valdecilla Research Institute (IDIVAL), Dobra Health Center, Torrelavega, Cantabria, Spain
| | - Konstantinos Douros
- School of Medicine, 3rd Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Asma El Sony
- Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum, Sudan
| | - Carlos González Diaz
- Department of Pediatrics, University of the Basque Country, Bilbao, Vizcaya, Spain.,UPV/EHU, Basurto University Hospital, Bilbao, Vizcaya, Spain
| | - Ms Albi Rodríguez
- Pediatric Pneumology and Allergy Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Ana Moreno-Salvador
- Pediatric Allergy Unit, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Spain
| | - Luis F Pérez-Martini
- Asociación Guatemalteca de Neumología y Cirugía de Tórax, Guatemala, Ciudad, Guatemala
| | | | - Andrei Shpakou
- Department of Theory of Physical Culture and Sport Medicine, Yanka Kupala State University of Grodno, Grodno, Belarus
| | | | - Marzieh Tavakol
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - José Valverde-Molina
- Department of Pediatrics, Hospital General Universitario Santa Lucia, Cartagena, Murcia, Spain
| | - Abdullah A Yousef
- College of Medicine, Imam Abdulrahman bin Faisal University, Al Khobar, Saudi Arabia.,Department of Pediatrics, King Fahd Hospital of the University Alkhobar, Al Khobar, Saudi Arabia
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
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13
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Alshahrani MS, Alshaqaq HM, Alhumaid J, Binammar AA, AlSalem KH, Alghamdi A, Abdulhady A, Yehia M, AlSulaibikh A, Al Jumaan M, Albuli WH, Ibrahim T, Yousef AA, Almubarak Y, Alhazzani W. High-Flow Nasal Cannula Treatment in Patients with COVID-19 Acute Hypoxemic Respiratory Failure: A Prospective Cohort Study. Saudi J Med Med Sci 2021; 9:215-222. [PMID: 34667467 PMCID: PMC8474003 DOI: 10.4103/sjmms.sjmms_316_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Early use of high-flow nasal cannula (HFNC) decreases the need for endotracheal intubation (EI) in different respiratory failure causes. While HFNC is used in coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF) under weak recommendations, its efficacy remains to be investigated. OBJECTIVES The primary objective was to examine HFNC efficacy in preventing EI among COVID-19 patients with AHRF. Secondary objectives were to determine predictors of HFNC success/failure, mortality rate, and length of hospital and intensive care unit (ICU) stay. PATIENTS AND METHODS This is a prospective cohort study conducted at a single tertiary care centre in Saudi Arabia from April to August 2020. Adult patients admitted to the ICU with AHRF secondary to COVID-19 pneumonia and managed with HFNC were included. We excluded patients who were intubated or managed with non-invasive ventilation before HFNC. RESULTS Forty-four patients received HFNC for a median duration of 3 days (interquartile range, 1-5 days). The mean age was 57 ± 14 years, and 86% were men. HFNC failure and EI occurred in 29 (66%) patients. Patients in whom HNFC treatment failed had a higher risk of death (52% versus 0%; P = 0.001). After adjusting for confounding factors, a high SOFA score and a low ROX index were significantly associated with HFNC failure (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.04-1.93; P = 0.025; and HR, 0.61; 95% CI, 0.42-0.88; P = 0.008, respectively). CONCLUSIONS One-third of hypoxemic COVID-19 patients who received HFNC did not require intubation. High SOFA score and low ROX index were associated with HFNC failure.
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Affiliation(s)
- Mohammed S Alshahrani
- Department of Emergency Medicine, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
- Department of Intensive Care, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Hassan M. Alshaqaq
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Kingdom of Saudi Arabia
| | - Jehan Alhumaid
- Preventive Dental Sciences Department, College of Dentistry, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Kingdom of Saudi Arabia
| | - Ammar A. Binammar
- College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Kingdom of Saudi Arabia
| | - Khalid H AlSalem
- Department of Emergency Medicine, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Abdulazez Alghamdi
- Respiratory Care Services, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Kingdom of Saudi Arabia
| | - Ahmed Abdulhady
- Critical Care Department, Faculty of Medicine, Alexandria University, Egypt
| | - Moamen Yehia
- Critical Care Department, Faculty of Medicine, Cairo University, Egypt
| | - Amal AlSulaibikh
- Department of Emergency Medicine, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Mohammed Al Jumaan
- Department of Emergency Medicine, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Waleed H Albuli
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Talal Ibrahim
- Department of Intensive Care, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Yousef Almubarak
- Department of Intensive Care, King Fahd Hospital of the University, College of Medicine, Kingdom of Saudi Arabia
| | - Waleed Alhazzani
- Department of Medicine, Evidence, and Impact, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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14
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Al-Qahtani MH, Yousef AA, Awary BH, Albuali WH, Al Ghamdi MA, AlOmar RS, AlShamlan NA, Yousef HA, Motabgani S, AlAmer NA, Alsawad KM, Altaweel FY, Altaweel KS, AlQunais RA, Alsubaie FA, Al Shammari MA. Correction to: Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia. BMC Emerg Med 2021; 21:99. [PMID: 34454412 PMCID: PMC8403387 DOI: 10.1186/s12873-021-00492-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mohammad H Al-Qahtani
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Abdullah A Yousef
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Bassam H Awary
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Waleed H Albuali
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Mohammed A Al Ghamdi
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia.
| | - Nouf A AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Haneen A Yousef
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Sameerah Motabgani
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Naheel A AlAmer
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Kawthar M Alsawad
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Y Altaweel
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Kawther S Altaweel
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Roaya A AlQunais
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Fatima A Alsubaie
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammari
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
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15
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Al-Qahtani MH, Yousef AA, Awary BH, Albuali WH, Al Ghamdi MA, AlOmar RS, AlShamlan NA, Yousef HA, Motabgani S, AlAmer NA, Alsawad KM, Altaweel FY, Altaweel KS, AlQunais RA, Alsubaie FA, Al Shammari MA. Characteristics of visits and predictors of admission from a paediatric emergency room in Saudi Arabia. BMC Emerg Med 2021; 21:72. [PMID: 34154525 PMCID: PMC8215860 DOI: 10.1186/s12873-021-00467-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/04/2021] [Indexed: 01/05/2023] Open
Abstract
Background The Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38). Conclusions A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.
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Affiliation(s)
- Mohammad H Al-Qahtani
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Abdullah A Yousef
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Bassam H Awary
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Waleed H Albuali
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Mohammed A Al Ghamdi
- Department of Paediatrics, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.,King Fahd Hospital of the University, Al-Khobar, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia.
| | - Nouf A AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Haneen A Yousef
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Sameerah Motabgani
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Naheel A AlAmer
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
| | - Kawthar M Alsawad
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Y Altaweel
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Kawther S Altaweel
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Roaya A AlQunais
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Fatima A Alsubaie
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammari
- Department of Family and Community Medicine, Imam Abdulrahman Bin University, Dammam, Saudi Arabia
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Alharbi AS, Yousef AA, Alharbi SA, Al-Shamrani A, Alqwaiee MM, Almeziny M, Said YS, Alshehri SA, Alotaibi FN, Mosalli R, Alawam KA, Alsaadi MM. Application of aerosol therapy in respiratory diseases in children: A Saudi expert consensus. Ann Thorac Med 2021; 16:188-218. [PMID: 34012486 PMCID: PMC8109687 DOI: 10.4103/atm.atm_74_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 11/27/2022] Open
Abstract
The Saudi Pediatric Pulmonology Association (SPPA) is a subsidiary of the Saudi Thoracic Society (STS), which consists of a group of Saudi experts with well-respected academic and clinical backgrounds in the fields of asthma and other respiratory diseases. The SPPA Expert Panel realized the need to draw up a clear, simple to understand, and easy to use guidance regarding the application of different aerosol therapies in respiratory diseases in children, due to the high prevalence and high economic burden of these diseases in Saudi Arabia. This statement was developed based on the available literature, new evidence, and experts' practice to come up with such consensuses about the usage of different aerosol therapies for the management of respiratory diseases in children (asthma and nonasthma) in different patient settings, including outpatient, emergency room, intensive care unit, and inpatient settings. For this purpose, SPPA has initiated and formed a national committee which consists of experts from concerned specialties (pediatric pulmonology, pediatric emergency, clinical pharmacology, pediatric respiratory therapy, as well as pediatric and neonatal intensive care). These committee members are from different healthcare sectors in Saudi Arabia (Ministry of Health, Ministry of Defence, Ministry of Education, and private healthcare sector). In addition to that, this committee is representing different regions in Saudi Arabia (Eastern, Central, and Western region). The subject was divided into several topics which were then assigned to at least two experts. The authors searched the literature according to their own strategies without central literature review. To achieve consensus, draft reports and recommendations were reviewed and voted on by the whole panel.
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Affiliation(s)
- Adel S. Alharbi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Pediatrics, King Fahd Hospital of the University, Khobar, Saudi Arabia
| | - Saleh A. Alharbi
- Department of Pediatrics, Umm Al-Qura University, Mecca, Saudi Arabia
- Department of Pediatrics, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Mansour M. Alqwaiee
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Mohammed Almeziny
- Department of Pharmacy, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yazan S. Said
- Department of Pediatrics, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saleh Ali Alshehri
- Department of Emergency, Pediatric Emergency Division, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Faisal N. Alotaibi
- Department of Pediatrics, Prince Sultan Military City, Ministry of Defence, Riyadh, Saudi Arabia
| | - Rafat Mosalli
- Department of Pediatrics, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Pediatrics, International Medical Center, Jeddah, Saudi Arabia
| | - Khaled Ali Alawam
- Department of Respiratory Therapy Sciences, Inaya Medical College, Riyadh, Saudi Arabia
| | - Muslim M. Alsaadi
- Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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17
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Al-Moamary MS, Alhaider SA, Alangari AA, Idrees MM, Zeitouni MO, Al Ghobain MO, Alanazi AF, Al-Harbi AS, Yousef AA, Alorainy HS, Al-Hajjaj MS. The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2021; 16:4-56. [PMID: 33680125 PMCID: PMC7908897 DOI: 10.4103/atm.atm_697_20] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/10/2020] [Indexed: 11/04/2022] Open
Abstract
The Saudi Initiative for Asthma 2021 (SINA-2021) is the fifth version of asthma guidelines for the diagnosis and management of asthma for adults and children, which is developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5-12 years, and children aged less than 5 years. SINA guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. Medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient-doctor partnership in the management that also includes a self-management plan.
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Affiliation(s)
- Mohamed S. Al-Moamary
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A. Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdullah A. Alangari
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Majdy M. Idrees
- Respiratory Division, Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed O. Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed O. Al Ghobain
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah F. Alanazi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Adel S. Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Hassan S. Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohamed S. Al-Hajjaj
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Alharbi NS, Alnasser Y, Alenizi AS, Alanazi AS, Alharbi AH, AlQurashi FO, Nafisah I, Yousef AA. Did the National Lockdown in Saudi Arabia Reduce Lower Respiratory Illnesses in Children? Front Pediatr 2021; 9:717739. [PMID: 34869094 PMCID: PMC8637928 DOI: 10.3389/fped.2021.717739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: This study aims to explore the effect of lockdown and early precautionary measures implemented in Saudi Arabia on number of pediatric hospitalizations due to lower respiratory illnesses (bronchiolitis, asthma, and pneumonia). Methods: This is a retrospective cross-sectional study aims to review patients from four major hospitals in Saudi Arabia. All pediatric hospitalizations secondary to asthma, bronchiolitis, and pneumonia during the months of the lockdown (March, April, and May) in 2020 were documented. Then, they were compared to the previous 2 years. Variables like number of hospitalizations, oxygen requirement, mechanical ventilation, admission to the intensive care unit (ICU), length of stay, and results of viral studies were collected. Results: We included 1,003 children from four different centers. Males were slightly higher than females (55.8% vs. 44.2%). Total number of hospitalizations in 2020 was 201, significantly lower than 399 and 403 hospitalizations in 2019 and 2018, respectively (P < 0.01). The major drop happened on the months of April and May. Although bronchiolitis hospitalizations' dropped by more than half in 2020 compared to the previous 2 years, it was not statistically significant (P = 0.07). But, asthma hospitalizations were significantly less in 2020 compared to the previous 2 years (49-65% reduction, P = 0.003). Number of pneumonia cases were lowered in 2020 compared to the previous 2 years. However, proportion of pneumonia diagnosis to total hospitalizations increased in 2020 (55% compared to 50% and 35%). There was a surge of viral testing during a period of uncertainty in the early phase of the pandemic. This total reduction in hospitalization was not associated with higher oxygen requirements, mechanical ventilation, ICU admissions or longer hospital stay. Conclusions: Lockdown and precautionary measures executed during the early phase of COVID-19 pandemic helped decrease the number of hospitalizations due to lower respiratory illnesses in Saudi Arabia. Reduction in hospitalizations seems less likely to be secondary to hospital avoidance or delayed presentations as number of ICU admission and oxygen requirements did not increase. The post pandemic pattern of respiratory illnesses among children needs further research.
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Affiliation(s)
- Nasser S Alharbi
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yossef Alnasser
- Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia.,King Saud Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Faisal O AlQurashi
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ibrahim Nafisah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
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19
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Albuali WH, Algamdi AA, Hasan EA, Al-Qahtani MH, Yousef AA, Al Ghamdi MA, Bubshait DK, Alshahrani MS, AlQurashi FO, Bou Shahmah TA, Awary BH. Use of a Mortality Prediction Model in Children on Mechanical Ventilation: A 5-Year Experience in a Tertiary University Hospital. J Multidiscip Healthc 2020; 13:1507-1516. [PMID: 33204099 PMCID: PMC7667207 DOI: 10.2147/jmdh.s282108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose Currently, several scoring systems for predicting mortality in severely ill children who require treatment in a pediatric intensive care unit (PICU) have been established. However, despite providing high-quality care, children might develop complications that can cause rapid deterioration in health status and can lead to death. Hence, this study aimed to establish a simple early predictive mortality (SEPM) model with high specificity in identifying severely ill children who would possibly benefit from extensive mechanical ventilation during PICU admission. Patients and Methods This is a retrospective longitudinal study that included pediatric patients aged older than two weeks who were on mechanical ventilation and were admitted to the PICU of King Fahd Hospital of the University from January 2015 to December 2019. Results In total, 400 pediatric patients were included in this study. The mortality rate of children on mechanical ventilation was 28.90%, and most deaths were associated with respiratory (n = 124 [31%]), cardiovascular (n = 76 [19%]), and neurological (n = 68 [17%]) causes. The SEPM model was reported to be effective in predicting mortality, with an accuracy, specificity, and sensitivity of 92.5%, 97.31%, and 66.15%, respectively. Moreover, the accuracy, specificity, and sensitivity of the Pediatric Risk of Mortality (PRISM) III score in predicting mortality was 95.25%, 98.51%, and 78.46%, respectively. Conclusion The SEPM model had a high specificity for mortality prediction. In this model, only six clinical predictors were used, which might be easily obtained in the early period of PICU admission. The ability of the SEPM model and the PRISM III score in predicting mortality in severely ill children was comparable. However, the accuracy of the newly established model in other settings should be validated, and a prospective longitudinal study that considers the effect of the treatment on the model’s predictive ability must be conducted.
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Affiliation(s)
- Waleed H Albuali
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal A Algamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Elham A Hasan
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad A Al Ghamdi
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dalal K Bubshait
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed S Alshahrani
- Emergency and Critical Care Medicine Departments, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Talal A Bou Shahmah
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bassam H Awary
- Department of Pediatrics, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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20
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Alharbi SA, Kobeisy SAN, AlKhater SA, Alharbi AS, Alqwaiee MM, Alotaibi FN, Alawam KA, Alahmadi TS, Al-Somali FM, Almaghamsi TM, Yousef AA. Childhood Asthma Awareness in Saudi Arabia: Five-Year Follow-Up Study. J Asthma Allergy 2020; 13:399-407. [PMID: 33061466 PMCID: PMC7537987 DOI: 10.2147/jaa.s272850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Bronchial asthma is a chronic inflammatory airway disease that is characterized by reversible airway obstruction due to bronchial hyperresponsiveness. It is one of the most common chronic diseases. In Saudi Arabia, asthma affects 2 million people with asthma frequency in children markedly higher than adults with regional variations ranging from 9% to 33.7%. Objective The aim of this study is to measure asthma awareness and knowledge of study participants during the ongoing annual Saudi asthma awareness campaigns and compare them with previous survey data conducted in 2014. Methods A cross-sectional study was carried out in the form of a survey distributed across three major cities in Saudi Arabia, Jeddah, Riyadh and Dammam, during the National Asthma Awareness Campaign in major regional shopping centers in April 2019. Asthma knowledge scores across different demographic groups were generated from surveyed data. Descriptive and correlative statistical analyses were performed to identify factors associated with changes in asthma knowledge. Scores were compared to previous survey results. Results The mean score for asthma knowledge was 15.6 out of 25. Asthma knowledge significantly correlated with age (P=0.002), asthma status of the participants (P=0.001), having children with asthma (P=0.005) or knowing friends or family with asthma (P=0.029) but not with other socioeconomic factors such as gender, marital status, occupation, level of education and number of children in the family (P > 0.05). There was a significant difference in the asthma scores from 2014 (M= 63%, SD=26) to 2019 (M= 70%, SD= 26) conditions; t (24) = -2.106, p=0.046. Conclusion Further educational campaigns are necessary to enhance and measure general public awareness of asthma, its differential diagnosis against other respiratory infections, environmental triggers, risk factors as well as treatment options.
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Affiliation(s)
- Saleh A Alharbi
- Department of Pediatrics, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.,Department of Pediatrics, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | - Suzan A AlKhater
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Pediatrics, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
| | - Adel S Alharbi
- Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Turki S Alahmadi
- Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Faisal M Al-Somali
- Department of Pediatrics, Sulaiman Al Habib Hospital, Al Khobar, Saudi Arabia
| | - Talal M Almaghamsi
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Pediatrics, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
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21
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Al-Moamary MS, Alhaider SA, Alangari AA, Al Ghobain MO, Zeitouni MO, Idrees MM, Alanazi AF, Al-Harbi AS, Yousef AA, Alorainy HS, Al-Hajjaj MS. The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2019; 14:3-48. [PMID: 30745934 PMCID: PMC6341863 DOI: 10.4103/atm.atm_327_18] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This is the fourth version of the updated guidelines 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 the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is now more aligned for different age groups. The guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with integration of recommendations related to biologic agents, evidence-based updates on treatment, and role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.
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Affiliation(s)
- Mohamed S Al-Moamary
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah A Alangari
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed O Al Ghobain
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed O Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majdy M Idrees
- Respiratory Division, Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah F Alanazi
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Adel S Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hassan S Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed S Al-Hajjaj
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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22
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Abstract
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 (less than 28 weeks' gestation) comprised 9% and very preterm infants (28 to less than 32 weeks' gestation) comprised 20%. Extremely low-birth-weight (ELBW) infants (less than 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.
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Affiliation(s)
- Faisal O Al-Qurashi
- Department of Pediatrics, King Fahd Hospital of the University, University of Dammam, Dammam, Kingdom of Saudi Arabia. E-mail.
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23
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Al-Moamary MS, Alhaider SA, Idrees MM, Al Ghobain MO, Zeitouni MO, Al-Harbi AS, Yousef AA, Al-Matar H, Alorainy HS, Al-Hajjaj MS. The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2016; 11:3-42. [PMID: 26933455 PMCID: PMC4748613 DOI: 10.4103/1817-1737.173196] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Mohamed S Al-Moamary
- Department of Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majdy M Idrees
- Department of Medicine, Pulmonary Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed O Al Ghobain
- Department of Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed O Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Adel S Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, College of Medicine, University of Dammam, Dammam, Saudi Arabia
| | - Hussain Al-Matar
- Department of Medicine, Imam Abdulrahman Al Faisal Hospital, Dammam, Saudi Arabia
| | - Hassan S Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed S Al-Hajjaj
- Department of Medicine, Respiratory Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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24
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Bubshait DK, Albuali WH, Yousef AA, Obeid OE, Alkharsah KR, Hassan MI, Vatte C, Alzahrani AJ, Bukhari H. Clinical description of human bocavirus viremia in children with LRTI, Eastern Province, Saudi Arabia. Ann Thorac Med 2015; 10:146-9. [PMID: 25829968 PMCID: PMC4375745 DOI: 10.4103/1817-1737.151437] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/22/2014] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Dalal K Bubshait
- Department of Pediatrics, University of Dammam, Dammam, Saudi Arabia
| | | | - Abdullah A Yousef
- Department of Pediatrics, University of Dammam, Dammam, Saudi Arabia
| | | | - Khaled R Alkharsah
- Prince Mohammed Bin Fahd Center for Research and Consultation Studies, University of Dammam, Dammam, Saudi Arabia
| | | | - Chittibabu Vatte
- Prince Mohammed Bin Fahd Center for Research and Consultation Studies, University of Dammam, Dammam, Saudi Arabia
| | - Alhusain J Alzahrani
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Huda Bukhari
- Department of Medicine, University of Dammam, Dammam, Saudi Arabia
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25
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Yousef HA, Koura M, Yousef AA. Knowledge about bronchial asthma management in primary health care physicians in Al-Khobar City, Saudi Arabia. J Family Community Med 2015; 22:1-7. [PMID: 25657604 PMCID: PMC4317988 DOI: 10.4103/2230-8229.149567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context: The prevalence of bronchial asthma (BA) is increasing in the Kingdom of Saudi Arabia. Primary health care (PHC) centers follow the national protocol, which is based on the severity of the disease for the management of asthma. The Saudi initiative for asthma (SINA) management adopted from the global initiative for asthma guidelines, which was recommended by several recent studies, is based on the control level of asthma. Aims: To assess the knowledge of PHC physicians and family medicine (FM) residents in Al-Khobar, about the management of BA. Methodology: A cross-sectional study was conducted in all PHC centers and the university FM clinic in Al-Khobar. All PHC physicians and 3rd and 4th year FM residents were included in the study. A self-administered questionnaire developed according to SINA guidelines was used to assess theoretical knowledge of BA, and a predesigned checklist was used to assess the different inhaler techniques. Scoring was established and collected data were analyzed. Results: Only 8% of the sample had good theoretical knowledge of BA; 41% had poor knowledge. The knowledge of the residents was better than that of the PHC physicians. The mean knowledge score was significantly better among those using guidelines compared to the rest. About 23% had good knowledge of inhaler techniques. Knowledge of PHC physicians and FM residents about dry powder inhalers was deficient, and PHC physicians had little knowledge of metered dose inhalers with spacers. Conclusion: The knowledge of physicians about the management of BA was deficient. The national guidelines based on the level of control for asthma management should be updated and physicians given periodic training.
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Affiliation(s)
- Haneen A Yousef
- Department of Family and Community Medicine, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Manal Koura
- Department of Family and Community Medicine, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia
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26
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Gierer S, Hofmann-Winkler H, Albuali WH, Bertram S, Al-Rubaish AM, Yousef AA, Al-Nafaie AN, Al-Ali AK, Obeid OE, Alkharsah KR, Pöhlmann S. Lack of MERS coronavirus neutralizing antibodies in humans, eastern province, Saudi Arabia. Emerg Infect Dis 2014; 19:2034-6. [PMID: 24274664 PMCID: PMC3840893 DOI: 10.3201/eid1912.130701] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
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.
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27
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Alumran A, Hou XY, Sun J, Yousef AA, Hurst C. Assessing the construct validity and reliability of the Parental Perception on Antibiotics (PAPA) scales. BMC Public Health 2014; 14:73. [PMID: 24456730 PMCID: PMC3909352 DOI: 10.1186/1471-2458-14-73] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 01/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The 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. METHODS 1111 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. RESULTS A 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. CONCLUSION The 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.
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Affiliation(s)
| | | | | | | | - Cameron Hurst
- Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Srinagarind Hospital, Khon Kaen 40002, Thailand.
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28
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Abstract
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.
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Affiliation(s)
- Abdullah A Yousef
- Department of Pediatrics, King Fahd Hospital of the University, University of Dammam, Saudi Arabia
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29
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Abstract
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.
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Affiliation(s)
- Abdullah A Yousef
- Department of Pediatrics, King Fahd Hospital of the University, University of Dammam, Dammam, Saudi Arabia
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30
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Yousef AA, Amr YM. The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study. Int J Obstet Anesth 2010; 19:401-4. [PMID: 20833531 DOI: 10.1016/j.ijoa.2010.07.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 03/31/2010] [Accepted: 07/25/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Combined spinal-epidural anaesthesia is commonly used for elective caesarean section. Intrathecal injection produces rapid onset with minimal doses of local anaesthetic and epidural administration can be used to prolong the block. Our study examined the effects of adding magnesium sulphate to epidural bupivacaine and fentanyl in patients undergoing elective caesarean section using combined spinal-epidural anaesthesia. METHODS Women ASA physical status I or II at term were recruited. All received 2 mL intrathecal 0.5% hyperbaric bupivacaine, 10 mL epidural 0.25% plain bupivacaine with fentanyl 100 μg, and were randomly allocated to receive either 10 mL of epidural 0.9% sodium chloride or 10 mL epidural 5% magnesium sulphate. The quality of surgical anaesthesia, incidence of hypotension, Apgar scores, intraoperative pain assessment, onset of postoperative pain, sedation scores and side effects were recorded in the postoperative period. RESULTS Ninety women were recruited. There was no difference in the time taken for the block to reach T4 sensory level, time to reach the highest level of sensory block, time interval between first neuraxial injection and onset of surgery between the groups. Women who received magnesium had greater motor block and muscle relaxation (P<0.05). Apgar scores were 7 or more in almost all neonates in both groups. There was no significant difference in the incidence of hypotension, nausea and vomiting and duration of motor blockade between the groups. Women who received magnesium showed less shivering and later onset of post operative pain (P<0.05). CONCLUSION The addition of magnesium to epidural bupivacaine and fentanyl in women undergoing elective caesarean section with combined spinal-epidural anaesthesia improved intraoperative conditions and the quality of postoperative analgesia.
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Affiliation(s)
- A A Yousef
- Department of Anesthesia, Faculty of Medicine, Tanta University, Tanta, Egypt.
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Abstract
Interest in azithromycin in the management of patients with cystic fibrosis has grown over the last decade. Uniquely this drug has both antibacterial and immune modulating effects which appear to be the reason for its clinical benefit as proven in several well designed clinical studies. In this review we discuss the proposed mechanisms of action of azithromycin and review the evidence for its clinical effectiveness and safety in cystic fibrosis.
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Affiliation(s)
- Abdullah A Yousef
- Department of Respiratory Medicine, Sydney Children's Hospital, High Street, Randwick 2031, University of New South Wales, Randwick, Sydney, Australia.
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Yousef AA, Jaffé A. Challenging respiratory infections in cystic fibrosis. Med J Aust 2009; 191:236-7. [DOI: 10.5694/j.1326-5377.2009.tb02767.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 05/17/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Abdullah A Yousef
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW
| | - Adam Jaffé
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW
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Abbas AA, Husain AH, Abdelaal MA, Albaz NM, Yousef AA, Fryer CJ. Acute lymphoblastic leukemia presenting with extensive skeletal lesions and bone marrow necrosis. Med Pediatr Oncol 2001; 37:64-6. [PMID: 11466728 DOI: 10.1002/mpo.1167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A A Abbas
- Pediatric Oncology Unit, Pediatric Department, King Khalid National Guard Hospital, Jeddah, Saudi Arabia.
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Abstract
This study is designed to evaluate the efficacy of treatment of bladder neck obstruction using objective (urodynamic) and subjective (assessment of satisfaction) parameters and to investigate sexual function. The results of transurethral 4 and 8 o'clock incisions of the bladder neck in 62 men (mean age 48.5 years) were reviewed with a mean follow-up of 6-12 months. Preoperative urodynamic evaluation was compared to recent postoperative urodynamic evaluation. There is marked symptomatic improvement after transurethral incision of the bladder outlet. The mean peak urine flow rate increased from 7.2 ml/s to 16.8 ml/s. Fifty-three men (85.4%) reported long-term improvement after transurethral incision of the bladder neck with an overall satisfaction rate of 71% (range 0 to 100). Five men (8%) reported new retrograde ejaculation after transurethral incision of the bladder neck. These results demonstrate that in well selected, properly diagnosed cases 4 and 8 o'clock transurethral incision of the bladder neck is an effective procedure for long-term relief of bladder outlet obstruction.
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Affiliation(s)
- M A el-Baz
- Department of Urology, Ain Shams University, Cairo, Egypt
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Abstract
A single carboxyhaemoglobin (COHb) estimation of late evening blood sample among non-smokers, cigarette smokers, and sheesha smokers was evaluated among Saudis. The COHb level in smokers of 15 to 40 cigarettes a day ranged between 0.7 and 10.3 with a mean value of 6.1 +/- 2.58 COHb. Values among sheesha smokers ranged between 6.5 and 13.9 with a mean value of 8.8 +/- 1.83, significantly higher than those of cigarette smokers (P less than 0.001) for a given degree of exposure to tobacco smoke.
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Abou-Zeid AA, Yousef AA. Effect of sodium arsenite on the biosynthesis of mitomycins by Streptomyces caespitosus and mode of action of mitomycin C on Bacillus subtilis NRRL B-543. Folia Microbiol (Praha) 1976; 21:36-42. [PMID: 814067 DOI: 10.1007/bf02879004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Addition of different concentrations of sodium arsenite to the fermentation medium used for the production of mitomycin antibiotics by Streptomyces caespitosus hindered the biosynthesis of mitomycins and led to the accumulation of 2-oxoglutarate, pyruvate and acetone. Mitomycin C isolated and purified using thin-layer chromatography in low concentration of about 0.1 mug/ml did not affect the RNA, DNA and protein biosynthesis of the growing Bacillus subtilis, while at 10 mug/ml mitomycin C markedly affected RNA, DNA and protein biosynthesis.
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Abou-Zeid AA, Yousef AA. Factors affecting the biosynthesis of mitomycins by Streptomyces caespitosus. Acta Microbiol Pol A 1972; 4:119-26. [PMID: 4627036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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