Assessment of Hounsfield Units and Factors Associated with Fragmentation of Renal Stones by Extracorporeal Shock Wave Lithotripsy: A Computerized Tomography Study

The success rate of extracorporeal shock wave lithotripsy (ESWL) is influenced by various factors, including stone density, and is determined through computed tomography scans in terms of Hounsfield units (HU).

MATERIALS AND METHODS

This retrospective single-center study was conducted in the King Fahad Hospital. Sixty-seven adult patients with renal and ureteric stones were selected randomly and enrolled in the study. Their ages ranged from 20 to 69 years. The patients were examined with non-contrast enhancement (NCCT) to assess the HU of their stones and were consequently treated with ESWL.

RESULTS

Of the 67 patients, 37.3% had stones that were completely fragmented, while 62.7% had stones that were partially fragmented. The HU, location of the stone, multiplicity of the stone, and patient age were found to be significant factors contributing to stone fragility (p-values < 0.05). The HU data were found to have a positive significant linear correlation with serum calcium (r = 0.28, p-value = 0.036), while serum acid had a negative correlation (r = -0.55, p-value < 0.001). Thus, the probability of calcium-containing stone formation increases with increased HU. In contrast, uric acid stone formation likely develops with decreasing HU with serum uric acid. Renal stones in patients with diabetes mellitus and hypertension were not completely fragmented compared to those without clinical history.

CONCLUSIONS

Mean HU, location of the stone, laterality, stone status, and the number of ESWL sessions are the most significant factors affecting stone fragility. CT attenuation values can predict the composition of stones from serum calcium and uric acid examinations. Hypertension and diabetes mellitus are risk factors for renal stone fragmentation.

Sonographic Assessment of Renal Transplantation in Adult Saudi Patients: A Cross-Sectional Retrospective Study

Kidney transplantation stands as a practical and cost-effective treatment option for end-stage renal disease patients, offering an improved quality of life with reduced morbidity when compared with hemodialysis. To evaluate the status of transplanted kidneys in Saudi patients, we conducted a retrospective single-center study at Jazan, Saudi Arabia, involving 46 adult renal recipients enrolled randomly from 2015 to December 2022. Using high-frequency ultrasound, we performed Duplex ultrasound examinations to assess renal allografts. The study revealed that the renal grafts exhibited normal length, with preserved cortical medullary differentiation (CMD) in 84.8% of cases and poor CMD in 15.2%. The echogenicity of the grafts remained normal in 69.6% of instances. Interestingly, we observed a significant rise in resistance index values as the graft duration increased (P = .04), whereas patients with abnormal creatinine levels displayed decreased peak systolic velocity and end-diastolic velocity. Notably, sonographic graft assessments unveiled complications, including perinephric fluid accumulation (8.7%), simple renal cysts (10.86%), hydronephrosis (8.7%), and one case of graft rejection. Receiver operating characteristics analysis for serum blood creatinine levels and abnormal parenchymal findings yielded fair to poor predictive accuracy, with varying sensitivity and specificity measures that lacked statistical significance. In conclusion, our study revealed that most Saudi renal transplant recipients exhibited grafts with normal echogenicity, preserved CMD, and limited perinephric fluid. This investigation provides valuable insights into sonographic changes and Doppler parameters of renal grafts, potentially aiding in the early detection of graft rejection and facilitating diagnostic and therapeutic planning.

Assessment of the Knowledge and Practice of Infection Control among Radiographers in Saudi Arabia: A Cross-Sectional Survey Study

Effective control of healthcare-associated infections (HAIs) involves a collaborative effort among various healthcare stakeholders, including healthcare workers, patients, and professionals. Radiographers, as essential members of the healthcare team, play a crucial role in HAI prevention by diligently adhering to standard infection control precautions (SICP) and maintaining a high level of knowledge regarding infection control procedures. The study aimed to assess the knowledge and practice of radiographers concerning infection control in radiology departments in Saudi Arabia.

METHODS

A descriptive cross-sectional study was conducted in Saudi Arabia in the period from February to May 2022, with data collected using an online survey in the form of a google forms questionnaire disseminated through social media as an electronic link and including the patient's demographic characteristic such as age, gender, education level, experience, and prior infection control training and multiple closed ended questions to assess knowledge of standard infection control precautions and the practice of infection control. Overall, 113 participants responded to the survey and entered their responses directly, and the data were analyzed using the SPSS (statistical package for social science).

RESULTS

The study revealed that the mean score of knowledge and awareness of the practice of infection control among radiographers in Saudi Arabia was (63.0 and 61.9, respectively), which were considered moderate levels. Females were significantly more knowledgeable about infection control and more aware of the practice than males (p-values = 0.019). The participants who previously attended courses of infection control training had a significantly higher score with a mean rank of (60.9) than those who had not (43.4), (p-value = 0.013). The radiographers' level of experience, age, and academic qualification had no significant influence on overall knowledge and practice of infection control (p-values > 0.05).

CONCLUSIONS

In Saudi Arabia, radiographers have a moderate level of knowledge and practice of infection control. There is a need for an ongoing training and education program for practicing radiographers to ensure they perform better in infection control measures.

Safety of Ultrasound Exposure: Awareness of Ultrasound Bioeffects among Saudi Sonographers

BACKGROUND

Ultrasound tends to produce biological effects on body tissues. Therefore, the application of ultrasound safety rules is needed in all ultrasound examinations to avoid bioeffects that may occur because of a high thermal index (TI) and mechanical index (MI). This study aimed to explore the Saudi sonographers' awareness of ultrasound safety and bioeffects.

METHODS

A descriptive cross-sectional study was conducted, and the data was collected using an online survey google forms questionnaire disseminated through social media (Telegram, WhatsApp, and Twitter) as an electronic link. A total of 70 participants responded to the survey directly, and then, the data was analyzed using SPSS (Statistical Package for Social Science).

RESULTS

Regarding the awareness of TI and MI, 64.3% of the participants were aware of TI and 65.7% of MI as safety ultrasound indices; moreover, 74.3% of the participants were aware of the ALARA principle "As Low as Reasonably Achievable." Participants' knowledge concerning more heat production in pulsed Doppler ultrasound modes was poor (31.5%). Most of the sonographers, i.e., 77.1% were aware of the relationship between the risk of activation and MI, and 58.6% of the participants were acquainted with the current FDA output limits. In comparison, 58.6% of the participants were aware of the bioeffects of ultrasound contrast agents. There was no significant correlation between the educational level and the degree of awareness of ultrasound bioeffects and safety (P-value> 0.05).

CONCLUSION

In this study, it was found that sonographers were aware of the theoretical principles of ultrasound safety indices and the ALARA principle, although they had poor knowledge of ultrasound bioeffects in Doppler mode.

Clinical presentation and angiographic findings of acute myocardial infarction in young adults in Jazan region

BACKGROUND

There is a paucity of information about the clinical features and angiographic findings in young patients with acute myocardial infarction (MI), especially in the Arab Peninsula countries.

OBJECTIVE

The aim of this study was to assess the proposed risk factors, clinical presentation, and angiographic findings of acute myocardial infarction in young adults.

METHODS

This prospective study included young (range, 18 to 45 years) patients who presented with acute MI based on clinical evaluation, laboratory investigation, and electrocardiogram, and they underwent a coronary angiography procedure.

KEY FINDINGS

Data of 109 patients with a diagnosis of acute MI were collected. Patients' mean age was 39.98 ± 7.52 years (range, 31 to 45 years), and 92.7% (101) were male. Smoking was the highest risk factor in 67% of patients, obesity and overweight in 66%, sedentary lifestyle in 64%, dyslipidaemia in 33%, and hypertension in 28%. Smoking was the most common risk factor for acute MI in males (p = 0.009), whereas sedentary lifestyle was the most common risk factor in females (p = 0.028). Chest pain typical of acute MI was the most common presenting symptom in 96% of patients (p < 0.001). On admission, 96% of patients were conscious, and 95% were oriented. On angiography, the left anterior descending artery (LAD) was affected in 57%, the right coronary artery (RCA) was affected in 42%, and the left circumflex artery (LCX) was affected in 32% of patients. The LAD was severely affected in 44%, the RCA was severely affected in 25.7%, and the LCX was severely affected in 19.26% of patients (p < 0.001).

CONCLUSION

Smoking, obesity, sedentary lifestyle, dyslipidaemia, and hypertension were the most common risk factors for acute MI. Smoking was the most common risk factor in males and sedentary lifestyle in females. The LAD was the most commonly affected coronary artery, followed by the RCA and LCX arteries, with the same order for severity of stenosis.

Work-related musculoskeletal symptoms among Saudi radiologists: a cross-sectional multi-centre study

BACKGROUND

Musculoskeletal disorders are common health problems worldwide. Several factors cause these symptoms, including ergonomics and other individual considerations. Computer users are prone to repetitive strain injuries that increase the risk of developing musculoskeletal symptoms (MSS). Radiologists are susceptible to developing MSS because they work long hours analysing medical images on computers in an increasingly digitalised field. This study aimed to identify the prevalence of MSS among Saudi radiologists and the associated risk factors.

METHODS

This study was a cross-sectional, non-interventional, self-administered online survey. The study was conducted on 814 Saudi radiologists from various regions in Saudi Arabia. The study's outcome was the presence of MSS in any body region that limited participation in routine activities over the previous 12 months. The results were descriptively examined using binary logistic regression analysis to estimate the odds ratio (OR) of participants who had disabling MSS in the previous 12 months. All university, public, and private radiologists received an online survey containing questions about work surroundings, workload (e.g., spent at a computer workstation), and demographic characteristics.

RESULTS

The prevalence of MSS among the radiologists was 87.7%. Most of the participants (82%) were younger than 40 years of age. Radiography and computed tomography were the most common imaging modalities that caused MSS (53.4% and 26.8%, respectively). The most common symptoms were neck pain (59.3%) and lower back pain (57.1%). After adjustment, age, years of experience, and part-time employment were significantly associated with increased MSS (OR = .219, 95% CI = .057-.836; OR = .235, 95% CI = 087-.634; and OR = 2.673, 95% CI = 1.434-4.981, respectively). Women were more likely to report MSS than males (OR = 2.12, 95% CI = 1.327-3.377).

CONCLUSIONS

MSS are common among Saudi radiologists, with neck pain and lower back pain being the most frequently reported symptoms. Gender, age, years of experience, type of imaging modality, and employment status were the most common associated risk factors for developing MSS. These findings are vital for the development of interventional plans to reduce the prevalence of musculoskeletal complaints in clinical radiologists.

Assessment of Lower Limb Deep Vein Thrombosis: Characterization and Associated Risk Factors Using Triplex Doppler Imaging

Background

Deep vein thrombosis (DVT) is a common health problem. Accurate diagnosis of DVT is essential to avoid potentially fatal acute consequences of pulmonary embolism.

Aim

The study aims to assess deep venous thrombosis (DVT) of the lower limbs and to analyze the related risk factors.

Methods

This is a retrospective study including 60 patients who were examined using Triplex Doppler imaging. The patients were referred to the imaging departments with symptoms of lower limb DVT. The risk of DVT was expressed as an odds ratio (OR) with 95% confidence interval. Multiple logistic regression analysis was used to detect the independent risk factors. P value <0.05 was considered a significant statistic.

Results

Among the Saudi patients in Najran, acute DVT was more prevalent than chronic one (56.7% vs 38.3%), while subacute is less frequent (5%). DVTs are more prevalent in females than males (60% vs 40%) and most commonly affect patients older than 40. DVTs affect the left lower limb veins more than the right limb (75% vs 15%) and are less frequent on both sides (10%). The left popliteal vein (PV) and left common femoral vein (CFV) were the most common sites for acute DVTs. Binary logistic analysis revealed the independent risk factors for developing lower extremity DVT; malignancy (OR = 2.84, 95% CI = 0.518-15.513), surgery (OR = 2.66, 95% CI = 0.411-17.281), trauma (OR = 2.30, 95% CI = 0.452-11.658), and diabetes and hypertension (OR = 1.53, 95% CI = 0.335-6.969).

Conclusion

Acute lower limb DVT was more prevalent than chronic one. Malignancy, surgery, trauma, diabetes mellitus, and hypertension were the most common risk factors for lower limb DVTs. Left popliteal and left common femoral veins were the most common sites of acute DVTs.

Identifying cerebral microstructural changes in patients with COVID-19 using MRI: A systematic review

Coronavirus disease 2019 (COVID-19) is an epidemic viral disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the excessive number of neurological articles that have investigated the effect of COVID-19 on the brain from the neurological point of view, very few studies have investigated the impact of COVID-19 on the cerebral microstructure and function of the brain. The aim of this study was to summarize the results of the existing studies on cerebral microstructural changes in COVID-19 patients, specifically the use of quantitative volumetric analysis, blood oxygen level dependent (BOLD), and diffusion tensor imaging (DTI). We searched PubMed/MEDLINE, ScienceDirect, Semantic Scholar, and Google Scholar from December 2020 to April 2022. A well-constructed search strategy was used to identify the articles for review. Seven research articles have met this study's inclusion and exclusion criteria, which have applied neuroimaging tools such as quantitative volumetric analysis, BOLD, and DTI to investigate cerebral microstructure changes in COVID-19 patients. A significant effect of COVID-19 was found in the brain such as hypoperfusion of cerebral blood flow, increased gray matter (GM) volume, and reduced cortical thickness. The insula and thalamic radiation were the most frequent GM region and white matter tract, respectively, that are involved in SARS-CoV-2. COVID-19 was found to be associated with changes in cerebral microstructures. These abnormalities in brain areas might lead to be associated with behaviors, mental and neurological alterations that need to be considered carefully in future studies.

Can Thyrotropin, Tri-Iodothyronine, and Thyroxine Hormones be Predictors of Cancer in Thyroid Lesions?

Background Thyroid nodules are a common medical problem worldwide. This study aims to investigate and elucidate the relationship between thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3), and malignant thyroid nodules. Methods This prospective cross-sectional study was conducted at a public specialist hospital in Saudi Arabia from February 2020 to February 2021. All thyroid nodules were scanned using ultrasound imaging, and the largest diameter was measured for each and classified according to the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS) classification system. Thyroid function tests TSH, T3, and T4 were measured. Definitive diagnoses of thyroid nodules were given based on cytology. A one-way analysis of variance (ANOVA) test was used to compare means, and cross-tabulation was used to correlate the variables in the study. Results A total of 222 patients participated in this study; 23.42% were male and 76.57% were females. The mean age was 44.73 ± 13.31 years (range: 18 to 85 years). The percentage of malignancy was 20.6%, 36.3%, and 91.2% in TIRADS 3, TIRADS 4, and TIRADS 5, respectively. A weak positive linear relationship was noted between nodule size and TSH (R²= 0.012). The study demonstrates that TSH increases in malignant nodules more than in benign nodules, while T4 and T3 are decreased in malignant nodules. Conclusion The level of TSH increases in patients with malignant thyroid nodules more than in benign nodules, which can be used as a predictor of malignancy, while T4 and T3 reduced in malignant nodules with an ambiguous relationship.

Factors Influencing Undergraduate Students' Preference of Health Sciences Specialties

BACKGROUND

It is necessary to determine what motivates students to pursue a particular specialty of their choosing to maintain a balance of medical practitioners from various disciplines.

OBJECTIVE

The study aims to assess factors influencing undergraduate students of Applied Medical Sciences in choosing a specialty or discipline.

METHODS

This cross-sectional study was conducted among first-year students of the faculty of applied medical sciences at Taibah University. One hundred and twenty-five participants were enrolled in the study. The students were asked to respond and complete the designed 9-item questionnaire. The Statistical Package for the Social Sciences (BM SPSS Statistics for Windows, Version 23.0, Armonk, NY: IBM Corp.) was used to analyze the data. A comparison between departments of the faculty was carried out.

RESULTS

125 participants were satisfied with their current faculty or discipline. They stated that medicine was the first choice (43.2%), followed by clinical nutrition (11.2%), dentistry (8%), diagnostic radiology (7.2%), and clinical laboratory (5.6%). The most important factors that affect students' choice of discipline were helping patients and the community (32.8%), personal desire (30.4%), personal desire and helping patients (22.4%), and job opportunity and prestige (9.5%), with gender variations. Family enforcement and finances were less frequent factors affecting students' specialty preferences.

CONCLUSION

The human medicine specialization was the first choice for most female and male undergraduate students who entered the faculty of applied medical sciences. Furthermore, the most influencing factor affecting students' choices was helping patients and the community.

Impact of extended pre-scan written instructions on motion artifacts during head magnetic resonance imaging

This study aimed to assess the effect of extending pre-scan written instructions to patients undergoing head magnetic resonance imaging (MRI) examinations on motion artifacts. A controlled study was conducted in King Fahad Hospital at the Department of Radiology. A total of 100 patients were involved: 50 received only routine oral hospital instructions (control group), and another 50 received pre-scan extended written instructions besides routine oral hospital instructions (intervention group). The head MRI images were assessed regarding motion artifacts. Informed consent was obtained from all patients included in the study. The incidence of motion artifacts was significantly less in the intervention group than in the control group, 10% and 58%, respectively (p-value=0.001). The motion artifacts decreased significantly in the intervention group compared to the control group. Extending written information before an MRI scan could significantly reduce motion artifacts and improve image quality.

A Triplex Ultrasound Evaluation of Preclinical Changes in Type 2 Diabetes in Foot Arteries

Background and objective: Type 2 diabetes mellitus (T2DM) is a significant health problem that is becoming more prevalent worldwide. This study aimed to assess hemodynamic and morphological parameters in diabetic patients' foot arteries and compare them to those obtained in asymptomatic control group.

Materials and methods: This is a cross-sectional case-control study. B-mode ultrasound, color Doppler, and pulse wave Doppler were conducted to assess the dorsalis pedis arteries (DPAs) and posterior tibial arteries (PTAs). The morphological, total vascular diameter, wall thickness, and flow Doppler indices were measured. A total of 200 hundred participants were selected randomly using a random sampling technique. One hundred diabetic patients and 100 non-diabetic persons were determined.

Results: In diabetic patients, the overall grayscale diameter and wall thickness of foot arteries were statistically significantly larger than the asymptomatic group in the right DPA (p<0.01), left DPA (p<0.001), right PTA (p<0.001), and left PTA (p<0.001). In the diabetic group, the level of hemoglobin A1c (HbA1c) was positively correlated with blood flow resistive index (RI) in the right DPA (r=0.839; p<0.001), left DPA (r=0.801; p<0.001), right PTA (r=0.801; p<0.001), and left PTA (r=0.801; p<0.001). No significant differences were noted in both groups in blood flow Doppler parameters - pulsatility index (PI) and resistive index (RI).

Conclusion: Overall grayscale diameters of foot arteries are larger in the diabetes group than in the control group, indicating arterial wall thickening as an early indicator of diabetes-related alterations. PI of both DPA and RI of right DPA were increased in diabetic patients more than the control group. The level of glycosylatedhemoglobin A1c (HbA1c) was strongly linked with the blood flow resistive index in diabetes patients.

Accuracy of Magnetic Resonance Spectroscopy in Discrimination of Neoplastic and Non-Neoplastic Brain Lesions

Background

Differentiation of brain lesions by conventional MRI alone is not enough. The introduction of sophisticated imaging methods, such as MR Spectroscopy (MRS), will contribute to accurate differentiation.

Objective

To determine the diagnostic accuracy of MRS in differentiating neoplasm and non-neoplastic brain lesion.

Methodology

This is a cross-sectional descriptive study conducted at Khartoum State from the period of 2015 to 2017. Thirty cases with brain lesions were included in the study investigated with MRS (Single-voxel spectroscopy) and conventional MRI. A comparison of MRS findings and histopathologic analysis was performed. The ratios of Cho/Cr and Cho/NAA were analyzed and compared between neoplastic and non-neoplastic brain masses. Data were analyzed using SPSS version 23.

Results

Out of the 30 patients affected with brain lesions, there were 16 females and 14 males with a mean age of 44 +- 18 years. The ratios of Cho/Cr and Cho/NAA were higher in gliomas, astrocytoma, and meningioma than non-neoplastic lesions. Kappa statistical value (K) showed a good agreement between MRS and histopathological analysis (K= 0.60). The diagnostic accuracy of MRS was 100%, with 82.60% sensitivity, 85.71% specificity, 95% PPV, and 60% NPV.

Conclusion

MRS has high diagnostic accuracy in differentiating neoplasm from non-neoplastic brain tumors. The elevation ratios of Choline-to- N-acetyl aspartate and choline-to- creatine can help neurosurgeons and clinicians differentiate benign from malignant masses.

Assessment of Knowledge, Attitude, and Practice Concerning COVID-19 Among Undergraduate Students of Faculty of Applied Medical Sciences at King Khalid University, Abha, Kingdom of Saudi Arabia: A Cross-Sectional Surveyed Study

BACKGROUND AND OBJECTIVE

The Kingdom of Saudi Arabia has exerted great efforts to prevent the spread of COVID-19. This research aims to scrutinize the outlook, awareness, and customs of Saudi undergraduate students regarding COVID-19.

METHODS

The current cross-sectional study comprises 178 undergraduate students in the Faculty of Applied Medical Sciences. The data were collected from online Google form questionnaires. The differences were picked out of the questionnaires, and the mean scores of the differences were duly assessed. The variables associated with knowledge, attitude, and practice toward COVID-19 were evaluated; moreover, a comparative study was conducted on these variables in different faculty departments. ANOVA, Student's t-test, and binary logistic regression analysis were used to assess the data on knowledge, attitude, and practice.

RESULTS

Most of the undergraduate students were well acquainted with COVID-19. We obtained the mean knowledge score for COVID-19 to be 3.08 ± .82 (range: 1-5), indicating good knowledge. The attitude means the score was 3.02 ± .61 (range: 0-4), implying good positive attitudes. On assessing the mean score of practices, it was found 5 ± .47 (range: 0-7), pointing towards perfect practices. There were no significant differences between males and females regarding knowledge, attitudes, and practice toward COVID-19 (p-value < 0.05).

CONCLUSION

Students of Applied Medical Sciences are knowledgeable about COVID-19. Health education programs should be focused on protection and safety from COVID-19 for Applied Medical Sciences students, especially Medical Rehabilitation Sciences and Radiology. Hand hygiene awareness programs must be conducted for undergraduate students. Infection control should be part of the undergraduate applied for medical sciences curriculum program.

Sonographic Evaluation of the Pancreas in Type 1 Diabetes Mellitus: A Case-control Study

BACKGROUND

Pancreas is a vital insulin-producing gland, and it is subjected to various disorders which produce alteration in the morphology and function. Ultrasound (US) of the pancreas is sensitive for evaluating the gland and provides the accurate diagnosis of pancreatic diseases. The aim of this study is to determine whether there were alterations in pancreatic size and echogenicity in type 1 diabetes mellitus (DM).

METHODS

A total of 100 patients with Type-1 DM (insulin dependent) were examined using the ultrasonography. They were compared to 22 healthy controls. Measurements of the pancreas were performed on type 1 diabetic patients and controls.

RESULTS

Pancreatic diameters of the head, body, and tail of the pancreas were reduced in Type 1 DM versus controls (1.78 vs. 1.80 cm, 95% confidence interval [CI]: -0.147 -0.099, P = 0.699 for the head of the pancreas; and 1.093 vs. 1.13 cm: 95% CI: -2.97-1.196, P = 0.484 for the body of the pancreas; 1.12 vs. 1.46 cm, 95% CI: -0.491-0.194, P < 0.001 for the tail of the pancreas). The echogenicity of the pancreas in patients with Type 1 DM increased significantly as the duration of the disease increased (P = 0.015).

CONCLUSION

Individuals with Type 1 DM have reduced pancreatic size in comparison with controls. Patients with Type 1 DM have increased echogenicity of the pancreas as the duration of the disease increased.

The Impact of Khat (Catha edulis) on Hemodynamics of the Common Carotid Arteries in Regular Khat Chewers: A Case-control Study Using Doppler Ultrasound

Background:

To evaluate the effect of chewing khat on the hemodynamics of the common carotid arteries (CCAs) using Doppler ultrasound imaging.

Methods:

This is a cross-sectional case–control study. Fifty volunteers who were chronic regular khat chewers were selected and compared with healthy nonkhat chewers. They were examined using Doppler imaging with a 7–10 MHz linear transducer. The resistivity index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity of the CCAs were determined according to the standard protocol of carotid Doppler ultrasound.

Results:

The RI and PI of the right and left CCAs were significantly higher in khat chewers compared to controls (P < 0.001). The PSV of the right and left CCAs was considerably higher in khat chewers compared to controls (P < 0.001 and 0.04, respectively).

Conclusion:

The Doppler values of blood flow velocity, resistivity, and pulsatility were significantly higher in chronic regular khat chewers compared to nonkhat chewers. Khat is a significant contributory factor for increasing the hemodynamics of the CCAs.

Patients' perceptions and attitude towards MRI safety in Asir Region, Saudi Arabia

PURPOSE

To assess the knowledge and attitudes of Saudi patients toward the safety of magnetic resonance imaging (MRI).

METHODS

A cross-sectional study was conducted on 142 Saudi patients at King Khalid hospital, Asir, Saudi Arabia. Data were collected using a self-questionnaire based on MRI safety issues gained from the literature. The questionnaire was divided into two sections, one containing the respondents' sociodemographic information and the other assessing their knowledge and attitudes toward participating in MRI.

RESULTS

A total of 142 patients responded to the survey, and their average age was 31.5 ± 4 years. The majority were married and held a bachelor's degree. The mean knowledge score regarding MRI safety was 0.29 ± 0.25, which reflects poor knowledge, whereas the attitude score was 0.67 ± 0.20, reflecting a moderately positive attitude. Awareness and attitude among patients improved as education levels increased. Finally, only 53.5% of the respondents were aware of the noise produced by the MRI scanner.

CONCLUSION

This study demonstrated that the awareness of MRI safety among patients in the Asir Region is poor, although they showed positive attitudes toward the issue. Thus, education is necessary for patients to improve awareness of MRI safety to facilitate MRI examinations, which will help decrease scan time and image artefacts.

Sensitivity and Features of Computed Tomography in Diagnosis of COVID-19 Pneumonia: A Meta-analysis

Introduction: Early diagnosis of COVID-19 is important for disease treatment and management. Computed Tomography (CT) is a fast and easy modality for diagnosis and management plan of patients with COVID-19. In the literature, several studies were done to assess the sensitivity of CT for diagnosis of COVID-19 infection in comparison to Reverse Transcription Polymerase Chain Reaction (RT-PCR). Some studies stated that CT was more sensitive diagnostic modality for COVID-19 than RT-PCR. However, the sensitivity of CT for COVID-19 varies in these studies. Aim: This literature review and meta-analysis was designed to determine the CT features of COVID-19 pneumonia, to verify the pooled sensitivity of CT for the diagnosis of COVID-19 and to review the different reasons (e.g., the disease stage or severity and the negative or positive RT-PCR results) for the variations in CT sensitivity. Materials and Methods: This review analysed 31 articles selected from the Europe BMC, PubMed, Science Direct, and Scopus databases. Participant gender mean and median age, CT features of COVID-19 pneumonia were sought for and reviewed. The data was analysed using Microsoft excel version 10 and OpenMeta (Analyst) software (http://www.cebm.brown.edu/openmeta/) to verify the pooled sensitivity of CT in detection and diagnosis of COVID-19 pneumonia using meta-analyses forest plot, Receiver Operating Characteristic (ROC) curve, cumulative meta-analyses forest plot and leave one forest plot. Results: The most common CT findings of COVID-19 pneumonia were bilateral lung involvement, Ground Glass Opacity (GGO), and consolidation, and Crazy-paving pattern. The CT finding is more prominent in symptomatic and severe cases than in a symptomatic and mild cases specifically the presence of consolidation and peripherals lesion distribution. The pooled sensitivity of CT is 90% in diagnosis and detection of COVID-19 pneumonia (ranged 60-100%). Conclusion: Combination of CT chest and laboratory tests along with clinical manifestation and epidemiological features should be considered to confirm the final diagnosis of COVID-19 pneumonia.

Evaluation of Post-Vaccination Symptoms of Two Common COVID-19 Vaccines Used in Abha, Aseer Region, Kingdom of Saudi Arabia

BACKGROUND

The Pfizer-BioNTech (BNT162b2) and the Oxford-AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccines have shown promising safety and acceptability. However, COVID-19 vaccine side effects play an essential role in public vaccine confidence. We aimed to study the side effects of these COVID-19 vaccines.

METHODS

A randomized, cross-sectional descriptive study was conducted between March and May of 2021. In total, 330 participants among the King Khalid University community in the Aseer region of the Kingdom of Saudi Arabia reported their side effects following the COVID-19 vaccine. A questionnaire was designed and validated to collect the participants' demographic data and COVID-19-related symptoms after COVID-19 vaccine injection.

RESULTS

Symptoms associated with COVID-19 were reported by 226 participants (68.5%). The most common side effects reported by the participants were fever (n = 136, 41.2%), fatigue (n = 119, 36.1%), headache (n = 86, 24.2%), malaise (n = 121, 36.7%), myalgia (n = 121, 36.7%), and muscle and joint pain (n = 76, 23%). Of the participants, 5.1% became infected with COVID-19 after vaccination. Symptoms were significantly more common in males than in females (p = 0.006).

CONCLUSION

The incidence of COVID-19 vaccination side effects in the Aseer region, Kingdom of Saudi Arabia, was consistent with the manufacturers' data. The most common post-vaccination symptoms reported by the participants were fever, myalgia, malaise, fatigue, muscle and joint pain, and headache. The results of this study showed significant variation in adverse events between Pfizer-BioNTech and Oxford-AstraZeneca COVID-19 vaccines. Healthcare providers and recipients of vaccines can be more confident about the safety of Pfizer-BioNTech and Oxford-AstraZeneca COVID-19 vaccines.

Sonographic assessment of kidneys in patients with hypertension co-existed with diabetes mellitus and ischemic heart disease

Background

Hypertension is one of the major world health problems. Ultrasonography plays a useful role in the assessment of morphologicalchanges at the kidneys in hypertensive patients.

Aim

To assess sonographic findings of the kidneys in hypertensive patients' co-morbidities with type 2 diabetes mellitus and ischemic heart disease (IDH).

Materials and Methods

This was a prospective cross-sectional study involved 100 participants with primary hypertension selected by a method of simple convenient sampling. The patients were examined using ultrasonography to assess the sonographic findings of the kidneys. The renal length, corticomedullary differentiation (CMD), and renal artery diameters were assessed. Statistical Package for the Social Sciences (SPSS version 23.0) was used in data analysis.

Results

The length of the right kidney was 8.9850 ± 1.01 cm and 9.48 ± 0.98 cm for the left kidney. Among the hypertensive patients, the incidence of hypertension was highest in housewives (27%) and students (23%) as compared with the other groups. The sonographic findings were 18% affected with simple renal cysts, 7% poor CMD, and the majority had normal kidneys. Significant correlation was found between age and sonographic findings of kidneys (r = 0.21, P value = 0.033).

Conclusion

Simple renal cysts, poor CMD, and stenosis of renal arteries were most common sonographic findings in hypertension. Simple renal cystshad a significant association with hypertension.

Impact of Khat (<i>Catha edulis</i>) Chewing on Carotid Intima-media Thickness

BACKGROUND AND OBJECTIVE

Khat has severe adverse socio-economic consequences. It causes serious cardiovascular, neurological and psychiatric problems. The study aimed to evaluate the effect of chewing khat on intima-media thickness (IMT) of the common carotid arteries.

MATERIALS AND METHODS

This was a descriptive case-control cross-sectional study. A total of 50 participants of chronic regular khat chewers were investigated. B-mode ultrasound 7-10 MHz linear transducers used for assessment of common carotid arteries according to the standard carotid sonography protocol. The IMT was measured and the presence of plaques was assessed.

RESULTS

The carotid IMT was significantly increased in regular khat chewers more than the controls (p-value = 0.016). The common carotid IMT increased in smokers more than non-smokers among khat chewers (0.6710±0.20687 vs. 0.5789±0.16859 mm). Significant correlations existed between the duration of chewing khat and age with the presence of plaque (p-values = 0.013 and 0.002, respectively).

CONCLUSION

There is a significant correlation between carotid plaque and longtime khat chewing. Khat is a contributory factor for increasing carotid intima-media thickness and formation of carotid plaques. A combination of khat and smoking produce more thickening of carotid intima-media.

Characterization of Foot Mycetoma Using Sonography and Color Doppler Imaging

BACKGROUND AND OBJECTIVE

Mycetoma of the foot, commonly referred to as Madura foot, is a chronic granulomatous infection, which impacts vascularization of the affected region. This study aimed to evaluate foot mycetoma using Doppler and sonography techniques to identify the principle sonographic features and blood flow patterns associated with the condition.

MATERIALS AND METHODS

This was a cross-sectional prospective single-center study conducted at the Mycetoma Research Center (MCR) in Khartoum State, Sudan. Sixty patients with Madura foot were examined using a Duplex ultrasound machine with a 7-10 MHZ linear probe. Data was analyzed using SPSS software. The distribution of demographic data was evaluated by simple descriptive statistics. Statistical tests was performed using Student's independent t-tests to compare different forms of mycetoma and Chi-square tests to examine differences in blood flow patterns between fungal (eumycetoma) and bacterial (actinomycetoma) forms of the infection.

RESULTS

The presence of multiple cavities and aggregated grains were more common in eumycetoma than in actinomycetoma. The echotexture was significantly more heterogeneous in eumycetoma than in actinomycetoma (p = 0.03). Eumycetoma had higher vascularity than actinomycetoma.

CONCLUSION

Mycetoma has characteristic sonographic features and patterns of vascularity, which are essential to differentiate between the fungal and bacterial forms of mycetoma.

The Readiness For Interprofessional Education (IPE) In The School Setting Among The Internship Students Of Applied Medical Sciences At Taibah University

OBJECTIVE

The study aims to assess the readiness of Interprofessional Education (IPE) in the school setting among the Internship Students of Applied Medical Sciences at Taibah University.

METHODS

This study utilized a survey targeting internship students of Applied Medical Sciences; departments Diagnostic Radiologic Technology, Medical Laboratory Technology, and Clinical Nutrition, at Taibah University. We used a modified Readiness for Inter-professional Learning Scale (RIPLS) survey to collect the data of this study. Data were analyzed using SPSS software version 21.

RESULTS

A 100 surveys distributed, 40 were returned. Most of the internship students (88.7%) agreed that IPE could make them more collaborated and can enhance teamwork skill to them. A total of 36.25% of the internship student agreed, and 50.01% disagree about the negative professional identity of the IPE. 86.66% of the internship student agreed, and 50.01% disagree about the positive professional identity of the IPE. They responded that sharing learning with other health care professionals will help them to communicate better with patients and other professionals and to improve practice. 65.84% of the internship student agreed, and 23.75% disagreed about the impact of IPE on their role and responsibility. The difference between the internship student at the end level of the internship and internship student at the beginning level of the internship, towards the positive thinking about other healthcare professionals was 0.015.

CONCLUSION

The study concluded that there was a readiness of IPE in the school setting among the Internship Students Students of Applied Medical Sciences at Taibah University. The majority of the internship student agreed that IPE could make them more collaborated and can enhance teamwork skill to them. There was a significant difference between the internship student at the end level of the internship and internship student at the beginning level of the internship, towards the positive thinking about other healthcare professionals.

Early signs of middle cerebral artery infarction on multidetector computed tomography: Review of 20 cases

OBJECTIVE

This study intended to assess the occurrence of early signs of middle cerebral artery (MCA) on multidetector computed tomography (MDCT) in correlation with duration of the clinical features of stroke.

PATIENTS AND METHODS

This retrospective study analyzed the electronic records of 20 patients with MCA infarction. The detected signs studied according to the onset of the clinical features of stroke to the time of CT imaging.

RESULTS

Out of 20 patients with MCA infarction included in this study, the results revealed a significant relationship between the presence of insular ribbon sign and/or subtle hypodensity and hyperacute infarction (P < 0.001 and 0.003, respectively). Results revealed significant relationship between the occurrence of hypodense area, effacement of the cortical sulci, and compression of the ipsilateral lateral ventricle with acute infarction (6-72 h), (P = 0.006, 0.007, and 0.002) (odds ratio = 0.047, 0.050 and 0.028) and (95% confidence interval = 0.004-0.552, 0.004-0.597 and 0.002-0.367) respectively.

CONCLUSION

MDCT can detect nearly half of MCA infarctions in the first 6 h. Insular ribbon sign and subtle hypodensity were the most significant findings in the first 6 h of stroke. Hypodense area was a significant sign after 6 h. Diabetes mellitus and ischemic heart disease were the most common risk factors. Hemiparesis was the most common clinical finding in MCA infarction.

Giant frontal mucocele presenting with displacement of the eye globe

In this case, a 70-year-old female patient presented with large forehead swelling that occurred 2 years prior, with slow progressive enlargement that mimicked the behavior of a neoplasm. There was severe inferior displacement of the right orbital globe to the level of the nares. Brain computed tomography showed a large expansive lesion in the right frontal sinus with bony wall thinning without destruction or erosion. Brain magnetic resonance imaging showed high signal intensity of the contents in T1- and T2-weighted images with only peripheral enhancement after contrast administration. These features were consistent with a typical right frontal mucocele.