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Raffa LH, Fatani M, Alghamdi R. Insights into Risk: Exploring Retinopathy of Prematurity and Short-term Comorbidities in Moderate-to-Late Preterm Infants. Niger J Clin Pract 2024; 27:124-130. [PMID: 38317045 DOI: 10.4103/njcp.njcp_576_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/08/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) and short-term comorbidity data moderate-to-late preterm (MLP) infants in Saudi Arabia are limited. AIM The present study mainly aimed to identify ROP incidence and severity in MLP infants. The secondary objective was to explore whether moderate preterm infants are more prone to systemic short-term comorbidities compared to late preterm infants. MATERIALS AND METHODS This retrospective study was conducted at King Abdulaziz University Hospital, a tertiary center in Jeddah, Saudi Arabia. Two-hundred and sixty-eight MLP infants born with gestational ages (GAs) of 32 to 36 + 6 weeks were included. Births were classified as moderate preterm (GA 32 to 33 + 6 weeks) and late preterm (GA 34 to 36 + 6 weeks) and the two groups were compared with an independent t-test. RESULTS ROP incidence was 1.5%; all cases were stage 1 and involved zone II or III. No patient had type 1 ROP requiring treatment. The short-term comorbidity incidence was high (76.1%) and included hyperbilirubinemia (n = 206, 76.7%), respiratory distress syndrome (n = 178, 66.4%), hypoglycemia (n = 32, 11.9%,), and transient tachypnea of newborn (n = 25, 9.3%). Moderate preterm infants were more likely to have lower birth weight (P < 0.001), any-stage ROP (P = 0.032), respiratory distress syndrome (P = 0.031), intraventricular hemorrhage (P = 0.038), and hyperbilirubinemia (P < 0.001) compared to the late preterm infants. CONCLUSIONS Any-stage ROP incidence among MLP infants was low, with no type 1 ROP cases requiring treatment. Short-term comorbidity incidence was relatively high among the moderate preterm infants. Despite the low non-type 1 ROP incidence at our center, MLP infants require proper surveillance of systemic short-term comorbidities.
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Affiliation(s)
- L H Raffa
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - M Fatani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - R Alghamdi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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AlAbdulKader A, Alsheikh S, Alghamdi R, AlHarkan K, AlShamlan N, Alqahtani H, Awad FA, Alotaibi R. Association Between Multi-Morbidities and Polypharmacy Among Older Adults at an Academic Medical Center in Saudi Arabia. Med Arch 2023; 77:471-476. [PMID: 38313108 PMCID: PMC10834046 DOI: 10.5455/medarh.2023.77.471-476] [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: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024] Open
Abstract
Background Polypharmacy, or the routine use of five or more medications, can result in impacting patients' quality of life. Objective to examine the association between multi-morbidities and polypharmacy, and to examine prescription practices in the elderly. Methods This is a retrospective cross-sectional study. Data were gathered from electronic medical records (EMR) at King Fahad University Hospital (KFHU) and the Family & Community Medicine Center (FCMC) of Imam Abdulrahman bin Faisal University (IAU), between January 1, 2019, and December 31, 2020. We included individuals aged 60 and above with at least one dispensed prescription in 2019 and 2020. Of the 76,216 patient records reviewed, 5,060 met the inclusion criteria. Polypharmacy was defined as a monthly average of five or more prescribed medications. The prevalence of polypharmacy was calculated by year, sex, and age group, and findings were summarized using mean medication numbers and standard deviations for each stratum. An app using R programming language was developed to help visualize patients' medication histories through interactive plots. Results Polypharmacy prevalence was 46% in 2019 and 44.6% in 2020. The mean and standard deviation of medications per person was 5.17 (3.42) in 2019 and 5.04 (3.37) in 2020. Females had a higher average number of medications than males, 5.17 (3.47) vs 5.04 (3.32). The age group of 80-85 had the highest number of medications at 5.6 (3.6), while those aged 90 and above had the lowest number at 4.48 (2.64). The presence of comorbidities was positively associated with the mean monthly medication count (P value < 0.01). Conclusion Our study revealed a high prevalence of polypharmacy among elderly patients at KFHU/FCMC, and a positive association with multi-morbidities. Consequently, measures must be taken to mitigate this globally emerging issue's impact and rapid progression.
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Affiliation(s)
- Assim AlAbdulKader
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahad Alsheikh
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rizam Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid AlHarkan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hatem Alqahtani
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Feras Al Awad
- Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Raed Alotaibi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 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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Alsheikh S, Alghamdi R, Alqatari A, Alfareed A, AlSaleh M. Combined Factor V and VIII Deficiency with LMAN1 Mutation: A Report of 3 Saudi Siblings. Am J Case Rep 2022; 23:e937312. [PMID: 36116005 PMCID: PMC9495817 DOI: 10.12659/ajcr.937312] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Case series
Patients: Male, 7-year-old • Female, 5-year-old • Male, 12-year-old
Final Diagnosis: Combined deficiency of FV and FVIII (F5F8D)
Symptoms: Bleeding signs and symptoms
Medication: —
Clinical Procedure: —
Specialty: Hematology • Pediatrics and Neonatology
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Affiliation(s)
- Shahad Alsheikh
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rizam Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahlam Alqatari
- Hematology and Oncology Unit, Department of Paediatrics, King Fahad University Hospital, Al Khobar, Saudi Arabia
| | - Abdullah Alfareed
- Hematology and Oncology Unit, Department of Paediatrics, King Fahad University Hospital, Al Khobar, Saudi Arabia
| | - Mona AlSaleh
- Hematology and Oncology Unit, Department of Paediatrics, King Fahad University Hospital, Al Khobar, Saudi Arabia
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Elbawab H, Aljehani Y, AlReshaid FT, Almusabeh HA, Al-Harbi TM, Alghamdi R. Sternoclavicular joint osteomyelitis; delayed bone resection with muscle flap: A case report. Int J Surg Case Rep 2020; 77:426-429. [PMID: 33227690 PMCID: PMC7691679 DOI: 10.1016/j.ijscr.2020.10.135] [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: 10/20/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Sternoclavicular joint (SCJ) osteomyelitis is a very rare condition. Here, we report an uncommon case of a complicated SCJ osteomyelitis in a patient with an anterior chest wall trauma. PRESENTATION OF CASE A 61-year-old male a known case of dyslipidemia, hypertension (HTN), and type II diabetes mellitus (T2DM). The patient presented with pain and erythema over the right SCJ following trauma to the same location. Two weeks later, the patient presented with erythematous swelling with a sinus discharging pus, although he was discharged on oral antibiotics, analgesics, and had underwent an incisional drainage. Computerized Tomography (CT) of the chest showed fluid collection surrounding the right SCJ together with joint effusion suggestive of SCJ osteomyelitis. The patient underwent initial debridement and a definitive bone resection with pectoralis muscle flap two weeks following. Five months later, the patient was seen in the outpatient clinic, the wound was completely healed, and he has a normal function of the right arm. DISCUSSION The management of SCJ osteomyelitis is not well established, yet it can be approached medically, surgically, or both. CONCLUSION Surgical intervention is indicated in cases of SCJ osteomyelitis after the failure of antibiotic therapy trial. This is especially the case in the presence of abscess and bone destruction. SCJ debridement followed by delayed resection and pectoralis muscle flap might offer better results than merely debridement alone or with resection of the joint.
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Affiliation(s)
- Hatem Elbawab
- Thoracic Unit, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia.
| | - Yasser Aljehani
- Thoracic Unit, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - Farouk T AlReshaid
- Thoracic Unit, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | | | | | - Rizam Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia
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Lane D, Alghamdi R, Muscat M, Kaur MS, Davis T, Cole R, Patel P, Tomaszewski M, Gupta P. 1424The diagnosis of non-adherence in hypertension using a urine biochemical screen is unaffected by drug pharmacokinetics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Suboptimal drug adherence in hypertension is pandemic and traditional diagnostic tools to detect non-adherence have lacked accuracy and robustness. The inability to identify non-adherence has therefore driven the development of biochemical drug screening by liquid chromatography tandem mass spectrometry (LC- MS/MS) in urine and blood, which are the most accurate metrics presently available. Urinary antihypertensive testing is evidenced to improve non-adherence rates, significantly decrease blood pressure after physician intervention, and be cost effective. The European Society of Cardiology (ESC) and European Society of Hypertension (ESH) 2018 guidelines have recommended the use of biochemical testing for non-adherence diagnosis. However, it has been argued that the variable pharmacokinetic parameters of the medication (such as their half-lives and clearance rates) may affect the detection of medications in urine and hence the determination of adherence. We hypothesized that pharmacokinetic parameters do not affect the detection of antihypertensive medications in urine.
Aim
This study compared the pharmacokinetic parameters of the most commonly prescribed antihypertensive medications against their detection in urine by LC-MS/MS.
Methods
Results of urinary drug screens from 463 hypertensive patients (total prescribed medications N=1709) were collated. An adherence score termed as the C score (number of detected vs. prescribed medication) was generated for each of the 27 common antihypertensive medications. Pharmacokinetic parameters such as bioavailability, plasma concentration, volume of distribution, half-life, plasma clearance and urinary excretion values for each drug were obtained from published literature. Partial linear correlation was conducted between the C score of all the medications and each pharmacokinetic parameter studied.
Results
40% of patients were non-adherent. The average number of prescribed medications was high (N=3.7, SD: 1.5), and the average number of drugs detected was lower (N=2.5, SD: 1.6). Amlodipine was the most prescribed (N=224), and clonidine was the least (N=10). The half-lives ranged from 0.87 to 39 hours for bumetanide and amlodipine respectively. The urinary excretion percentage varied from <1% for nifedipine, and 94% for benfroflumethiazide. No significant correlation was found between any drug C score and their respective pharmacokinetic variables such as the medication half-lives (figure1).
Half-life versus adherence score
Conclusion
This study reports no significant correlation between drug pharmacokinetics and adherence. To the best of our knowledge this is the first study of its kind. Urinary biochemical testing by LC-MS/MS for non-adherence remains a valid tool for diagnosis although further detailed pharmacokinetic studies are needed to confirm this finding.
Acknowledgement/Funding
None
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Affiliation(s)
- D Lane
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - R Alghamdi
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M Muscat
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M S Kaur
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - T Davis
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - R Cole
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - P Patel
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
| | - M Tomaszewski
- University of Manchester, Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - P Gupta
- University Hospitals of Leicester NHS Trust, Department of Chemical Pathology and Metabolic Medicine, Leicester, United Kingdom
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Alghamdi R, Bejar C, Steff M, Deschamps L, Marinho E, Crickx B, Descamps V. Intravenous immunoglobulins as a treatment of interstitial granulomatous dermatitis with arthritis. Br J Dermatol 2012; 167:218-20. [DOI: 10.1111/j.1365-2133.2012.10854.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alghamdi R, Descamps V, Deschamps L, Bejar C, Steff M, Marinho E, Crickx B. Efficacité des immunoglobulines intraveineuses dans le traitement de la dermatite interstitielle granulomateuse. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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