The Effect of Weaning Practices on the Nutritional and Health Status of Saudi Preschool Children

Background Weaning is a complex procedure that gradually introduces complementary foods to the baby's diet. Solid food should be started between the ages of 6 and 12 months. Weaning is a challenging and crucial stage in an infant's development. Extreme caution should be used during weaning an infant because delaying it can cause issues like sluggish growth, difficulties feeding, malnutrition, and iron deficiency. Objective The current study aims to determine the impact of delayed or early weaning practices on the nutritional status of preschool children in Saudi Arabia. Data was gathered about the time of complementary food introduction, preferred foods in the initial stages, and a child's health compared to those practices.  Methodology By convenient sampling, a cross-sectional study was conducted to gather data from 385 parents of Saudi children at preschool age. Questionnaires were shared online. Data were recorded and analyzed on IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Descriptive analysis and multivariate ANOVA (MANOVA) tests were performed. Results Only 6.23% of the infants were introduced to complimentary food at optimal age (6 to 12 months), whereas 85% were found to have delayed weaning. As per the BMI, 74.4% of preschool children were severely underweight, 53.6% of infants consumed pureed vegetables early during weaning, and 64% of infants were introduced to eggs and cheese within the first year of life. The timing, pattern, and food items of weaning had a significant (p<0.05) impact on general physical health, as 48.8% of children had pale skin, 46.9% felt tired, 36.5% had swollen joints, and 42% complained of itching and an upset stomach. Conclusion This study couldn't define the direction of significance. Further studies can be done on a larger scale where biochemical tests, and screening can be done on children to find if any significant health problem is prevailing, and the direction of association can be defined.

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.

The Neoplasms Mimicker: A Pictorial Review of Hydatid Disease

Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.

The utilization of artificial intelligence applications to improve breast cancer detection and prognosis

Breast imaging faces challenges with the current increase in medical imaging requests and lesions that breast screening programs can miss. Solutions to improve these challenges are being sought with the recent advancement and adoption of artificial intelligent (AI)-based applications to enhance workflow efficiency as well as patient-healthcare outcomes. rtificial intelligent tools have been proposed and used to analyze different modes of breast imaging, in most of the published studies, mainly for the detection and classification of breast lesions, breast lesion segmentation, breast density evaluation, and breast cancer risk assessment. This article reviews the background of the Conventional Computer-aided Detection system and AI, AI-based applications in breast medical imaging for the identification, segmentation, and categorization of lesions, breast density and cancer risk evaluation. In addition, the challenges, and limitations of AI-based applications in breast imaging are also discussed.

The role of teleradiology during COVID-19 outbreak: Saudi radiologists' perspectives

OBJECTIVES

To evaluate the role of teleradiology during the COVID-19 pandemic from Saudi radiologists' perspectives to improve the radiology quality service.

METHODS

A cross-sectional study was carried out in Saudi Arabia among radiologists working at local hospitals from October to November 2021. It contains 21 questions involved demographic information; general information on teleradiology services; and the impact of teleradiology during COVID-19. One-way ANOVA was used to compare demographic groups. Chi-square test was used to compare demographic groups regarding their distribution of responses. All tests were carried out <0.05 level of significance.

RESULTS

A total of 102 radiologists participated in this study (56% males, 44% females), 58.8% of them were sub-specialized in chest radiology. Regarding the general status of teleradiology, 69.6% of participants believed that teleradiology is a helpful tool for imaging interpretation. However, 44% of them were uncertain on the impact of teleradiology on patients' confidentiality. Approximately 87% of participants agreed that there is a positive contribution of teleradiology during COVID-19, which enables decreasing risk of infection and workload. There was a significant difference between professional degrees and overall participant responses (p<0.05). Academicians agreed that it enhances radiology departments' work (mean=17.78, SD=1.86).

CONCLUSION

Concerns raised on complicated cases that require physical presence of patients, cannot be performed by teleradiology. Additionally, it might provide insufficient communication with other professionals to discuss images.

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.

The Motivational Factors of Choosing Diagnostic Radiology as a Profession Among Saudi Radiography Students

PURPOSE

To identify factors influencing Saudi students to choose radiography as their academic major and future career field.

MATERIAL AND METHOD

This study involved quantitative (online questionnaire) and qualitative (semi-structured interview) approaches. An online questionnaire was distributed among (n = 308) students. The questionnaire contained 30 questions covering the following three domains: economy, vocational and personal. A total of 25 individual semi-structured interviews were conducted with purposive sampling of radiography students in seven universities (public and private) across the western region of Saudi Arabia. Interview responses were coded, and main themes were extracted based on Miles and Huberman's framework.

RESULTS

The findings demonstrated that radiography was the first option as profession for 44% of the study participants. Several factors that study participants considered important were in the realm of patient care, helping patients, radiographer-patient relations, science-based profession, and the desire to work in the healthcare system. A few participants (14%) reported that they are planning to change their profession to another medical speciality. Four themes were identified from the interviews: 1) Profession decision-making, 2) changing career", 3) difficulties and challenges, and 4) recommended radiography as a profession.

CONCLUSION

The results of the study support the need to bridge the gap between high school, universities, and employment through a collaborative network to assist students in exploring their career path by providing sufficient information and experience.

Investigation Study of Ultrasound Practitioners’ Awareness about Artefacts of Hepatobiliary Imaging in Almadinah Almunawwarah

Objectives:

To investigate the knowledge and awareness of ultrasound practitioners’ concerning ultrasound artefacts in evaluating the hepatobiliary system.

Methods:

This electronic questionnaire-based comparative study involved the ultrasound practitioners’ who work in the radiology departments in Almadinah Almunawwarah governmental hospitals during the period from 1 November 2020 to 30 April 2021. Spearman’s rho correlation test was used to correlate between knowledge and job, academic qualification, and years of experience. A T-test and cross tabulation test were done to compare the knowledge about artefacts among radiologists and radiologic technologists.

Results:

This study involved 94 participants distributed as 22 (23.4%) radiologists and 72 (76.6%) radiologic technologists. The results shows that 85%, 71%, 73%, 69%, 54% and 53% of the participants assigned the acoustic shadowing, acoustic enhancement, ring down, side lobe, reverberation and mirror artefacts, as artefacts respectively. However, 68%, 53%, 19%, 19%, 18%, and 40% of the participants gave correct final diagnosis of acoustic shadowing, acoustic enhancement, ring down, side lobes, reverberation, and mirror artifacts, respectively. Spearman’s rho correlation test shows significant correlation between participants with more than three years experience and knowledge related mirror artefacts (r=0.328, p=0.001). It shows significant correlation between radiologists with knowledge related mirror artefacts (r=0.367, p<0.001). A significant correlation was found between highly qualified participants and knowledge related mirror artefacts (r=0.336, p=0.001) and side lobe artefacts (r=0.237, p=0.008).

Conclusion:

The questionnaire-based comparative study of knowledge about artefacts of hepatobiliary ultrasound imaging reveals a high level of Ultrasound practitioners’ knowledge in differentiating artefacts from pathology with a high level of knowledge in identifying hepatobiliary acoustic shadowing and acoustic enhancement artefacts. However, insufficient knowledge was noted in identifying mirror, side lobe, reverberation and ring down artefacts. A direct link was found between academic qualification, years of experience and practioners’ knowledge among.

Saudi Radiologists’ and Radiographers’ Perceptions of Accreditation Programmes in Clinical Radiology Departments: A Cross-Sectional Study

Purpose

The hospital accreditation programme is an assessment tool that involves a comprehensive evaluation by an external independent accreditation body to ensure consistency in clinical practice by adhering to the established standards and guidelines. The study aims to investigate Radiology professionals’ perceptions of the impact of accreditation and implementation of change towards the quality-of-service delivery in Radiology Departments.

Methods

A cross-sectional prospective study was conducted in Saudi Arabia among radiology professionals (ie, radiographers and radiologists) from July to September 2021. After obtaining institutional review board approval from the local ethics committee and using a non-probability convenient sampling technique, 335 participants completed the survey, which was distributed via social media channels, and through professional networks within hospitals across the country.

Results

A total of 335 participants agreed to participate. The study’s participants strongly agreed that the accreditation programmes have positively impacted customer satisfaction and care provided to patients. A significant difference was identified in the level of agreement on the effect of accreditation programmes when hospital types and personnel qualifications were tested (P < 0.05). Radiology personnel who worked in academic hospitals and who had diplomas and PhDs degrees showed a significantly higher level of agreement than other participants (P < 0.05).

Conclusion

Saudi radiologists and radiographers showed strong agreement or agreement towards hospital accreditation programmes domains’ criteria. The results of the study support the need to bridge the gap between higher-level management and employees in order to facilitate change and enhance the standards of quality and practice in radiology departments. Additional policies are needed to continue and strengthen quality improvement programmes.

The Diagnostic Deceiver: Radiological Pictorial Review of Tuberculosis

Tuberculosis (TB) is a bacterial infection with Mycobacterium tuberculosis; it is a public health problem worldwide and one of the leading causes of mortality. Since December 2019, the COVID-19 pandemic has created unprecedented health challenges and disrupted the TB health services, especially in high-burden countries with ever-increasing prevalence. Extrapulmonary and even pulmonary TB are an important cause of nonspecific clinical and radiological manifestations and can masquerade as any benign or malignant medical case, thus causing disastrous conditions and diagnostic dilemmas. Clinical manifestations and routine laboratory tests have limitations in directing physicians to diagnose TB. Medical-imaging examinations play an essential role in detecting tissue abnormalities and early suspecting diagnosis of TB in different organs. Radiologists and physicians should be familiar with and aware of the radiological manifestations of TB to contribute to the early suspicion and diagnosis of TB. The purpose of this article is to illustrate the common radiologic patterns of pulmonary and extrapulmonary TB. This article will be beneficial for radiologists, medical students, chest physicians, and infectious-disease doctors who are interested in the diagnosis of TB.

Saudi Radiology Personnel's Perceptions of Artificial Intelligence Implementation: A Cross-Sectional Study

PURPOSE

Artificial intelligence (AI) in radiology has been a subject of heated debate. The external perception is that algorithms and machines cannot offer better diagnosis than radiologists. Reluctance to implement AI maybe due to the opacity in how AI applications work and the challenging and lengthy validation process. In this study, Saudi radiology personnel's familiarity with AI applications and its usefulness in clinical practice were investigated.

METHODS

A cross-sectional study was conducted in Saudi Arabia among radiology personnel from March to April 2021. Radiology personnel nationwide were surveyed electronically using Google form. The questionnaire included 12-questions related to AI usefulness in clinical practice and participants' knowledge about AI and their acceptance level to learn and implement this technology into clinical practice. Participants' trust level was also measured; Kruskal-Wallis test was used to examine differences between groups.

RESULTS

A total of 224 respondents from various radiology-related occupations participated in the survey. The lowest trust level in AI applications was shown by radiologists (p = 0.033). Eighty-two percent of participants (n = 184) had never used AI in their departments. Most respondents (n = 160, 71.4%) reported lack of formal education regarding AI-based applications. Most participants (n = 214, 95.5%) showed strong interest in AI education and are willing to incorporate it into the clinical practice of radiology. Almost half of radiography students (22/46, 47.8%) believe that their job might be at risk due to AI application (p = 0.038).

CONCLUSION

Radiology personnel's knowledge of AI has a significant impact on their willingness to learn, use and adapt this technology in clinical practice. Participants demonstrated a positive attitude towards AI, showed a reasonable understanding and are highly motivated to learn and incorporate it into clinical practice. Some participants felt that their jobs were threatened by AI adaptation, but this belief might change with good training and education programmes.

A rare phenotype of breast hydatid cyst causing misdiagnosis and unnecessary intervention: a case report

Hydatid cyst (cystic echinococcosis) is a chronic parasitic infection by the larval stage of the cestode that is called Echinococcus granulosus (E. granulosus) resulting in the development of cystic lesions in animals and humans. In this report, we describe a rare phenotype of hydatid cyst in the breast of a 23-year-old female presented with breast mass in the left upper outer quadrant for 3 months with palpable left axillary lymph nodes. Both US and mammography provided a picture of complex suspicious cystosolid lesion with amorphous micro-calcification (BIRAD-4A). Surgical consultation was performed and Tru-Cut biopsy was recommended. Histopathology results revealed multiple viable protoscolices of E. granulosus and suggested the final diagnosis of breast hydatid cyst. The patient returned with ruptured and infected hydatid cyst of the breast and started treatment with Albendazole 400 mg twice daily in addition to antibiotics. Following-up after two months of Albendazole treatment showed a dramatic shrinkage in the size of the cystic lesion. In conclusion, hydatid cyst should be considered as a differential diagnosis of any cystic or cystosolid lesion in the breast and any organ in the body from head to toe apart from the hair and nails. Radiologists should be aware to the benign lesions that may mimic breast cancer to avoid misdiagnosis and unnecessary invasive procedures and consequent complications.

The gap between ultrasonography and computed tomography in measuring the size of urinary calculi

Objective

Due to a lack of studies regarding the need for computed tomography (CT) in measuring the size of each urinary calculus before surgery, this study was conducted to elucidate the difference between ultrasonography (US) and CT in measuring the size of urinary stones.

Methods

A retrospective review of 100 stones from 83 patients. Each urinary stone was measured using both US and CT; both measurements were then compared.

Results

Of 83 patients, the mean age was 39.29 ± 23.76 years; 47 (56.62%) were male and 36 (43.37%) were female. Most of the urinary stones were <10 mm (50.0%) followed by 11-20 mm (42.0%), (P < 0.001). A cross-tabulation test revealed strong compatibility between US and CT in measuring the size of urinary stones (73.7% in stones <10 mm, 66.7% in stones 11-20 mm and 50% in stones >21 mm), (P < 0.001). Spearman's rho correlation test revealed strong compatibility between stone diameters measured by US and CT (r = 0.755), (P = 0 < 0.001). T-test for equality of means revealed no significant difference in the measured size using US and CT (mean = 11.80 ± 5.83 vs. 11.65 ± 6.59, respectively), mean difference = 0.15, and P = 0.865, 95% confidence interval: -1.584-1.884.

Conclusion

No significant difference in measuring the size of urinary stones using US and CT. However, US may slightly overestimate small stones in some cases.