Foot care practices of diabetic patients in Saudi Arabia

Diabetic foot is a serious complication that causes lower extremity amputations. The aim of this study was to identify the patient’s awareness about risk factors for diabetic foot disease and to explore the knowledge and foot care practices among diabetic patients in a Saudi population. This cross-sectional study was conducted in King Khalid University Hospital (KKUH), King Abdulaziz University Hospital (KAUH), King Fahad Medical City, National Guard Hospital, Military Hospital, and Prince Salman Hospital capital city of Saudi Arabia. Patients were eligible if they had diabetes foot disease, signed the consent form, and completed the questionnaire. We selected 350 patients from different hospitals between November-2011 and April-2012. The majority of patients (68%) were selected from King Saud University hospitals. The mean age of patients was 50.87 ± 15.9 years with a range of 20–90 years. The majority of patients were male (64.3%) and had a family history of hypertension (55.4%), high total cholesterol (58.6%), and other diabetes (58.9%). A family history of smoking, a major risk factor for diabetic foot, was found in 20.3% of cases. Sixty percent of the patients were using oral medications, 27.1% were using insulin therapy, 10% were using both oral and insulin therapies, and 10% were on diet. In our study, 19.4% of participants were illiterate while 80.6% had a high school or university level education. Our findings also revealed that some patients had a lack of knowledge concerning diabetic foot disease and future complications. Patients are unaware of the risk factors for diabetes foot and practice poor foot care. Awareness programs should be mandatory in all hospitals and diabetes clinics to help compensate for the lack of awareness and lack of podiatric educational services. Such programs may decrease the risk of diabetes foot disease.     

A survey of 1,000 cases referred for cytogenetic study to King Khalid University Hospital, Saudi Arabia.

We reviewed cytogenetic studies that have been done in 1,000 consecutive non-oncology samples that were referred to the Cytogenetics Unit at King Khalid University Hospital, Riyadh, Saudi Arabia. The cases were grouped according to the referral diagnosis and the requested cytogenetic service. The frequency of the different types of numerical and structural abnormalities was determined and the relative frequency of cases with abnormal karyotype was calculated in each group. This study should assist physicians in Saudi Arabia and surrounding countries by increasing the awareness of the frequency of cytogenetic abnormality in different diagnostic groups. It also gives figures for comparison with other countries and research centers.     

Conservation of genetic resources for five traditional crops from Jazan,SW Saudi Arabia,at the KACST Gene-Bank

The conservation of five traditional crops is an important aspect of achieving national food security. In the present study, we aimed to collect and conserve germplasm of five local crops from the Jazan region of southwestern Saudi Arabia: Sorghum: Sorghum bicolor (L.) Moench); Barley (Hordeum vulgare L.) Millet (Pennisetum glaucum (L.) R. Br.); Sesame (Sesamum indicum L.) and Guar (Cyamopsis tetragonoloba (L.) Taub). Forty-one seed accessions of these five crops were collected and tested to determine seed moisture content (MC%) and quality as indicators of their potential to survive during long-term dry storage at ?18 °C (i.e. ex-situ conservation of genetic resources). Seed viability was assessed using germination tests, the tetrazolium chloride (TZ) test and X-ray imaging. Seeds of the five crops had very low MC% and high viability (fully developed embryos and germination >91%), indicating that they were of good quality and had high potential for long-term survival in gene banks. The genetic resources of these crops (seeds) have now been preserved at the gene-bank of King Abdulaziz City for Science and Technology (KACST-BGB), Riyadh, Saudi Arabia.     

Dependency of prescribed CT dose on table height,patient size,and localizer acquisition for one clinical MDCT

PurposeThe purpose of this study was to quantify the effect that table height, patient size, and localizer acquisition order may have on AEC prescribed dose.Method and materialsThree phantoms were used for this study: the Mercury Phantom, acrylic sheets, and an anthropomorphic phantom. A lateral (LAT) and a posterior-anterior (PA) localizer was acquired for each phantom at different table heights on a MDCT scanner (GE Discovery CT750 HD). AEC scan acquisitions were prescribed for each combination of phantom, localizer orientation, and table height ±4 cm with the center position; the displayed CTDI_vol was recorded. Based on the institutional dose monitoring program, the relationship between change in CTDI_vol and change in table height were studied for LAT and AP localizers for clinical exams.ResultsFor all phantom scans based on the PA localizer, the percent change in ranged between −18% and 42% for table heights 4 cm below and above proper centering; while for the LAT localizer, the percent change in CTDI_vol from ideal were no greater than 12% different for ±4 cm differences in table height. Change in CTDI_vol and change in table height displayed a strong linear relationship for AP localizer exams (P = 0.002), and weak correlation for LAT localizer exams (P = 0.12).ConclusionsSince uncertainty in vertical patient positioning is inherently greater than lateral positioning, the LAT localizer should be utilized to precisely and reproducibly deliver the intended amount of radiation prescribed by CT protocols.     

Cytological studies of certain desert mammals of Saudi Arabia 5. The karyotype of Meriones rex

Male and female specimens of Meriones rex were collected from agricultural areas of Asir province in Saudi Arabia. The mitotic and meiotic chromosomes were analysed and the diploid number of chromosomes was found to be 38. The karyotype showed 24 metacentric, 10 submetacentric and 2 acrocentric autosomes. The sex chromosomes were represented by a medium-sized metacentric X and a small metacentric Y chromosome. The fundamental number (FN) was 74.This project has been supported by Research Center of College of Science, King Saud University (Zoo/1402/11), Riyadh, Saudi Arabia.     

Estimation of cancer risks during mammography procedure in Saudi Arabia

The aims of the present work were to quantify radiation doses arises from patients' exposure in mammographic X-ray imaging procedures and to estimate the radiation induced cancer risk. Sixty patients were evaluated using a calibrated digital mammography unit at King Khaled Hospital and Prince Sultan Center, Alkharj, Saudi Arabia. The average patient age (years) was 44.4 ± 10 (26–69). The average and range of exposure parameters were 29.1 ± 1.9 (24.0–33.0) and 78.4 ± 17.5 (28.0–173.0) for X-ray tube potential (kVp) and current multiplied by the exposure time (s) (mAs), respectively. The MGD (mGy) per single projection for craniocaudal (CC), Medio lateral oblique (MLO) and lateromedial (LM) was 1.02 ± 0.2 (0.4–1.8), 1.1 ± 0.3 (0.5–1.8), 1.1 ± 0.3 (0.5–1.9) per procedure, in that order. The average cancer risk per projection is 177 per million procedures. The cancer risk is significant during multiple image acquisition. The study revealed that 80% of the procedures with normal findings. However, precise justification is required especially for young patients.     

Optimizing coffee cultivation and its impact on economic growth and export earnings of the producing countries: The case of Saudi Arabia

Coffee is one of the historical socioeconomic crops. It has received an increasing attention at the global level, due to its positive interlinkage with the economic growth and on the gross domestic product for most of the producing countries, particularly, developing and least developed countries. Saudi Arabia is one of the coffee producing countries that has a relative comparative advantage of coffee cultivation. Yet, coffee cultivation has not received as much attention in Saudi Arabia as that of producing countries around the world. This study aims to assess the current state of coffee cultivation in Saudi Arabia and to investigate the potential to optimize coffee cultivation in Saudi Arabia that maximizes the net national economic return and export earnings, given limitation of cultivated areas, local market activities, and international trade activities. The study statistically analyzed primary data collected from around (65) coffee farms and traders in the study regions at the south and southwest Saudi Arabia, and optimized coffee cultivation in Saudi Arabia using LINGO optimization software. Empirical results of the study revealed the great potential of Saudi Arabia to expand coffee cultivation at south and southwest regions to meet the escalating local demand and to increase its share at the world market up to 2%. Optimization of coffee cultivation in Saudi Arabia showed a high potential to meet the local demand for coffee by producing 80.07 thousand tons grown over 2861.78 hectares and to generate a net return equivalent to $395.72 million a year, which is equivalent to $138.28 thousand per hectare and $4.94 thousand per ton of coffee. Optimizing coffee cultivation will play a substantial role to increase market share of Saudi Arabia to about 1–2% of the world market by increasing its export volume, respectively, to about 69.66 and 112.56 thousand tons, the national net economic return by about $395.86 and $395.95 million a year, and the export earnings of coffee by about $219.43–354.57 million a year, which in turns, will serve the national strategic trend to diversify the economic base and lower the dependency of incomes generated from oil exportation.     

Tabanidae (Diptera) of Saudi Arabia

Samples were collected from southern, central and eastern regions of Saudi Arabia using Malaise traps and sweep nets. Nine species of Tabanidae were identified, two for the first time from Saudi Arabia, Hybomitra peculiaris (Szilády) and Atylotus pulchellus (Loew).Therefore, the total number of Tabanidae in Saudi Arabia is 31 species. Remarks of the species recorded in this study were given. A key to the genera of Tabanidae occurring in the Arabian Peninsula is also provided. Available literature for Saudi Arabian Tabanidae is summarized and provided. It is concluded that the tabanid fauna of Saudi Arabia is more similar to that of the Palaearctic region than to the Afrotropical region.     

Mortality of shallow reef corals in the western Arabian Gulf following aerial exposure in winter

Aerial exposure of patch reef corals occurred in Tarut Bay, western Arabian Gulf, (Saudi Arabia) between December 1991 and May 1992, and coincided with extreme low spring tides (below the predicted lowest astronomical tide-LAT). Colonies of Acropora and Stylophora occurring at the highest levels on the tops of patch reef platforms were most affected by the low tides. Corals fully exposed to air suffered total mortality, whereas those not fully exposed suffered tissue damage to their upper parts. Exposure occurred during winter months when air and water temperatures are at their lowest in the gulf. Coupling of extremely low spring tides with wind-induced negative surges (below LAT) are not regular events but are not infrequent. Cold temperatures and exposure may act in concert to produce disproportionate mortalities of reef flat corals in the shallow coastal areas of eastern Saudi Arabia. It is highly unlikely that the Gulf War oil spill played any role in the observed damage to reef corals in the Gulf in 1992.     

Cryptosporidiosis in young children suffering from diarrhoea in Riyadh, Saudi Arabia.

A one-year study of patients (0-120 months of age) with diarrhoea at King Abdel-Aziz University Hospital (KAUH) in Riyadh, Saudi Arabia, detected two cases of cryptosporidiosis. Stool specimens from 174 children with diarrhoea and negative for other parasitic infection were examined using a safranin-methylene blue stain (S-MB). Two children (L.1%) were showing Cryptosporidium oocysts. None of 50 control children who did not have diarrhoea and was free of Giardia lamblia was Cryptosporidium positive.     

Updating national diagnostic reference levels for interventional cardiology and methodological aspects

The aim of this study is to propose national diagnostic reference levels (DRL) for updating in the field of interventional cardiology and to include technical details to help plan optimization.Medical physics experts and interventional cardiologists from 14 hospitals provided patient dose indicators from coronary angiography and percutaneous coronary interventions. Information about X-ray system dose settings and image quality was also provided.The dose values from 30,024 procedures and 26 interventional laboratories were recorded. The national DRLs proposed for coronary angiography and percutaneous coronary interventions were respectively 39 and 78 Gy·cm² for air kerma area product (P_KA), 530 and 1300 mGy for air kerma at reference point (K_a,r), 6.7 and 15 min of fluoroscopy time and 760 and 1300 cine images. 36% of the KAP meters required correction factors from 10 to 35%. The dose management systems should allow these corrections to be included automatically. The dose per image in cine in reference conditions differed in a factor of 5.5.Including X-ray system dose settings in the methodology provides an insight into the differences between hospitals. The DRLs proposed for Spain in this work were similar to those proposed in the last European survey. The poor correlation between X-ray systems dose settings and patient dose indicators highlights that other factors such as operation protocols and complexity may have more impact in patient dose indicators, which allows a wide margin for optimization. Dose reduction technology together with appropriate training programs will be determinant in the future reduction of patient dose indicators.     

The economic burden of dengue fever in the Kingdom of Saudi Arabia

Rapid urbanization, global trade, and the exceptionally great numbers of worldwide visitors during Hajj and Umrah have all placed the Kingdom of Saudi Arabia at a significant risk of introducing several vector-borne tropical diseases, such as dengue fever virus (DENV) infection. In this study we estimated DENV infection cost of illness (COI) in Saudi Arabia in the period 2013–2017, by processing national data including all declared cases recorded in referral centers in the western region, being the endemic region of the country. Using a statistically validated predictive model that was built on a representative sample of 717 laboratory-confirmed cases of DENV infection, direct costs, due to care-related expenditures, were estimated by applying the predictive equation to national data. However, indirect costs, which are due to productivity loss, were estimated using the human capital model based on gross domestic product adjusted for invalidity duration. Further, under-reporting was adjusted by using an expansion factor EF = 3. We observed highest estimated costs in 2016 with over US$168.5 Million total costs, including direct (US$29.0 Million) and indirect (US$139.5 Million) costs, for a total 4415 confirmed cases. The total DENV COI for the five years was estimated as US$551.0 Million for a total 15,369 patients (59.7%) out of 25,745 declared cases, resulting in an average cost of US$11 947.6 by patient. Depending on the year, productivity years loss costs accounted for 63.3% to 83.8% of the estimated total costs. Dengue has a substantial local economic burden that costs US$110.2 Million per year, stressing the urgent need for an effective national prevention strategy to perform considerable cost-savings besides reducing morbidity.     

Higher patient doses through X-ray imaging procedures

Medical imaging using X-rays has been one of the most popular imaging modalities ever since the discovery of X-rays 125 years ago. With unquestionable benefits, concerns about radiation risks have frequently been raised. Computed tomography (CT) and fluoroscopic guided interventional procedures have the potential to impart higher radiation exposure to patients than radiographic examinations. Despite technological advances, there have been instances of increased doses per procedure mainly because of better diagnostic information in images. However, cumulative dose from multiple procedures is creating new concerns as effective doses >100 mSv are not uncommon. There is a need for action at all levels. Manufacturers must produce equipment that can provide a quality diagnostic image at substantially lesser dose and better implementation of optimization strategies by users. There is an urgent need for the industry to develop CT scanners with sub-mSv radiation dose, a goal that has been lingering. It appears that a new monochromatic X-ray source will lead to replacement of X-ray tubes all over the world in coming years and will lead to a drastic reduction in radiation doses. This innovation will impact all X-ray imaging and will help dose reduction. For interventional procedures, the likely employment of robotic systems in practice may drastically reduce radiation exposures to operators- but patient exposure will still remain an issue. Training needs always need to be emphasized and practiced.     

Diagnostic X-ray examinations and increased chromosome translocations: evidence from three studies

Controversy regarding potential health risks from increased use of medical diagnostic radiologic examinations has come to public attention. We evaluated whether chromosome damage, specifically translocations, which are a potentially intermediate biomarker for cancer risk, was increased after exposure to diagnostic X-rays, with particular interest in the ionizing radiation dose–response below the level of approximately 50 mGy. Chromosome translocation frequency data from three separately conducted occupational studies of ionizing radiation were pooled together. Studies 1 and 2 included 79 and 150 medical radiologic technologists, respectively, and study 3 included 83 airline pilots and 50 university faculty members (total = 155 women and 207 men; mean age = 62 years, range 34–90). Information on personal history of radiographic examinations was collected from a detailed questionnaire. We computed a cumulative red bone marrow (RBM) dose score based on the numbers and types of X-ray examinations reported with 1 unit approximating 1 mGy. Poisson regression analyses were adjusted for age and laboratory method. Mean RBM dose scores were 49, 42, and 11 for Studies 1–3, respectively (overall mean = 33.5, range 0–303). Translocation frequencies significantly increased with increasing dose score (P < 0.001). Restricting the analysis to the lowest dose scores of under 50 did not materially change these results. We conclude that chromosome damage is associated with low levels of radiation exposure from diagnostic X-ray examinations, including dose scores of approximately 50 and lower, suggesting the possibility of long-term adverse health effects.     

Group Composition and Adult Sex-ratio of Hamadryas Baboons (Papio hamadryas hamadryas) in Central Eritrea

During a survey of the geographical distribution and abundance of hamadryas baboons (Papio hamadryas hamadryas) in central Eritrea, we collected detailed demographic data on six bands at four sites in different ecogeographical zones. The proportions of age-sex classes within the six bands differed only with respect to juveniles. The general social organization of the Eritrean hamadryas baboons is similar to that reported for Ethiopia and Saudi Arabia. Eritrean hamadryas baboons live in a nested fission-fusion system, with one-male units as the basic social entity. Although the baboons were not provisioned, as they are in many places in Saudi Arabia, and habitat quality in Eritrea is lower than that in Ethiopia, sex-ratios and group composition corresponded more to those found in the Saudi Arabian population. Sex-ratios within the study population, in bands and also in one-male units were significantly more female-biased than in Ethiopian ones, and one-male units tended to be larger. Data from Eritrea suggest that these differences are due to a combination of a heavily fluctuating rainfall pattern and differential maturation of the sexes.     

Survey of the reptilian fauna of the Kingdom of Saudi Arabia. V. The lizard fauna of Turaif region

Turaif area located in the Northern border region of Saudi Arabia is one of the most important regions of the Kingdom. This work was proposed to throw light on the diversity of lizard fauna investigated through the collection and subsequent identification of specimens from different localities of Turaif region of Kingdom of Saudi Arabia. Sixteen species of lizards belonging to 5 families (Agamidae, Gekkonidae, Lacertidae, Scincidae and Varanidae) were recorded. Lacertidae was the most common family. Three species of lizards namely Acanthodactylus orientalis, Acanthodactylus scutellatus and Acanthodactylus grandis were reported for the first time in the Turaif region of Saudi Arabia. The geographical distribution of the collected species within this province was mapped.     

Growth stages and ageing criteria of Arabian Mountain gazelles (Gazella gazella Pallas, 1766: Antilopinae,Bovidae)

This research project was designed to be of both academic and practical value in the conservation of Mountain gazelle and represents an attempt to provide data for sex and age classification of this endangered species hitherto unpublished. Growth data and ageing criteria of 177 individuals of known age, obtained from a captive population, kept under uniform conditions at King Khalid Wildlife Research Centre in Saudi Arabia, were examined. Measurements of horn length, shoulder height, living body weight, neck circumference and forehead-horn length ratio were established and a field classification for ageing female and male Mountain gazelles was suggested.     

Comparison of the activity and productivity of Carniolan (Apis mellifera carnica Pollmann) and Yemeni (Apis mellifera jemenitica Ruttner) subspecies under environmental conditions of the Al-Ahsa oasis of eastern Saudi Arabia

This study was conducted at the apiary of the Agricultural and Veterinary Training and Research Station of King Faisal University in the Al-Ahsa oasis of eastern Saudi Arabia. We performed a comparison between Carniolan (Apis mellifera carnica Pollmann) and Yemeni (Apis mellifera jemenitica Ruttner) honeybee races to determine the monthly fluctuations in foraging activity, pollen collection, colony growth and honey yield production under the environmental conditions of the Al-Ahsa oasis of eastern Saudi Arabia. We found three peaks in the flight activity of the two races, and the largest peaks occurred during September and October. Compared to Carniolan bee colonies, the performance of Yemeni bee colonies was superior in terms of stored pollen, worker and drone brood rearing, and the adult population size. The Carniolan bee colonies produced 27.77% and 27.50% more honey than the Yemeni bee colonies during the flow seasons of alfalfa and sidir, respectively, with an average increase of 27.64%. It could be concluded that the race of bees is an important factor affecting the activity and productivity of honeybee colonies. The Yemeni bee race produced more pollen, a larger brood and more bees, which exhibited a longer survival. The imported Carniolan bees can be reared in eastern Saudi Arabia, but the Yemeni bee race is still better.