Electronic Sepsis Screening Among Patients Admitted to Hospital Wards: A Stepped-Wedge Cluster Randomized Trial.

Importance: Sepsis screening is recommended among hospitalized patients but is supported by limited evidence of effectiveness.

Objective: To evaluate the effect of electronic sepsis screening, compared with no screening, on mortality among hospitalized ward patients.

Design, Setting, And Participants: In a stepped-wedge, cluster randomized trial at 5 hospitals in Saudi Arabia, 45 wards (clusters) were randomized into 9 sequences, 5 wards each, to have sepsis screening implemented at 2-month periods.

Primary hyperparathyroidism in Saudi Arabia revisited: a multi-centre observational study.

Purpose: Primary hyperparathyroidism (PHPT) is a common cause of hypercalcemia and remains understudied within the Arabian population. The present study, the largest of its kind within the Gulf Cooperation Council (GCC) countries, aims to determine the demographics and clinical presentation of PHPT in Saudi Arabia.

Methods: In this multi-center retrospective study involving three tertiary hospitals in different geographic locations of Saudi Arabia namely, Riyadh, Al Ahsa and Jeddah, a total of 205 out of 243 confirmed PHPT cases aged 16 to 93 years old were included (N = 96 from Riyadh; N = 59 from Al Ahsa and N = 50 from Jeddah).

Electronic early notification of sepsis in hospitalized ward patients: a study protocol for a stepped-wedge cluster randomized controlled trial.

Background: To evaluate the effect of screening for sepsis using an electronic sepsis alert vs. no alert in hospitalized ward patients on 90-day in-hospital mortality.

Methods: The SCREEN trial is designed as a stepped-wedge cluster randomized controlled trial.

Managing critical care during COVID-19 pandemic: The experience of an ICU of a tertiary care hospital.

Background: The COVID-19 pandemic has strained ICUs worldwide. To learn from our experience, we described the critical care response to the outbreak.

Methods: This is a case study of the response of the Intensive Care Department (75-bed capacity) at a tertiary-care hospital to COVID-19 pandemic, which resulted in a high number of critically ill patients.

Prevalence of sleep duration among Saudi adults.

To examine the associations between sleep duration and a variety of demographic and clinical variables in a sample of Saudi adults.  Methods: A cross-sectional study among 2,095 participants was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between May and October 2014. A questionnaire was administered to collect data related to clinical health outcomes and demographic characteristics.

Level of dietary awareness among Saudi dialysis patients and the influence of various factors.

Our objective was to investigate the degree of dietary awareness of Saudi patients on chronic hemodialysis and influencing factors on this awareness. This is an interviewadministered survey-based cross-sectional study carried out on adult dialysis patients at the King Abdulaziz Medical City, Riyadh. The first part of the survey consisted of the collection of demographic data and the second part consisted of questions in the areas of awareness on the dietary influence of sodium, potassium, fluid intake and calcium/phosphorous and lipids.

Medical grand rounds in Riyadh, Saudi Arabia: Current attitudes and barriers.

Background: Medical grand rounds (MGRs) are considered key educational tools in most academic medical institutions. In this multi-center cross-sectional survey, we tried to determine the current attitudes of local medical practitioners to MGRs, as well as perceived barriers.

Methodology: A total of 120 physicians from the National Guard Hospital, King Fahad Medical City, King Khalid University Hospital and King Faisal Specialist Hospital participated in the survey.

Frequency and clinical significance of respiratory isolates of non-tuberculous mycobacteria in Riyadh, Saudi Arabia.

Background And Aims: The prevalence of pulmonary non-tuberculous mycobacteria (NTM) disease is increasing worldwide. The aim of this study was to assess the frequency and clinical significance of NTM isolated from respiratory specimens at King Abdul-Aziz Medical City-Riyadh, Saudi Arabia.

Methods: The medical records of all patients who had at least one respiratory specimen that was positive for growth of NTM between 2006 and 2012 were retrospectively reviewed.

Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center.

Objective: The objective of this study was to assess the prevalence of polypharmacy (PP) and the associated factors in medical outpatients.

Materials And Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily.

A case of first degree AV block in carbon monoxide poisoning patient.

Carbon monoxide (CO) intoxication is one of the most common types of poisoning. Cardiac manifestations of CO poisoning are limited to case reports of Electrocardiogram (ECG) changes, myocardial dysfunction and myocardial ischemia. A 22 year old Saudi male was admitted to the emergency department with decreased level of consciousness after being involved in a fire at home.

Improper inhaler technique is associated with poor asthma control and frequent emergency department visits.

Background: Uncontrolled asthma remains a frequent cause of emergency department (ED) visits and hospital admissions. Improper asthma inhaler device use is most likely one of the major causes associated with uncontrolled asthma and frequent ED visits.

Objectives: To evaluate the inhaler technique among asthmatic patients seen in ED, and to investigate the characteristics of these patients and factors associated with improper use of inhaler devices and its relationship with asthma control and ED visits.

Acute brucellosis presenting as gastroenteritis: case report.

Brucellosis is a systemic infection with multiple presentations. In spite of its oral mode of transmission and gastrointestinal pathogenesis, systemic symptoms are usually more prominent than gastrointestinal ones. Acute brucellosis presenting as gastroenteritis is rare in adults and could be the only manifestation of the disease.

Comparison of achievement of NICE targets in type 2 diabetes in Riyadh, Saudi Arabia and Grimsby, United Kingdom: an audit.

Objective: To compare the achievement of NICE guidelines for diabetic care at two hospitals in Riyadh, Saudi Arabia and Grimsby, United Kingdom.

Methods: Electronic records of type 2 diabetic patients followed up at internal medicine clinics at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia and Diana Princess of Wales Hospital (DPWH), Grimsby, United Kingdom were studied and compared for meeting the NICE standards of diabetic care regarding HbAlc, lipid profile, hypertension and urine dipstick testing and control.

Results: Out of 100 patients studied at each hospital, yearly blood pressure recording, HbA1c, lipid profile and urine dipstick testing were done in 95, 89, 84, 51 and 100, 81, 92, 95 percent at KAMC and DPWH, respectively.

Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia.

Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF) in a tertiary hospital in Riyadh, Saudi Arabia.

Materials And Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008.

Results: Documented acute and chronic AF was present in 157 (21.

Extremely elevated erythrocyte sedimentation rate: etiology at a tertiary care center in Saudi Arabia.

Objective: To evaluate the etiology of extremely elevated erythrocyte sedimentation rate (ESR) in adolescents and adults at a tertiary care center.

Methods: This retrospective, cross-sectional, observational study was carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia using the Westergren method of determining ESR in adolescents and adults aged >or=12 years. The patients included inpatients and outpatients with medical, surgical, and gynecological problems.

Increased risk of hypertension, proteinuria and preeclampsia in pregnant Saudi females with IgA nephropathy.

Background: IgA nephropathy is fairly prevalent in Saudi Arabia. In this paper we examine the natural history of pregnancies and their impact on renal function in Saudi females affected by this condition.

Methods: We followed a series of 12 patients, documented to have IgA nephritis by kidney biopsy, during their gestation.

Meeting the American Diabetic Association standards of diabetic care.

Although there are numerous studies on diabetes mellitus in Saudi Arabia, data on the extent to which American Diabetic Association (ADA) standards of diabetic care are met, is scarce. We studied the computerized records of adult diabetic patients followed-up in outpatient internal medicine clinics at our tertiary care center in Riyadh, Saudi Arabia to find out how many of them met the ADA standards of diabetic care regarding fasting blood glucose, HbA1c, LDL-C, hypertension, proteinuria screening and use of anti-platelet, lipid lowering or recommended anti-hypertensive medications. Out of 1,188 type-2 diabetic patients studied, blood pressure readings were available in 1180 (99%) while results of fasting blood glucose, HbA1c, LDL-C and albuminuria screening were available for 1123 (95%), 968 (81%), 1037 (87%) and 307 patients, (26%) respectively.

Global hospital bed utilization crisis. A different approach.

Objective: To test the effect of improved physician availability on hospital bed utilization.

Methods: A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching units (CTU) were compared head-to-head.

Primary CNS lymphoma presenting as fever of unknown origin.

We report a case of fever of unknown origin in an immunocompetent patient as the first manifestation of primary central nervous lymphoma. To our knowledge this is the first reported case in the literature of this association. We recommend brain imaging to be considered in patients presenting with fever of unknown origin and no apparent diagnosis after extensive investigation.

Oral lesions in Saudi renal transplant patients.

Renal transplantation has evolved as the best treatment option for patients with end-stage renal disease. Different oral problems arise in these patients, either as a direct consequence of drug-induced immunosuppression or pharmacokinetics. To determine the prevalence of intra-oral lesions in a group of medically stable Saudi renal transplant patients (RTP) and to identify possible risk factors, in comparison with age and sex-matched healthy control subjects (HCS), we studied 58 RTP and 52 HCS.

Acute renal infarction secondary to atrial fibrillation - mimicking renal stone picture.

Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as a renal stone.

Acute myeloblastic leukemia in a patient with primary antiphospholipid syndrome.

Antiphospholipid syndrome is characterized by venous and arterial thrombosis, recurrent pregnancy loss and the presence of the lupus anticoagulant, anticardiolipin antibodies or both. Antiphospholipid syndrome may occur as a primary disease or in patients with systemic lupus erythematosus or other autoimmune, infectious or neoplastic disorders. In this paper we report a 29-year-old Saudi female, a known case of antiphospholipid syndrome, presented with complaints of fever, breathlessness and generalized fatigue.