There is need in the Arab world for validated instruments that can reliably assess infant feeding... more There is need in the Arab world for validated instruments that can reliably assess infant feeding attitudes among women. The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has consistently shown good reliability and validity in different cultures and the ability to predict breastfeeding intention and exclusivity. This study assessed the psychometric properties of the Arabic version of the IIFAS (IIFAS-A). After translating to classical Arabic and back-translating to English, the IIFAS-A was pilot tested among 20 women for comprehension, clarity, length, and cultural appropriateness. The IIFAS-A was then validated among 170 women enrolled in a breastfeeding promotion and support clinical trial in Lebanon. The IIFAS-A showed acceptable internal consistency reliability (Cronbach's α = 0.640), with principal components analysis revealing that it is unidimensional. The 17 items had good interitem reliabilities ranging between 0.599 and 0.665. The number of breastfed children was the only predictor of the overall IIFAS-A score in a multivariate stepwise regression model (β = 1.531, P < .0001). The 17-item IIFAS-A is a reliable and valid instrument for measuring women's infant feeding attitudes in the Arab context.
To determine factors associated with pubertal gynecomastia. A cross-sectional study among healthy... more To determine factors associated with pubertal gynecomastia. A cross-sectional study among healthy male school children and adolescents in Riyadh, Saudi Arabia. Subjects were selected from diverse socioeconomic backgrounds. Tanner stage, height, weight, blood hormonal levels (leutilizing hormone [LH], follicle-stimulating hormone [FSH], total testosterone, and estradiol), and anthropometric and lipid parameters (body mass index [BMI], triglycerides, high-density lipoprotein [HDL], and low-density lipoprotein [LDL]), were collected and compared in children with and without gynecomastia. The study included 542 children and adolescents. Median (interquartile range) age in the whole group was 11(8-13) years. The prevalence of gynecomastia was 185/542 (34%), with a peak at age 14. The 2 groups compared had nonsignificant difference in cholesterol (P=.331), LH (P=.215) and FSH (P=.571) levels. Those with gynecomastia were significantly older, had lower gonad stage, had higher anthropometri...
Serum procalcitonin is commonly used to differentiate systemic inflammation due to infection from... more Serum procalcitonin is commonly used to differentiate systemic inflammation due to infection from non-infectious causes. Limited data exist on the value of procalcitonin in predicting relative adrenal insufficiency (RAI). This study evaluated the value of procalcitonin in predicting RAI and mortality in cirrhotic patients with septic shock. This was a post-hoc analysis of a randomized placebo-controlled trial that evaluated low-dose hydrocortisone in cirrhotic patients with septic shock. Extracted first study-day data included serum procalcitonin, baseline serum cortisol, cortisol level after 250 microg - adrenocorticotropic hormone stimulation test and 28 - day mortality. RAI was defined as a baseline serum cortisol < 10 microg/dL or cortisol not rising by > 9 microg/dL after stimulation. Procalcitonin > 0.5 ng/mL was considered high. Forty-five patients had serum procalcitonin measured (mean = 2.7 +/- 3.2 ng/mL, first and third quartiles were 0.3 and 3.3 ng/mL, respective...
Airway management and endotracheal intubation are essential skills for pediatric residents. Simul... more Airway management and endotracheal intubation are essential skills for pediatric residents. Simulation-based technology is used for training residents but it remains unclear whether high fidelity simulation results in better retention of skills compared to low fidelity. The study assesses high fidelity simulation of endotracheal intubation and traditional low fidelity training in improving pediatric residents' knowledge retention and technical skills; and if the difference translates into higher "real time" intubation success rates. Second and third year pediatric residents were randomized into high fidelity (intervention) or low fidelity simulation (control) groups. Airway management and intubation skills were taught using a didactic lecture and demonstration on low fidelity mannequins. Knowledge was assessed before randomization (T0) and 6 months after training (T6). Other outcome measures were: 1) airway management and intubation skills at T6 and T12 (12 months late...
In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one s... more In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one set of guidelines are available. The aim of the study was to assess the agreement between the European Society of Cardiology (ESC) 2011 Guidelines for CVD Prevention and the Canadian Cardiovascular Society (CCS) 2009 Guidelines in recommending lipid lowering interventions in a seemingly healthy cohort of Lebanese persons. A nationally representative cohort of Lebanon was identified according to the World Health Organization (WHO) Steps Criteria. From this cohort, a group of 283 adult individuals not known to have chronic illnesses was selected. Using the algorithms present in each guideline, lipid lowering recommendations for each individual were determined. Agreement between the two guideline recommendations was determined using the Kappa test. As per ESC, 3.9% of the participants required immediate drug therapy, 15.5% should be considered for drug therapy, and 80.1% required lifestyle i...
Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury... more Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury profiles and ICU outcomes of patients in a tertiary trauma care referral center in Riyadh, Saudi Arabia. A retrospective analysis of ICU data collected prospectively over 5 years in a 21-bed medical and surgical intensive care unit (ICU) in a tertiary care teaching hospital. We collected ICU data on all patients admitted secondary to motor vehicle accidents (MVAs), excluding patients younger than 18 years, brain dead patients and readmissions. We collected data on age, gender, and Glasgow coma scale score at admission, injury severity scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and other data. Multivariate logistic regression was used to identify predictors of mortality. During the study period, of 1659 patients, MVA was the most common cause of injury (78.4%), followed by pedestrian accident (12.7%). ICU mortality included 221 patients (13.3%) during th...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012
We aimed from our study to assess how students and clinical supervisors perceive students' ac... more We aimed from our study to assess how students and clinical supervisors perceive students' achievement in the internal medicine subspecialty clinical attachments in comparison with the general attachments. We conducted a cross-sectional study comparing students' self-assessment ratings during the Medicine Block general and subspecialties clinical attachments at our college of medicine during the period between February 2007 and June 2009. We assessed the level of agreement between students' self-assessment in the different subspecialties with their self-assessment in the general attachments. We repeated the same calculation for the supervisors' assessment. Eighty-three students were included; these students attended eight different clinical attachments. A total of 517 self-assessment forms were completed (120 general internal medicine clinical attachments and 397 forms in different specialty attachments). The clinical supervisors completed parallel assessment forms. ...
The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) is ru... more The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) is running a PBL-based curriculum. A progress test was used to evaluate components of the basic medical and clinical sciences curriculum. To evaluate the performance of students at different levels of the college of medicine curriculum through USMLE-based test that focused on basic medical and clinical sciences topics. The USMLE-based basic medical and clinical sciences progress test has been conducted since 2007. It covers nine topics, including: anatomy; physiology; histology; epidemiology; biochemistry; behavioral sciences, pathology, pharmacology and immunology/microbiology. Here we analyzed results of three consecutive years of all students in years 1-4. There was a good correlation between progress test results and students' GPA. Progress test results in the clinical topics were better than basic medical sciences. In basic medical sciences, results of pharmacology, biochemistry, beh...
Intracranial pressure (ICP) monitoring is recommended in patients with a severe traumatic brain i... more Intracranial pressure (ICP) monitoring is recommended in patients with a severe traumatic brain injury (TBI) and an abnormal computed tomography (CT) scan. However, there is contradicting evidence about whether ICP monitoring improves outcome. The purpose of this study was to examine the relationship between ICP monitoring and outcomes in patients with severe TBI. From February 2001 to December 2008, a total of 477 consecutive adult (> or =18 years) patients with severe TBI were included retrospectively in the study. Patients who underwent ICP monitoring (n=52) were compared with those who did not (n=425). The primary outcome was hospital mortality. Secondary outcomes were ICU mortality, mechanical ventilation duration, the need for tracheostomy, and ICU and hospital length of stay (LOS). After adjustment for multiple potential confounding factors, ICP monitoring was not associated with significant difference in hospital or ICU mortality (odds ratio [OR] = 1.71, 95% confidence in...
To produce a conceptually equivalent Arabic version of the Chronic Obstructive Pulmonary Disease ... more To produce a conceptually equivalent Arabic version of the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT), and to assess its reliability. A prospective observational study was carried out from June 2010 to September 2010 at King Abdulaziz Medical City and King Khalid University Hospital, Riyadh, Saudi Arabia. We conducted this study in 2 phases. Phase 1: the translation of the CAT from English to Arabic, through forward and backward translation, as well as pilot testing. Phase 2: assessment of the test-retest reliability of the CAT for 45 patients with COPD who received optimal care by their pulmonologist. This study was conducted on 45 participants. The CAT mean total (+/- SD) score at the test session was 10.7+/-5.8, and 9.2+/-4.5 at the re-test session. The interclass correlation of the total score was 0.9 (p=0.000076). The strongest correlation was for the item of confidence in leaving home with a value of 0.92 (p=0.000082), whereas the weakest was for the it...
The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and... more The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and morbidity in critically ill trauma patients admitted to ICU. Nested cohort study within a Randomized Controlled Trial. All trauma patients with GCS < or = 9 included in the original trial were included in this study. Primary outcome was ICU mortality. There was no difference in ICU mortality between IIT and CIT groups (6.5% vs. 5.5%, p = 0.67). After adjustment for baseline characteristics, IIT therapy was also not associated with mortality (Adjusted Hazard Ratio 1.33, 95% CI 0.35-5.05). IIT therapy was associated with a significant increase in the incidence of hypoglycemia as compared to CIT, at least one hypoglycemia episode occurred in 18.5% of patients in IIT and 1.3% in the CIT group (P < 0.0001). IIT was not associated with survival improvement in trauma patients admitted to ICU and was associated with increased incidence of hypoglycemia.
Growing evidence suggests that glycaemic variability increases diabetic complications. However, t... more Growing evidence suggests that glycaemic variability increases diabetic complications. However, the significance of glycaemic variability in critically ill patients remains unclear. We evaluated the predictors of glycaemic fluctuation and its association with critical care outcomes. This is a nested-cohort study within a clinical trial in which 523 patients at a medical surgical intensive care unit were randomised to either intensive insulin therapy (target glycaemic control: 4.4 to 6.1 mmol/l) or conventional insulin therapy (target control: 10.0 to 11.1 mmol/l). Glycaemic fluctuation was defined as the mean difference between the highest and lowest daily blood glucose. Patients were divided into wide and narrow fluctuation groups according to the median glycaemic fluctuation (6.0 mmol/l). The association between glycaemic fluctuation and different intensive care unit outcomes was studied. Predictors of glycaemic fluctuation were age (odds ratio for each year increment 1.03, 95% co...
... Nursing workload and perception about intensive insulin therapy in critically ill adult patie... more ... Nursing workload and perception about intensive insulin therapy in critically ill adult patients. Auteur(s) / Author(s). SAMARKANDY Sahal J. (1) ; AL-DORZI Hasan M. (2) ; TAMIM Hani M. (2) ; ARABI Yaseen M. (2) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...
... Authors Al-Kadri, HM; Al-Marri, NF; Tamim, HM Journal Saudi Medical Journal 2009 Vol. 30 No. ... more ... Authors Al-Kadri, HM; Al-Marri, NF; Tamim, HM Journal Saudi Medical Journal 2009 Vol. 30 No. 12 pp. 1613-1614 ISSN 0379-5284 URL http://www.smj.org.sa Record Number 20103015981. Abstract. A retrospective study among patients admitted to King Abdulaziz Medical City ...
To identify health-related risk factors for the development of post partum hemorrhage (PPH) in Sa... more To identify health-related risk factors for the development of post partum hemorrhage (PPH) in Saudi women and to estimate the incidence of primary PPH. A case-control study was conducted between July 1, 2007 and June 30, 2008 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. One hundred and one patients with PPH and 209 control patients were included. Bivariate associations between the different risk factors for the development of PPH were studied. Multivariate logistic regression analysis to identify significant risk factors for the occurrence of this obstetrics complication was carried out. High parity was associated with a 17% increased risk of PPH. Risk factors in preeclampsia was associated with >6-fold increase. History of antepartum hemorrhage (APH) increased the risk for PPH by >8-fold. Other factors were: multiple pregnancy, vaginal delivery, prolonged third stage of labor, and presence of cardiotocograph (CTG) abnormalities. Risk factors for developing PPH among...
... Critically Ill Patients , HM Al-Dorzi , H. Tamim , Y. Arabi A. Heijan1 2 3 4 King Saud Bin Ab... more ... Critically Ill Patients , HM Al-Dorzi , H. Tamim , Y. Arabi A. Heijan1 2 3 4 King Saud Bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City, Riyadh, Saudi Arabia, King Abdulaziz Medical 1 2 City, Riyadh ...
Near-fatal asthma (NFA) has not been well studied in Saudi Arabia. We evaluated NFA risk factors ... more Near-fatal asthma (NFA) has not been well studied in Saudi Arabia. We evaluated NFA risk factors in asthmatics admitted to a tertiary-care hospital and described NFA management and outcomes. This was a retrospective study of NFA patients admitted to an ICU in Riyadh (2006-2010). NFA was defined as a severe asthma attack requiring intubation. To evaluate NFA risk factors, randomly selected patients admitted to the ward for asthma exacerbation were used as controls. Collected data included demographics, information on prior asthma control and various NFA treatments and outcomes. Thirty NFA cases were admitted to the ICU in the five-year period. Compared to controls (N = 120), NFA patients were younger (37.5 ± 19.9 vs. 50.3 ± 23.1 years, P = 0.004) and predominantly males (70.0% vs. 41.7%, P = 0.005) and used less inhaled steroids/long-acting ß2-agonists combination (13.6% vs. 38.7% P = 0.024. Most (73.3%) NFA cases presented in the cool months (October-March). On multivariate analysis, age (odds ratio [OR] 0.96; 95% confidence interval [CI], 0.92-0.99, P = 0.015) and the number of ED visits in the preceding year (OR, 1.25; 95% CI, 1.00-1.55) were associated with NFA. Rescue NFA management included ketamine (50%) and theophylline (19%) infusions. NFA outcomes included: neuromyopathy (23%), mechanical ventilation duration = 6.4 ± 4.7 days, tracheostomy (13%) and mortality (0%). Neuromuscular blockade duration was associated with neuromyopathy (OR, 3.16 per one day increment; 95% CI, 1.27-7.83). In our study, NFA risk factors were younger age and higher number of ED visits. NFA had significant morbidity. Reducing neuromuscular blockade duration during ventilator management may decrease neuromyopathy risk.
There is need in the Arab world for validated instruments that can reliably assess infant feeding... more There is need in the Arab world for validated instruments that can reliably assess infant feeding attitudes among women. The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has consistently shown good reliability and validity in different cultures and the ability to predict breastfeeding intention and exclusivity. This study assessed the psychometric properties of the Arabic version of the IIFAS (IIFAS-A). After translating to classical Arabic and back-translating to English, the IIFAS-A was pilot tested among 20 women for comprehension, clarity, length, and cultural appropriateness. The IIFAS-A was then validated among 170 women enrolled in a breastfeeding promotion and support clinical trial in Lebanon. The IIFAS-A showed acceptable internal consistency reliability (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s α = 0.640), with principal components analysis revealing that it is unidimensional. The 17 items had good interitem reliabilities ranging between 0.599 and 0.665. The number of breastfed children was the only predictor of the overall IIFAS-A score in a multivariate stepwise regression model (β = 1.531, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). The 17-item IIFAS-A is a reliable and valid instrument for measuring women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s infant feeding attitudes in the Arab context.
To determine factors associated with pubertal gynecomastia. A cross-sectional study among healthy... more To determine factors associated with pubertal gynecomastia. A cross-sectional study among healthy male school children and adolescents in Riyadh, Saudi Arabia. Subjects were selected from diverse socioeconomic backgrounds. Tanner stage, height, weight, blood hormonal levels (leutilizing hormone [LH], follicle-stimulating hormone [FSH], total testosterone, and estradiol), and anthropometric and lipid parameters (body mass index [BMI], triglycerides, high-density lipoprotein [HDL], and low-density lipoprotein [LDL]), were collected and compared in children with and without gynecomastia. The study included 542 children and adolescents. Median (interquartile range) age in the whole group was 11(8-13) years. The prevalence of gynecomastia was 185/542 (34%), with a peak at age 14. The 2 groups compared had nonsignificant difference in cholesterol (P=.331), LH (P=.215) and FSH (P=.571) levels. Those with gynecomastia were significantly older, had lower gonad stage, had higher anthropometri...
Serum procalcitonin is commonly used to differentiate systemic inflammation due to infection from... more Serum procalcitonin is commonly used to differentiate systemic inflammation due to infection from non-infectious causes. Limited data exist on the value of procalcitonin in predicting relative adrenal insufficiency (RAI). This study evaluated the value of procalcitonin in predicting RAI and mortality in cirrhotic patients with septic shock. This was a post-hoc analysis of a randomized placebo-controlled trial that evaluated low-dose hydrocortisone in cirrhotic patients with septic shock. Extracted first study-day data included serum procalcitonin, baseline serum cortisol, cortisol level after 250 microg - adrenocorticotropic hormone stimulation test and 28 - day mortality. RAI was defined as a baseline serum cortisol < 10 microg/dL or cortisol not rising by > 9 microg/dL after stimulation. Procalcitonin > 0.5 ng/mL was considered high. Forty-five patients had serum procalcitonin measured (mean = 2.7 +/- 3.2 ng/mL, first and third quartiles were 0.3 and 3.3 ng/mL, respective...
Airway management and endotracheal intubation are essential skills for pediatric residents. Simul... more Airway management and endotracheal intubation are essential skills for pediatric residents. Simulation-based technology is used for training residents but it remains unclear whether high fidelity simulation results in better retention of skills compared to low fidelity. The study assesses high fidelity simulation of endotracheal intubation and traditional low fidelity training in improving pediatric residents' knowledge retention and technical skills; and if the difference translates into higher "real time" intubation success rates. Second and third year pediatric residents were randomized into high fidelity (intervention) or low fidelity simulation (control) groups. Airway management and intubation skills were taught using a didactic lecture and demonstration on low fidelity mannequins. Knowledge was assessed before randomization (T0) and 6 months after training (T6). Other outcome measures were: 1) airway management and intubation skills at T6 and T12 (12 months late...
In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one s... more In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one set of guidelines are available. The aim of the study was to assess the agreement between the European Society of Cardiology (ESC) 2011 Guidelines for CVD Prevention and the Canadian Cardiovascular Society (CCS) 2009 Guidelines in recommending lipid lowering interventions in a seemingly healthy cohort of Lebanese persons. A nationally representative cohort of Lebanon was identified according to the World Health Organization (WHO) Steps Criteria. From this cohort, a group of 283 adult individuals not known to have chronic illnesses was selected. Using the algorithms present in each guideline, lipid lowering recommendations for each individual were determined. Agreement between the two guideline recommendations was determined using the Kappa test. As per ESC, 3.9% of the participants required immediate drug therapy, 15.5% should be considered for drug therapy, and 80.1% required lifestyle i...
Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury... more Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury profiles and ICU outcomes of patients in a tertiary trauma care referral center in Riyadh, Saudi Arabia. A retrospective analysis of ICU data collected prospectively over 5 years in a 21-bed medical and surgical intensive care unit (ICU) in a tertiary care teaching hospital. We collected ICU data on all patients admitted secondary to motor vehicle accidents (MVAs), excluding patients younger than 18 years, brain dead patients and readmissions. We collected data on age, gender, and Glasgow coma scale score at admission, injury severity scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and other data. Multivariate logistic regression was used to identify predictors of mortality. During the study period, of 1659 patients, MVA was the most common cause of injury (78.4%), followed by pedestrian accident (12.7%). ICU mortality included 221 patients (13.3%) during th...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012
We aimed from our study to assess how students and clinical supervisors perceive students' ac... more We aimed from our study to assess how students and clinical supervisors perceive students' achievement in the internal medicine subspecialty clinical attachments in comparison with the general attachments. We conducted a cross-sectional study comparing students' self-assessment ratings during the Medicine Block general and subspecialties clinical attachments at our college of medicine during the period between February 2007 and June 2009. We assessed the level of agreement between students' self-assessment in the different subspecialties with their self-assessment in the general attachments. We repeated the same calculation for the supervisors' assessment. Eighty-three students were included; these students attended eight different clinical attachments. A total of 517 self-assessment forms were completed (120 general internal medicine clinical attachments and 397 forms in different specialty attachments). The clinical supervisors completed parallel assessment forms. ...
The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) is ru... more The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) is running a PBL-based curriculum. A progress test was used to evaluate components of the basic medical and clinical sciences curriculum. To evaluate the performance of students at different levels of the college of medicine curriculum through USMLE-based test that focused on basic medical and clinical sciences topics. The USMLE-based basic medical and clinical sciences progress test has been conducted since 2007. It covers nine topics, including: anatomy; physiology; histology; epidemiology; biochemistry; behavioral sciences, pathology, pharmacology and immunology/microbiology. Here we analyzed results of three consecutive years of all students in years 1-4. There was a good correlation between progress test results and students' GPA. Progress test results in the clinical topics were better than basic medical sciences. In basic medical sciences, results of pharmacology, biochemistry, beh...
Intracranial pressure (ICP) monitoring is recommended in patients with a severe traumatic brain i... more Intracranial pressure (ICP) monitoring is recommended in patients with a severe traumatic brain injury (TBI) and an abnormal computed tomography (CT) scan. However, there is contradicting evidence about whether ICP monitoring improves outcome. The purpose of this study was to examine the relationship between ICP monitoring and outcomes in patients with severe TBI. From February 2001 to December 2008, a total of 477 consecutive adult (> or =18 years) patients with severe TBI were included retrospectively in the study. Patients who underwent ICP monitoring (n=52) were compared with those who did not (n=425). The primary outcome was hospital mortality. Secondary outcomes were ICU mortality, mechanical ventilation duration, the need for tracheostomy, and ICU and hospital length of stay (LOS). After adjustment for multiple potential confounding factors, ICP monitoring was not associated with significant difference in hospital or ICU mortality (odds ratio [OR] = 1.71, 95% confidence in...
To produce a conceptually equivalent Arabic version of the Chronic Obstructive Pulmonary Disease ... more To produce a conceptually equivalent Arabic version of the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT), and to assess its reliability. A prospective observational study was carried out from June 2010 to September 2010 at King Abdulaziz Medical City and King Khalid University Hospital, Riyadh, Saudi Arabia. We conducted this study in 2 phases. Phase 1: the translation of the CAT from English to Arabic, through forward and backward translation, as well as pilot testing. Phase 2: assessment of the test-retest reliability of the CAT for 45 patients with COPD who received optimal care by their pulmonologist. This study was conducted on 45 participants. The CAT mean total (+/- SD) score at the test session was 10.7+/-5.8, and 9.2+/-4.5 at the re-test session. The interclass correlation of the total score was 0.9 (p=0.000076). The strongest correlation was for the item of confidence in leaving home with a value of 0.92 (p=0.000082), whereas the weakest was for the it...
The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and... more The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and morbidity in critically ill trauma patients admitted to ICU. Nested cohort study within a Randomized Controlled Trial. All trauma patients with GCS < or = 9 included in the original trial were included in this study. Primary outcome was ICU mortality. There was no difference in ICU mortality between IIT and CIT groups (6.5% vs. 5.5%, p = 0.67). After adjustment for baseline characteristics, IIT therapy was also not associated with mortality (Adjusted Hazard Ratio 1.33, 95% CI 0.35-5.05). IIT therapy was associated with a significant increase in the incidence of hypoglycemia as compared to CIT, at least one hypoglycemia episode occurred in 18.5% of patients in IIT and 1.3% in the CIT group (P < 0.0001). IIT was not associated with survival improvement in trauma patients admitted to ICU and was associated with increased incidence of hypoglycemia.
Growing evidence suggests that glycaemic variability increases diabetic complications. However, t... more Growing evidence suggests that glycaemic variability increases diabetic complications. However, the significance of glycaemic variability in critically ill patients remains unclear. We evaluated the predictors of glycaemic fluctuation and its association with critical care outcomes. This is a nested-cohort study within a clinical trial in which 523 patients at a medical surgical intensive care unit were randomised to either intensive insulin therapy (target glycaemic control: 4.4 to 6.1 mmol/l) or conventional insulin therapy (target control: 10.0 to 11.1 mmol/l). Glycaemic fluctuation was defined as the mean difference between the highest and lowest daily blood glucose. Patients were divided into wide and narrow fluctuation groups according to the median glycaemic fluctuation (6.0 mmol/l). The association between glycaemic fluctuation and different intensive care unit outcomes was studied. Predictors of glycaemic fluctuation were age (odds ratio for each year increment 1.03, 95% co...
... Nursing workload and perception about intensive insulin therapy in critically ill adult patie... more ... Nursing workload and perception about intensive insulin therapy in critically ill adult patients. Auteur(s) / Author(s). SAMARKANDY Sahal J. (1) ; AL-DORZI Hasan M. (2) ; TAMIM Hani M. (2) ; ARABI Yaseen M. (2) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...
... Authors Al-Kadri, HM; Al-Marri, NF; Tamim, HM Journal Saudi Medical Journal 2009 Vol. 30 No. ... more ... Authors Al-Kadri, HM; Al-Marri, NF; Tamim, HM Journal Saudi Medical Journal 2009 Vol. 30 No. 12 pp. 1613-1614 ISSN 0379-5284 URL http://www.smj.org.sa Record Number 20103015981. Abstract. A retrospective study among patients admitted to King Abdulaziz Medical City ...
To identify health-related risk factors for the development of post partum hemorrhage (PPH) in Sa... more To identify health-related risk factors for the development of post partum hemorrhage (PPH) in Saudi women and to estimate the incidence of primary PPH. A case-control study was conducted between July 1, 2007 and June 30, 2008 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. One hundred and one patients with PPH and 209 control patients were included. Bivariate associations between the different risk factors for the development of PPH were studied. Multivariate logistic regression analysis to identify significant risk factors for the occurrence of this obstetrics complication was carried out. High parity was associated with a 17% increased risk of PPH. Risk factors in preeclampsia was associated with >6-fold increase. History of antepartum hemorrhage (APH) increased the risk for PPH by >8-fold. Other factors were: multiple pregnancy, vaginal delivery, prolonged third stage of labor, and presence of cardiotocograph (CTG) abnormalities. Risk factors for developing PPH among...
... Critically Ill Patients , HM Al-Dorzi , H. Tamim , Y. Arabi A. Heijan1 2 3 4 King Saud Bin Ab... more ... Critically Ill Patients , HM Al-Dorzi , H. Tamim , Y. Arabi A. Heijan1 2 3 4 King Saud Bin Abdulaziz University for Health Sciences and King Abdulaziz Medical City, Riyadh, Saudi Arabia, King Abdulaziz Medical 1 2 City, Riyadh ...
Near-fatal asthma (NFA) has not been well studied in Saudi Arabia. We evaluated NFA risk factors ... more Near-fatal asthma (NFA) has not been well studied in Saudi Arabia. We evaluated NFA risk factors in asthmatics admitted to a tertiary-care hospital and described NFA management and outcomes. This was a retrospective study of NFA patients admitted to an ICU in Riyadh (2006-2010). NFA was defined as a severe asthma attack requiring intubation. To evaluate NFA risk factors, randomly selected patients admitted to the ward for asthma exacerbation were used as controls. Collected data included demographics, information on prior asthma control and various NFA treatments and outcomes. Thirty NFA cases were admitted to the ICU in the five-year period. Compared to controls (N = 120), NFA patients were younger (37.5 ± 19.9 vs. 50.3 ± 23.1 years, P = 0.004) and predominantly males (70.0% vs. 41.7%, P = 0.005) and used less inhaled steroids/long-acting ß2-agonists combination (13.6% vs. 38.7% P = 0.024. Most (73.3%) NFA cases presented in the cool months (October-March). On multivariate analysis, age (odds ratio [OR] 0.96; 95% confidence interval [CI], 0.92-0.99, P = 0.015) and the number of ED visits in the preceding year (OR, 1.25; 95% CI, 1.00-1.55) were associated with NFA. Rescue NFA management included ketamine (50%) and theophylline (19%) infusions. NFA outcomes included: neuromyopathy (23%), mechanical ventilation duration = 6.4 ± 4.7 days, tracheostomy (13%) and mortality (0%). Neuromuscular blockade duration was associated with neuromyopathy (OR, 3.16 per one day increment; 95% CI, 1.27-7.83). In our study, NFA risk factors were younger age and higher number of ED visits. NFA had significant morbidity. Reducing neuromuscular blockade duration during ventilator management may decrease neuromyopathy risk.
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