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1.  Assessment of knowledge of celiac disease among health care professionals 
Saudi Medical Journal  2015;36(6):751-753.
Objectives:
To assess knowledge of celiac disease among medical professionals (physicians).
Methods:
We conducted a cross-sectional survey of hospital-based medical staff in primary, secondary, and tertiary care public, and private hospitals in Riyadh, Saudi Arabia (KSA). We carried out the study between January 2013 and January 2104 at King Khalid University Hospital, King Saud University, Riyadh, KSA. A pretested questionnaire was distributed to the potential participants. A scoring system was used to classify the level of knowledge of participants into 3 categories: poor, fair, and good.
Results:
A total of 109 physicians completed the survey and of these participants, 86.3% were from public hospitals, and 13.7% from private hospitals; 58.7% were males. Of the physicians, 19.2% had poor knowledge. Interns and residents had fair to good knowledge, but registrars, specialists, and even the consultants were less knowledgeable of celiac disease.
Conclusion:
Knowledge of celiac disease is poor among a significant number of physicians including consultants, which can potentially lead to delays in diagnosis. Educational programs need to be developed to improve awareness of celiac disease in the health care profession.
doi:10.15537/smj.2015.6.11519
PMCID: PMC4454913  PMID: 25987121
2.  Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children 
Purpose
To describe the clinical characteristics of celiac disease (CD) among Saudi children and to determine the adherence rate to gluten free diet (GFD) and its determinant factors among them.
Methods
A cross-sectional study was conducted, in which all the families registered in the Saudi Celiac Patients Support Group were sent an online survey. Only families with children 18 years of age and younger with biopsy-confirmed CD were included.
Results
The median age of the 113 included children was 9.9 years, the median age at symptom onset was 5.5 years and the median age at diagnosis was 7 years, the median time between the presentation and the final diagnosis was 1 year. Sixty two of the involved children were females. Ninety two percent of the patients were symptomatic at the diagnosis while eight percent were asymptomatic. The commonest presenting symptoms included: chronic abdominal pain (59.3%), poor weight gain (54%), abdominal distention, gases, bloating (46.1%) and chronic diarrhea (41.6%). Sixty percent of the involved children were reported to be strictly adherent to GFD. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate.
Conclusion
CD has similar clinical presentations among Saudi children compared to other parts of the ward; however, the adherence to GFD is relatively poor. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate.
doi:10.5223/pghn.2015.18.1.23
PMCID: PMC4391997  PMID: 25866730
Celiac disease; Gluten-free diet; Child; Saudi Arabia
3.  Regional Prevalence of Short Stature in Saudi School-Age Children and Adolescents 
The Scientific World Journal  2012;2012:505709.
Objective. To assess the magnitude of regional difference in prevalence of short stature in Saudi children and adolescents. Subjects and Methods. A representative sample from three different regions of the Kingdom of Saudi Arabia (KSA) (North, Southwest, and Center) was used to calculate the prevalence of short stature (standard deviation score less than −2) in children 5 to 17 years of age. Results. There were 9018 children and adolescents from 5 to 17 years of age (3366, 2825, and 2827 in the Northern, Southwestern and Central regions, resp.) and 51% were boys. In both school-age children and adolescents, there was a significantly higher prevalence of short stature in the Southwestern than in the Northern or the Central region (P < 0.0001). Conclusion. The finding of significant regional variation between regions helps in planning priorities for research and preventive measures.
doi:10.1100/2012/505709
PMCID: PMC3317609  PMID: 22606050
4.  Regional Variation in Prevalence of Overweight and Obesity in Saudi Children and Adolescents 
Background/Aims:
There are limited data on regional variation of overweight and obesity in the Kingdom of Saudi Arabia. Therefore, the aim of this report is to explore the magnitude of these variation in order to focus preventive programs to regional needs.
Setting and Design:
Community-based multistage random sample of representative cohort from each region.
Patients and Methods:
the study sample was cross-sectional, representative of healthy children and adolescents from 2 to 17 years of age. Body mass index (BMI) was calculated according to the formula (weight/height2). The 2000 center for disease control reference was used for the calculation of prevalence of overweight and obesity defined as the proportion of children and adolescents whose BMI for age was above 85th and 95th percentiles respectively, for Northern, Southwestern and Central regions of the Kingdom. Chi-square test was used to assess the difference in prevalence between regions and a P value of <0.05 was considered significant.
Results:
The sample size was 3525, 3413 and 4174 from 2-17 years of age in the Central, Southwestern and Northern regions respectively. The overall prevalence of overweight was 21%, 13.4% and 20.1%, that of obesity was 9.3%, 6% and 9.1% in the Central, Southwestern and Northern regions respectively indicating a significantly-lower prevalence in the Southwestern compared to other regions (P<0.0001).
Conclusions:
This report revealed significant regional variations important to consider in planning preventive and therapeutic programs tailored to the needs of each region.
doi:10.4103/1319-3767.93818
PMCID: PMC3326974  PMID: 22421719
Obesity; prevalence of overweight; regional variations; Saudi children
5.  Prevalence of short stature in Saudi children and adolescents 
Annals of Saudi Medicine  2011;31(5):498-501.
BACKGROUND AND OBJECTIVE:
Data on stature in Saudi children and adolescents are limited. The objective of this report was to establish the national prevalence of short stature in Saudi children and adolescents.
DESIGN AND SETTING:
Community-based, cross-sectional study conducted over 2 years (2004, 2005)
PATIENTS AND METHODS:
The national data set of the Saudi reference was used to calculate the stature for age for children and adolescents 5 to 18 years of age. Using the 2007 World Health Organization (WHO) reference, the prevalence of moderate and severe short stature was defined as the proportion of children whose standard deviation score for stature for age was less than -2 and -3, respectively. In addition, the 2000 Center for Disease Control (CDC) and the older 1978 National Center for Health Statistics (NCHS)/WHO references were used for comparison.
RESULTS:
Using the 2007 WHO reference, sample size in the Saudi reference was 19 372 healthy children and adolescents 5 to 17 years of age, with 50.8% being boys. The overall prevalence of moderate and severe short stature in boys was 11.3% and 1.8%, respectively; and in girls, 10.5% and 1.2%, respectively. The prevalence of moderate short stature was 12.1%, 11% and 11.3% in boys and 10.9%, 11.3% and 10.5% in girls when the 1978 WHO, the 2000 CDC and the 2007 WHO references were used, respectively.
CONCLUSIONS:
The national prevalence of short stature in Saudi children and adolescents is intermediate compared with the international level. Improvement in the socioeconomic and health status of children and adolescents should lead to a reduction in the prevalence of short stature.
doi:10.4103/0256-4947.84628
PMCID: PMC3183685  PMID: 21911988
6.  Prevalence of malnutrition in Saudi children: a community-based study 
Annals of Saudi Medicine  2010;30(5):381-385.
BACKGROUND AND OBJECTIVE:
There is no published information on the prevalence of malnutrition in Saudi Arabia. The objective of this study was to establish the prevalence data.
METHODS:
The prevalence of nutritional indicators in the form of underweight, stunting, and wasting in a national sample of children younger than 5 years of age was calculated using the new WHO standards as reference. Calculations were performed using the corresponding WHO software. The prevalence of moderate and severe underweight, wasting and stunting, was defined as the proportion of children whose weight for age, weight for height, and height for age were below –2 and –3 standard deviation scores, respectively.
RESULTS:
The number of children younger than 5 years of age was 15 516 and 50.5% were boys. The prevalence of moderate and severe underweight was 6.9% and 1.3%, respectively. The prevalence of moderate and severe wasting was 9.8% and 2.9%, respectively. Finally, the prevalence of moderate and severe stunting was 10.9% and 2.8%, respectively. The prevalence was lower in girls for all indicators. Comparison of the prevalence of nutritional indicators in selected countries demonstrates large disparity with an intermediate position for Saudi Arabia.
CONCLUSION:
This report establishes the national prevalence of malnutrition among Saudi children. Compared to data from other countries, these prevalence rates are still higher than other countries with less economic resources, indicating that more efforts are needed to improve the nutritional status of children.
doi:10.4103/0256-4947.67076
PMCID: PMC2941251  PMID: 20697172
7.  Prevalence of overweight and obesity in Saudi children and adolescents 
Annals of Saudi Medicine  2010;30(3):203-208.
BACKGROUND AND OBJECTIVE:
There is limited information on overweight and obesity in Saudi children and adolescents. The objective of this study was to establish the national prevalence of overweight and obesity in Saudi children and adolescents.
METHODS:
The 2005 Saudi reference data set was used to calculate the body mass index (BMI) for children aged 5 to 18 years. Using the 2007 WHO reference, the prevalence of overweight, obesity and severe obesity were defined as the proportion of children with a BMI standard deviation score more than +1, +2 and +3, respectively. The 2000 CDC reference was also used for comparison.
RESULTS:
There were 19 317 healthy children and adolescents from 5 to 18 years of age, 50.8% of whom were boys. The overall prevalence of overweight, obesity and severe obesity in all age groups was 23.1%, 9.3% and 2%, respectively. A significantly lower prevalence of overweight (23.8 vs 20.4; P<.001) and obesity (9.5 vs 5.7; P<.001) was found when the CDC reference was used.
CONCLUSIONS:
This report establishes baseline national prevalence rates for overweight, obesity and severe obesity in Saudi children and adolescents, indicating intermediate levels between developing and industrialized countries. Measures should be implemented to prevent further increases in the numbers of overweight school-age children and adolescents and the associated health hazards.
doi:10.4103/0256-4947.62833
PMCID: PMC2886870  PMID: 20427936
8.  Blood pressure standards for Saudi children and adolescents 
Annals of Saudi Medicine  2009;29(3):173-178.
BACKGROUND AND OBJECTIVES:
Blood pressure levels may vary in children because of genetic, ethnic and socioeconomic factors. To date, there have been no large national studies in Saudi Arabia on blood pressure in children. Therefore, we sought to establish representative blood pressure reference centiles for Saudi Arabian children and adolescents.
SUBJECTS AND METHODS:
We selected a sample of children and adolescents aged from birth to 18 years by multi-stage probability sampling of the Saudi population. The selected sample represented Saudi children from the whole country. Data were collected through a house-to-house survey of all selected households in all 13 regions in the country. Data were analyzed to study the distribution pattern of systolic (SBP) and diastolic blood pressure (DBP) and to develop reference values. The 90th percentile of SBP and DBP values for each age were compared with values from a Turkish and an American study.
RESULTS:
A total of 16 226 Saudi children and adolescents from birth to 18 years were studied. Blood pressure rose steadily with age in both boys and girls. The average annual increase in SBP was 1.66 mm Hg for boys and 1.44 mm Hg for girls. The average annual increase in DBP was 0.83 mm Hg for boys and 0.77 mm Hg for girls. DBP rose sharply in boys at the age of 18 years. Values for the 90th percentile of both SBP and DBP varied in Saudi children from their Turkish and American counterparts for all age groups.
CONCLUSION:
Blood pressure values in this study differed from those from other studies in developing countries and in the United States, indicating that comparison across studies is difficult and from that every population should use their own normal standards to define measured blood pressure levels in children.
doi:10.4103/0256-4947.51787
PMCID: PMC2813655  PMID: 19448364
9.  Liver Size in Saudi Children and Adolescents 
Background/Aim:
To examine the liver size in Saudi children and adolescents.
Methods:
A large sample of children was selected from the general population by multistage random probability sampling for the assessment of physical growth. A random subsample of children–newborns to 18 years old–was taken from this larger sample for this study. Liver size below the costal margin and liver span along the midclavicular line were determined by physicians. Data were analyzed using SPSS software and medians and standard deviations were calculated.
Results:
Between 2004 and 2005, 18 112 healthy children up to 18 years of age were examined. All were term and appropriate for gestational age. There were 9 130 boys and 8 982 girls, yielding a nearly 1:1 male to female ratio. The maximum palpable liver size below the costal margin was 2.4 cm. The median and + 2 SD liver span at birth were 4 and 6.9 cm, respectively. There was no difference in the liver span between boys and girls of up to 60 months of age. Thereafter, a difference could be seen increasing with age, with girls having smaller liver spans than boys.
Conclusion:
This manuscript reports the liver size in Saudi children and adolescents. The data should help physicians in the interpretation of liver size determined by physical examination of children and adolescents.
doi:10.4103/1319-3767.45052
PMCID: PMC2702944  PMID: 19568553
Children; liver size; liver span; Saudi Arabia
10.  Does consanguinity increase the risk of bronchial asthma in children? 
Annals of Thoracic Medicine  2008;3(2):41-43.
There is a high prevalence of consanguinity and bronchial asthma in Saudi Arabia. The objective of this study is to explore the effect of parental consanguinity on the occurrence of bronchial asthma in children. The study sample was determined by multistage random probability sampling of Saudi households. The families with at least one child with asthma were matched with an equal number of families randomly selected from a list of families with healthy children, the latter families being designated as controls. There were 103 families with children having physician-diagnosed bronchial asthma, matched with an equal number of families with no children with asthma. This resulted in 140 children with bronchial asthma and 295 children from controls. The age and gender distribution of the children with bronchial asthma and children from controls were similar. There were 54/103 (52.4%) and 61/103 (59.2%) cases of positive parental consanguinity in asthmatic children and children from controls respectively (P = 0.40). Analysis of consanguinity status of the parents of children with asthma and parents among controls indicates that 71/140 (51%) of the children with asthma and 163/295 (55.3%) of the children from controls had positive parental overall consanguinity (P = 0.43). The results of this study suggest that parental consanguinity does not increase the risk of bronchial asthma in children.
doi:10.4103/1817-1737.39634
PMCID: PMC2700455  PMID: 19561903
Bronchial asthma; consanguinity; Saudi Arabia

Results 1-10 (10)