20 research outputs found
Predictors of the Third (Booster) Dose of COVID-19 Vaccine Intention among the Healthcare Workers in Saudi Arabia: An Online Cross-Sectional Survey
No full textObjective: The COVID-19 pandemic is still continuing throughout the world, with newer genetic variants regularly appearing from different parts of the world. Considering the waning of immunity against COVID-19 infection even with two doses of the COVID-19 vaccine, regulatory authorities have authorised booster COVID-19 vaccination in many countries, especially for vulnerable populations, including healthcare workers. The current study analysed factors predicting the third (booster) dose of COVID-19 vaccine intention, including the health belief model (HBM), among the healthcare workers in Saudi Arabia. Methods: The current study was a cross-sectional online survey performed from 1st October 2021 to 30th November 2021, using a questionnaire prepared in Google(TM) form among healthcare workers in Saudi Arabia. The questionnaire asked demographic factors, COVID-19 experience of participants, subjective assessment of health, intention of COVID-19 booster dose vaccination, preferences for local/foreign-made vaccines, and health belief of the study population related to COVID-19 infection and COVID-19 booster dose. Results: This study received 2059 complete responses. The study population reported mixed health belief with respect to the susceptibility of COVID-19 infection, and higher health belief perception regarding the severity. The perceptions of the study participants regarding the benefits of COVID-19 booster dose were positive. There were few barriers to COVID-19 booster dose expressed by study participants. A total of 1464 (71.1%) study participants reported positive intent for receiving a COVID-19 booster dose. The study showed significant association between definite intention to receive a booster dose and nationality (p = 0.001), marital status (p = 0.017), gender (p < 0.001), education level (p = 0.001), monthly income (p < 0.001), and co-morbid medical illness (p = 0.045). The perception of the COVID-19 booster vaccine as a good idea to minimise worries about getting COVID-19 (OR = 2.28, CI 1.89–2.76), and perceptions that receiving the third (booster) dose reduces the risk of COVID-19 infection and associated complications (OR= 2.69, CI = 2.17–3.34), of the perceived benefit construct of HBM, predicted significantly higher definite intention to receive a booster dose. The concern with the safety of the vaccine (OR= 0.40, CI 0.34–0.47) under the perceived barriers construct of HBM predicted as significantly higher no definite intention to receive a booster dose. Conclusions: The results of the present study can guide policy makers in their efforts to promote booster doses of COVID-19 vaccination among the healthcare workers in Saudi Arabia
Primary hepatic neuroendocrine tumour requiring live donor liver transplantation: case report and concise review
No full textPrimary hepatic neuroendocrine tumours are rare tumours effecting relatively young patients. As metastatic neuroendocrine tumours to the liver are much more common, extensive investigations are crucial to exclude a primary tumour elsewhere. We report a case of a 27 year old woman who presented with fatigue, increased abdominal girth and feeling of early satiety and bloating. Extensive work up failed to show tumour at another primary site. Hepatic artery embolization showed no effect, so the patient underwent total hepatectomy and live-donor liver transplant. Grossly the tumour measured 27 cm. Microscopic examination showed bland, monomorphic cells growing in tubuloglandular and trabecular growth patterns. Cells were positive for neuroendocrine (synaptophysin, chromogranin, CD56) and epithelial markers (MOC31, CK7, CK19). Cytoplasmic dense neurosecretory vesicles were seen on ultrastructural examination. Based on the Ki-67 rate, mitotic count, lack of marked nuclear atypia and absence of necrosis, a diagnosis of primary neuroendocrine grade 2 was conferred
Enteral Nutrition Prescription in Children and Adults with Inflammatory Bowel Diseases: Gaps in Current Gastroenterology Practice in Saudi Arabia
No full textBackground: Evidence for the effectiveness of enteral nutrition (EN) for the management of patients with inflammatory bowel disease (IBD) is well-established. However, there is considerable global variation in EN practices. This study aimed to characterize the practices and perceptions of gastroenterologists regarding the use of EN in patients with IBD in one of the largest countries in the Gulf region. Methods: A cross-sectional study was conducted on pediatric and adult gastroenterologists working in Saudi Arabia who are involved in IBD management. A self-administered web-based survey was distributed via social media platforms and mailing lists of national gastroenterology societies. Results: A total of 80 gastroenterologists completed the survey. However, only 55 reported that they were currently practicing EN in any form. EN was mostly indicated by gastroenterologists who “sometimes” recommend EN for: the prevention and correction of undernutrition (50.9%), preoperative optimization (50.9%), and the induction of remission in patients with active and long-standing CD (36.4%), at initial diagnosis (34.5%), during the management of complications (61.8%), and after failing to respond to pharmacological therapy (58.2%). Exclusive enteral nutrition (EEN) is regularly recommended by 14.5% of gastroenterologists. The prescription of EEN was significantly associated with the pediatric profession (p < 0.01), IBD specialty (p < 0.05), level of nutrition education during training (p < 0.01), and previous training in a unit with regular EN use (p < 0.01). The most reported barriers to using EN were patients’ lack of acceptance (73.8%) and poor adherence (65%). A lack of dietitian support and a lack of standardized protocols were also reported as barriers by many physicians. Pediatric gastroenterologists were more likely to use at least one assessment method to evaluate EN success. Conclusion: EN practices differ between gastroenterologists working in Saudi Arabia. Future EN protocols should be optimized to support both children and adults with IBD. Gastroenterology training programs should offer nutrition support-focused training to help physicians better utilize EN
Invasive Mucormycosis in a Patient With Liver Cirrhosis: Case Report and Review of the Literature
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Use of COVID-19 vaccines in patients with liver disease and post-liver transplantation: Position statement of the Saudi association for the study of liver diseases and transplantation
No full textPatients with chronic liver disease (CLD) and liver transplant recipients are at increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19). Although several studies demonstrated the safety and efficacy of COVID-19 vaccines in the general population, data in CLD patients and liver transplant recipients are lacking. Two COVID-19 vaccines were approved by the Saudi Food and Drug Authority and rolled out to several million recipients in Saudi Arabia. These vaccines are mRNA-based vaccine BNT162b2 from Pfizer/BioNTech and adenovirus-based AZD1222 from Oxford/AstraZeneca from three manufacturing sites (EU Nodes, Serum Institute of India, and South Korea Bio). The Saudi Association for the Study of Liver diseases and Transplantation (SASLT) has reviewed the available evidence and issued interim recommendations for COVID-19 vaccination in CLD and liver transplant recipients. Since there is no evidence contradicting the safety and immunogenicity of the currently approved COVID-19 vaccines in patients with CLD and hepatobiliary cancer and liver transplant recipients, the SASLT recommends vaccination in those patient populations. CLD and hepatobiliary cancer patients and liver transplant recipients should be prioritized depending on the risk factors for severe COVID-19. In transplant recipients, the optimal timing of vaccination remains unknown; however, immunization is recommended after the initial immunosuppression phase. Patients with CLD and liver transplant candidates or recipients should be closely monitored after COVID-19 vaccination. These patient populations should be included in future clinical trials to provide further evidence on the efficacy and safety of COVID-19 vaccines
Nonalcoholic fatty liver disease burden – Saudi Arabia and United Arab Emirates, 2017–2030
No full textBackground/Aim: Due to epidemic levels of obesity and type 2 diabetes mellitus (DM), nonalcoholic fatty liver disease (NAFLD) and resulting nonalcoholic steatohepatitis (NASH) will be driving factors in liver disease burden in the coming years in Saudi Arabia and United Arab Emirates (UAE).
Materials and Methods: Models were used to estimate NAFLD and NASH disease progression, primarily based on changes in adult prevalence rates of adult obesity and DM. The published estimates and expert interviews were used to build and validate the model projections.
Results: In both countries, the prevalence of NAFLD increased through 2030 parallel to projected increases in the prevalence of obesity and DM. By 2030, there were an estimated 12,534,000 NAFLD cases in Saudi Arabia and 372,000 cases in UAE. Increases in NASH cases were relatively greater than the NAFLD cases due to aging of the population and disease progression. Likewise, prevalent cases of compensated cirrhosis and advanced liver disease are projected to at least double by 2030, while annual incident liver deaths increase in both countries to 4800 deaths in Saudi Arabia and 140 deaths in UAE.
Conclusions: Continued high rates of adult obesity and DM, in combination with aging populations, suggest that advanced liver disease and mortality attributable to NAFLD/NASH will increase across both countries. Reducing the growth of the NAFLD population, along with potential therapeutic options, will be needed to reduce liver disease burden
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