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Prevalence of childhood obesity among children and adolescents in Saudi Arabia : a systematic review

Mon, 01 Jan 2024 00:00:00 GMT

Title: Prevalence of childhood obesity among children and adolescents in Saudi Arabia : a systematic review Authors: Adam, Tasneem R.; Hamed, Ahmed M.; Mohammed, Heba Saad M.; Elsayed Elshareef, Tarteel Elryahi; Mushaeb, Hanan; Al Harbi, Awad Nafel A.; Bawarith, Boran M.; Almalki, Ahmed Abdullah Almaki; Alzaheb, Nawal; Alqarni, Abdulaziz Hassan; Abdelbaky, Mona Abstract: Childhood obesity is a growing public health concern worldwide, with significant implications for long-term health outcomes. Thus, the aim of this study is to highlight the prevalence and trend of obesity among children and adolescents in Saudi Arabia over the last 24 years. This systematic review included participants aged 2 to 19 years without systemic disease, reporting the prevalence of obesity using the Centers for Disease Control and Prevention (CDC) classification and BMI calculation, from studies in English or Arabic published between January 2000 and April 2024. We conducted a comprehensive search across multiple databases including ProQuest, Google Scholar, ISI Web of Science, Embase via Ovid, and MEDLINE via Ovid, and reviewed references of included studies. Data were extracted and quality assessed independently by two authors, with any disagreements resolved through discussion with a third reviewer, using the Newcastle-Ottawa Scale modified for this study. This systematic review included 21 studies from Saudi Arabia, published between 2006 and 2023, with participants aged 2 to 19 years. The studies involved a total of 63,512 subjects. Among children, the prevalence of overweight ranged from 5% to 29%, while obesity ranged from 3.8% to 49.7%, classified using CDC criteria. Quality assessment rated 10 studies as Very Good, 10 as Good, and one as Unsatisfactory. The systematic review of childhood obesity prevalence in Saudi Arabia over the past 24 years highlights alarming trends and significant public health implications. Our analysis emphasizes an increase in obesity rates among children and adolescents, revealing a complex link of socioeconomic, cultural, and lifestyle factors contributing to this epidemic.

The safety and efficacy of hypertonic saline in achieving primary fascial closure following damage control laparotomy: a systematic review and meta-analysis

Mon, 01 Jan 2024 00:00:00 GMT

Title: The safety and efficacy of hypertonic saline in achieving primary fascial closure following damage control laparotomy: a systematic review and meta-analysis Authors: Muscat, Neil; Shah, Shaneel; Zammit, Neill Abstract: Effective fluid management is critical in patients undergoing damage control laparotomy (DCL) for trauma and sepsis. Hypertonic saline (HTS) has been proposed as an alternative to isotonic fluids to enhance primary fascial closure rates and optimize fluid balance. This systematic review and meta-analysis aims to evaluate the efficacy and safety of HTS compared to isotonic fluids in patients undergoing DCL. A comprehensive literature search was conducted across multiple databases up to the 14 th of June 2024, identifying studies that compared HTS to isotonic fluids in adult patients undergoing DCL for trauma or sepsis. Eligible studies included randomized controlled trials and observational studies reporting outcomes such as early primary fascial closure (EPFC) rates, time to fascial closure, fluid requirements, electrolyte imbalances, renal function, and mortality. Data extraction and quality assessment were performed independently by two reviewers, and pooled analyses were conducted using fixed-effect models where appropriate. Four studies encompassing 375 patients met the inclusion criteria, with 100 patients receiving HTS and 275 receiving isotonic fluids. HTS administration was associated with a significantly higher EPFC rate compared to isotonic fluids (odds ratio (OR): 0.314; 95% confidence interval (CI): 0.142-0.696; p=0.004). The mean time to fascial closure was also significantly reduced in the HTS group by approximately eight hours (mean difference (MD): 8.007 hours; 95% CI: 5.558-10.596; p<0.001). Patients receiving HTS required significantly less total fluid over 48 hours (MD: 1.055 liters; 95% CI: 0.713-1.398; p<0.001). While HTS use led to higher peak sodium levels (MD: -4.318 mEq/L; 95% CI: -4.702 to -3.934; p<0.001), there were no significant differences in peak creatinine levels, need for inpatient renal replacement therapy, or 28-day mortality between the groups. HTS appears to be effective in improving EPFC rates and reducing both time to closure and overall fluid requirements in patients undergoing DCL for trauma and sepsis. Although associated with higher serum sodium levels, HTS did not increase the risk of renal dysfunction or mortality. These findings suggest that HTS is a safe and efficacious alternative to isotonic fluids in the management of critically ill patients requiring DCL. Further large-scale, randomized controlled trials are warranted to confirm these results and inform clinical guidelines.

‘I took a gamble and I lost’ : unwarranted patient regrets about choice of treatment of uveal melanoma

Sat, 01 Jan 2005 00:00:00 GMT

Title: ‘I took a gamble and I lost’ : unwarranted patient regrets about choice of treatment of uveal melanoma Authors: Carbonaro, Francis; Damato, Bertil Abstract: We report a patient with uveal melanoma who mistakenly blamed himself for developing metastatic disease because he had chosen to undergo brachytherapy for his primary tumour instead of enucleation. Our impression is that this important cause of psychological morbidity has not received sufficient attention in the published literature. [excerpt]

The heritability of optic disc parameters : a classic twin study

Tue, 01 Jan 2008 00:00:00 GMT

Title: The heritability of optic disc parameters : a classic twin study Authors: Healey, Paul; Carbonaro, Francis; Taylor, Bronwen; Spector, Tim D.; Mitchell, Paul; Hammond, Christopher J. Abstract: Purpose: To examine the roles of genetic and environmental factors in the optic disc in a classic twin study. Methods: Five hundred six pairs of twins were recruited to participate from the Twins U.K. Adult Twin Registry at St. Thomas' Hospital, London. Photographs of the optic disc were obtained, and the covariance of optic disc, cup, and rim areas within monozygotic (MZ) and dizygotic (DZ) pairs was compared, and genetic modeling techniques were used to determine the relative contributions of genes and environment to the variation in optic disc parameters in this population. Results: Mean optic disc, cup, and rim areas were 2.62 (range, 1.06-4.87), 0.98 (range, 0.25-4.72), and 1.64 (range, 1.43-6.16) mm(2), respectively. The MZ correlations were higher than those of DZ pairs for disc and cup areas (correlation coefficient, 0.73/0.81 and 0.41/0.50 for MZ and DZ twins, respectively). The correlation for optic rim was also higher in MZ (0.62) than in DZ (0.43) pairs. Modeling suggested heritability for the optic disc area of 0.73 and for the optic cup area of 0.66. The heritability of the rim area was lower at 0.34, with a significant shared environmental component of 0.27 and individual factors (including measurement error) explaining 39% of the variance of the rim area. Conclusions: This study has demonstrated that genetic effects were important in the determination of optic disc parameters in this twin population, with genetic factors explaining 73%, 66%, and 34% of the variation of optic disc, cup, and rim areas, respectively. Environmental factors also seemed to be important.