Background:The rate of preexisting diabetes mellitus (DM) in Saudi Arabia is one of the highest in the world. The role of preconception care (PCC) is well-established as a means of improving pregnancy outcomes in DM.Objectives:To assess the rate of preconception counseling, the level of PCC knowledge, and the rate of unplanned pregnancies in Saudi women with DM.Materials and Methods:A cross-sectional study was conducted among 355 Saudi women aged 18–49 years with self-reported DM. The study questionnaire contained variables about the provision of preconception counseling, knowledge of PCC facts, and the number of unplanned pregnancies after developing DM. The level of PCC knowledge was evaluated using a modified Likert scale. Statistical Package for Social Sciences 20 was used for statistical analysis. Descriptive statistics, mean and standard deviation, and percentages were calculated; t-test was used for statistical significance.Results:About one-third of the participants had received preconception counseling after being diagnosed with DM. Counseling on PCC for older and married participants was significantly less. Of the 355 participants, 42.8% had little or no PCC knowledge. All pregnancies that occurred after developing DM were unplanned.Conclusions:The rate of preconception counseling, the level of PCC knowledge in the studied Saudi women with DM is suboptimal, and none of the pregnancies that occurred after developing DM was planned. The study highlights the need for PCC programs that target all Saudi women of child-bearing age with DM, and their families starting at the age of puberty and at diagnosis of type 2DM, to optimize women's health and improve pregnancy outcomes.

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BackgroundSudomotor dysfunction is manifested clinically as abnormal sweating leading to dryness of feet skin and increased risk of foot ulceration. The aim of this study was to test the performance of foot electrochemical skin conductance (ESC) to detect diabetic peripheral neuropathy and the risk of foot ulceration against traditional methods in Saudi patients with diabetes mellitus.MethodsThis cross-sectional study was conducted on 296 Saudi patients with diabetes mellitus. Painful neuropathic symptoms were evaluated using the neuropathy symptom score (NSS). The risk of foot ulceration and diabetic peripheral neuropathy were determined using the neuropathy disability score (NDS). Vibration perception threshold (VPT) was assessed using neurothesiometer. Neurophysiological assessment of the right and left sural, peroneal and tibial nerves was performed in 222 participants. Diabetic peripheral neuropathy was defined according to the definition of the American Academy of Neurology. ESC was measured with Sudoscan.ResultsFeet-ESC decreased as the scores of sensory and motor function tests increased. Feet-ESC decreased as the NSS, NDS and severity of diabetic peripheral neuropathy increased. Sensitivity of feet-ESC < 50μS to detect diabetic peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 90.1, 61 and 63.8 % respectively and specificity 77, 85 and 81.9 % respectively. Sensitivity of feet-ESC < 70μS to detect diabetic peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 100, 80.6 and 80.9 % respectively. Sensitivity and specificity of feet-ESC < 70μS to detect confirmed-diabetic peripheral neuropathy were 67.5 and 58.9 % respectively.ConclusionSudoscan a simple and objective tool can be used to detect diabetic peripheral neuropathy and the risk of foot ulceration among patients with diabetes mellitus. Prospective studies to confirm our results are warranted.

Ninety-three rectal swabs of lambs and young goats from two extensively and two intensively managed herds in Jordan were taken and examined for Shiga toxin-producing Escherichia coli (STEC). The bacteriological examination included the preenrichment of rectal swabs in EC broth with novobiocin, and a subsequent parallel isolation on enterohemolysin agar and immunomagnetic separation with cultivation on CT-SMAC. The STEC O157:H7 strains were demonstrated in 8 of 32 diarrheic lambs 1-to 3-weeks old in one sheep herd with intensive milk production. In the remaining three herds, serogroups O128, O78, O15 and serotype O128:K85 of STEC strains were the most frequent findings. The presence of stx2, ehlyA and eaeA genes in all STEC O157:H7 isolates was confirmed by PCR. In two untypable STEC isolates, stx2 and ehlyA genes were detected. In other STEC non-O157 isolates, only stx1 a ehlyA genes were found. All STEC O157:H7 isolates were resistant against sulphonamides and chloramphenicol, five were also resistant against ampicillin and streptomycin, one against co-trimoxazole. One isolate was resistant against ampicillin, ampicillin-sulbactam, cephalosporins (cefazolin, cefuroxime), monobactams (aztreonam), sulphonamides, co-trimoxazole, aminoglycosides, tetracycline and chloramphenicol. Compared the resistant STEC O157:H7 isolates, the multiresistant isolate had a different RAPD pattern. Of 36 STEC non-O157 isolates, one isolate was resistant against sulphonamides and co-trimoxazole, and another one against ampicillin, streptomycin, sulphonamides and co-trimoxazole. STEC isolates resistant against antimicrobial agents were demonstrated only in herds with intensive management.