To identify the occurrence of upper respiratory tract infections (URTI), diarrheal diseases and trauma during the Hajj season, and the practice of some preventive measures by pilgrims. Methods: A cohort study during November and December 2009 among hajjis registered while visiting Primary Health Care Centers of Riyadh, Kingdom of Saudi Arabia to get mandatory meningococcal meningitis vaccination. On return from hajj, hajjis were contacted on telephone to collect information on occurrence of URTI and diarrhea along with other associated activities in Hajj. Results: Out of 1507 hajjis, 54.7% developed symptoms; 97% reported upper respiratory tract symptoms, and 9.3% reported diarrheal symptoms. Those <40 years of age were more likely to develop an URTI. The incidence of diarrheal diseases or trauma was not statistically associated with age. No statistical difference for educational level was found for URTI or trauma, but there was a statistically significant difference for diarrheal diseases. There was no statistical difference for nationality in relation to diarrheal diseases and trauma, but there was a statistically significant difference for URTI. There was a statistically significant difference of URTI between those pilgrims who used the face mask most of the time and those who used it sometimes. Conclusion: Upper respiratory tract infections is a common health problem among studied domestic hajjis. Generally, there is room for improvement in the adoption of preventive measures by hajjis; and there is still limited information on the use of facemasks in spite of the fact that using it significantly decreases the risk for URTI.

Objectives:To investigate the epidemiology of pediatric hand fractures and to provide recommendations regarding prevention.Methods:Medical records and x-rays were retrospectively reviewed for age at the time of injury, gender, fracture pattern, place where the injury occurred, and mechanism of injury. The study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2005 and December 2011.Results:Of 361 cases reviewed, there were 291 (80.6%) male and 70 (19.4%) female patients. Most (46.2%) were in the age group of 13-18 years. For age group 1-4 years, the most common place of occurrence was at home (81.3%) and for the group 13-18 years, outdoors was the place of occurrence (64.7%). Females were mostly injured at home while males had similar distribution of indoor and outdoor injuries. The most common causes of fractures were: door slams in the 1-8 years age group; falls at home, in the 9-12 years age group; and both falls at home and sports in the oldest age group (13-18 years). The little finger ray are the most frequently injured part of the hand followed by the middle finger.Conclusion:Our series showed that most hand fractures in children occurred at home, which requires reevaluation of home settings. Implementation of safety measures during sports activities are relevant in the oldest age group.

a b s t r a c tBackground: MERS-CoV emerged as a zoonotic disease in Saudi Arabia with 1437 cases as of July 2016. This study aimed at describing the epidemiology of MERS-CoV infection, clinical aspects of the disease and the determinants of survival. Methods: The medical records of Prince Mohamed Bin Abdulaziz Hospital were reviewed between April 2014 and December 2015 to identify admission and discharge with MERS-CoV. Patient's characteristics, epidemiologic and clinical data and laboratory results were extracted and described. Logistic regression analyses were used to model the determinants of the survival of these patients. Significance of the results were judged at the 5% level. Results: 249 confirmed cases were admitted mostly in August (20.48%) and September (14.86%) of the year 2015. A third (39.36%) reported contact with an index case, developed the disease after 6.2 days and continued to shed the virus for 13.17 days on average. The case fatality rate was 20.08%. Independent predictors of being discharged alive among confirmed cases were younger age (OR A = 0.953), breathing ambient air (OR A = 8.981), not being transferred to the ICU (OR A = 24.240) and not receiving renal replacement therapy (OR A = 8.342). These variables explain 63.9% of the variability of patients' status at discharge. Conclusion: MERS-CoV spread from human-to-human as community acquired and nosocomial infection. The study identified high risk patients in need for special medical attention in order to improve patients' outcome.

OBJECTIVES:The objectives of this study were to determine the rate of mobile phones use while driving by the students of King Saud University, Riyadh, Saudi Arabia, their perception of the risks, and contribution to collisions.MATERIALS AND METHODS:A cross-sectional study was conducted in May 2014 targeting 986 male students of King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to obtain data on possessing a driving license, years of driving experience, driving hours, and collision or near misses in the 6 months preceding the study. Eight statements were used to assess the behavior and perceptions related to the use of mobile phones while driving. Data were analyzed using the Chi-square statistic, odds ratio, and the 95% confidence interval.RESULTS:Almost half of the participants (45.3%) had driving experience of 4–6 years and 18.3% of them did not possess a driving license. Collision in the preceding 6 months was reported by 44.6% of participants, and 37.9% of them attributed these collisions to mobile phones. Variable proportions reported that they always texted (53.3%) or talked on a handheld (66.2%) or hands-free (26.1%) phones while driving. A higher proportion conceded that there were hazards in texting (77.0%) and speaking on handheld mobile phones (83.9%) rather than hands-free (35.9%) while driving. The risk increased significantly from 2.052 among participants who reported that they drove daily for 1–2 h to 3.165 of those who reported that they drove for more than 6 h. No significant risk was observed in relation to participants' perceptions, age, driving experience, and possession of a driving license.CONCLUSIONS:There was a risk of collision with the use of handheld and hands-free mobile phones. As hands-free mobile phones are no safer, national legislation should consider restricting their use by drivers and implementing legislations to reinforce safety on the roads. An objective assessment of the contribution of mobile phones to road traffic injuries is recommended.

Background: Type 2 Diabetes (T2D) in children and adolescents has become an important public health concern due to the increase in childhood obesity worldwide. The urgency to address T2D is evident as children and adolescents are at a higher risk of complications due to prolonged disease duration. We aimed to estimate the incidence rate (IR) of T2D in Kuwaiti children and adolescents aged 14 years and younger between 2011 and 2013 and to describe their clinical characteristics at the time of diagnosis.Material and Methods: All newly diagnosed patients were registered through the Childhood-Onset Diabetes electronic Registry implemented in Kuwait. Cases who met the 2018 ISPAD guidelines for diagnosis of T2D were included.Results: A total of 32 patients were included, equally distributed gender-wise, with a mean age 12.2 years (±1.7 SD), lower for females than males (11.5 vs. 12.2, p < 0.025). Data ascertainment was 94.1% (95%CI; 91.6–96.6%). Overall IR was 2.56 (95% CI; 1.78-3.56) per 100,000 Kuwaiti children and adolescents per year. Most of the patients (n = 30; 93.8%) presented with T2D between the ages 10–14 years, with age-specific IR of 8.0 (95%CI; 5.5–11.3). No statistically significant difference between males and females with regards to BMI z scores or HbA1C at diagnosis.Conclusion: The true incidence of T2D in Kuwaiti children and adolescents is expected to be considerably higher as we have reported only symptomatic cases. Future research should focus on screening children and adolescents at risk to enable accurate estimates. More efforts are needed to better understand the clinical course of T2D early in life to improve management, prevent complications and improve quality of life.

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Background: MERS-CoV emerged as a zoonotic disease in Saudi Arabia with 1437 cases as of July 2016.Objective: This study aimed at describing the epidemiology of MERS-CoV infection, clinical aspects of the disease and the determinants of survival.Methods: Medical records were reviewed between April 2014 and December 2015 to identify admission and discharge with MERS-CoV. Patients' characteristics, epidemiologic and clinical data and laboratory results were extracted and described. Logistic regression analyses were used to model the determinants of the survival of these patients. Significance of the results were judged at the 5% level.Results: 249 laboratory confirmed cases were admitted mostly in August (20.48%) and September (14.86%) of the year 2015. These cases were non-healthcare workers (85.14%), Saudi (58.63%), males (57.03%) with a mean age of 46.71±17.92 years. A third (39.36%) reported contact with suspected or confirmed cases, developed the disease after 6.2 days and continued to shed the virus for 13.17 days on average. The case fatality rate was 20.08%. The likelihood of being discharged alive was significantly higher among non-Saudi (OR=2.35), healthcare workers (OR=10.822), with no co-morbidities (OR=6.57).Conclusions: MERS-CoV mortality is higher among older patients with severe disease. Further studies are recommended for a better estimation of the incubation period and the period of communicability and the role of animal reservoir.

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