<b><i>Objectives:</i></b> Social media (SM) are evolving and dynamic applications which can be used in health-care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. This review aims to analyze, summarize, and describe the current Saudi experience of SM use for health. <b><i>Methods:</i></b> A MEDLINE/PubMed electronic database search was performed in July 2020 utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The initial search has yielded a total of 263 articles, of which 25 met our inclusion criteria. <b><i>Results:</i></b> In Saudi Arabia, the literature reports a high interest in using SM for health-related purposes among the public, with a prevalence of &#x3e;51%. The Saudi population has been found to highly favor the use of WhatsApp and Twitter for gaining and exchanging knowledge. Multiple facilitators and barriers have been identified and further categorized based on the users’ population, such as general public, health-care practitioners, and patients with specific conditions. Overall, the common facilitator and barrier between all users’ population categories were found to be younger age and lack of time, respectively. <b><i>Conclusion:</i></b> SM use for health-care activities is increasing in Saudi Arabia. Thus, it is important for SM-based health education programs to target specific population and patients’ demographics with programs tailored to their particular interests and needs. This is particularly evident in the current achievements and future plans of the Saudi Ministry of Health.

OBJECTIVE: We evaluated glycemic control among T1DM pediatric patients attending the endocrinology pediatrics clinics at King Fahd Hospital of the University (KFHU) prior to and during COVID-19 restraining regulations. In addition, we assessed the trends and variations in the incidence of T1DM during 2017-2021, including the COVID-19 years by identifying newly diagnosed patients presenting to pediatrics emergency department (ED) in KFHU. METHODS: To estimate the effect of COVID-19 on the incidence of T1DM, we identified newly diagnosed cases of T1DM among pediatric patients attending the ED during the years 2017- 2021. The participants' data were collected through electronic medical records. Information collected included patient age, sex, and HbA1c readings. Three HbA1c readings of interest that were defined and collected are pre-COVID reading, in-COVID reading, and post-COVID reading. RESULTS: The difference of female participants' readings was statistically non-significant (Z= -0.416, p = 0.678), with a pre- and post-COVID median of 10.70 (Q1= 9.00, Q3= 12.15), and 10.50 (Q1= 8.80, Q3= 12.35), respectively. In contrast, the difference was statistically significant among male participants (Z= -2.334, p = 0.02), with a pre- and post-COVID median of 10.20 (Q1= 8.70, Q3= 11.80), and 10.65 (Q1= 9.00, Q3= 12.70), respectively. There was a statistically significant increase in HbA1c of persons > 11 years old (Z= -2.471, p= 0.013), with a pre- and post-COVID median of 10.40 (Q1= 9.00, Q3= 12.10), and 10.90 (Q1= 9.00, Q3= 12.60), respectively. Conversely, persons ≤ 11 years old showed no statistically significant change in HbA1c (Z= -.457, p= 0.648), with a pre- and post-COVID median of 10.45 (Q1= 8.70, Q3= 11.85), and 10.20 (Q1= 8.40, Q3= 12.075), respectively. Disregarding any influence of time, the effect of sex showed no statistically significant difference in HbA1c between males and females [F (1,125) = 0.008, p = 0.930]. Meanwhile, the age effect on HbA1c, regardless of time influence, was statistically significant [F (1,125) = 4.993, p = 0.027]. There was no statistically significant interaction between time and sex on HbA1c levels [F (1.74, 217) = 0.096, p = 0.883] and between age and time [F (3.92,289.57) = 1.693, p = 0.190]. CONCLUSIONS: The number of visits to healthcare facilities dropped significantly during the COVID-19 pandemic, but the rate of newly diagnosed T1DM increased. There was a variable effect on HbA1c levels of those patients, which suggests that each demographic group in the population might have been affected differently by the pandemic. Future research should determine factors associated with better glycemic control and measures to sustain these changes the pandemic might have created.

Child abuse is one of the medico-legal issues a physician may face during his/her clinical practice. It has devastating effects on both the child and family, especially psychological. If falsely identified as a child abuse case, it could result in detrimental consequences. Therefore, physicians must recognise and be able to rule out child abuse mimickers, which are often conditions that are mistakenly confused with true physical child abuse. Injuries like bruises and burns are common presentations and therefore it is important to consider cutaneous abuse mimics to avoid incorrect diagnosis of child abuse. This review article sheds light on the most common cutaneous conditions that can mimic physical child abuse, where patients present with patterns of various skin lesions that raise a suspicion of child abuse.

No abstract

OBJECTIVES: To epidemiologically assess the influence of COVID-19 pandemic on newly diagnosed type 1 diabetes mellitus presenting with diabetic ketoacidosis at the teaching hospital of the university, Eastern province, Saudi Arabia. METHODS: We enrolled newly diagnosed type 1 diabetes mellitus cases among pediatric patients attending the emergency department and outpatient clinics during 2019-2021. The participants' data were collected from electronic medical records which included patients' age at diagnosis, sex, nationality, height, weight, year of diagnosis, length of stay, presentation, random blood sugar, blood gas readings, electrolyte panel, and time of resolution of the diabetic ketoacidosis if present. RESULTS: 108 patients were included with an average age of 8.87 ± 4.21 years and 53.70% were females. The demographic characteristics of all diabetic pediatric patients prior to COVID-19 and during COVID-19 were studied and the difference was statistically insignificant. Furthermore, initial pH and HCO3 tests were found to be lower in the moderate to severe diabetic ketoacidosis group (7.17 and 11.2, respectively) compared to the mild group (7.27 and 15.50, respectively) and the differences were statically significant (P < 0.001). CONCLUSION: Patients newly diagnosed with type 1 diabetes mellitus during the COVID-19 pandemic tended to have a more severe presentation of diabetic ketoacidosis in terms of PH and HCO3.

Idiopathic CD4 Lymphopenia is a heterogeneous condition, recognized in the late 20th century, with a wide spectrum of presentations, requiring a high index of suspicion to avoid misdiagnosing the condition. This case highlights the diversity in its clinical presentations in the context of an autosomal dominant pattern of inheritance. We are reporting a case of a nine-year-old child, initially labelled by her primary treating hospital as primary ciliary dyskinesia after presenting with chronic cough, purulent nasal discharge, and recurrent chest infections. She was referred to our facility, a tertiary center, as her condition marginally improved. After the patient has undergone a comprehensive diagnostic workup, including a gene study, she was found to be carrying a mutation known to cause idiopathic CD4 lymphopenia. Extended work up of her family showed that two of her siblings have inherited an autosomal dominant mutation from their mother who had a milder form of the disease. This condition is an extremely rare condition in children, which can be easily mislabeled. Thus, healthcare providers should avoid labeling certain long-standing diseases unless the diagnosis has been established. We encourage leveraging the use of the latest revolutionary genetic testing techniques to confirm the diagnosis of such puzzling cases.

Castleman’s disease is a disorder of the lymph nodes that encompasses heterogeneous clinical conditions and can be classified into two main types - hyaline vascular and plasma cell. The affected age group ranges widely from two to 80 years old at the time of diagnosis, with a variable clinical presentation. The etiology of Castleman’s disease is not yet well-understood; however, a number of factors have been linked to its pathogenesis including certain cytokines, viral infections, autoimmunity, immunodeficiency, chronic inflammation, and Kaposi sarcoma. In this study, we present a case of a 52-year-old Saudi female with a history of pulmonary embolism and deep venous thrombosis, who was then found to have mild splenomegaly, mediastinal, bilateral hilar, supraclavicular, paraaortic, and right axillary lymphadenopathy on CT scan, to be later diagnosed as a multicentric Castleman’s disease (MCD). Moreover, the clinical picture, pathogenesis, clinical and histological variants, as well as the treatment options of MCD are discussed.