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Objectives:To assess the primary healthcare physicians’ adherence to referral guidelines for acute low back pain and if there is any association with experience level.Methods:A cross-sectional study held in Tertiary care hospital, Riyadh, Kingdom of Saudi Arabia. Questionnaires were distributed in-person between October 2017 and January 2018 among 100 primary healthcare physicians, with a 79% response rate.Results:The distribution between male to female was 43%-57%. Twenty-five percent of physicians encounter 1-5 patients weekly, while 28% encounter more than 15 patients. The physicians included had a higher than expected adherence to referral guidelines with percentages ranging between 63-94% referral rates for back pain related red flags. A trend was noted where there was an increase in referral decisions with increased experience when encountering red flags. More experienced physicians were more likely to refer when encountering; pain worse after prolonged sitting, limited mobility, and pain worse while coughing or sneezing (p<0.05).Conclusion:Primary healthcare physicians working in one health system in Riyadh had a higher than expected adherence to referral guidelines for back pain related red flags.

Background Eye injuries in children due to chemicals constitute a medical emergency since they result in severe ocular damage. Objective To determine the factors and management outcomes of chemical burns in the eyes of Saudi children. The study was performed at a tertiary eye center in the Kingdom of Saudi Arabia. Methods Children aged 16 years and under who had ocular chemical burns from 2009 to 2021 were enrolled in a single-armed cohort study. Data collection was done on patient demographics, injury type, and previous treatment. A modified Roper-Hall classification was used to grade the ocular injuries. The research study revealed the outcome to be best-corrected visual acuity (BCVA), one year after presentation and management. Results This study included 185 eyes from 147 children with chemical burns. The main profile of this study comprised the following categories: male (72.1%), grade 4 injury (27.6%), injury by acid (57.1%), burns at home (66%), and first aid was given to (35.4%) of the children. One year after treatment, there were 58 (31.4%) eyes with BCVA from 20/20 to 20/60, 31 cases (16.8%) with BCVA from 20/60 to 20/200, and 86 (46.5%) cases with severe visual impairment (SVI). Treatments included the release of symblepharon in 34 (18.4%) eyes and amniotic membrane transplantation (AMT) in 27 (14.6%) eyes. Poor visual outcomes were correlated with chemical burn severity (RR = 1.45, P =0.04). First aid administration ( P = 0.86) and type of chemical (acid vs non-acid) ( P = 0.83) did not differ significantly in association with SVI at the one-year follow-up. Conclusion Visual outcomes of chemical burns in children were not promising even after one year of treatment. Public health initiatives are critical to prevent chemical burns in mitigating the poor visual prognosis.

Background: Diabetes is a very common chronic endocrinological disease. A total of 8.8% of the adult population worldwide was diabetics. Diabetic retinopathy is a silent disease, early detection and intervention is essential for its management and prognosis. Aim: To assess the diabetic patients’ awareness of diabetic retinopathy symptoms and complications. Methods: This is a cross-sectional community-based study which was conducted in Saudi Arabia using a survey from the period between June and September 2018 on all diabetic Saudi participants between 15 and 75 years of age. Results: This study involved 385 participants. The average age of the participants was 47.82 ± 14.49. The study only involved patients who were diagnosed with type 1 diabetes mellites (DM) or 2 DM. And 81% of the samples were diagnosed with type 2 DM. A total of 311 participants were aware of the DM effect on the eye. There was a significant difference between gender regarding the effect of DM on the retina in good control patients. On the subject of the source of participants’ knowledge of DM and its complication, there was a notable difference between groups. Conclusion: An acceptable level of knowledgewas noted among patients. However, some points of knowledge should be increased.

Background Rhinoplasty is a one of the most commonly performed facial surgery aiming at restoring facial aesthetics and improving quality of life. Utility outcome scores are modern, and emerging tools are used to evaluate the burden of a health state on individuals. The study aims to evaluate the impact of living with nasal deformity among real patients and healthy individuals using utility outcome scores. Methods A cross-sectional study was conducted at Otolaryngology and Plastic Surgery clinics in a tertiary center. Healthy individuals were recruited from public facilities. A case scenario was developed to reflect an imaginary patient (Nora) with a functional and aesthetic nasal deformity and distributed to participants. Three utility outcomes scores were used: visual analog scale (VAS), time trade-off (TTO), and standard gambling (SG). Results A total of 407 adult participants were included. Most participants were female (52%). Healthy individuals comprised 71%, and actual patients comprised 29%. Mean VAS score was 0.77 (ie, participants scored Nora's health state as 77%), TTO score was 0.87 (ie, participants were willing to sacrifice 4 years to have Nora's condition corrected), and SD score was 0.91 (ie, participants were willing to take a 9% risk of death to have Nora's condition corrected). Scores differed among actual patients and healthy individuals (P < 0.0001 for VAS and TTO, P = 0.02 for SG). Conclusion Living with a nasal deformity has a significant impact on quality of life. Both patients and healthy individuals are willing to trade a significant number of years to get the condition corrected.

This study aimed to understand the barriers that contribute to diagnostic and therapeutic delays in patients with advanced proliferative diabetic retinopathy (PDR). Patients and Methods: This cross-sectional study targeted patients with advanced PDR who never received any ocular intervention at King Khaled Eye Specialist Hospital in Saudi Arabia. An Arabic-language questionnaire was used to interview the participants over a period of 6 months. The questionnaire comprised sociodemographic questions followed by several sections to assess the causes of delay in diagnosis and management. Variables were analyzed descriptively and reported as numbers and percentages using SPSS 22. Results: A total of 338 patients were included in the study. Most patients were older than 50 years (60.4%), and decreased vision was the main complaint at presentation (81%). Vitreous hemorrhage was the most common diagnosis (46%). Patients' lack of knowledge about the importance of DR screening programs and problems with healthcare system screenings were the most frequent causes of delay in diabetic retinopathy (DR) diagnosis and management. Conclusion: DR is still a major cause of permanent blindness that is treatable with regular follow-up and timely management. Even though DR screening and treatment in Saudi Arabia have improved drastically over the last years, socioeconomic and health system factors remain barriers to the improvement of outcomes of DR.