Objectives: The aims of this study were:1) to assess the awareness of diabetes and its systemic and oral complications among adults with diabetes in Saudi Arabia, 2) to evaluate their behaviors toward maintaining proper oral hygiene and factors associated with adequate oral health knowledge, and 3) to identify what recommendations and improvements are needed in diabetic clinics in KSA. Methods: A validated questionnaire of six parts was distributed online to include all diabetes patients in Saudi Arabia. After applying the criteria, 400 diabetes responses were included. The data was analyzed using SPSS statistical software version 24. Descriptive statistics, univariate and multivariate analysis were used to report the results. Results: Participants’ responses showed that older aged patients with type 2 diabetes and the longer duration of diabetes had higher levels of awareness regarding oral health. However, their knowledge about being at high risk for oral diseases was low compared to their awareness regarding systemic complications. Relatively lower percentages of the participants (55.9%) were aware that diabetes can make teeth and gums worse and that gum disease makes it harder to control blood sugar (24.8%). Almost two thirds of the individuals believed that they should have regular visits to dental clinics, but many barriers were identified for their irregularity or no visits. With regards to the participants’ source of information, 52% learned from health care providers, and 50% from the internet. Conclusions: Our study revealed comparatively better results of awareness than previous studies reported in Saudi Arabia, however not to the desired standard. Therefore, both dentists and all healthcare providers should be encouraged to take the responsibility to promote proper oral hygiene practices among their diabetic patients in order to reduce the risk of having periodontal diseases. Further research is required to identify obstacles preventing those patients from having regular dentist visits. Key words: Diabetes, oral health, periodontal disease, awareness, Saudi Arabia
Background: Catheter-related infection (CRI) is a serious complication among hemodialysis patients, associated with significant morbidity and mortality. This study investigated the incidence, predictors, presentation, and complications of CRI. Methods: This single-center, retrospective, observational study enrolled all eligible chronic hemodialysis patients with tunneled central venous catheters inserted between June 2016 and June 2019. Results: Over 3 years, 63 patients (59% men) with a total of 27,395 catheter days were included of these patients. The median age was 68 years (interquartile range [IQR]: 58,76), and median hemodialysis duration was 62 months (IQR: 16,101). A total of 30 episodes of clinical CRI occurred, resulting in an overall incidence rate of 1.1 per 1,000 catheter days. CRI was significantly associated with baseline anemia (adjusted hazard ratio [AHR]=3.29; 95% confidence interval [CI], 1.42–7.64; P=0.006) and the use of the femoral vein as opposed to internal jugular vein (AHR=3.23; 95% CI, 1.29–8.06; P=0.012). The incidence of catheter-related bacteremia was 0.91 per 1,000 catheter days, and the most commonly isolated organism was Staphylococcus aureus (26%). Recurrent infection developed in 9/27 (33.3%) episodes and was lower among catheter salvage with antibiotic lock and catheter removal compared to catheter salvage alone. Conclusions: Anemia and the use of the femoral instead of the internal jugular vein are associated with a higher incidence of CRI. Catheter-related blood stream infection was associated with increased mortality, recurrence rate, and resource utilization. Along with systemic antibiotics, catheter management such as catheter removal or antibiotic lock use may help reduce the recurrence rate.
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