Background and objectives: Subclinical hypothyroidism is an asymptomatic condition with normal thyroxin and raised thyroid stimulating hormone (TSH) level. The objective of the study was to determine the prevalence of subclinical hypothyroidism in primary health care (PHC) settings in Riyadh and explore the relationship of TSH level with age, gender, family history, body mass index, and co-morbid conditions. Subjects and methods: A cross-sectional study of adult visitors to nine satellites PHC clinics in military housing in Riyadh was carried out. TSH concentration and free T4 levels were measured. Data were collected by nurses and physicians during routine clinical practice in primary care. Descriptive analysis was performed on all variables in study, and relationships were explored using chi-square, t-test, analysis of variance, and linear regression. Results: A total of 340 out of 394 participants in the study gave blood samples. Subclinical hyperthyroidism was identified in 2.1% (p = .001) and subclinical hypothyroidism in 10.3% (p = .001) of the PHC visitors. TSH levels were found to be significantly higher (p = .047) in elderly population of ≥60 years and those with family history of thyroid disease. Non-significant upward trends were noted in TSH levels with hyperlipidemia and increasing blood pressure. No overt hyperthyroidism or hypothyroidism was found in our study sample. Conclusion: Subclinical hypothyroidism has a prevalence of 10% of adults visiting PHC’s. TSH levels are higher in the elderly, which warrants screening of those aged 60 years and above.

Aims To identify and evaluate clinical pharmacology (CP) online curricular (e‐Learning) resources that are internationally available for medical students. Methods Literature searches of Medline, EMBASE and ERIC databases and an online survey of faculty members of international English language medical schools, were used to identify CP e‐Learning resources. Resources that were accessible online in English and aimed to improve the quality of prescribing specific medications were then evaluated using a summary percentage score for comprehensiveness, usability and quality, and for content suitability. Results Our literature searches and survey of 252 faculty (40.7% response rate) in 219 medical schools identified 22 and 59 resources respectively. After screening and removing duplicates, 8 eligible resources remained for evaluation. Mean total score was 53% (standard deviation = 13). The Australian National Prescribing Curriculum, ranked highest with a score of 77%, based primarily on very good ratings for usability, quality and suitable content. Conclusion Using a novel method and evaluation metric to identify, classify, and rate English language CP e‐Learning resources, the National Prescribing Curriculum was the highest ranked open access resource. Future work is required to implement and evaluate its effectiveness on prescribing competence.

Background: COVID-19 has rapidly progressed to a pandemic causing a severe burden on healthcare systems worldwide. It has proven to be a serious threat to certain populations such as elderly and chronically ill people. In this study we aim to determine risk factors contributing and affecting COVID-19 severity and deterioration during the course of illness. Methods: This is a retrospective cohort study for all hospitalized patients who were diagnosed with COVID-19 from March to July 2020.Results: A total of 639 patients were included in this study. The majority were Saudi patients (87.3%). 465 (76%) were symptomatic with abnormal x-ray imaging diagnosis (56.2%). Predetermined clinical risk factors were obesity (46.3%), hypertension (42.3%), diabetes mellitus (41.8%), dyslipidemia (39%), Ischemic heart disease (13.2%), chronic lung disease (11%), chronic kidney disease (10.3%), cancer (7.9%), congestive heart failure (6.1%), and immunocompromised patients (4.6%). It was also found that chest x-ray finding upon diagnosis, and presentation of symptoms had a significant impact on the pattern of deterioration.Conclusion: This study found that elderly and chronically ill patients are at higher risk for more severe COVID-19 infection and risk of deterioration, hospitalization, intensive care unit admission, and probably death when compared to younger and healthier patients.

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