Though often considered a disease of children, otitis media can affect the elderly. The incidence of otitis media among elderly population is variable among countries, but generally low, with a value ranging from 0.25-9%. However, dangerous complications may occur. Otitis media is a complex spectrum of diseases that include acute otitis media, otitis media with effusion, suppurative otitis media, and mastoiditis. Otitis media in elderly doesn’t feature the classical presentation in children. Elderly patients experience otalgia with or without hearing loss or signs of inflammation. Infection may spread to either to adjacent structures leading to mastoiditis, petrositis, labyrinthitis, or facial nerve palsy, or intracranially leading to meningitis, subarachnoid abscess, subdural abscess, encephalitis, brain abscess, lateral or sigmoid venous sinus thrombosis, and otitis hydrocephalus. The mainstay strategies for prevention of otitis media are the adequate proper treatment of each infection, and tight control of modifiable risk factors such as tobacco smoking, immunosuppression, upper respiratory tract infection, allergy, and craniofacial abnormalities. Antimicrobial treatment should be continued for at least 10-14 years.

Background: Diabetic retinopathy (DR) is one of the preventable serious complications of diabetes mellitus and if not properly discovered and managed may lead to blindness. Objectives:To determine the prevalence of DR and its severity among type 2 diabetic patients.Patients and methods: Cross-sectional study was carried out among a consecutive sample of type 2 diabetic patients, who were followed up in Retina clinic WAZARAT primary healthcare (PHC), Prince Sultan Military Medical Center (PSMMC), Riyadh. A wellstructured data sheet form was used to collect data, included demographic factor and clinical parameters. Results:The study included 376 patients. Their age ranged between 31 and 84 years with an arithmetic mean of 58.03 years and standard deviation of (±) 10.06 years. Prevalence of DR among type 2 diabetic patients was 45.2%. The most frequently reported type was non-proliferative diabetic retinopathy (NPDR) (74.1%). Macular edema was observed among 43.5% of patients with DR and 19.7% of the total patients. Multivariate logistic regression analysis results revealed that with increase in patient`s age by one year, there was increase in the risk of developing DR by 8% (AOR = 1.08; 95% CI: 1.05-1.12), p < 0.001. Female patients were at almost double risk for developing DR compared to male patients (AOR = 1.92; 95% CI: 1.05-1.12), p < 0.001. Compared to patients whose HbA1c% ranged between 6.5 and 7.9% as a reference category, those with HbA1c% level ranged between 8 and 9.9% and ≥10% were at higher significant risk for developing DR (

Background: Falls injuries remain the major cause of hospitalization and disability among children and are the fifth leading cause of death among infants.Objective: To assess the knowledge, attitude and barriers of parents regarding falls prevention and management in children under 5 years of age. Material and Methods:A cross-sectional descriptive study was done in Prince Sultan Military Medical City (PSMMC) outpatient clinics and primary health care centers, Riyadh, Saudi Arabia among a convenience sample of parents of children aged 5 years or less.Data were collected through a validated self-administrated questionnaire contained 4 main parts: Socio demographic characteristics of parents, detailed description of the children`s falls, knowledge about child falls prevention and management (14 statements) and attitude of parents towards child falls prevention and management (5 statements). Results:The study included 360 out of 384 targeted parents with a response rate of 93.75%. Almost two-thirds (65%) of the respondents were mothers and 47.5% aged between 25 and 34 years. The total parental knowledge score was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 12 out of a possible maximum of 14 and its IQR was 12-14. Mothers were more knowledgeable about child falls prevention and management than fathers, p = 0.012. Parents aged between 25 and 34 years has the highest knowledge score, p < 0.001. Parents with Bachelor degree expressed the highest score, p = 0.011.Unemployed were more knowledgeable than employed parents, p = 0.004. Parents live in extended families had the highest score, p < 0.001. There was a statistically significant positive correlation between number of family members and total knowledge score (r "Spearman`s coefficient of correlation" = 0.106, p = 0.045). Parents who had history of receiving any training courses in first aid were more knowledgeable, p = 0.001. Overall, total parental attitude score towards fall prevention and management was abnormally distributed as shown by significant Shapiro-Wilk test, p < 0,001. Its median value was 9 out of a possible maximum of 10 and its IQR was 8-10. The highest attitude score towards child fall prevention and management was observed among parents with lowest educational level, p = 0.030. Students expressed higher score of attitude score, p = 0.002. Divorced parents expressed higher attitude score than widowed parents, p < 0.001. There was a statistically significant positive correlation between number of rooms and total attitude score (r = 0.148, p = 0.005). Parents who had history of receiving any training courses in first aid were more likely to have better attitude compared to their counterparts, p < 0.001. Conclusion:Parental knowledge of and attitude towards child fall prevention and management were good in general. However, lack of their training in first aid represented the main barrier affecting their knowledge and attitude.