Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18

Search results for: Abdulfattah W. Alamri

18 Successful Treatment of Multifocal XDR Tuberculosis Osteomyelitis

Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman


We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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17 Words of Peace in the Speeches of the Egyptian President, Abdulfattah El-Sisi: A Corpus-Based Study

Authors: Mohamed S. Negm, Waleed S. Mandour


The present study aims primarily at investigating words of peace (lexemes of peace) in the formal speeches of the Egyptian president Abdulfattah El-Sisi in a two-year span of time, from 2018 to 2019. This paper attempts to shed light not only on the contextual use of the antonyms, war and peace, but also it underpins quantitative analysis through the current methods of corpus linguistics. As such, the researchers have deployed a corpus-based approach in collecting, encoding, and processing 30 presidential speeches over the stated period (23,411 words and 25,541 tokens in total). Further, semantic fields and collocational networkzs are identified and compared statistically. Results have shown a significant propensity of adopting peace, including its relevant collocation network, textually and therefore, ideationally, at the expense of war concept which in most cases surfaces euphemistically through the noun conflict. The president has not justified the action of war with an honorable cause or a valid reason. Such results, so far, have indicated a positive sociopolitical mindset the Egyptian president possesses and moreover, reveal national and international fair dealing on arising issues.

Keywords: CADS, collocation network, corpus linguistics, critical discourse analysis

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16 The Role of Graphene Oxide on Titanium Dioxide Performance for Photovoltaic Applications

Authors: Abdelmajid Timoumi, Salah Alamri, Hatem Alamri


TiO₂ Graphene Oxide (TiO₂-GO) nanocomposite was prepared using the spin coating technique of suspension of Graphene Oxide (GO) nanosheets and Titanium Tetra Isopropoxide (TIP). The prepared nanocomposites samples were characterized by X-ray diffractometer, Scanning Electron Microscope and Atomic Force Microscope to examine their structures and morphologies. UV-vis transmittance and reflectance spectroscopy was employed to estimate band gap energies. From the TiO₂-GO samples, a 0.25 μm thin layer on a piece of glass 2x2 cm was created. The X-ray diffraction analysis revealed that the as-deposited layers are amorphous in nature. The surface morphology images demonstrate that the layers grew in distributed with some spherical/rod-like and partially agglomerated TiGO on the surface of the composite. The Atomic Force Microscopy indicated that the films are smooth with slightly larger surface roughness. The analysis of optical absorption data of the layers showed that the values of band gap energy decreased from 3.46 eV to 1.40 eV, depending on the grams of GO doping. This reduction might be attributed to electron and/or hole trapping at the donor and acceptor levels in the TiO₂ band structure. Observed results have shown that the inclusion of GO in the TiO₂ matrix have exhibited significant and excellent properties, which would be promising for application in the photovoltaic application.

Keywords: titanium dioxide, graphene oxide, thin films, solar cells

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15 Synthesis and Use of Thiourea Derivative (1-Phenyl-3- Benzoyl-2-Thiourea) for Extraction of Cadmium Ion

Authors: Abdulfattah M. Alkherraz, Zaineb I. Lusta, Ahmed E. Zubi


The environmental pollution by heavy metals became more problematic nowadays. To solve the problem of Cadmium accumulation in human organs which lead to dangerous effects on human health, and to determine its concentration, the organic legand 1-phenyl-3-benzoyl-2-thiourea was used to extract the cadmium ions from its solution. This legand as one of thiourea derivatives was successfully synthesized. The legand was characterized by NMR and CHN elemental analysis, and used to extract the cadmium from its solutions by formation of a stable complex at neutral pH. The complex was characterized by elemental analysis and melting point. The concentrations of cadmium ions before and after the extraction were determined by Atomic Absorption Spectrophotometer (AAS). The data show the percentage of the extract was more than 98.7% of the concentration of cadmium used in the study.

Keywords: thiourea derivatives, cadmium extraction, water, environment

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14 Comparing Spontaneous Hydrolysis Rates of Activated Models of DNA and RNA

Authors: Mohamed S. Sasi, Adel M. Mlitan, Abdulfattah M. Alkherraz


This research project aims to investigate difference in relative rates concerning phosphoryl transfer relevant to biological catalysis of DNA and RNA in the pH-independent reactions. Activated Models of DNA and RNA for alkyl-aryl phosphate diesters (with 4-nitrophenyl as a good leaving group) have successfully been prepared to gather kinetic parameters. Eyring plots for the pH–independent hydrolysis of 1 and 2 were established at different temperatures in the range 100–160 °C. These measurements have been used to provide a better estimate for the difference in relative rates between the reactivity of DNA and RNA cleavage. Eyring plot gave an extrapolated rate of kH2O = 1 × 10-10 s -1 for 1 (RNA model) and 2 (DNA model) at 25°C. Comparing the reactivity of RNA model and DNA model shows that the difference in relative rates in the pH-independent reactions is surprisingly very similar at 25°. This allows us to obtain chemical insights into how biological catalysts such as enzymes may have evolved to perform their current functions.

Keywords: DNA and RNA models, relative rates, reactivity, phosphoryl transfe

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13 Design and Thermal Analysis of a Concrete House in Libya Using BEopt

Authors: Gamal Alamri, Tariq Iqbal


This paper presents an optimum designs and thermal analysis of concrete house in the hot climate of Libya. For this goal we have used BEopt software (building energy optimization) that provides capabilities for estimating residential building design and thermal analysis. The most area of the house that is exposed to the sunlight’s is the roof leading to heat gain. Therefore, house cooling consumes high energy. The cooling energy consumption is three times the heating energy consumption. In order to maintain comfortable indoor conditions in a low-energy house, the entire building envelope needs to be perfectly insulated and prevented from air leakages. Insulated roof is selected to reduce cooling demand, and the paper presents details and BEopt simulation results. Designed house needs 12.02mmbtus/year. Furthermore, the modeling indicates that the designed house is close to achieving the Passive standard.

Keywords: concrete house design, thermal analysis, hot climate, BEopt software

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12 Lack of BIM Training: Investigating Practical Solutions for the State of Kuwait

Authors: Noor M. Abdulfattah, Ahmed M. Khalafallah, Nabil A. Kartam


Despite the evident benefits of building information modeling (BIM) to the construction industry, it faces significant implementation challenges in the State of Kuwait. This study investigates the awareness of construction stakeholders of BIM implementation challenges, and identifies various solutions to overcome these challenges. Specifically, the main objectives of this study are to: (1) characterize the barriers that deter utilization of BIM, (2) examine the awareness of engineers, architects, and construction stakeholders of these barriers, and (3) identify practical solutions to facilitate BIM utilization. A questionnaire survey was designed to collect data on the aforementioned objectives from local companies and senior BIM experts. It was found that engineers are highly aware of BIM implementation barriers. In addition, it was concluded from the questionnaire that the biggest barrier is the lack of BIM training. Based on expert feedback, the study concluded with a number of recommendations on how to overcome the barriers of BIM utilization. This should prove useful to the construction industry stakeholders and can lead to significant changes to design and construction practices.

Keywords: building information modeling (BIM), construction, information technology, challenges

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11 Behavioural Intention to Use Learning Management System (LMS) among Postgraduate Students: An Application of Utaut Model

Authors: Kamaludeen Samaila, Khashyaullah Abdulfattah, Fahimi Ahmad Bin Amir


The study was conducted to examine the relationship between selected factors (performance expectancy, effort expectancy, social influence and facilitating condition) and students’ intention to use the learning management system (LMS), as well as investigating the factors predicting students’ intention to use the LMS. The study was specifically conducted at the Faculty of Educational Study of University Putra Malaysia. Questionnaires were distributed to 277 respondents using a random sampling technique. SPSS Version 22 was employed in analyzing the data; the findings of this study indicated that performance expectancy (r = .69, p < .01), effort expectancy (r=.60, p < .01), social influence (r = .61, p < .01), and facilitating condition (r=.42, p < .01), were significantly related to students’ intention to use the LMS. In addition, the result also revealed that performance expectancy (β = .436, p < .05), social influence (β=.232, p < .05), and effort expectancy (β = .193, p < .05) were strong predictors of students’ intention to use the LMS. The analysis further indicated that (R2) is 0.054 which means that 54% of variation in the dependent variable is explained by the entire predictor variables entered into the regression model. Understanding the factors that affect students’ intention to use the LMS could help the lecturers, LMS managers and university management to develop the policies that may attract students to use the LMS.

Keywords: LMS, postgraduate students, PutraBlas, students’ intention, UPM, UTAUT model

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10 Saudi Arabian Science and Mathematics Teachers’ Attitudes toward Integrating STEM in Teaching before and after Participating in a Professional Development Workshop

Authors: Abdulwali H. Aldahmash, Naem M. Alamri


The purpose of this study was to analyze Saudi Arabian science and mathematics teachers’ attitudes toward integrating STEM in teaching before and after they participated in a professional development workshop focused on STEM integration in a specific middle school science and mathematics unit. The participants were 48 Saudi Arabian science and mathematics teachers who participated in a three-day workshop held in Riyadh, Saudi Arabia. The research method was a pretest-posttest group design. The primary data source was the instrument for teachers' attitudes toward teaching integrated STEM. The results indicate that Saudi Arabian science and mathematics teachers’ perceptions of difficulties decreased due to their participation in the professional development workshop on integrated STEM. Meanwhile, the teachers' self-efficacy improved following their participation in the STEM professional development (PD) workshop. However, no perceived effect was found for the teachers' perceptions of the relevance of or their anxiety about or enjoyment of integrated STEM teaching due to their participation in the three-day PD workshop.

Keywords: STEM integration, attitude toward STEM, STEM workshop, professional development

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9 Mechanical and Barrier Properties of Cellulose Fibers/HNT Reinforced Epoxy Nanocomposites

Authors: H. Alamri


Natural fiber reinforced composites have attracted researchers for their desirable properties of toughness, high modulus, low density, recyclability, and renewability. In fact, the use of natural fibers in polymer composites has the potential to produce materials with higher specific strength and specific modulus due of their low density. Likewise, polymer-nano-filler composites have been widely investigated for their unique and significant improvement in strength, modulus, impact strength, barrier properties, heat resistance and thermal stability. In this paper, The addition of halloysite nanotubes (HNTs) with three different weight percentages (1%, 3% and 5%) on enhancing barrier and flexural strength and modulus of cellulose-fiber (CF) /epoxy composites after water treatment for six months was studied. Results indicated that water uptake decreased as HNT content increased. The presence of HNT improved flexural strength and flexural modulus of CF/epoxy composites. SEM results showed damages in fiber-matrix interfacial bonding due to water absorption. The addition of HNTs was found to enhance to adhesion between fibers and matrix.

Keywords: mechanical properties, epoxy, nanocomposites, halloysite nanotubes

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8 Performance Comparison of Outlier Detection Techniques Based Classification in Wireless Sensor Networks

Authors: Ayadi Aya, Ghorbel Oussama, M. Obeid Abdulfattah, Abid Mohamed


Nowadays, many wireless sensor networks have been distributed in the real world to collect valuable raw sensed data. The challenge is to extract high-level knowledge from this huge amount of data. However, the identification of outliers can lead to the discovery of useful and meaningful knowledge. In the field of wireless sensor networks, an outlier is defined as a measurement that deviates from the normal behavior of sensed data. Many detection techniques of outliers in WSNs have been extensively studied in the past decade and have focused on classic based algorithms. These techniques identify outlier in the real transaction dataset. This survey aims at providing a structured and comprehensive overview of the existing researches on classification based outlier detection techniques as applicable to WSNs. Thus, we have identified key hypotheses, which are used by these approaches to differentiate between normal and outlier behavior. In addition, this paper tries to provide an easier and a succinct understanding of the classification based techniques. Furthermore, we identified the advantages and disadvantages of different classification based techniques and we presented a comparative guide with useful paradigms for promoting outliers detection research in various WSN applications and suggested further opportunities for future research.

Keywords: bayesian networks, classification-based approaches, KPCA, neural networks, one-class SVM, outlier detection, wireless sensor networks

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7 Difficulty and Complexity in Dealing with Visual Pollution in the Historical Cities: The Historical City of Ibb-Yemen as a Case Study

Authors: Abdulfattah A. Q .Alwah, Wen Li, Mohammed A. Q. Alwah, Duc Thien Tran, Bing Xi Liu


The historical cities in the third world suffer from many environmental problems; one of them is the spread of visual pollution manifestations. These phenomena increase with low levels of public awareness and low per capita income. The historical city of Ibb is suffering from a variety of visual pollution of the urban environment, so it has been chosen as a case study. This study aims to identify the difficulty and complexity of dealing with visual pollutions manifestations in the historical city of Ibb, and to provide appropriate solutions, which suit with the complex and contradictory circumstances. The study relies on an inductive approach to achieve its aims through two methods; the first is a visual survey of the visual pollution phenomenon based on images and researcher notes. The Second method is the analyses of the opinions and impressions of the city's residents and visitors through interviews, in addition to interviews with the officials in the competent authorities, and some specialists in the field of urban environment. Through the results of the field study and discussion of the interview results, this study presents an analysis of the phenomenon of visual distortion of the historical city of Ibb regarding the appearances and the reasons. Furthermore, this study provides appropriate solutions, which suitable with the complex and contradictory circumstances. These solutions take two paths: the first one is to stop the spread of visual distortions, and the second path is to address the current visual pollutions.

Keywords: visual pollution, visual image, urban environment, difficulty, complexity, historical cities, the historical city of Ibb

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6 Coffee Consumption: Predictors, Prevalence, Awareness, and Trend among Saudi University Students

Authors: Nasiruddin Khan, Hanan A. Alfawaz, Sobhy M. Yakout, Malak N. K. Khattak, Amani A. Alsaikhan, Areej A. Almousa, Taghreed A. Alsuwailem, Taghreed M. Almjlad, Nada A. Alamri, Sahar G. Alshammari, Nasser M. Al-Daghri


The consumption of coffee as a beverage is increasing in every part of the world. However, its excessive intake might exert negative effects. Our objective was to demonstrate the prevalence and awareness of coffee consumption among Saudi students and its determinants among this section of the population. Nine hundred thirty female students participated from various departments of King Saud University in a survey-based study using a face-to-face interview. The study demonstrates a high prevalence of coffee consumption (88.2%) among students in the Riyadh region. Certain situations such as exams were associated with increased frequency of coffee intake combined with unhealthy dietary habits of adding other ingredients such as sugar and spices in amount more than needed. Unmarried and fresh year students with high academic grades were associated with higher coffee consumption. The main determinants of coffee consumption among university students were high BMI and increased family income level. Continued awareness and basic knowledge, along with understanding the importance of reading food labels, should be provided to young generations. The university students must be cautioned to limit excessive coffee consumption and maintain healthy dietary habits.

Keywords: academic performance, BMI, coffee, health awareness

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5 Perception and Attitudes of Medical Students towards Dermatology as a Future Specialty.

Authors: Rakan Alajmi, Rahaf Alnazzawi, Yara Aljefri, Abdullah Alafif, Ali Alraddadi, Awadh Alamri


Background: The distribution of physicians in different specialties across Saudi Arabia is determined by the career choices of medical students. Dermatology residency program is one of the highly competitive programs here in Saudi Arabia. Assessing and understanding the factors perceived to be attractive in choosing dermatology will aid the directors of the specialty programs to plan for a more balanced workforce distribution to better suit the needs of the specialties. Aim: The aim of our study is to determine and assess the factors perceived to be significantly attractive when choosing dermatology as a future specialty. Methods: The study is a cross-sectional study conducted in King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A validated questionnaire was sent electronically to clinical year medical students. In addition to the questionnaire, gender, grade point average, preferred specialty, and other socio-demographic data were assessed. Results: A total of 121 clinical years medical students completed the questionnaire, 8 (6.6%) preferred dermatology as a specialty. 76 (62.8%) of the participants score a grade point average of more than 4.5 and 83 students (68.6%) chose their specialty during clinical years. The appeal of being a dermatologist (P= 0.047), the portrayal of different specialities in the media (P= 0.005), and the likelihood that dermatologists can influence patients’ lives (P=0.010) were shown to be significantly attractive factors. Conclusion: There are many factors that are affecting students’ choices when choosing a medical specialty. The appeal of being a dermatologist, the portrayal of different specialities in the media, and the likelihood that dermatologists can influence patients’ lives were shown to be significantly attractive factors when choosing dermatology as a future specialty. Recognizing medical students’ specialty perception will lead them to a proper specialty tailored to their needs.

Keywords: dermatology, career choice, medical specialties, student's perception

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4 A Retrospective Study - Demographical, Clinical and Pharmacological Correlate of Seclusion, Self-Discharge, Physical Aggression and Use of PRN Psychotropics Within The First 72 Hours Of Admission in The Acute Psychiatric Unit in Saudi Arabia

Authors: Asma AlAmri, Ahmed Hassab Errasoul


Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.

Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion

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3 The Awareness of Cardiovascular Diseases among General Population in Western Regions of Saudi Arabia

Authors: Ali Saeed Alghamdi, Basel Mazen Alsolami, Basel Saeed Alghamdi, Muhanad Saleh Alzahrani Alamri, Salman Anwar Thabet, Abdulhalim J. Kinsara


Objectives: This study measures the knowledge of the cardiovascular disease among the general population in western regions of Saudi Arabia, and it aimed to increase the level of awareness about cardiovascular diseases among the general population by providing an awareness lecture that included information about the risk factors, major symptoms, and prevention of cardiovascular diseases. The lecture has been attached at the end of the questionnaire. Setting: This study was conducted through an online questionnaire that included our aim and main objectives that targeted the general population in the Western regions of Saudi Arabia (Makkah and Madinah regions). Participants: This study participants were 460 collected through an online questionnaire. Methods: All Saudi citizens and residents who live in the western region of Saudi Arabia aged 18 years and above will be invited to participate voluntarily. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart diseases, with cardiac symptoms and risk factors sections. Results: The majority of respondents were females (74.8%) and Saudis. The knowledge about cardiovascular disease risk factors was weak. Only (18.5%) scores an excellent response regarding risk factors awareness. Lack of exercise, stress, and obesity were the most known risk factors. Regarding cardiovascular disease symptoms, chest pain scores the highest symptom (87.6%) among other symptoms like dyspnea, syncope, and excessive sweating. Participants revealed a poor awareness regarding cardiovascular disease symptoms also (0.9%). However, preventable factors for cardiovascular diseases were more knowledgeable than others categories in this study (60% fall into excellent knowledge). Smoking cessation, normal cholesterol level, and normal blood pressure score the highest preventable methods (92.2%), (88.6%), and (78.7%) respectively. 83.7% of the participant have attended the awareness lecture, and 99 of the attendees reported that the lecture increased their knowledge about cardiovascular disease. Conclusion: This study discussed the level of community awareness of cardiovascular disease in terms of symptoms, risk factors, and protective factors. We found a huge lack of the participant's level of knowledge about the disease and how to prevent it. Moreover, we measure the prevalence of the comorbidities among our participants (diabetes, hypertension, hypercholesterolemia/ hypertriglyceridemia) and their extent of adherence to their medication. In conclusion, this study not only demonstrates awareness of cardiovascular disease risk factors, symptoms, management, and the association between each domain but also provides educational material. Further educational material and campaigns are required to increase awareness and knowledge about cardiovascular diseases.

Keywords: awareness, cardiovascular diseases, education, prevention, risk factors

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2 Ibrutinib and the Potential Risk of Cardiac Failure: A Review of Pharmacovigilance Data

Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda


Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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1 Prevalence of Chronic Diseases and Predictors of Mortality in Home Health Care Service: Data From Saudi Arabia

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani


Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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