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Background: High breastfeeding self-efficacy is linked with lower rates of postpartum depression. No study from Saudi Arabia has previously assessed the relation between breastfeeding self-efficacy and postpartum depression. Objective: To determine the correlation between breastfeeding self-efficacy and postpartum depression in a cohort from Saudi Arabia. Materials and Methods: This cross-sectional study included mothers who had given birth between February to June 2022 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, and were between 2 weeks and 3 months postpartum. Data were collected using a self-administered questionnaire comprising the following three sections: sociodemographic characteristics, Edinburgh Postpartum Depression Scale (EPDS), and Breastfeeding Self Efficacy Scale-Short Form (BSES-SF). Results: A total of 257 participants completed the questionnaire, with most aged 25-34 years (59.1%). The prevalence of postpartum depression was 25.3%, and it was significantly associated with lack of support from the husband and family during pregnancy (for both, P < 0.001), history of violence (P < 0.001), family history of depression (P = 0.045), complications during pregnancy (P = 0.004), and multiple pregnancies (P = 0.004). The mean score on the BSES-SF was 47.4, and participants who scored above the mean had significantly lower rates of postpartum depression (P = 0.003). In addition, an inverse relation was noted between BSES-SF and postpartum depression scores (r = -0.297): when the scores of BSES-SF increased, the scores of postpartum depression decreased. Conclusion: The rate of postpartum depression was high in Jeddah, Saudi Arabia; nonetheless, positive breastfeeding self-efficacy was found to be correlated with lower rates of postpartum depression. These findings indicate the need for careful screening of patients at risk of postpartum depression and for providing breastfeeding support/knowledge, both in the antenatal and postpartum periods.
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Background Preterm delivery is a significant contributor to neonatal and infant morbidity and mortality. Preventive methods are preferable to treatment protocols for reducing perinatal mortality and morbidity. The calcium channel blocker nifedipine has the potential to be employed as a tocolytic, whereas the phosphodiesterase inhibitor sildenafil citrate promotes smooth muscle relaxation. Objective This study aims to examine the tocolytic effect of nifedipine in combination with sildenafil citrate in managing preterm labour (PTL). Methods After approval from the ethical board, 160 patients fulfilling the selection criteria were enrolled in the study from the outpatient and emergency department of obstetrics and gynaecology, University of Lahore, Pakistan. After taking written informed consent, their demographic profile, i.e., name, age, gestational age at presentation, parity, and expected date of delivery was noted. Patients were randomly assigned in a 1:1 ratio to two study groups (Group A: sildenafil citrate + nifedipine) and (Group B: nifedipine) using a computer-generated random number table to obtain a trial sequence. In group A, each patient was given nifedipine 20 mg orally, followed by 10 mg orally every eight hours for 48 hours and vaginal administration of sildenafil citrate, 25 mg at eight-hour intervals, for 48 hours. In group B, females were given nifedipine 20 mg orally, followed by 10 mg orally every 8 hours for 48 hours. They were kept admitted for 72 hours. SPSS Statistics version 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) was used to enter and analyse the collected data. Mean and standard deviation was calculated for quantitative variables like age, gestational age at presentation, gestational age at delivery, and BMI. Frequency and percentage were calculated for parity and preterm delivery. Results The study involved 160 patients, with the average age in Group A being 29.60±4.9 years and in Group B being 30.96±4.98 years. In terms of gestational age at delivery, Group A had an average of 34.16±1.7 weeks, while Group B had an average of 33.5±1.8 weeks (p-value<0.05). Preterm delivery was observed in 68.5% of Group A and 41.3% of Group B, with a significant p-value of 0.001. The study also discovered that the duration of prolonged pregnancy was significantly higher in Group A compared to Group B, with averages of 14.96±10.37 days and 10.24±8.97 days, respectively (p-value=0.002). Conclusion The results of this study suggest that the combination of sildenafil citrate and nifedipine may offer a promising new approach to improving pregnancy outcomes in cases of PTL. In the present study, sildenafil citrate plus nifedipine showed a significant effect in the management of PTL and prolongation in mean gestational age at delivery.
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INTRODUCTION: Unplanned readmissions are frequent, costly, and perhaps avoidable. We aim to identify the rate, causes, and predictive factors of hospital readmission after hysterectomy within 60 days post-discharge at King Abdulaziz University Hospital (KAUH). METHODS: Retrospective record review of all patients who underwent hysterectomy for benign and malignant conditions from January 2017 to December 2022. Patients were evaluated for demographics, comorbidities, and causes for readmission. RESULTS: Of 117 patients, the unplanned readmission rate was 9.4% and 7.7% for benign and malignant conditions, respectively. Infections (25%) and abdominal pain (20%) were common causes. Patients with increased intraoperative bleeding (P = 0.013) and cancer patients (0.044) had an increased risk for readmission. Readmitted patients had significantly higher baseline health burdens when compared to non-readmitted patients using the American Society of Anesthesiology scores (ASA) (p = 0.011) and the Cumulative Illness Rating Scale (CIRS) (p = 0.004). CONCLUSION: The 60-day readmission rate after a hysterectomy was 17.1%. Infections and abdominal pain represented common causes. Malignancy and increased intraoperative blood loss are significant risk factors. In order to decrease the readmission rate, addressing common reasons may be beneficial.
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STUDY OBJECTIVES: The aim of this study was to find if there is an association between maternal height and mode of delivery, as well as an association between maternal height and baby's weight as a secondary outcome. METHOD: This retrospective record review was performed at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, including patients admitted between January 2016 to December 2017. All nulligravida with singleton term pregnancies who gave birth were included in this study. Pregnant women with planned elective cesarean section (CS) and incomplete records were excluded. The maternal demographic and clinical data (age, height, weight, hypertension, gestational diabetes (GDM), body mass index (BMI), smoking status, gestational age, regional analgesia during delivery, type of delivery, postpartum hemorrhage (PPH), and episiotomy), neonatal birth weight, and Apgar score were obtained from KAUH computerized records. Our primary outcome was the mode of delivery. The secondary outcome was the classification of neonatal weight into small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age (LGA). Maternal height was divided into seven groups. Descriptive statistics using mean and standard deviation were used for continuous variables. Frequencies and percentages were used for categorical variables. Student's t-test and chi-square tests were used to evaluate the differences between continuous and categorical variables. RESULT: A total of 1067 women were included in this study. Most were at 40 weeks of gestation age (14.9%) with a mean height of 156.4±6.2 cm. Of the total, 76.9% were spontaneous vaginal delivery without operative assistance, 15.9% were delivered via CS, and 7.2% delivered vaginally with the assistance of forceps or ventouse. The mean neonatal birth weight was 2994 ± 451 gms with most neonates (87.3%) having a birth weight between 2500 and 4000 gms. Most babies were of average weight for their gestational age at delivery. There was a significant negative association between maternal height with CS (p=0.017). Moreover, there was a correlation between maternal height and the baby's birth weight (p=0.01), and we found that for every 1 cm increase in women's height, the baby's weight increases by 12.8 gms. CONCLUSION: Our study didn't find an association between maternal height and vaginal delivery or operative vaginal delivery. However, there was an impact of maternal height on CS delivery. Therefore, we suggest screening for short maternal height as they have an increased risk of having an emergency CS. In our secondary outcome, we found a positive association between maternal height and baby's birth weight.
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Introduction Female genital cosmetic surgery (FGCS) is a trending topic in the field of gynecology practice. It is defined as any genital procedure that is not medically indicated but is designed to improve the appearance of the genitals. With the increasing demand for FGCS, little is known about the attitudes of physicians, especially gynecologists, toward FGCS. The study objective is to assess physicians' attitudes towards female genital cosmetic surgeries in Jeddah, Saudi Arabia. Methods A cross-sectional survey was done among physicians in Jeddah, Saudi Arabia. Four-sectioned questionnaires were distributed to physicians. All board-certified consultants and registrars of obstetrics and gynecology, plastic, and reconstructive surgery in private/public hospitals were included in the study. Data management was done using the SPSS program version 19 (IBM Corp., Armonk, NY, USA). Results Out of 165 physicians, 40 were practicing physicians (female genital cosmetic surgery) (24.2%) while 125 were non-practicing physicians (75.8%). The age of practicing and non-practicing respondents ranges from 26 to 60 with a mean and standard deviation (42.6±8.6) and 24 to 60 (40.1±8.9) years old. Our study showed that there were females under 18 years old requesting FGCS from all physicians. Results of attitude towards FGCS showed that the majority of non-practicing physicians were more comfortable in providing advice about FGCS (N=53) and very confident about female anatomy (N=65). Non-practicing physicians also knew a lot more about the long and short-term risks of FGCS and discussed them all the time with their patients. In terms of giving advice on labiaplasty, clitoral hood reduction, perineoplasty, hymenoplasty, and G-spot augmentation procedures, practicing physicians were more confident compared to non-practicing physicians. Statistical analysis showed a significant difference between practicing and non-practicing physicians in terms of gender (p=0.001), career level (p=0.005) and type of work (p=0.006), giving advice on labiaplasty (p=0.001), clitoral hood reduction (p=0.001), perineoplasty (p=0.016) and G-spot augmentation (p=0.001), the number of patients per month, patients seeking advice about FGCS, knowledge about short-term and long-term risks and possible risks of FGCS, vaginal examination, offering referral/counseling and confidence in assessing female anatomy (all, p=0.001). Conclusion Physicians in Jeddah, Saudi Arabia showed an overall positive attitude towards FGCS. The study suggests that with enough training and knowledge about FGCS, physicians could exhibit a more positive attitude towards FGCS.
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INTRODUCTION: Neurokinin-1 receptor (NK-1R) induces inflammatory reactions in peripheral tissues but its regulatory effects in target tissues is dependent on receptor signalling. Substance P (SP) has a high affinity for the NK-1R, to which it binds preferentially. We aimed to investigate the expression of NK-1R in World Health Organization (WHO) grade 4 astrocytomas as well as in oral squamous cell carcinoma (OSCC) and urothelial carcinoma, and its association with disease progression. MATERIAL AND METHODS: The study included tissue samples from 19 brain astrocytomas, 40 OSCCs and 10 urothelial carcinomas. NK-1R expression was quantitatively assessed in the tumour cells using immunohistochemistry. The relationship between NK-1R expression in astrocytomas and recurrence-free interval has been explored. RESULTS: The results showed that the NK-1R was intensely expressed in patients with WHO grade 4 astrocytoma, OSCC and urothelial carcinoma. However, cases clinically diagnosed as a low-grade cancer showed reduced NK-1R expression. CONCLUSIONS: NK-1R is overexpressed in all cases of WHO grade 4 astrocytoma, OSCC and urothelial carcinoma. The ubi-quitous presence of SP/NK-1R complex during tumour development and progression suggests a possible therapeutic key strategy to use NK-1R antagonist as an adjuvant therapy in the future.