Background: urinary tract infections (UTI) are one of the most common types of bacterial infection in patients with diabetes mellitus (DM). There are certain aspects to diabetes that makes it a risk factor for getting urinary tract infection and additionally, diabetes may also predispose to certain complications. Methodology: in this paper we aim to carry out a systematic review on observational (nonrandomized) studies on PUBMED. Aim: to evaluate the prevalence, pathogenesis, diagnosis, management and complications of UTI in patients with DM. Conclusion: the proper management of UTI in diabetics is crucial, as prompt diagnosis and correct use of antibiotics is vital for treatment. Future research in this regard will hopefully decrease the burden of UTI in diabetic patients. Keywords: Urinary tract infections, diabetes mellitus, UTI in DM, risk factors of UTI, diagnoses of UTI, treatment option of UTI in diabetic patient, complication of UTI in diabetic patient

Background Meropenem is commonly used in the ICU to treat gram-negative infections. Due to various pathophysiological changes, critically ill patients are at higher risk of having subtherapeutic concentrations and hence have a higher risk of treatment failure—especially in regions where gram-negative drug resistance is increasing, such as Saudi Arabia. No studies have evaluated the pharmacokinetics of meropenem in critically ill patients in Saudi Arabia. Our primary objective is to assess the percentage of patients achieving the therapeutic target for meropenem. Methods This prospective observational study was conducted in the ICUs of King Khalid University Hospital. Patient were included if >18 years-of-age and received meropenem for a clinically suspected or proven bacterial infection. The primary outcome was to assess the percentage of patients who achieved the pharmacokinetic/pharmacodynamic (PKPD) therapeutic target of a free trough concentration four times the MIC. The secondary outcome was to estimate the pharmacokinetics of meropenem. Pharmacokinetic analysis was performed using Monolix Suite 2020R1 (Lixoft, France). Results Trough concentrations were highly variable and ranged from <0.5 µg/mL to 39 µg/mL, with a mean ± SD trough concentration of 8.5 ± 8 µg/mL. Only 46% of patients achieved the therapeutic target. The only significant predictor of failing to achieve the PKPD target was augmented renal clearance. Conclusion In conclusion, more than half of our patients did not achieve the PKPD target. Thus, there is a need for better dosing strategies of meropenem in critically ill patients in Saudi Arabia such as extended and continuous infusion.

Objectives: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with prehospital delay. Methods: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, Original Article and multivariate analysis were used to examine factors associated with pre-hospital delay. Results: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). Conclusion: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the benefits of availing an ambulance service.

Background: there is a high prevalence of osteoporosis in KSA indicating a low preventive measures and a lack of knowledge about radiological investigations importance and hazards. Objectives: assessing the general knowledge of osteoporosis risks, screening, treatment and physical activity as well as evaluating the awareness about radiological investigations timing and effects. Methods: a community survey study based on a reliable questionnaire that was distributed among general community in Abha city from March 2017 to June 2017. Results: most of subjects were young, females and have college degree. Only 17% of subjects reported having osteoporosis. Most of participants (52%) have good overall general knowledge but only 42% had good knowledge regarding the calcium recommendations and 21% have good knowledge about importance of physical activity in prevention of osteoporosis. 60% of subject shave good knowledge about the risk factors of osteoporosis and 75% had good knowledge regarding the symptoms and radiological investigations. Conclusion: The overall knowledge in Abha City was good in 52% of subjects however, the levels of knowledge about preventive measures were poor while the majority had adequate knowledge regarding the risk factors, symptoms and radiological investigations. Although, a moderate prevalence of good knowledge, educational programs must be adopted by health authorities to motivate healthy behaviors for prevention of osteoporosis in our community.

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