Background: Readmissions remain a persistent challenge in the care process of heart failure (HF). This study aimed to assess the 30 and 90-day readmission rates of HF and the associated risk factors. Materials and Methods: This retrospective cohort study targeted adult patients admitted for HF to King Abdulaziz Medical City between January 2016 and December 2018. The primary outcome variables were 30- and 90-day readmissions. Descriptive statistics were used for the continuous variables, which displayed the mean, standard deviation, and minimum and maximum values. The binary logistic regression technique was used to investigate risk factors for 30- and 90-day readmissions. Results: The 30- and 90-day readmission rates were 39.6% and 37.6%, respectively. Hypertension (P < 0.001), chronic kidney disease (P = 0.03), hypothyroidism (P = 0.04), and pulmonary diseases (P < 0.001) were all deemed as risk factors for readmission within 30 days. Body mass index (P = 0.03), dyslipidemia (P = 0.04), chronic kidney disease (P = 0.03), arrhythmias (P = 0.007), and pulmonary diseases (P < 0.001) were all deemed as significant predictors of readmission within 90 days. Conclusion: The 30- and 90-day readmission rates were 39.6% and 37.6%, respectively. Hypertension, chronic kidney disease, hypothyroidism, and pulmonary diseases were significant predictors for 30-day readmission. Body mass index, dyslipidemia, chronic kidney disease, arrhythmias, and pulmonary diseases were significant predictors for 90-day readmissions. These predictors must be taken into consideration to develop strategies to reduce readmission rates and mitigate a burden on health-care resources and patients' morbidity.

Background The fabella is a sesamoid bone usually embedded within the tendon of the lateral head of the gastrocnemius, articulating with the posterior surface of the lateral femoral condyle. Recently, the fabella was associated with primary osteoarthritis. The current study aimed to estimate its incidence and distribution in patients with osteoarthritis in Riyadh, Saudi Arabia, and its effect on disease severity and deformity in osteoarthritic knees. Methods We conducted a retrospective chart review study and included 901 patients with primary knee osteoarthritis between January 2016 and December 2020. All data were retrieved from the hospital data management system using a customized data collection form which included baseline demographics of the patients and specific parameters for the study such as type of knee deformity, Kellgren-Lawrence classification, OA severity, and location of fabella. Results Overall fabella incidence in 901 patients was 21.9% (22.4% in females, 20.1% in males) with no significant difference between sexes (χ² = 0.515, P = 0.473), but was more prevalent among older patients age 50–60 years; prevalence 28.6% (χ² = 11.178, P = 0.025). The Kellgren-Lawrence classification stage was significantly higher in knees with fabella because 117 (59.4%) patients were classified as stage 4 (χ² = 9.694, P = 0.021). Genu varum was the most prevalent deformity occurring concomitantly with fabella in osteoarthritic knees, observed in 122 patients (61.9%). Conclusion The presence of fabella was positively correlated with older age and higher severity of primary osteoarthritis.

Objective: To assess the attitudes of pediatricians working at the Ministry of National Guard-Health Affairs (MNGHA) to report cases of child sexual abuse (CSA) and to determine the association between the demographic, cultural characteristics, and the attitude toward reporting. Participants and Settings: The participants included all pediatricians, from consultants to residents, employed at the Pediatric Department of the King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital, Riyadh. Additional inclusion criteria were females and males, Saudis and non-Saudis, and age 20—60 years. Methods: A self-administered, hard copy questionnaire was distributed to 277 pediatricians, and the response rate was 58.48%. The sensitivity/specificity emphasis mean score was calculated. Categorical variables were tested against the sensitivity/specificity emphasis mean score using an ANOVA and an independent sample t-test. The reliability of the questionnaire was measured with Cronbach's alpha. Results: In total, 153 completed questionnaires were analyzed. The responses were inclined toward balanced (indecisive toward reporting) and high specificity (favors the decision not to report suspected CSA). No significant difference was found in the sensitivity/specificity mean score between the different levels of professionals, experience, age, gender, and number of prior child abuse-related courses. The skepticism scale showed, for the different professional levels, that the staff physician/resident believed the 3- to 5-year-old girls and boys to be genuine. The consultants/associate consultants believed 6- to 12- year and 13- to 17-year-old girls and boys to be true most of the time. Nearly half of the participants indicated that their reporting decision was affected by the possible consequences of reporting suspected CSA for the children's families and the social perceptions of sexually abused children as adults. Conclusion: The results highlight the low reporting rates of CSA cases. The findings suggest a lack of training and experience of the professionals in this area of assessing, detecting, and reporting CSA cases.

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