Objectives: To analyze the concept of diet adherence and its components in the management of type 2 diabetes mellitus (T2DM). Methods: The Walker and Avant (2011) method of concept analysis was used. Scientific databases were queried for research articles in the English language published during 2010–2020 using the search terms: compliance, adherence, treatment adherence, diet adherence, T2DM, and concept analysis. The tools that measure diet adherence and its attributes were identified and evaluated. Results: The concept of diet adherence implies the process of following a diet plan by means of self-monitoring, maintaining, and preventing relapses. Diet adherence is facilitated by antecedents which comprise motivation, understanding the dietary recommendations, developing appropriate health beliefs, self-efficacy, setting achievable goals, and receiving social support. Successful diet adherence brings consequences in health as reflected in improved T2DM-specific clinical parameters and enhanced health-related quality of life. Conclusions: Patients with T2DM often have poor diet adherence due to failure to understand, implement, and maintain the required antecedents, such as motivation, understanding, health beliefs, self-efficacy, practical goals, and social support. Healthcare providers need to ensure that the patients understand the concept of diet adherence and implement it in their daily lives. Further research is needed into diet adherence and its components to evolve more effective measures to be communicated to T2DM patients.

Keywords:

Compliance; Adherence; Treatment Adherence; Type 2 Diabetes Mellitus.

Objectives: Japanese encephalitis (JE) is one of the major mosquito-borne infectious diseases in the Western Pacific region, accounting for 20%–30% of mortality cases. The JE virus (JEV) seroprevalence fluctuations indicate that continuous research is important for prevention and control activities. By mapping JEV seroprevalence by age stratification, the population profile for immunity and susceptibility can be identified to aid in vaccination program planning. Thus, this study aimed to determine the trend of age-specific JEV seroprevalence. Methods: We conducted a systematic review of all studies conducted on JEV seroprevalence between 2010 and 2019. The two search engines used were PubMed and Web of Science. Eligible criteria were set, and articles were screened according to the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines. Three investigators cross-checked all articles assigned. Data were extracted into an Excel sheet, and results were tabulated in tables and graphs accordingly. Results: Four studies from four countries (Taiwan, Sri Lanka, South Korea, and India) met the eligibility criteria. The papers showed an increasing trend of JEV seropositivity in all countries as their populations reach older age cohorts. Nonetheless, there were slight downtrend notches seen among young adults in Taiwan and India before increasing after reaching more mature ages. South Korea has the highest seroprevalence rate (97.8%–98.3%) among the compared countries. This is most likely because it was the earliest to introduce the JEV vaccine in 1967, which was later made mandatory in the early 1980s, while India has the lowest seroprevalence rate (12.9%–18.1%). Among the old vaccination-naïve population, seropositivity is commonly derived from natural infection. Conclusions: Decreases in reported JE cases are mainly due to immunization. As JEV is expected to remain in nature and the zoonotic chains, the risk of infection will persist. Hence, it is important to apply JEV vaccination protocols in national immunization programs, prioritizing young children.

Keywords: Encephalitis, Japanese; Seroepidemiologic Studies; Vaccination; Age Factors.

Objectives: To assess the risk factors of snake envenomation and the associated complications that patients present with, using data from two different emergency departments in Oman. The secondary aim was to describe the common characteristics of the presenting patients. Methods: This multicenter retrospective observational study reviewed all cases presenting with symptoms of snakebite to the emergency departments of Sultan Qaboos University Hospital (tertiary) from March 2016 until August 2017 and Rustaq Hospital (secondary) from August 2015 to August 2017. Results: A total of 212 cases met the inclusion criteria. Coagulopathy was observed in 82 (38.7%) patients, while 14 (6.6%) had acute kidney injury (AKI) and 5 (2.4%) had external bleeding. Of the patients who developed AKI, 85.7% (p < 0.001) had encountered the snake in a valley and initially had bleeding from the site of the bite (p < 0.001) and vomiting (p < 0.007). The delay in receiving the anti-snake venom (ASV) increased the risk of AKI (p < 0.016). Of the patients who developed coagulopathy, 47.6% (p < 0.001) had encountered the snake on a farm and 72.0% (p < 0.002) received the bite to a lower limb. Increased time from bite to ASV was associated with development of coagulopathy (p < 0.001). No patient death was recorded. Conclusions: The location (terrain) where the snake was encountered was associated with the patient’s risk for either AKI or coagulopathy, which suggests the preference of different snake species to different types of habitat. The time elapsed between the bite and the ASV administration was associated with higher risk of development of AKI or coagulopathy.

Keywords: Risk Factors, Snakebite Envenomation; Oman, Emergency Department.

Objectives: To identify the prevalence of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus (T2DM) in Bahrain and to assess the risk factors for the same. Methods: This retrospective cross-sectional study investigated a random sample of patients who were treated for T2DM during 2018 at non-communicable disease clinics in primary health centers in Bahrain. Cases of 382 patients who underwent abdominal ultrasonography were selected for the study. The collected patients' data were statistically analyzed. Prevalence of NAFLD among T2DM patients and the possible risk factors were assessed. Results: The mean age of the study population (N = 382) was 59.0±12.0 years. The majority (61.5%) were women. Hypertension (57.9%) was the most prevalent associated condition. Most patients were either overweight (30.5%) or obese (58.3%). Fatty liver was found in 68.1% patients based on ultrasound imaging. Elevated alanine aminotransferase was found in 75 (21.0%) out of 357 (93.5%) patients who were tested for the same. The significant risk factors identified for fatty liver were female (p = 0.013), high body mass index (BMI) (p < 0.001), high waist circumference (p = 0.011), and high triglyceride levels (p = 0.043). Binary logistic regression identified BMI as an independent risk factor for fatty liver (p = 0.005). Conclusions: The prevalence of NAFLD among patients with T2DM in Bahrain is high, and comparable to the levels reported in other studies. Female and high BMI, waist circumference, and triglyceride level are risk factors for NAFLD, while BMI is an independent risk factor.

Keywords: Diabetes Mellitus; Non-alcoholic Fatty Liver Disease; Prevalence; Risk Factors; Bahrain.

Objectives: To assess the prevalence of bruxism and occupational stress among Saudi Arabian fighter pilots. Methods: This was an observational, cross-sectional study where 110 fighter pilots were compared with 110 control non-pilots. The data collection was carried out by two dentists between February 2018 and May 2019. The subjects who consented to the study completed the Karasek’s Demand-Control questionnaire (short version) comprising 11 questions (5 for demand and 6 for control) designed to measure occupational stress. The assessment of bruxism was made using the non-instrumental approach of the International Consensus on the Assessment of Bruxism which includes both clinical examination and self-report of diurnal and nocturnal bruxism. A logistic regression test was performed with bruxism as the dependent variable controlling for occupational stress, type of occupation, and smoking status. Results: The total sample comprising pilots and non-pilots had an overall bruxism prevalence of 41.8%, with more pilots (52.7%) than non-pilots (30.9%) having the condition. Occupational stress was experienced by more pilots than non-pilots (45.5% vs. 27.3%, respectively). Bruxism was significantly associated with type of occupation (pilots vs. non-pilots) controlling for occupational stress in both univariate and multivariate logistic regression tests; odd ratio (OR) = 2.5; (95% confidence interval (CI): 1.1-5.4, p = 0.016) and OR = 2.6; (95% CI: 1.2-5.8, p = 0.020), respectively. Conclusions: The pilots demonstrated significantly higher occupational stress and bruxism than the non-pilots. The pilots were 3.9 times more likely to have a combination of stress and bruxism than non-pilots. Further investigations are necessary to determine whether any causal relationship exists between occupational stress
and bruxism.

Keywords: Bruxism; Occupational Stress; Military Personnel; Prevalence; Saudi Arabia.

Objectives: Many studies suggest that depression is prevalent among patients suffering from inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). Both depression and IBD have a significant disease burden. However, these studies have mostly been conducted among European and American populations and there is a paucity of studies from Arab countries. This study aimed to examine the prevalence and predictors of depressive symptoms among adult IBD patients attending a tertiary care hospital in Muscat, Oman. Methods: We conducted a cross-sectional study among a random sample of patients aged ≥ 18 years who attended the gastroenterology clinic at Sultan Qaboos University Hospital, Muscat, Oman, between June 2018 and January 2019. Participants were asked to complete the Patient Health Questionnaire-9, which is used to assess depression, and a sociodemographic survey. Logistic regression analysis was used to identify the independent predictors of depressive symptoms among the study sample. Adjusted odds ratios (aORs) were also reported. Results: This study included 201 participants, with an average age of 36 years. Just over half (51.2%) of participants were female. The mean duration of the patients’ IBD diagnosis was 1.9±0.3 years, the majority (n = 174, 86.6%) of the participants had UC, 80.1% (n = 161) of the participants had received steroids, and 5.5% of the sample had a history of a surgical stoma. The medical comorbidities among the participants were cerebrovascular accidents (24.9%), hypertension (24.5%), and diabetes mellitus (23.9%). The prevalence of depressive symptoms was 23.4%. The logistic regression analysis resulted in four independent predictors of depression: being female (OR = 2.090, p = 0.047), history of surgical stoma (OR = 5.737, p < 0.001), comorbid diagnosis of hypertension (OR = 2.846, p = 0.007), and history of a cerebrovascular accident (OR = 2.651, p = 0.011). Conclusions: Depressive symptoms are prevalent among Omani patients with IBD. Certain clinical factors appeared to increase the risk of depression among this population. The findings of this study fill a gap in the existing literature and call for further work aiming at screening and managing depression among IBD patients.

Keywords: Depression; Cross-Sectional Studies; Patient Health Questionnaire; Colitis, Ulcerative; Crohn Disease; Prevalence; Oman.

Objectives: We sought to identify the most commonly used antihypertensive medications in pregnant women and to determine the impact of these medications on perinatal (maternal and fetal) outcomes. Methods: The medical records of 484 hypertensive pregnant women who attended a tertiary university hospital during the study period were retrospectively evaluated for eligibility. Singleton pregnancies of women on antihypertensive medications and who delivered in the hospital were included in the study. Results: A total of 210 women (mean age of 32.4±5.6 years and mean body mass index of 34.0±8.1 kg/m2) were eligible for inclusion in the study. The most prevalent subtype of hypertension was preeclampsia (41.4%). Low birth weight (LBW), preterm delivery (PTD), intrauterine growth restriction (IUGR), small for gestational age (SGA), respiratory distress syndrome, and neonatal care unit admissions were significantly higher in women with preeclampsia than in the women with other types of hypertension. Labetalol was the most commonly prescribed antihypertensive drug. There were 101 (48.1%) women on combined therapy. LBW, PTD, IUGR, SGA, respiratory distress syndrome, absent end diastolic flow, neonatal care unit admission, preeclampsia, and high dependency unit admissions of mothers were significantly higher in the women who received combined therapy. Conclusions: Labetalol was the most commonly prescribed antihypertensive drug in this cohort, and women on combined antihypertensive medications had significantly higher maternal and fetal complications. A larger prospective study including hypertensive women with or without antihypertensive medications in more than one center is needed to evaluate the effect of these drugs on perinatal outcomes.

Keywords: Pregnancy; Pregnant Women; Antihypertensive Agents; Pre-Eclampsia; Pregnancy Outcome.

Objectives: Childhood cancers affect 6.7% of those under 14 in Oman, with leukemia being the most common. The psychological distress of having a child with leukemia is often compounded by perceived unmet needs by the child’s primary caregiver. We aimed to identify factors contributing to perceived unmet needs among primary caregivers of Omani children with leukemia. Methods: We conducted a cross-sectional study among 119 Omani caregivers accompanying their children to the National Oncology Center, Muscat, Oman. We used an Arabic version of the Needs Assessment of Family Caregivers-Cancer (NAFC-C) questionnaire to assess perceived unmet needs in seven domains. Results: A total of 119 Omani primary caregivers were contacted; 101 agreed to participate in the study (response rate: 84.9%). Linear regression analysis showed significant correlations between total NAFC-C scores and the child’s (p = 0.014) and caregiver’s age (p < 0.001), and employment status (p = 0.024) and income (p = 0.028). Unmet needs in the obtaining information domain correlated with caregiver’s age (p < 0.001), caring time (p = 0.018), and number of family members (p < 0.001), whereas needs in the maintaining own strength domain correlated with the child’s gender (p = 0.028), time since diagnosis (p = 0.004), caregiver’s age (p < 0.001), and education level (p = 0.019). Unmet needs in the accompanying the sick child domain were correlated with the child’s gender (p = 0.049), caregiver’s gender (p < 0.001), and income (p < 0.001). Conclusions: Various sociodemographic variables affected the unmet needs of primary caregivers of children with leukemias in Oman. Healthcare professionals in Oman should be aware of such factors to reduce caregiver distress.

Keywords: Caregivers; Child; Leukemia; Health Services Needs and Demand; Needs Assessment; Oman.

Objectives: The most common surgical option for releasing the first annular pulley in trigger digit (TD) is classic open surgery followed by blind percutaneous release. However, they have been related to major complications and incomplete releases, respectively. Intrasheath sonographically-guided first annular pulley release has recently been shown to be safe and effective in every digit. The objectives of this pilot study were to preliminary compare clinically an intrasheath sonographically-guided first annular pulley release versus a classic open technique and to evaluate the feasibility of a future clinical trial in patients with TDs. Methods: Thirty patients were randomized 1:1 in an external pilot study comparing the two surgical techniques: a percutaneous sonographically-guided release performed through a 1 mm incision using a hook knife versus a classic open surgery with a 1 cm incision. Inclusion criteria were primary TD grade III (Froimson). We defined success if primary (safety and efficacy) and secondary (recruitment rates, compliance, completion, treatment blinding, personnel resources, and sample size calculation for the clinical trial) objectives could be matched. We registered the grip strength, the QuickDASH score and a set of postoperative clinical variables at one, three, and six weeks and at three months. We calculated the sample size for the clinical trial using the QuickDASH at the end of the follow-up. Outcomes assessors were blinded. Results: All patients in both groups showed resolution of their symptoms with no associated complications or relapses. Secondary feasibility objectives were matched: 76.9% of eligible patients were included in the study, 3.3% refused randomization, 20 patients per month were recruited, 100% received blinded treatment, 98.5% showed compliance, and 100% completed the study. The sample size for a future clinical trial was 84 patients. There were no differences in grip strength. The intrasheath sonographically-guided first annular pulley release showed significantly better QuickDASH scores, until the sixth postoperative week. Conclusions: The intrasheath sonographically-guided first annular pulley release is safe and efficacious, and shows a trend toward clinical superiority versus the classic open procedure, which should be confirmed with a clinical trial. Our study shows that a randomized clinical trial is feasible.

Keywords: Trigger Finger Disorder; Ultrasonography, Interventional; Surgery.

Objectives: Hematological toxicity induced by chemotherapy is known to be caused by multiple factors, including genetic factors such as polymorphisms. The polymorphisms may occur in drug efflux transporter proteins and enzymes involved in drug metabolism. We investigate the incidence of hematological toxicities and their relation to the haplotype ATP-binding cassette B1 (ABCB1) which were polymorphisms of C1236T, C3435T, G2677T, and glutathione S-transferase P1 (GSTP1) A313G genes in Indonesian breast cancer patients who received anthracycline during chemotherapy. Methods: This retrospective cohort study was conducted on 138 breast cancer patients who underwent three cycles of chemotherapy in H. Adam Malik Hospital, Medan, Indonesia, who satisfied the inclusion criteria. The DNA of these patients was extracted from the peripheral leukocytes. Single nucleotide polymorphism (SNP) ABCB1 and GSTP1 were examined by the polymerase chain reaction-restriction fragment length polymorphism method. Data on patient characteristics and the incidence of hematological toxicity after each of the three cycles of chemotherapy were obtained from the medical records. The variations in absolute neutrophil count (ANC) and anemia were analyzed using the Friedmann test and the Wilcoxon signed-rank test. The Kruskal-Wallis test was used to investigate the association of ABCB1 and GSTP1 polymorphisms with anemia and neutropenia. The frequency distributions of genotypes and alleles were determined using the Hardy-Weinberg Equilibrium (HWE). Results: Post the chemotherapy cycles, there was decrease in ANC (Mean±SD: 5 644.4±2 962.5 mm3 vs. 3 034.8±2 049.6 mm3) and increase in anemia (12.1±1.5 g/dL vs. 11.2± 1.3 g/dL) (p < 0.050 for each). No relation was observed between ABCB1 polymorphism, either in each SNP or in the form of haplotype (the combination of more than one SNP), and the incidence of anemia and neutropenia (p > 0.050). There was also no correlation between GSTP1 polymorphisms, anemia and neutropenia incidence (p > 0.050). The ABCB1 and GSTP1 genotypes and alleles frequency distribution showed no deviation from HWE (p > 0.050). Conclusions: Indonesia breast cancer patients who underwent three cycles of chemotherapy demonstrated susceptibility to hematological toxicity by developing side effects such as anemia and neutropenia. However, no relationship was found between hematological toxicity and ABCB1 and GSTP1 polymorphisms.

Keywords: ABCB1 Protein; GSTP1 Protein, Human; Polymorphism, Gene; Toxicity; Chemotherapy; Breast Cancer.

Objectives: To evaluate the impact of late-onset sepsis (LOS) in preterm infants on brain injury and neurodevelopmental outcomes at 36 months corrected age (CA). Methods: We retrospectively analyzed the medical records of 203 preterm neonates of 24–32 weeks gestational age who were admitted between January and December 2017 at the neonatal intensive care unit (NICU) of a maternity hospital in Kuwait. The cases were stratified into no sepsis, early-onset sepsis (first onset of sepsis ≤ 72 hours postnatally), and LOS (> 72 hours postnatally). Brain injury was assessed from MRI records. Neurodevelopmental outcomes were evaluated at 36 months CA using Bayley-III scales of infant development. Results: Out of 203 neonates, 16 had early-onset sepsis with Klebsiella pneumonia and group B streptococcus, and 93 developed LOS with K. pneumonia and gram-positive cocci in clusters. There were no group-wise differences in the prevalence of intraventricular hemorrhage (n = 68) or white matter injury (n = 42). However, higher cerebellar hemorrhage risk (adjusted odds ratio = 4.6 (1.3–18.6; p = 0.030) was observed in LOS group. At 36 months CA, infants in the LOS group were more likely to have lower motor, cognitive, and language composite scores. After adjusting for gestational age, birth weight, cerebellar hemorrhage, and white matter injury, the relationship between LOS and lower motor scores remained significant (adjusted β = –9.5, 95% CI: –16.4 to –2.7; p = 0.007), whereas the association with cognitive and language scores were no longer significant. Conclusions: LOS in preterm neonates significantly raises the risk of cerebellar hemorrhage and lower motor scores by three years of age.

Keywords: Infant, Newborn; Sepsis; Infections; Brain Injuries; Hemorrhage.

We present a glimpse of vascular malformations seen at Sultan Qaboos University Hospital from July 2014 to December 2019. The cases are sporadic in nature. Molecular genetic studies can be conducted in patients with a family history of vascular malformations. Cultural practices relating to dress codes may lead to delays in presentation. A diagnostic/management algorithm about vascular malformations would help healthcare professionals diagnose, counsel, and refer appropriately, and a national registry would further enhance research and patient support groups.

Keywords: Vascular Malformations; Child; Molecular Biology; Oman.

Warts are common benign skin tumors caused by human papilloma viruses. Recalcitrant facial warts tend to be cosmetically embarrassing to patients and difficult to treat for doctors. Recently, intralesional immunotherapy by antigens like Bacille Calmette–Guerin vaccine, candida antigen, and measles, mumps, and rubella (MMR) vaccine has shown promising efficacy. Here, we report two cases of Omani men who presented with recalcitrant facial warts that resolved completely with a single intralesional injection of the MMR vaccine.

Keywords: Immunotherapy; Intralesional Injections; Measles-Mumps-Rubella Vaccine; Warts; Oman.

Laryngeal hemangioma is a rare benign tumor of the larynx with predilection for a supraglottal subsite. Common presentations include hoarseness, dyspnea, and dysphagia, with a typical appearance of a reddish-purplish mass. A capillary form of the tumor, lobular capillary hemangioma (LCH) is extremely rare in adults and is predominantly unilateral. Diagnosis is made histologically by the distinct lobular growth pattern of capillary proliferation. Here, we report a 50-year-old male chronic smoker who presented with 3-month history of progressive hoarseness, dry cough, and intermittent dyspnea. Flexible endoscopy of the larynx showed irregular pinkish-white masses on the middle third of the bilateral vocal folds. The provisional diagnosis of glottic carcinoma was ruled out by histopathology, and the final diagnosis was bilateral glottic LCH, making it the first recorded case of this condition in literature. The patient underwent endolaryngeal microsurgery with subepithelial excision, a procedure that can be both diagnostic and therapeutic for this rare tumor.

Keywords: Glottis; Lobular Capillary Hemangioma; Pyogenic Granuloma; Adult; Hoarseness.

Cardiopulmonary resuscitation induced consciousness is a very rare phenomenon where patients who are in cardiac arrest and undergoing cardio-pulmonary resuscitation (CPR) express signs of consciousness such as talking, making purposeful limb movements, and opening eyes. This phenomenon leads to frequent CPR interruptions and put the CPR team under psychological pressure, impacting the quality of the resuscitation proceedings. We report presents the case of a 49-year-old man who presented with ischemic chest pain, and then had a witnessed in-hospital cardiac arrest. During the CPR, he gave intermittent signs of consciousness despite the absence of return of spontaneous circulation. The CPR team had to restrain, sedate, and intubate the patient to facilitate the resuscitation process.

Keywords: Cardiac arrest; Awareness; Consciousness; CPR; CPRIC; Cardiopulmonary Resuscitation.

Cardiovascular manifestations are well recognized features of hyperthyroidism, particularly Graves’ disease. Common cardiac complications include atrial fibrillation, hypertension, and high or normal output congestive heart failure. In rare cases, acute pericarditis can be a manifestation of Graves’ disease. We present a 28-year-old male who presented with acute pericarditis and was later diagnosed with Graves’ disease.

Keywords: Pericarditis; Graves’ Disease; Autoimmune Disease.

Feeding tubes (FTs) are commonly used as urinary catheters in neonates and children. Though generally safe, serious complications can result if the catheter spontaneously knots inside the bladder. We report a case of a spontaneous knotting of an intravesical Fr 6 FT in a late preterm female baby following urethral catheterization to collect a urine sample. The knotted catheter was removed via suprapubic cystotomy. The infant had good postoperative recovery.

Keywords: Urinary Catheterization; Neonate; Oman.

Objectives: To share the experience of Agile Teams using Lean Method to facilitate improvement projects during the COVID-19 pandemic. Methods: A tertiary hospital in Oman mobilized agile teams using lean methods to streamline the workflow during the early stages of COVID-19 pandemic in year 2020. Results: The collaborative network generated by the agile teams increased interdepartmental engagement within the hospital and trimmed workflows, thus improving patient care despite the pandemic. Conclusions: Agile teams using lean methods demonstrably enhance collaboration and efficiency in healthcare, leading to improved patient care.

Keywords: COVID-19; Pandemics; Leadership; Telemedicine; Outpatients; Day care; Hospitals.

Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite statin-controlled low-density lipoprotein cholesterol (LDL-C) in the Centralized Pan-Middle East Survey on the under treatment of hypercholesterolemia. Methods: The non-HDL-C target achievement in patients with diabetes mellites (DM) and patients with established ASCVD was defined according to European Society of Cardiology and European Atherosclerosis Society 2019 guidelines for managing dyslipidemia. Patients were stratified to controlled LDL-C defined as < 70 mg/dL (< 1.8 mmol/L) with normal TG < 150 mg/dL (< 1.7 mmol/L) and high TG between 150–400 mg/dL (1.7–4.5 mmol/L). Results: The mean age of our cohort was 58.0±11.0 years, 6.8% (n = 717) were male, 9.7% (104) were smokers, and 48.4% (n = 518) had body mass index of ≥ 30 kg/m2. Those with high TG levels male (76.5% vs. 63.8%; p < 0.001), smokers (16.1% vs. 7.7%; p < 0.001), have metabolic syndrome (77.6% vs. 17.1%; p < 0.001), and low HDL-C levels (79.2% vs. 49.4%; p < 0.001). The majority (93.9%, n = 1008) were on statins (atorvastatin and rosuvastatin) with only 2.2% (n = 24) on the combined statins plus fenofibrate/gemfibrozil. Only 27.4% (n = 294) of patients had non-HDL-C goal attainment. Goal attainment rates in patients with diabetes (3.1% vs. 34,4%; p < 0.001), coronary artery disease (CAD) (2.4% vs. 37.9%; p < 0.001), diabetes plus CAD (0% vs. 40.0%; p < 0.001), and CVD (0% vs. 30.0%; p =0.048) were significantly lower in those with higher TG levels. Conclusions: A large proportion of statin-controlled LDL-C diabetic patients and patients with established ASCVD with high TGs did not achieve the non-HDL-C target. Our study did not demonstrate an association between ASCVD and high TG levels; and therefore, a follow-up study is highly required to assess long-term ASCVD outcomes in this cohort.

Keywords: Triglycerides; Cholesterol, LDL; Cardiovascular Diseases; Risk Factors; Diabetes Mellitus; Arabs.