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BackgroundAs the SARS-CoV-2 Omicron variant spreads in several countries, healthcare workers' (HCWs) perceptions and worries regarding vaccine effectiveness and boosters warrant reassessment.MethodsAn online questionnaire among HCWs in Saudi Arabia (KSA) was distributed from Dec 1st−6th 2021 to assess their perceptions, vaccine advocacy to the Omicron variant, and their perception of the effectiveness of infection prevention measures and vaccination to prevent its spread, their Omicron variant related worries in comparison to the other variants, and their agreement with mandatory vaccination in general for adults.ResultsAmong the 1,285 HCW participants, two-thirds were female, 49.8 % were nurses, 46.4% were physicians, and 50.0% worked in tertiary care hospitals. 66.9% considered vaccination to be the most effective way to prevent the spread of the Omicron variant and future variants. The respondents however perceived social distancing (78.0%), universal masking (77.8%), and avoiding unnecessary travel (71.4%) as slightly superior to vaccination to prevent the spread of SARS-CoV-2 variants. HCWs aging 55 or older agreed significantly with vaccine ineffectiveness to control Omicron spread, while those who believed in non-pharmacological infection prevention measures agreed significantly with vaccination for that purpose. Male HCWs had a significant agreement with mandatory vaccination of all eligible adult populations. On the other hand, unwilling HCWs to receive the vaccine had strong disagreements with mandatory vaccination.ConclusionsThe current study in the first week of Omicron showed that only two-thirds of HCWs felt that vaccination was the best option to prevent the spread of the Omicron variant, indicating the need for further motivation campaigns for vaccination and booster dose. HCWs had a strong belief in infection prevention measures to contain the spread of SARS-CoV-2 variants that should be encouraged and augmented.

BackgroundAs the SARS-CoV2 Omicron variant spreads in several countries, healthcare workers’ (HCWs) perceptions and worries regarding vaccine effectiveness and boosters warrant reassessment.MethodsAn online questionnaire among HCWs in Saudi Arabia (KSA) was distributed from Dec 1st to 6th 2021 to assess their perceptions, vaccine advocacy to the Omicron variant, and their perception of the effectivness of infection prevention measures and vaccination to prevent its spread, their Omicron variant related worries in comparison to the other variants, and their agreement with mandatory vaccination in general for adults.ResultsAmong the 1285 HCW participants, two-thirds were female, 49.8 % were nurses, 46.4% were physicians, and 50.0% worked in tertiary care hospitals. 66.9% considered vaccination to be the most effective way to prevent the spread of the Omicron variant and future variants. The respondents however perceived social distancing (78.0%), universal masking (77.8%), and avoiding unnecessary travel (71.4%) as slightly superior to vaccination to prevent the spread of SARS-CoV-2 variants. HCWs aging 55 or older agreed singficanlty with vaccine ineffictivness to control Omicron spread, while those who believed in non-pharmacolgical infection prevention measures agreed signifcantly with vaccination for that purpose. Male HCWs had a significant agreement with mandatory vaccination of all eligible adult populations. On the other hand, unwilling HCWs to receive the vaccine had strong disagreements with mandatory vaccination.ConclusionsThe current study in the first week of Omicron showed that only two-thirds of HCWs felt that vaccination was the best option to prevent the spread of the Omicron variant, indicating the need for further motivation campaigns for vaccination and booster dose. HCWs had a strong belief in infection prevention measures to contain the spread of SARS-CoV-2 variants that should be encouraged and augmented.

BackgroundAs the COVID-19 Omicron variant emerged and spread globally at an alarming speed, healthcare workers’ (HCWs) uncertainties, worries, resilience, and coping strategies warrant assessment. The COVID-19 pandemic had a severe psychological impact on HCWs, including the development of Post-Traumatic Stress symptoms. Specific subgroups of HCWs, such as front-line and female workers, were more prone to poor mental health outcomes and difficulties facing stress.MethodsThe responses to an online questionnaire among HCWs in Saudi Arabia (KSA) were collected December 1-5, 2021, aiming to assess their Omicron variant’s uncertainties, worries, resilience, and coping strategies. Three validated instruments were used to achieve the study’s goals: the Brief Resilient Coping Scale, the Standard Stress Scale (SSS), and the Intolerance of Uncertainty Scale (IUS) - Short Form.ResultsThe online survey was completed by 1285 HCWs. Females made up the majority (64%). The BRCS score of resilient coping was negatively and substantially linked with the SSS score of stress (r=-0.313, p = 0.010). Furthermore, the IUS had a positive and significant relationship with stress (r=0.326, p= 0.010). Increased stress levels were linked to a considerable drop in resilient coping scores. Furthermore, being a Saudi HCW or a nurse was linked to a significant reduction in resilient coping ratings. Coping by following healthcare authorities’ preventative instructions and using the WHO website as a source of information was linked to a considerable rise in resilient coping.ConclusionsFollowing the emergence of the Omicron variant of SARS-CoV-2 in late 2021, a rapid investigation into the correlates of stress and resilient coping among the HCWs in KSA was conducted. The negative association between resilient coping and stress was clearly shown, as well as how underlying intolerance of uncertainty is linked to higher stress among HCWs quickly following the development of a new infectious threat. The study provides early insights to develop and promote coping strategies for emerging SARS-CoV-2 variants.

Background: Children with frequently relapsing nephrotic syndrome (FRNS) or Steroid-dependent nephrotic syndrome (SDNS) may be prescribed non-corticosteroid immunosuppressive agents whenever there is a failure to maintain remission with low-dose alternate-day prednisone and/or significant adverse effects of prednisone develop. A wide variety of immunosuppressive agents have been used in these patients to reduce the number of relapses and maintain remission. Objective: to evaluate the outcome of Steroid sparing agents in the management of FRNS and SDNS in children with nephrotic syndrome. Patients and methods: A retrospective study was conducted on all steroid-sensitive nephrotic syndrome (SSNS) children (1-11 years) who received any type of second line agents (e.g. CNI, MMF, cyclophosphamide, and Rituximab) over a period of 9 years from January 2010 to January 2019 in pediatric nephrology unit in Prince Sultan Military Medical City, Riyadh. Results: The study included 24 patients. Their age at diagnosis ranged between 1 and 11 years with a mean of 3.8 years and standard deviation of (±) 2.6 years. During the first year of steroid therapy, relapse occurred among 87% of patients; of them, the number of relapses being 4 or more in 21.7%. Regarding indication for the second line of treatment, SDNS was the most frequent reported (60.9%), followed by FRNS (30.4%). Concerning agents used in the second line, MMF ranked first (58.4%), followed by Cyclophosphamide (33.3%). Number of relapses after starting steroid sparing agent was more than once among 41.7% of patients. Duration of remission after starting steroid sparing agent ranged between 2 and 72 months (14±14.1). Overall response to the second line of treatment was observed among majority of patients (91.7%). Renal biopsy was performed in 45.8% of patients. Concerning side effects of steroid sparing agents, electrolytes disturbances and hypertension were reported by two (8.3%) and one (4.2%) patients respectively. Duration of remission was significantly longer among patients treated with cyclosporine (48±33.9 months) compared to other lines of treatment, pConclusion: The overall response of children with SDNS and FRNS to the second line agents was significant, with favorable longer remission free period with Cyclosporine use with no major side effects. Our results affected by the retrospective design of the study, as well as the small sample size. Therefore larger scale study with prospective design is highly encouraged.

Additional file 2. PICAR statement.

Additional file 1. Search strategy.

Additional file 3. PRISMA checklist.

Additional file 4. Evidence-Base Classifications.

Background: As the SARS-CoV-2 Omicron variant emerged and spread globally at an alarming speed, healthcare workers’ (HCWs) uncertainties, worries, resilience, and coping strategies warranted assessment. The COVID-19 pandemic had a severe psychological impact on HCWs, including the development of Post-Traumatic Stress symptoms. Specific subgroups of HCWs, such as front-line and female workers, were more prone to poor mental health outcomes and difficulties facing stress. Methods: The responses to an online questionnaire among HCWs in the Kingdom of Saudi Arabia (KSA) were collected from 1 December 2021 to 6 December 2021, aiming to assess their uncertainties, worries, resilience, and coping strategies regarding the Omicron variant. Three validated instruments were used to achieve the study’s goals: the Brief Resilient Coping Scale (BRCS), the Standard Stress Scale (SSS), and the Intolerance of Uncertainty Scale (IUS)—Short Form. Results: The online survey was completed by 1285 HCWs. Females made up the majority of the participants (64%). A total of 1285 HCW’s completed the online survey from all regions in KSA. Resilient coping scored by the BRCS was negatively and significantly correlated with stress as scored by the SSS (r = −0.313, p < 0.010). Moreover, intolerance of uncertainty scored by the IUS positively and significantly correlated with stress (r = 0.326, p < 0.010). Increased stress levels were linked to a considerable drop in resilient coping scores. Furthermore, being a Saudi HCW or a nurse was linked to a significant reduction in resilient coping ratings. Coping by following healthcare authorities’ preventative instructions and using the WHO website as a source of information was linked to a considerable rise in resilient coping. Conclusions: The negative association between resilient coping and stress was clearly shown, as well as how underlying intolerance of uncertainty is linked to higher stress among HCWs quickly following the development of a new infectious threat. The study provides early insights into developing and promoting coping strategies for emerging SARS-CoV-2 variants.

Background: urinary incontinence is a distressing common medical disease in which patient cannot control leakage of urine. The prevalence of urinary incontinence differs between countries and between different studies. The risk factors for urinary incontinence including increasing age, chronic cough, medical co-morbidity, childbirth, obesity, depression, smoking, gender and previous hysterectomy. Aim of the work: this study aimed to assess the prevalence of urinary incontinence in Saudi females and its associated risk factors. Methods: this was a cross-section study based on a survey on the internet, it included 400 female participants with a minimum age of 30 years old. Results: the prevalence of urinary incontinence was 44.25%, 66.3% of them were in age of 50 years and above. 43.5% of participants were obese, 19.5% were post-menopausal, 6.25% performed hysterectomy, 37.5 % had parity more than 3 times, 33% had depression and 35.5% had diabetes. Conclusion: prevalence of urinary incontinence was moderate. The most common risk factors for urinary incontinence were older age, menopause and high parity.

Background:Anxiety is the feeling of nervousness and fear from threatening events, the surgery can act as the causing event, resulting in preoperative anxiety. The preoperative anxiety can be caused by several factors and the main factor is anesthesia. Objective: To assess the anxiety of anesthesia pre-operatively. Design: Cross sectional study Methods: This is study was performed via an online survey during the period from September 2018 to November 2018. SPSS was used to analyze data. Main Outcome Measures: high pre-operative anxiety among patients Results:The present study included 400 individuals, the total Mean score ± SD of anxiety was 7.3±1.2. there was significant correlations between anxiety and gender (P-value=0.005), age (0.007), residency (P-value=0.02) as well as educational level (P-value=0.01). Conclusion:There was high pre-operative anxiety among patients and this anxiety was more common among females, older patients and those who had low education and came from rural areas. Limitation: small sample size Keywords: Anxiety, Anesthesia, patients, Pre-operative

The survival rate of kidney graft after kidney transplantation has been improved following the introduction of current immune suppression drugs. However, the risk of recurrence or de novo glomerulonephritis still remains. Most forms of glomerular disease can recur after transplantation [1] but different forms of glomerulonephritis have widely different allograft outcomes. Whereas IgA nephritis recurs in up to one third of transplanted patients, this is not associated with adverse effects on graft survival. In contrast, recurrent focal segmental glomerulosclerosis (FSGS) has an unfavorable prognosis [2] and so early detection and appropriate treatment can be crucial. We are presenting here a patient with primary FSGS who developed acute kidney injury and heavy proteinuria in the first week post-transplant that responded completely to multiple plasmapheresis sessions and four doses of Rituximab.