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Abdulmajeed Alshowair,1 Abdullah M Assiri,2 Abdullah Hussein Balfas,3 Rakan Alkhattabi,3 Tilal Abdalla Eltegani,3 Sara Altowairib,3 Abdullah Hamed Almalki,3 Eman Ahmed Alharbi,3 Suad Alotai,3 Fahad Alobaid,3 Najeeb Saud S Altowiher3 1Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia; 2Preventive Health, Ministry of Health, Riyadh, Saudi Arabia; 3Public Health Directorate, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi ArabiaCorrespondence: Abdulmajeed Alshowair, Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia, Tel +966547135224, Email dr.a.majeed@gmail.comPurpose: To estimate the prevalence and determinants of latent tuberculosis (LTBI) among inmates of four correctional facilities in Saudi Arabia.Methods: This is a retrospective review of health records. All inmates of four correctional facilities in Saudi Arabia were screened for tuberculosis in 2022. Their LTBI status was defined as more than 10mm Mantoux test result and negative X-ray chest result. The prevalence of LTBI and their determinants like age, gender, country of origin, location of the prison, and human immunodeficiency viruses (HIV) status were studied.Results: We reviewed screening data of 10,042 inmates in four Saudi prisons. The prevalence of LTBI was 7.4%. The risk difference of LTBI was significantly higher in males compared to female inmates (P < 0.001). The highest prevalence of LTBI was noticed among males (7.7%), those older than 60 years old (26.9%), and African expatriates (12.1%). None of the female inmates or those with HIV had LTBI. The binomial regression analysis revealed a highly significant effect of older age on the risk of having LTBI.Conclusion: The prevalence of LTBI was low among inmates at Saudi correctional facilities. The males, old age, and persons from African and Asian countries had a higher risk of LTBI. The prevalence of LTBI among inmates of Saudi prisons could be predicted by knowing their age group.Keywords: tuberculosis, latent tuberculosis, inmate screening

Abdulaziz M Al-Garni,1 Hasan S Alamri,1 Waddah M Alalmaei Asiri,1 Abdulaziz Muflih Abudasser,1 Amal Saad Alawashiz,2 Fatima Ahmed Badawi,2 Ghaidaa Abdulrahman Alqahtani,2 Sultan Saad Ali Alnasser,2 Abdulwahab Mufareh Assiri,2 Khalid Talab Salem Alshahrani,2 Osama Ayed Saleh Asiri,2 Ohoud Hussain Moalwi,2 Manar Saeed Alqahtani,2 Reema S Alqhatani2 1Department of Internal Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia; 2College of Medicine, King Khalid University, Abha, Saudi ArabiaCorrespondence: Abdulaziz M Al-Garni, Department of Internal Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia, Email amoalqarni@kku.edu.saBackground: Use of different social media platforms has increased radically over the past decade, emerging as an important part of adolescents and young people’s everyday life. This might exert potential adverse effects on sleep quality and daytime performance of young adults.Aim of Study: To assess the relation between use of social media platforms and sleep quality among public secondary school students.Methods: A cross-sectional study was conducted on 961 students in Aseer region, Saudi Arabia. Students were asked to fill in a structured interview questionnaire covering personal data, pattern of social media use, sleep quality using The Pittsburgh Sleep Quality Index (PSQI) and their mental health status using the depression, anxiety and stress scale (DASS-21).Results: Students’ ages ranged from 15 to 20 years with a mean age of 16.7 ± 2.1 years old. A total of 570 (59.3%) students were females. Tiktok (80%), Snapchat (77.9%), Instagram (63.8%) and YouTube (58.8%) were the most reported platforms used. Regarding their sleep quality, 34.7% of students were poor sleepers. TikTok use (OR 1.33, 95% CI 1.01– 1.77), hours spent on social media (OR 1.26, 95% CI 1.16– 1.37) and having moderate to severe depressive symptoms (OR 1.69, 95% CI 1.19– 2.40) were significant independent predictors of poor sleep among the studied sample.Conclusion: The present study emphasized the association between prolonged use of social media and poor sleep quality among Saudi adolescents. Awareness and behavioral change strategies and activities concerning the drawbacks of poor sleep and proper use of social media are urgently called for to control mental and physical health consequences of poor sleep and social media addiction.Keywords: adolescents, mental health, Saudi Arabia, screen time, sleep quality, snapchat, social media, students, tiktok

Abdullah M Assiri,1 Abdullah Alhelali,2 Ibrahim AL-Benhassan,3 Saeed Abo Hamed,3 Assaf Alkathiri,2 Elhadi Miskeen,4 Mohammed Alqarny5 1Department of Surgery, College of Medicine, Najran University, Najran, Saudi Arabia; 2Otolaryngology Department, Abha Children Hospital & Aseer Central Hospital, Abha, Saudi Arabia; 3Pediatric Critical Care Unit, Abha Maternity and Children Hospital, Abha, Saudi Arabia; 4Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 5Otolaryngology Head and Neck Surgery, Department of Surgery, College of Medicine, University of Bisha, Bisha, Saudi ArabiaCorrespondence: Mohammed Alqarny, Department of Surgery, College of Medicine, University of Bisha, P.O. Box 0011, Bisha, Asir, 61922, Saudi Arabia, Email maalgarni@ub.edu.saAbstract: Endotracheal intubation is common in the emergency department, intensive care units, and operating rooms. It involves the insertion of an endotracheal tube (ETT) through the mouth or nose into the trachea to maintain a patent airway and facilitate mechanical ventilation. Using a stylet during intubation can guide the ETT through the vocal cords. However, complications can arise when the stylet is not removed after successful intubation. Herewith, we reported a patient who was two years old and suffered from respiratory failure. However, in the first 12 hours, we observed a foreign body in the trachea, a small end of a metal stylet immediately removed by bronchoscope. This case demonstrates that multiple uses of a stylet, especially by a single user, can result in impaction of the stylet in the ETT during intubation, requiring force when the stylet is withdrawn after intubation, which can result in breakage, shearing, and retention of the stylet or plastic sheath in the lumen of the ETT.Keywords: stylet, foreign body, Saudi Arabia

Sumaya N Almohareb,1– 3 Majed S Al Yami,1– 3 Ahmed M Assiri,4 Omar A Almohammed5,6 1Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Department of Clinical Pharmacy, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; 4Health Volunteering Center, Ministry of Health, Riyadh, Saudi Arabia; 5Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 6Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Omar A Almohammed, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia, Tel +966 555104065, Email oalmohammed@ksu.edu.saPurpose: Venous thromboembolism (VTE), a major complication that has been reported in patients with COVID-19, is associated with an increased risk of mortality. The purpose of this study was to compare in-hospital mortality among hospitalized patients with COVID-19 who received high-intensity versus standard-intensity thromboprophylactic anticoagulation.Patients and Methods: A secondary database analysis was conducted using data for adult patients who were hospitalized for COVID-19 in Saudi Arabia and received enoxaparin for thromboprophylaxis during their hospitalization. While enoxaparin 40 mg daily is considered the standard-intensity, doses higher than the standard but not to reach the therapeutic dose were considered as high-intensity. The primary outcome in the study was in-hospital mortality, and the secondary outcomes included intensive care unit (ICU) and hospital length of stay. Chi-square and t-tests were used to assess the difference between the two independent groups, and propensity score matching was performed to adjust for baseline characteristics.Results: From 3508 patients who received high- or standard-intensity enoxaparin, 1422 patients, 711 in each group, were included in the analyses after propensity score matching. The mean age of the participants was 57.2 years, and around 30% of them were female. About 72% of the patients were admitted to the ICU. No difference was observed between the two groups in the in-hospital mortality outcome (36% vs 33.5% in the high-intensity and the standard group, respectively; RR=1.06, 95% CI 0.95– 1.18). However, patients who received high-intensity thromboprophylaxis had a significantly longer duration of hospitalization (15.6 days vs 13.6 days; p=0.003) and ICU stay (12.3 days vs 10.8 days; p=0.039) compared to patients who received the standard dose.Conclusion: The use of high-intensity thromboprophylaxis was not associated with a reduction in mortality. Therefore, our results do not support the routine use of high-intensity prophylactic anticoagulation in both ICU and non-ICU patients with COVID-19.Graphical Abstract: Keywords: COVID-19, venous thromboembolism, anticoagulation, thromboprophylaxis, mortality

Anas Khan, 1, 2 Ahmed Alahmari, 2 Yasir Almuzaini, 2 Nada Alturki, 2 Alhanouf Aburas, 3 Fahad A Alamri, 2 Mohammed Albagami, 4 Mashael Alzaid, 4 Turki Alharbi, 4 Rahaf Alomar, 4 Muath Abu Tayli, 4 Abdullah M Assiri, 5 Hani A Jokhdar 6 1Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Global Center of Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia; 3Health Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 4Saudi Data and Artificial Intelligence Authority, Riyadh, Saudi Arabia; 5Ministry of Health, Riyadh, Saudi Arabia; 6Deputyship of Public Health, Ministry of Health, Riyadh, Saudi ArabiaCorrespondence: Alhanouf AburasHealth Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaEmail Alhanoufaburas@gmail.comIntroduction: The novel coronavirus (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single-chain ribonucleic acid (RNA) virus. As of March 25, 2021, the total number of positive cases and fatalities in the Kingdom of Saudi Arabia (KSA) had reached 386,300 and 6624, respectively, with a case fatality rate of 1.71%. The KSA was among the leading nations to heed the advice of WHO officials and put strict precautionary and preventive measures in place to curb the early spread of COVID-19 before it was declared a global pandemic.Methodology: This was an uncontrolled before–after study following a mixed-method approach for data collection. National and regional data were extracted from the Health Electronic Surveillance Network (HESN), a centralized public health collection system for quantitative and statistical data. Quantitative and qualitative methods have been utilized in studying data derived from tech media.Results: The Saudi authorities utilized different technological tools to aid in managing and combating the COVID-19 pandemic. In the case of Al Madinah Al Mounawarah, after the implementation of several technologies, the most important being Tawakkalna, the number of active daily cases decreased by 61%.Conclusion: The use of the Tawakkalna application was proven to be a successful method in fighting the COVID-19 pandemic in the KSA. This vital and essential experience warrants the use of different digital technology that offers a personalized profile displaying the person’s status (affected, vaccinated, or no history of infection). This application played and will continue to play a crucial and effective role in pandemic containment in Saudi Arabia.Keywords: digital technology, risk management, Saudi Arabia, applications

Amani Almeharish,1 Abdullah M Assiri,2 Areej Alfattani,1 Edward De Vol1 1Department of Biostatics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 2Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaCorrespondence: Amani AlmeharishDepartment of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Kingdom of Saudi ArabiaEmail aalmeharish26@kfshrc.edu.saAbstract: The spread of COVID-19 has become a significant threat to economic activity throughout the world, and it has made life particularly difficult for research institutions. According to a report published by Spain’s largest public research body, Cybermetrics Labs, King Faisal Specialist Hospital and Research Centre (KFSH&RC) is ranked first among the leading hospitals in the Arab world, and it has instituted a wide range of policy changes to accommodate researchers by providing them with additional flexibility. The aim of this project was to highlight the most prevalent COVID-related global challenges facing research institutions and describe how research protocol at KFSH&RC has been adjusted to minimize the disruption experienced by its researchers.Keywords: SARS-CoV-2, COVID-19, healthcare, disease, research, virus

Abdullatif Taha Babakr,1 Osman Mohamed Elsheikh,2 Abdullah A Almarzouki,3 Adel Mohamed Assiri,1 Badr Eldin Elsonni Abdalla,4 Hani Yousif Zaki,5 Samir H Fatani,1 EssamEldin Mohamed NourEldin11Department of Medical Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia; 2Department of Biochemistry, Faculty of Medicine, International University of Africa, Khartoum, Sudan; 3Department of Internal Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, 4Department of Biochemistry, Sciences Faculty for Girls, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 5Department of Biochemistry and Nutrition, Faculty of Medicine, University of Gezira, Sudan Background: Autoantibodies to oxidized low-density lipoprotein (oxLDL) are a heterogeneous group of antibodies that are controversially discussed to be either pathogenic or protective. Biochemical and anthropometric measurements correlated with increased levels of these antibodies are also controversial, especially in conditions of impaired glucose tolerance and type 2 diabetes mellitus. The present study was conducted to evaluate levels of oxLDL antibodies and their correlation with obesity in different glycemic situations. Methods: Two hundred and seventy-four adult males were classified into three subgroups: group 1 (n=125), comprising a control group of nondiabetic subjects; group 2 (n=77), comprising subjects with impaired glucose tolerance; and group 3 (n=72), comprising patients with type 2 diabetes mellitus. Body mass index was calculated, and measurement of oxLDL and oxLDL antibodies was performed. Results: Higher mean concentrations of oxLDL were found in the type 2 diabetes mellitus and impaired glucose tolerance groups (143.5±21.9 U/L and 108.7±23.7 U/L, respectively). The mean value for the control group was 73.5±27.5 U/L (P

Objective: To systematically assess the effect of the adjunctive administration of corticosteroids in the treatment of acute bacterial meningitis.Methods: We performed a systematic review and meta-analysis by searching several databases for reports (published from January 1966 through February 2008) of placebo-controlled randomized trials of corticosteroid use in the treatment of adolescents and adults with acute bacterial meningitis. We used random-effects models. Sources of heterogeneity were explored by preplanned subgroup analyses.Results: The 4 eligible trials (published between 1999 and 2007) were of high methodological quality and included 1261 adult patients. Overall, the short-term mortality rate associated with corticosteroid administration was not significantly lower than that associated with placebo (relative risk [RR], 0.81; 95% confidence interval [CI], 0.54-1.20; I(2)=54%). A significant interaction was found between the effect of corticosteroids and the income status of the country (P=.02) and the prevalence of infection with human immunodeficiency virus (HIV) among study populations (P=.03). The administration of corticosteroids resulted in a lower short-term mortality rate than did the administration of placebo in high-income countries (pooled RR, 0.5; 95% CI, 0.27-0.92; I(2)=0%) and in the studies with a low prevalence of infection with HIV (RR, 0.66; 95% CI, 0.44-0.99; I(2)=0%). In studies from high-income countries, the number needed to treat with corticosteriods to prevent 1 death and 1 neurologic sequela was 12.5 (95% CI, 7.1-100.0) and 11.0 (95% CI, 5.6-100.0), respectively.Conclusion: Our meta-analysis suggests that the adjunctive administration of corticosteroids is beneficial in the treatment of adolescents and adults with bacterial meningitis in patient populations similar to those seen in high-income countries and in areas with a low prevalence of HIV infection. [ABSTRACT FROM AUTHOR]