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Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has had a significant psychological impact on people's lives, including healthcare providers. This impact has manifested in the form of anxiety and fear. Since COVID-19 is a respiratory disease spread through the mouth and nose, dental practitioners have experienced anxiety due to their close proximity to the oro-nasal tissues. Aim: To assess the mental health condition, specifically fear and anxiety, of a group of dental students in Saudi Arabia during the COVID-19 pandemic and to explore students' perceptions about dentistry as a career choice following the pandemic. Materials and Methods: A cross-sectional questionnairebased study was conducted, which included demographic data, the Coronavirus Anxiety Scale (CAS), the Fear of COVID-19 Scale (FCV-19S), as well as a few questions to assess why students chose dentistry as a career and their perceptions about dentistry as a career following the pandemic. A digital link to the questionnaires was distributed through social media outlets such as Twitter, WhatsApp, etc., with the aim of reaching dental students across all dental schools in Saudi Arabia. Dental students and those undergoing internships from both public and private Dental Colleges across Saudi Arabia were approached. The study included a total of 633 students from 21 dental schools across Saudi Arabia. Data were analysed using the Statistical Package for Social Sciences, including Analysis of Variance(ANOVA), independent t-tests, and Chi-square tests. Results: Fear and anxiety levels were found to be the highest among interns and fourth-year dental students, respectively. A total of 346 (54.66%) of the respondents reported that they chose dentistry as a career due to personal desire. Approximately, 239 (37.8%) of the respondents reported being either 'Not Sure' or would not choose dentistry as a career if they had the choice, considering the uncertainty created by the COVID-19 pandemic. Conclusion: Fear and anxiety were reported to be higher among dental students exposed to clinical practice. The majority of dental students reported that they would still choose dentistry as a career option despite the uncertainty caused by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Simple Summary: Glaucoma is a common eye condition linked to genes and aging. We studied genetic factors related to primary open-angle glaucoma (POAG) in adult Arabs from Saudi Arabia. We focused on two specific variations in apolipoprotein gene (APOE), namely rs429358 and rs7412, to examine whether these variations are more common in people with POAG. We compared the DNA from 179 people with POAG and 251 without. Our results showed that these genetic changes were not significantly linked to POAG. We also checked different combinations of these variations but did not observe a strong connection with POAG risk. The gene variations also did not affect eye pressure or other eye indicators, such as cup/disc, ratio linked to POAG. Overall, in our Saudi group, these specific gene variations do not seem to be major factors causing POAG. However, more studies with larger groups are needed to confirm this. Adult-onset glaucoma, an age-related neurodegenerative disease, is very prevalent among the elderly Arabs of Saudi origin. This study investigated the association between apolipoprotein E (APOE) gene variants (rs429358 and rs7412) and primary open-angle glaucoma (POAG) in Arabs of Saudi origin. A case-control genetic association study involving 179 POAG patients and 251 controls utilized Sanger sequencing to genotype APOE gene variants. The allele frequencies and genotype distributions for rs429358 and rs7412 did not show significant associations with POAG. The haplotype analysis revealed apoε3 (87.6% and 87.4%) as the most prevalent, followed by ε4 (2.8% and 3.6%) and ε2 (9.6% and 8.9%) in the controls and POAG patients, respectively. Although the ε2/ε3 genotype and ε2-carriers displayed a more than two-fold increased risk, statistical significance was not reached. Notably, these polymorphisms did not affect clinical markers, such as intraocular pressure and cup/disc ratio. The logistic regression analysis demonstrated no significant influence of age, sex, rs429358, or rs7412 polymorphisms on POAG. In conclusion, within the Saudi cohort, APOE variants (rs429358 and rs7412) do not appear to be associated with POAG and are not substantial risk factors for its development. However, additional population-based studies are required to validate these findings. [ABSTRACT FROM AUTHOR]

In the present study, we formulate a mathematical model to understand breast cancer in the population of Saudi Arabia. We consider a mathematical model and study its mathematical results. We show that the breast cancer model possesses a unique system of solutions. The stability results are shown for the model. We consider the reported cases in Saudi Arabia for the period 2004–2016. The data are given for the female population in Saudi Arabia that is suffering from breast cancer. The data are used to obtain the values of the parameters, and then we predict the long-term behavior with the obtained numerical results. The numerical results are obtained using the proposed parameterized approach. We present graphical results for the breast cancer model under effective parameters such as τ 1 , τ 2 , and τ 3 that cause decreasing future cases in the population of stages 3 and 4, and the disease-free condition. Chemotherapy generally increases the risk of cardiotoxicity, and, hence, our model result shows this fact. The combination of chemotherapy stages 3 and 4 and the parameters τ 1 and τ 2 together at a low-level rate and also treating the patients before the chemotherapy will decrease the population of cardiotoxicity. The findings of this study are intended to reduce the number of cardiotoxic patients and raise the number of patients who recover following chemotherapy, which will aid in public health decision making. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although the association between ambient temperature and mortality in local populations is evident, this relationship remains unclear in transient populations (e.g., due to immigration, mass gatherings, or displacement). The holy city of Mecca annually shelters two populations comprising its residents and the transitory Hajj pilgrims (>2 million people from >180 countries). Both live side by side in a hot desert climate, rendering the development of evidence-based heat-protective measures challenging. OBJECTIVES: We aimed to characterize the ambient temperature-mortality relationship and burden for the Mecca resident and Hajj transient populations, which have distinct levels of adaptation to ambient temperature. METHODS: We analyzed daily air temperature and mortality data for Mecca residents and pilgrims over nine Hajj seasons between 2006 and 2014, using a fitted standard time-series Poisson model. We characterized the temperature-mortality relationship with a distributed lag nonlinear model with 10 d of lag. We determined the minimum mortality temperature (MMT) and attributable deaths for heat and cold for the two populations. RESULTS: The median average daily temperature during the Hajj seasons was 30°C (19°C-37°C). There were 8,543 and 10,457 nonaccidental deaths reported during the study period among Mecca residents and pilgrims, respectively. The MMT was 2.5°C lower for pilgrims in comparison with the MMT for Mecca residents (23.5°C vs. 26.0°C). The temperature-mortality relationship shape varied from inverted J to U shape for the Mecca and pilgrim populations, respectively. Neither hot nor cold temperatures had a statistically significant association with mortality in Mecca residents. In contrast, for pilgrims, elevated temperatures were associated with significantly high attributable mortality of 70.8% [95% confidence interval (CI): 62.8, 76.0]. The effect of heat on pilgrims was immediate and sustained. DISCUSSION: Our findings indicate that pilgrims and Mecca residents exposed to the same hot environmental conditions exhibited distinct health outcomes. This conclusion suggests that a precision public health approach may be warranted to protect against high environmental temperature during mass gatherings of diverse populations. [ABSTRACT FROM AUTHOR]

Polymorphisms rs2472493 near ABCA1, rs7636836 in FNDC3B, and rs61275591 near the ANKRD55–MAP3K1 genes were previously reported to exhibit genome-wide significance in primary open-angle glaucoma (POAG). Since these polymorphisms have not been investigated in the Arab population of Saudi Arabia, we examined their association with POAG in a Saudi cohort. Genotyping was performed in 152 POAG cases and 246 controls using Taqman real-time assays and their associations with POAG and clinical markers, such as intraocular pressure, cup/disc ratio, and the number of antiglaucoma medications, were tested by statistical methods. There was no association observed between POAG and the minor allele frequencies of rs2472493[G], rs7636836[T], or rs61275591[A]. None of the genetic models such as co-dominant, dominant, recessive, over-dominant, and log-additive demonstrated any genotype link. The Rs2472493 genotype showed a modest association (p = 0.044) with the number of antiglaucoma medications in the POAG group, but no significant genotype effect on post hoc analysis. In addition, a G-T allelic haplotype of rs2472493 (ABCA1) and rs7636836 (FNDC3B) did show an over two-fold increased risk of POAG (odds ratio = 2.18), albeit non-significantly (p = 0.092). Similarly, no other allelic haplotype of the three variants showed any significant association with POAG. Our study did not replicate the genetic association of rs2472493 (ABCA1), rs763683 (FNDC3B), and rs61275591 (ANKRD55–MAP3K1) in POAG and related clinical phenotypes, suggesting that these polymorphisms are not associated with POAG in a Saudi cohort of Arab ethnicity. However, large population-based multicenter studies are needed to validate these results. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies investigated the endurance of symptoms and occurrence of complications three months after SARS-CoV-2 infection. This study aims to examine the prevalence, variation, and severity of continual symptoms in the post‐COVID-19 using a single-center questionnaire. Methods: The questionnaire was distributed among population in Saudi Arabia who recovered from COVID‐19 between April 1, 2020 and December 31, 2021. Results: A total of 744 participants completed the questionnaire, 318 (42.8%) recovered less than 3 months, 75 (10.1%) recovered 3–6 months, while 351 (47.2%) recovered more than 6 months. About half of the participants 353 (47.5%) had incessant symptoms and of those patients, more than half had two or more symptoms. Common symptoms included fatigue 189 (25.4%), headache 118 (15.9%), and myalgia 63 (8.5%). Of the participants, 189 (21.4%) experienced continual symptoms including anxiety in 98 (13.2%) and depression in 70 (9.5%). Conclusion: The current study showed a high proportion of individuals with long-COVID-19 symptoms. Thus, proper assessment of the individuals in the post-recovery period can guide the patients to the relevant clinics for rehabilitation. Moreover, there is a great importance to decrease COVID-19 infection, populations should be targeted to boost vaccine efficiency. [ABSTRACT FROM AUTHOR]

Purpose: This paper studies a simple SVIR (susceptible, vaccinated, infected, recovered) type of model to investigate the coronavirus's dynamics in Saudi Arabia with the recent cases of the coronavirus. Our purpose is to investigate coronavirus cases in Saudi Arabia and to predict the early eliminations as well as future case predictions. The impact of vaccinations on COVID-19 is also analyzed. Methods: We consider the recently introduced fractional derivative known as the generalized Hattaf fractional derivative to extend our COVID-19 model. To obtain the fitted and estimated values of the parameters, we consider the nonlinear least square fitting method. We present the numerical scheme using the newly introduced fractional operator for the graphical solution of the generalized fractional differential equation in the sense of the Hattaf fractional derivative. Mathematical as well as numerical aspects of the model are investigated. Results: The local stability of the model at disease-free equilibrium is shown. Further, we consider real cases from Saudi Arabia since 1 May–4 August 2022, to parameterize the model and obtain the basic reproduction number R 0 v ≈ 2.92 . Further, we find the equilibrium point of the endemic state and observe the possibility of the backward bifurcation for the model and present their results. We present the global stability of the model at the endemic case, which we found to be globally asymptotically stable when R 0 v > 1 . Conclusion: The simulation results using the recently introduced scheme are obtained and discussed in detail. We present graphical results with different fractional orders and found that when the order is decreased, the number of cases decreases. The sensitive parameters indicate that future infected cases decrease faster if face masks, social distancing, vaccination, etc., are effective. [ABSTRACT FROM AUTHOR]

Natural symmetry exists in several phenomena in physics, chemistry, and biology. Incorporating these symmetries in the differential equations used to characterize these processes is thus a valid modeling assumption. The present study investigates COVID-19 infection through the stochastic model. We consider the real infection data of COVID-19 in Saudi Arabia and present its detailed mathematical results. We first present the existence and uniqueness of the deterministic model and later study the dynamical properties of the deterministic model and determine the global asymptotic stability of the system for R 0 ≤ 1 . We then study the dynamic properties of the stochastic model and present its global unique solution for the model. We further study the extinction of the stochastic model. Further, we use the nonlinear least-square fitting technique to fit the data to the model for the deterministic and stochastic case and the estimated basic reproduction number is R 0 ≈ 1.1367 . We show that the stochastic model provides a good fitting to the real data. We use the numerical approach to solve the stochastic system by presenting the results graphically. The sensitive parameters that significantly impact the model dynamics and reduce the number of infected cases in the future are shown graphically. [ABSTRACT FROM AUTHOR]

Background: Pediatric overweight/obesity is a major health problem worldwide. Accurate parental perception of children's weight status is crucial in preventing and tackling this issue. Despite the consistent increase in prevalence of the childhood obesity in Saudi Arabia, the role of the parents is not well described. This study aims to explore Saudi parents' readiness to change the lifestyle of their overweight/obese children and the barriers facing it. Individuals and Methods: Through a cross-sectional design, 362 parents of overweight/obese children attending King Abdulla Specialized Children's Hospital were selected and requested to fill a predesigned questionnaire reflecting their perception about their children's weight status and their preparedness to change their lifestyle. A Chi-square test was used to verify significance. A P value of <0.05 was considered an indication of significance. Results: Among all overweight/obese children (n = 362), obese children formed 39.5 and 22.7% had morbid obesity. Only one half of the parents (49.7%) had correct perception about their children's weight. Correct perception increases significantly with an increase age of the child and in the presence of family history of diabetes, P < 0.05. Only 68.9% were worried about body weight of their children, the percentage was significantly higher in younger parents; parents with obese children and with a positive family history of hypertension P < 0.05. In total, 83.1% of the worried parents proceeded to preparation and action stages; the percentage was significantly higher among parents whom their children were free from identified comorbidities, P < 0.05. Conclusion: Misconception about real weight status of overweight/obese children is common in Saudi parents. Parents who have correct perception and worried about health status of their children are more likely to take actions. The first step in controlling children's obesity is to educate parents about how to recognize the real weight status of their children and to be aware about the health-related problems of obesity. [ABSTRACT FROM AUTHOR]

Video gaming is a popular source of entertainment among children and adolescents. Although the Middle East is home to one of the fastest growing communities of video game users, most of the research established on this topic has been carried out through small scale studies. Our aim in this study is to assess the prevalence of video game use and its association with aggressive behaviors among adolescents in Saudi Arabia. This is a cross-sectional study involving boys and girls (aged 15–18 years) in both private and public secondary high schools in Riyadh, Saudi Arabia. Each participant completed a self-administered modified version of the aggression questionnaire, which consisted of 29 items scored on a 5-point Likert scale. This questionnaire assessed aggressive behaviors domains: physical aggression, anger, hostility, and verbal aggression and types of videogames and time of use. A total of 485 students were included in this study. The mean age of participants was 16.5 ± 0.9 years; 48% were boys. Adolescents who participated in action games had higher mean verbal (p < 0.01) and physical aggression (p < 0.01) scores. Adventure game players had significantly higher mean scores in all four types of aggressive behavior (p < 0.01). Participants who played simulation games had higher mean verbal aggressiveness (p < 0.01). Adolescents who participated in sports games had greater mean levels of anger (p = 0.01) and physical aggression (p = 0.01). Those who played strategy/puzzle games reported significantly higher mean scores of anger (p < 0.01), hostility (p = 0.01), and verbal aggression (p = 0.01). Females were more likely to show higher mean anger (p < 0.01) scores, whereas males were more likely to show higher mean physical aggression scores (p < 0.01). Conclusions: Our results do suggest that playing video games increases adolescent aggressive behaviors, which has been supported by other studies. We recommend educating parents on the pros and cons of playing video games and that parents schedule and limit the time their children spend playing video games. [ABSTRACT FROM AUTHOR]

In the present investigations, we construct a new mathematical for the transmission dynamics of corona virus (COVID‐19) using the cases reported in Kingdom of Saudi Arabia for March 02 till July 31, 2020. We investigate the parameters values of the model using the least square curve fitting and the basic reproduction number is suggested for the given data is ℛ0 ≈ 1.2937. The stability results of the model are shown when the basic reproduction number is ℛ0 < 1. The model is locally asymptotically stable when ℛ0 < 1. Further, we show some important parameters that are more sensitive to the basic reproduction number ℛ0 using the PRCC method. The sensitive parameters that act as a control parameters that can reduce and control the infection in the population are shown graphically. The suggested control parameters can reduce dramatically the infection in the Kingdom of Saudi Arabia if the proper attention is paid to the suggested controls. [ABSTRACT FROM AUTHOR]

Objective: Recent studies have demonstrated an association of single nucleotide polymorphisms (SNPs) rs35934224 in TXNRD2 and rs6478746 near LMX1B genes in primary open-angle glaucoma (POAG) among Europeans. We performed a retrospective, case-control study to investigate the association between the rs35934224 (TXNRD2) and rs6478746 (LMX1B) and POAG in a middle-eastern population from Saudi Arabia. Methods: DNA from 399 participants consisting of 150 POAG cases (83 males and 67 females) and 249 controls (135 males and 114 females) were genotyped using TaqMan® real-time PCR. Statistical tests were performed to evaluate genetic association with POAG and related clinical indices. Results: The minor allele frequency (MAF) of rs35934224[T] was 0.19 and 0.20 in POAG and controls, respectively. The difference was non-significant (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 0.75–1.55, p = 0.663). Likewise, rs6478746[G] MAF was 0.12 in both cases and controls with no statistical significance (OR = 1.02, 95% CI = 0.67–1.56, p = 0.910). Genotype analysis showed no association with POAG for both the SNPs in combined and gender-stratified groups. Regression analysis showed no significant effect of risk factors such as age, sex, rs35934224, and rs6478746 genotypes on POAG outcome. Furthermore, both the SNPs showed no significant genotype effect on clinical indices such as intraocular pressure (IOP) and cup/disc ratio in POAG patients. Conclusions: Rs35934224 in TXNRD2 and rs6478746 near LMX1B genes are not associated with POAG or related clinical indices such as IOP and cup/disc ratio in a Saudi cohort. Since the study is limited by sample size further investigations are needed to confirm these results in a larger cohort. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We investigated the association between variants rs12997 in activin A receptor type I (ACVR1) and rs1043784 in BMP6 located in the 3' untranslated region, and primary open-angle glaucoma (POAG). The retrospective case-control study used TaqMan real-time PCR assay to genotype 400 subjects, including 150 patients with POAG and 250 controls. The minor 'G' allele of rs12997 in ACVR1 showed significant association with POAG (p=0.027, OR=1.39, 95% CI=1.03 to 1.87). Likewise, rs12997 genotypes showed moderate association with POAG in recessive (p=0.048, OR=1.80, 95% CI=1.01 to 3.20) and log-additive models (p=0.030, OR=1.39, 95% CI=1.03 to 1.87), but did not survive Bonferroni correction. Rs1043784 in BMP6 showed no associations. Furthermore, rs12997 G/G genotype significantly (p=0.033) increased the risk of POAG (twofolds) independent of age, sex and rs1043784 genotypes in regression analysis. However, clinical variables such as intraocular pressure and cup/disc ratio showed no association with both the polymorphisms. To conclude, the study shows a modest association between rs12997 in the ACVR1 gene, a member of the bone morphogenic protein signaling pathway and POAG. However, the results need further replication in large population-based cohorts and different ethnicities to validate its role as an important genetic biomarker. [ABSTRACT FROM AUTHOR]

The agricultural sector in Saudi Arabia has witnessed rapid growth in both production and area under cultivation over the last few decades. This has prompted some concern over the state and future availability of fossil groundwater resources, which have been used to drive this expansion. Large-scale studies using satellite gravimetric data show a declining trend over this region. However, water management agencies require much more detailed information on both the spatial distribution of agricultural fields and their varying levels of water exploitation through time than coarse gravimetric data can provide. Relying on self-reporting from farm operators or sporadic data collection campaigns to obtain needed information are not feasible options, nor do they allow for retrospective assessments. In this work, a water accounting framework that combines satellite data, meteorological output from weather prediction models, and a modified land surface hydrology model was developed to provide information on both irrigated crop water use and groundwater abstraction rates. Results from the local scale, comprising several thousand individual center-pivot fields, were then used to quantify the regional-scale response. To do this, a semi-automated approach for the delineation of center-pivot fields using a multi-temporal statistical analysis of Landsat 8 data was developed. Next, actual crop evaporation rates were estimated using a two-source energy balance (TSEB) model driven by leaf area index, land surface temperature, and albedo, all of which were derived from Landsat 8. The Community Atmosphere Biosphere Land Exchange (CABLE) model was then adapted to use satellite-based vegetation and related surface variables and forced with a 3 km reanalysis dataset from the Weather Research and Forecasting (WRF) model. Groundwater abstraction rates were then inferred by estimating the irrigation supplied to each individual center pivot, which was determined via an optimization approach that considered CABLE-based estimates of evaporation and TSEB-based satellite estimates. The framework was applied over two study regions in Saudi Arabia: a small-scale experimental facility of around 40 center pivots in Al Kharj that was used for an initial evaluation and a much larger agricultural region in Al Jawf province comprising more than 5000 individual fields across an area exceeding 2500 km2. Total groundwater abstraction for the year 2015 in Al Jawf was estimated at approximately 5.5 billion cubic meters, far exceeding any recharge to the groundwater system and further highlighting the need for a comprehensive water management strategy. Overall, this novel data–model fusion approach facilitates the compilation of national-scale groundwater abstractions while also detailing field-scale information that allows both farmers and water management agencies to make informed water accounting decisions across multiple spatial and temporal scales. [ABSTRACT FROM AUTHOR]

Introduction: Special needs children experience poorer oral health when compared to their compatriots. Moreover, Special Care School Children (SCSC) experience significant barriers to access proper oral health care. It has been found that they have high unmet oral health needs. Aim: The aim of this study was to assess the effectiveness of preventive oral health measures in a group of SCSC; boys, in Al-Kharj Governorate of Saudi Arabia. Materials and Methods: A longitudinal study was designed among SCSC in Al-Kharj Governorate of Saudi Arabia starting from October 2016 for a period of eight months. Only schools for boys were included in the study. Out of 936 students enrolled in the special needs education programme in 18 boys schools; 163 SCSC (boys) from eight primary schools were eventually included in the study. After the base line survey; the subjects were evaluated with predefined criteria at three monthly intervals until six months. The effectiveness of various preventive measures was evaluated for reduction in the risk of oral diseases. SCSC were divided into groups as per their specific health care need. Preventive oral health measures such as supervised tooth brushing with a fluoridated tooth paste was introduced with the help of teachers and parents of SCSC. Plaque levels were assessed by means of Plaque index. Various indices were used to measure dental caries including Decayed, Missing, and Filled Teeth (DMFT/dmft) as well as Decayed, Missing, and Filled Surfaces (DMFS/dmfs) index. The risk for dental caries was assessed by means of a cariogram model at the start and at the end of campaign. The data was computed using SPSS v20 programme. Means of the overall plaque score and the caries indices scores were calculated and compared among various special need groups among the SCSC. The significance level was set at p<0.05. Results: The overall mean plaque score of the group was 1.55. Plaque scores and mean decayed (D) component were significantly higher in intellectual disabilities as compared to physical disabilities. The mean DMFT and DMFS score was 3.2 and 6.42, respectively with mean decayed (D) component score of 2.67. There was no significant difference among caries prevalence and decayed (D) component among various groups of disabilities. Plaque index score reduced to 1.35 after three months and finally to 1.1 after six months. This was statistically significant (p<0.05). The actual chance to avoid new cavities in the cariogram increased from 5% to 73% at the end of the SCSC boys. Conclusion: There was a significant decrease in the risk for oral diseases after incorporation of preventive oral health measures for SCSC. [ABSTRACT FROM AUTHOR]

Background: Glaucoma is a polygenic neurodegenerative disease and the second most common cause of blindness in Saudi Arabia. To test the hypothesis that genetic variants in the genes involved in the bone morphogenic protein (BMP) signaling pathway may be associated with glaucoma, we investigated the association between 3′ untranslated region variants, rs12997 in ACVR1 and rs1043784 in BMP6, and primary angle-closure glaucoma (PACG) and pseudoexfoliation glaucoma (PXG). Methods: In a case-control study, TaqMan® real-time PCR-based genotyping was done in 444 subjects consisting of 250 controls, 101 PACG and 95 PXG cases, and tested for genetic association with glaucoma-types and other clinical phenotypes. Results: Rs12997[G] allele in ACVR1 exhibited significant 2-fold increased risk of PACG (p = 0.005) in women but not in men. Similarly, genotype analysis also showed that subjects carrying rs12997[G/G] genotype were at > 2-fold risk of PACG that remained significant after adjustment for age, sex, and Bonferroni correction in the recessive model. Furthermore, this effect was also significant in women only. In PXG, the rs12997[G/G] genotype showed a significant trend towards increased risk of the disease (OR = 2.04, 95% CI = 0.99–4.18, p = 0.049) but did not survive the Bonferroni correction. Regression analysis showed that rs12997[G/G] genotype was a significant predictor of PACG independent of age, sex, and rs1043784 genotypes. Likewise, age and rs12997[G/G] genotype showed significant effect on PXG outcome. The rs12997[A/G] genotype showed significant association with cup/disc ratio as compared to wild-type (p = 0.005) in PXG. Genotype and allele frequencies of rs1043784 in BMP6 did not show any significant association either with PACG or PXG. Conclusions: Our results suggest that the polymorphism rs12997 in the ACVR1 gene involved in the BMP signaling pathway is significantly associated with PACG and PXG in a Saudi cohort. This is the first study to associate this variant/gene with PACG and PXG. However, further studies would be needed to replicate these findings in a large population-based cohort. [ABSTRACT FROM AUTHOR]

Background: The pathogenic spectrum of bloodstream infections (BSIs) varies across regions. Monitoring the pathogenic profile and antimicrobial resistance is a prerequisite for effective therapy, infection control and for strategies aimed to counter antimicrobial resistance. The pathogenic spectrum of BSIs in blood cultures was analysed, focusing on the resistance patterns of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae, in Aljouf region. Methods: This descriptive cross-sectional study analysed the culture reports of all non-duplicate blood samples collected from January 1 to December 31, 2019. Antibiograms of A. baumannii, E. coli, and K. pneumoniae were analysed for antibiotic resistance. The frequency and percentages of multi-drug, extensively-drug, pan-drug and carbapenem resistance were calculated. Results: Of the 222 bloodstream infections, 62.2% and 36.4% were caused by gram-negative and gram-positive bacteria, respectively. Most BSIs occurred in patients aged ≥60 years (59.5%). Among the 103 isolates of the studied Gram-negative bacteria (GNB), 47.6%, 38.8%, and 2.9% were multi-drug, extensively drug and pan-drug resistant respectively. 46% of K. pneumoniae isolates were carbapenemase producers. Resistance to gentamycin, 1st–4th generation cephalosporins, and carbapenems was observed for A. baumannii. More than 70% of E. coli isolates were resistant to 3rd- and 4th-generation cephalosporins. Klebsiella pneumoniae presented a resistance rate of >60% to imipenems. Conclusions: Gram-negative bacteria dominate BSIs, with carbapenem-resistant K. pneumoniae most frequently detected in this region. Resistant GNB infections make it challenging to treat geriatric patients. Regional variations in antimicrobial resistance should be continually monitored. [ABSTRACT FROM AUTHOR]

Background: The economic transition in Saudi Arabia imposed negative consequences leading to an increase in the prevalence of obesity and its sequelae. Despite the commitment of high authorities in KSA to combat obesity, so far 25% of Saudis are still obese. The association between obesity, disordered eating attitude, and body image needs to be addressed. Aim: To explore the relationship between obesity, eating attitude, and body image satisfaction among students and employees at Princess Nourah University (PNU) and to compare the different modalities of assessing body weight. Methods: A cross-sectional study using a convenient sampling technique comprised of 550 participants. Obesity was assessed by anthropometric measurements and body composition monitor (BF511). Eating attitude test (EAT26) was used to determine eating attitude while body image satisfaction score was determined using body shape questionnaire (BSQ). Results: Around 382 (69.5%) students and 168 employees participated in the study. Obesity was significantly higher among employees (48.2%) vs students (27.7%) (P < 0.001). Body fat composition showed significant positive correlations ranging from weak-to-moderate (0.13 to 0.44) with other body measurements for students and employees. The disordered eating attitude was maximized among obese compared to other BMI groups (P < 0.05). Percentage of disordered eating attitude score correlated positively with BMI: 35.2% vs 52.3% among underweight and obese, respectively (P = 0.001). There was no statistical difference in eating attitudes between students and employees. BSQ score correlates positively with BMI (P < 0.001), it was 36.73 ± 18.68 vs 57.92 ± 18.50 for underweight and obese, respectively. The effect of BMI on body image score was 19.1%. Discussion and Conclusion: Obesity remains a significant health problem among Saudi females. Increased BMI is associated with increased disordered food attitude and the effect of BMI on body image score was minimal. [ABSTRACT FROM AUTHOR]

BACKGROUND: The timeliness of vaccinating children is the pillar of the cost-effective strategy of decreasing the burden of many infectious diseases. Delayed immunization creates the risk of failure. There is regional variation in the rate of delayed vaccination. The purpose of present study was to determine the timeliness of vaccination and reasons for delay in vaccinating children under the age of 2 years in Sakakah, Northern Saudi Arabia. MATERIALS AND METHODS: This study included 195 children under 2 years of age consecutively taken from four randomly selected primary health centers in Sakaka, Al Jouf province. A pretested proforma was used to screen the vaccination cards of the children for any delays in vaccination. Parents of children whose vaccinations had been delayed for more than 4 weeks were interviewed to determine the reasons for the delay. The reasons for delay were grouped under three different themes, i.e., child related, facility related and social issues. RESULTS: The mean age of the children was 8.6 ± 5 months; 45% were girls and 38% were first or second order babies. In our sampled population, 23% children had delayed vaccinations of more than 4 weeks. The delay was similar for both male and female children (21.5% of males and 25% of females). High education of parents, working mothers and low birth order were positively associated with timeliness of vaccine uptake (P < 0.05). Of those with delayed vaccination, only 15.6% mentioned facility or appointment related reasons; illness of the child was reported by 46.7%. CONCLUSION: There is considerable delay in vaccination of children in Sakakah, Northern Saudi Arabia. A third or more birth order of the child, parents having less than university education, and child's mother being home maker are related with increased risk of delayed vaccination. [ABSTRACT FROM AUTHOR]

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The aim of the study was to investigate the correlation pattern of social habits and cardiovascular risk assessment with disease history (e.g., obesity, T2DM and HPT) among free-living citizens of Saudi Arabia. Cross-sectional observational study design was used to collect the data among the citizens of Saudi Arabia. Convenient sampling technique was used to contact over 1163 free-living individuals. A self-administered questionnaire containing 49 items divided into following three sections was used to measure the correlation. Logistic regression analysis was used to predict the response. Sixty-seven percent (n = 725) of the respondents (male n = 419 (57.79%) vs. female n = 306 (42.21%), respectively; p > 0.01) perceived unhealthy nutritional habits. Also, a total of 785 (72.55%) participants (436 (55.54%) vs 349 (44.56%); males vs. females; p > 0.05) responded insufficient daily physical activity. Leisure time and uncontrolled eating were independently associated with BMI (S.E − 0.13, 95% CI − 1.81 to − 0.11, p = 0.035; and S.E 0.31, 95% CI 0.23 to 0.45, p < 0.001, respectively). T2DM showed significant independent association with leisure time, uncontrolled eating, and the Framingham risk (S.E − 0.25, 95% CI − 1.27 to − 0.14, p = 0.022; S.E 0.49, 95% CI 0.21 to 0.97, p < 0.001, and S.E − 0.17, 95% CI − 0.87 to − 0.13, p < 0.001, respectively). Study concluded a strong inverse correlation pattern between the level of physical activity (leisure time) with BMI, T2DM, obesity, and HPT. Uncontrolled eating behavior showed significant effect on BMI, obesity, and T2DM. However, HPT was significantly associated with work time (PA) and the Framingham risk assessment score. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence of acute kidney injury in patients treated with intravenous colistin. Study design: Cross sectional study. Study settings & duration: Study was conducted at Department of Medicine, King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia. Study duration was 6 months (June 2017-November 2017). Material & methods: Sample size of 147 patients was calculated using WHO calculator. Patients were selected using non probability consecutive sampling. Patients received intravenous colistin, were undergone through venous blood samples of creatinine. Patients with creatinine >2mg/dl were diagnosed with acute kidney injury. SPSS soft ware was used for data analysis. Descriptive and inferential statistics were calculated. Chi-square test was applied with p-value =0.05 significant. Results: Total 147 patients were included in study. There were 94(64%) female and 53(36%) males. Mean age of patients was 55±2.4 SD. Among all the patients 147 (100%), 20(14%) patients are at risk of acute kindney injury (AKI), 63(43%) had acute kindney injury while 5(3%) were diagnosed with kidney failure and 59(40%) remained intact with acute kindney injury diagnosis. Males, 40-80 years age group and BMI>30 kg/m2 had high proportion of acute kidney injury (p<0.05). Conclusion: Prevalence of acute kidney injury following colistin administration is very high as compare to previous thought. Further evidence is required for service planning and provision of information to clinicians to prevent deterioration of renal function. [ABSTRACT FROM AUTHOR]

Objective: Polymorphism rs13334190 in the zinc finger protein 469 gene has been suggested to predispose toward a "thin" cornea, which then becomes keratoconic or is directly pathogenic. Thus, we genotyped polymorphism rs13334190 in 127 unrelated keratoconus cases and 168 control subjects from Saudi Arabia using Taq-Man® assay. Results: The genotype frequency distribution did not deviate significantly from the Hardy--Weinberg equilibrium (p > 0.05). Overall, both the genotype and allele frequencies were not significantly different between cases and controls. A minor allele frequency of 0.068 was comparable to the aggregate rates ranging from 0.060 to 0.086 observed in other populations. Binary logistic regression analysis was performed to ascertain the effects of age, gender and genotype on the likelihood of having keratoconus. The analysis indicated that increased age was statistically signifi- cant (p = 0.000) and that females have a 2.19-fold increased risk (p = 0.018) of developing keratoconus. The genotype frequencies did not differ between the sporadic or familial keratoconus cases. Polymorphism rs13334190 is not an independent risk factor for keratoconus in the Saudi cohort. [ABSTRACT FROM AUTHOR]

Objectives: To quantify and evaluate the level of evidence (LOE) of Saudi publications in abdominal surgery and correlate the obtained results with that of other similar national and international studies. Methods: Study design was a systemic review. Literature search strategy was developed to retrieve available articles between January 2000 and December 2016 that are related to abdominal surgery utilizing PubMed and Google Scholar. Retrieved articles were analyzed in depth with several parameters, then evaluated using (OEBM) level of evidence scale. Results: One hundred and ninety-eight articles met the inclusion criteria. Of these, 50.5% were level III evidence studies. The most common study design was case reports (47%), and academic institutions had the highest rate of publications (47%). Conclusion: Saudi research in abdominal surgery published between 2000-2016 are of lower quality and of III and IV LOE, which is in the consistency with other specialties. We emphasize the need for promotion of a national and institutional research studies of I and II LOE with collaboration between different health care institutions. [ABSTRACT FROM AUTHOR]

Background: To investigate whether SNP rs4986790 in toll-like receptors (TLRs) is a risk factor for primary open angle glaucoma (POAG) in a Saudi population. Materials and methods: A cohort of 85 unrelated POAG patients and 95 unrelated control subjects from Saudi Arabia were genotyped utilizing Taq-Man® assay. The association between mutant genotypes and various clinical indices important for POAG was investigated. Results: Among cases, the normal pattern (A/A) was detected in 70 (82.4%) of the subjects, A/G in 14 (16.5%) and G/G in one subject only (1.2%). Among controls, prevalence of the genotype (A/A) was detected in 86 (90.5%), the (A/G) genotype in 8 (8.4%) and homozygous mutated genotype (G/G) in 1 (1.1%) subjects. Comparing cases to controls, the odds ratio of having heterozygous mutation (A/G) was 2.15 [95% CI: 0.853–5.417], which was not significant (p= 0.114). The odds ratio of having homozygous mutation (G/G) was 1.22 [95% CI: 0.075–19.99], which was statistically non-significant (p= 0.568). Likewise, the presence of the mutated allele (G) was non-significantly different between cases and controls (p= 0.154). Comparing cases to controls as regards co-morbidity with other systemic diseases, there were no statistically significant differences between groups in all assessed diseases except for a family history of glaucoma (p= 0.014) Conclusions: In conclusion, we could not detect any direct link between genotypes or allele frequencies of SNP rs4986790 in theTLR4gene and POAG. In contrast, genotype (A/A) may be protective against POAG especially among individuals with no family history of glaucoma. [ABSTRACT FROM AUTHOR]

Aims: To investigate the association between the rs1900004 polymorphism in the atonal bHLH transcription factor 7 ( ATOH7) gene and primary open angle glaucoma (POAG) in Saudi patients. Methods: Eighty-seven unrelated POAG cases and 94 unrelated control subjects of Saudi origin were genotyped utilizing a TaqMan® assay. The association between mutant genotypes and POAG and its related clinical indices was investigated. Results: The genotype and allele frequencies of the polymorphism in ATOH7 did not show any statistically significant association with POAG compared to controls. The minor allele frequency was 0.32 in both cases and controls. None of the demographic, systemic diseases nor glaucoma-specific clinical indices such as intraocular pressure (IOP), cup/disc ratio, and number of antiglaucoma medication, showed any significant association with genotypes. Binary logistic regression analysis (adjusted for age and gender) showed that age was a marginally significant risk factor for the development of glaucoma (adjusted odds ratio = 1.1; 95% confidence interval = 1.079-1.158; p < 0.0001). Conclusions: The study did not detect any direct link between genotype/allele frequency of rs1900004 in ATOH7 and POAG or its related clinical indices such as IOP and cup/disc ratio indicating that this polymorphism is not a risk factor for POAG in a Saudi cohort. [ABSTRACT FROM AUTHOR]

Purpose: To report the results of molecular karyotyping for a dysmorphic girl withCYP1B1-negative primary congenital glaucoma from Saudi Arabia, whereCYPB1mutations account for over 90% of cases of primary congenital glaucoma and the remaining cases are idiopathic. Methods:CYP1B1sequencing in the affected child; high-resolution array comparative genomic hybridization (array CGH) of the affected child and both unaffected parents (Affymetrix Cytogenetics Whole-Genome 2.7M array; Affymetrix Inc., Santa Clara, CA, USA). Results: The girl did not harborCYP1B1mutation by Sanger sequencing. Array CGH revealed 2de novo7p heterozygous duplications (7p21 – 7p14, encompassing 223 genes, and 7p14-7p11.2, encompassing 225 genes) and a 4p homozygous microdeletion (4p14) encompassing one gene only,DTHD1. Conclusions: The fact that this dysmorphic girl is Saudi Arabian and hasCYP1B1-negative primary congenital glaucoma suggests that her glaucoma phenotype is related to herde novocopy number variation. Loss or gain of one or more of the genes encompassed in the identified chromosomal areas may be associated with primary congenital glaucoma and/or other observed phenotypic features. [ABSTRACT FROM PUBLISHER]

Background: Behavioral aspects play a major role in the prevention of oral diseases. Moreover, not many people are aware of the relationship of smoking with potential oral diseases. Therefore, the aims of this study were to analyze oral hygiene behavior, smoking habits, and perceived oral health problems among a sample of university students in Al-Kharj, Saudi Arabia. Materials and Methods: A self-administered questionnaire about oral hygiene behavior, smoking, and perceived oral health problems was developed. The questionnaires were mainly distributed in Medical, Dental, and Pharmacy colleges of the university. Questionnaires completed at other colleges were included under the term "other colleges." Results: Overall, 380 questionnaires were returned. Majority of the students (92.4%) reported cleaning their teeth. Most of the students reported cleaning teeth once daily (48.7%). Just over a half (55.8%) reported having a dental check-up in the last 6 months, and a significantly higher number of dental students reported having a dental check-up (P < 0.05). Regarding smoking, the majority (63.4%) reported to have never smoked while 17.3% reported that they were smoking frequently. About 17.6% perceived oral health problems, including a significant proportion of those who reported frequent smoking. Conclusions: Oral hygiene behavior exhibited by the university students sample was similar. Majority cleaned their teeth, although only once. Smoking habit was not exhibited by the vast majority of students. Frequent smokers perceived oral health problems more than other students. [ABSTRACT FROM AUTHOR]

Morphological, nutritional and molecular analyses were carried out to assess genetic diversity among 35 introduced lentil genotypes (Lens culinaris Medik.). The genotypes exhibited significant differences for their field parameters and some of them showed noticeable superiority. The nutritional and proximate analysis showed that some genotypes were excellent sources of proteins, essential amino acids, minerals, anti-oxidants, total phenolic contents (TPC) and total flavonoid contents (TFC) and hence, highlights lentil nutritional and medicinal potential. Sequence-related amplified polymorphism (SRAP) and amplified fragments length polymorphism (AFLP) markers were used to estimate the genetic variability at the molecular level. The existence of a considerable amount of genetic diversity among the tested lentil genotypes was also proven at the molecular level. A total of 2894 polymorphic SRAP and 1625 AFLP loci were successfully amplified using six SRAP and four AFLP primer pair combinations. Polymorphism information content (PIC) values for SRAP and AFLP markers were higher than 0.8, indicating the power and higher resolution of those marker systems in detecting molecular diversity. UPGMA (unweighted pair group method with arithmetic average) cluster analysis based on molecular data revealed large number of sub clusters among genotypes, indicating high diversity levels. The data presented here showed that FLIP2009-64L and FLIP2009-69L could be used as a significant source of yield, total protein, essential amino acids, and antioxidant properties. The results suggest potential lentil cultivation in the central region of Saudi Arabia for its nutritional and medicinal properties, as well as sustainable soil fertility crop. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether the g.4760C > T mutation in the catalase gene ( CAT) is a risk factor for primary open angle glaucoma (POAG) in the Saudi population. Methods: A cohort of 225 unrelated POAG patients and 403 unrelated control subjects from Saudi Arabia were genotyped for a single nucleotide polymorphism (SNP; rs1001179; g.4760C > T) in the CAT gene utilizing Taq-Man® assay. The association between mutant genotypes and various clinical indices important for POAG was also investigated. Results: The distribution of different genotypes was comparable between both study groups. The genotype 'C/C' was predominant among cases; 169 (75.1%) as well as among the controls; 289 (71.7%). As for the heterozygous mutated genotype 'C/T', it was present in 52 (23.1%) of cases and 103 (25.6%) of controls, where the homozygous fully mutated genotype was present in only 4 (1.8%) of cases and 11 (2.7%) of the controls. The distribution of mutant allele was similar in both study groups ( p = 0.218). Interestingly, there was a trend of association between the type of the mutation (homozygous versus heterozygous) and three clinical parameters important for predicting the severity of the disease. These parameters include mean age of onset, mean level of intraocular pressure (IOP) and mean months of duration of encountering glaucoma. Conclusions: There were no statistically significant differences between cases and controls in terms of the different genotype distribution. This mutation is possibly associated with various clinical indices important for POAG and thus may be used as a parameter for assessing POAG severity, at least in this population. [ABSTRACT FROM AUTHOR]

Hemophilia A is a hemorrhagic trend almost exclusively affecting males (X-related recessive disease). In 85% of cases, it is caused by factor VIII deficiency, called hemophilia A or classic hemophilia. Successful anesthetic management depends on the special care and a multidisciplinary team of health professionals informed about the disease, including qualified hematologist, surgeon, and anesthesiologist. [ABSTRACT FROM AUTHOR]

Morphological and simple sequence repeat (SSR) approaches were used to determine the genetic diversity of 29 ryegrass (Lolium rigidum) genotypes belonging to eight populations collected from several regions in Saudi Arabia. In this study, 50 in Silico-developed SSR markers derived from genomic and expressed sequence tag (EST) microsatellites were examined. Analysis of variance showed highly significant differences in all studied traits. Cluster analysis based on the morphological data of the 29 Lolium genotypes and using PAST (paleontological statistics) software was performed. According to the results, clustering was based mostly on genotype location. The sensitive genotypes for herbicide were clustered in one group. In addition, using EST-SSR markers, we observed the existence of a considerable number of genetic variations among Lolium genotypes. From these markers, only 31 produced reasonable amplification products. The results showed that 23 SSR markers revealed that 74.19% were polymorphic. The number of alleles detected per primer ranged from one to five in the primer LTC SSR1. The tested primers amplified 1434 bands across eight populations, with an average of 46.26 bands per primer. The polymorphism information content (PIC) values ranged from 0.11 to 0.76 for the primers LT EST-SSR5 and LTC SSR1. The unweighted pair group method with arithmetic average (UPGMA) clustering of the 29 genotypes representing eight populations was based essentially on their locations and herbicide-tolerance levels. Most of the populations formed into four clusters, together representing genotypes. Moreover, the tolerant populations were distinguished from the sensitive ones. The relationship between the genetic diversity and geographical source of Lolium rigidum populations of Saudi Arabia was revealed through this study. The results showed that the efficiency of developed SSR markers are transferable across species. They have been helpful to assess the genetic diversity of the ryegrass population as this could be applied to differentiate between tolerant and sensitive populations of ryegrass. [ABSTRACT FROM AUTHOR]

Objectives To compare the recovery profile of sevoflurane and propofol in nasal surgical procedures. Design A prospective, double blind, randomized study Setting King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, a tertiary care teaching hospital, attached with King Saud University, Riyadh Saudi Arabia. Patients 60 ASA I-II patients age between 18-35 years, and weighing 50-80 kg, scheduled for nasal surgical procedures. Methods Patients were assigned randomly to one of the two groups, the Sevoflurane Group-S (n = 30) & the Propofol Group-P (n = 30). Anesthetic induction was carried out using propofol 2.0mg/kg. in both the groups. Cis-atracurium 0.15mg/kg was given for intubation. Airway was protected with a throat pack around the endo-tracheal tube. Fentanyl 1 microgram/kg was given as bolus followed by infusion at a rate of 1 microgram/ kg/ hour. Anesthesia was maintained with sevoflurane 2% in Group-S. and propofol infusion at a rate of 200 microgram/kg/min. in Group-P. 50% oxygen in nitrous oxide was given in both the groups. At the end of surgery, patients were extubated after reversal of the neuromuscular block. Immediate recovery was assessed by recording the time to breathe spontaneously, time to extubation, and time of spontaneous eyes movements from the time of giving reversal. Ketoprofen 1.5mg;kg intramuscularly was given to all patients before transfer to (PACU). In PACE, sedation score was assessed for 45 min. Intermediate recovery was assessed by TDT and DSST at 15, 30 and 45 min. Time taken to state name and father's name was recorded. Results Patients in Group-S breathed significantly earlier than those in Group-P. Group-P showed significantly better performance with TDT at 45 min and with DSST at 30 and 45 min. Conclusions We conclude that both sevoflurane and propofol provide early and comparable post anesthesia recovery for patients undergoing nasal surgical procedures. [ABSTRACT FROM AUTHOR]

Arthropod-borne infections are a medical and economic threat to humans and livestock. Over the last three decades, several unprecedented viral outbreaks have been recorded in the Western part of the Arabian Peninsula. However, little is known about the circulation and diversity of arthropod-borne viruses in this region. To prepare for new outbreaks of vector-borne diseases, it is important to detect which viruses circulate in each vector population. In this study, we used a metagenomics approach to characterize the RNA virome of ticks infesting dromedary camels (Camelus dromedaries) in Makkah province, Saudi Arabia. Two hundred ticks of species Hyalomma dromedarii (n = 196) and Hyalomma impeltatum (n = 4) were collected from the Alkhurma district in Jeddah and Al-Taif city. Virome analysis showed the presence of several tick-specific viruses and tick-borne viruses associated with severe illness in humans. Some were identified for the first time in the Arabian Peninsula. The human disease-associated viruses detected included Crimean Congo Hemorrhagic fever virus and Tamdy virus (family Nairoviridae), Guertu virus (family Phenuiviridae), and a novel coltivirus that shares similarities with Tarumizu virus, Tai forest reovirus and Kundal virus (family Reoviridae). Furthermore, Alkhurma hemorrhagic virus (Flaviviridae) was detected in two tick pools by specific qPCR. In addition, tick-specific viruses in families Phenuiviridae (phleboviruses), Iflaviridae, Chuviridae, Totiviridae and Flaviviridae (Pestivirus) were detected. The presence of human pathogenetic viruses warrants further efforts in tick surveillance, xenosurveillence, vector control, and sero-epidemiological investigations in human and animal populations to predict, contain and mitigate future outbreaks in the region. [ABSTRACT FROM AUTHOR]

Antimicrobial-resistance in Enterobacterales is a serious concern in Saudi Arabia. The present study retrospectively analyzed the antibiograms of Enterobacterales identified from 1 January 2019 to 31 December 2019 from a referral hospital in the Aljouf region of Saudi Arabia. The revised document of the Centers for Disease Control (CDC) CR-2015 and Magiorakos et al.'s document were used to define carbapenem resistance and classify resistant bacteria, respectively. The association of carbapenem resistance, MDR, and ESBL with various sociodemographic characteristics was assessed by the chi-square test and odds ratios. In total, 617 Enterobacterales were identified. The predominant (n = 533 (86.4%)) isolates consisted of 232 (37.6%), 200 (32.4%), and 101 (16.4%) Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, respectively. In general, 432 (81.0%) and 128 (24.0%) isolates were of MDR and ESBL, respectively. The MDR strains were recovered in higher frequency from intensive care units (OR = 3.24 (1.78–5.91); p < 0.01). E. coli and K. pneumoniae resistance rates to imipenem (2.55 (1.21–5.37); p < 0.01) and meropenem (2.18 (1.01–4.67); p < 0.04), respectively, were significantly higher in winter. The data emphasize that MDR isolates among Enterobacterales are highly prevalent. The studied Enterobacterales exhibited seasonal variation in antimicrobial resistance rates towards carbapenems and ESBL activity. [ABSTRACT FROM AUTHOR]

Quinoa cultivation has expanded from South America to many countries because of its wide adaptability and nutritional value. We evaluated 32 introduced quinoa genotypes using 17 qualitative and 11 quantitative traits under Saudi Arabia conditions during the 2018–2019 season. The quinoa genotypes showed considerable variation during the vegetative and maturity stages. Plant height values varied between 60 and 18 cm, and maturity ranged from 98 to 177 days. Leaf shapes were rhomboidal or triangular, with dentate or serrate margins. Green was the standard color for leaves and panicles at the flowering stage. The leaf granule colors were white, purple, and white-red. At 150 units of the Euclidean distance, the genotypes aggregated into four major groups based on their morphological traits. Twenty-one sequence-related amplified polymorphism (SRAP) primer pair combinations generated 75 amplified fragments (alleles), with a mean of 3.57 alleles per primer pair combination. Unweighted Pair-Group Method with Arithmetic means (UPGMA) clustering analysis showed that the quinoa genotypes were grouped based on origin or according to genetic background. Genotypes from South America presented higher mean values for the average number of alleles, Shannon index (0.411), gene diversity (0.271), and polymorphic percentage (83.95). Analysis of molecular variance (AMOVA) showed that most of the genetic variation was because of differences within populations (86%). The wide variability of the genotypes studied herein is of great importance for quinoa breeders. [ABSTRACT FROM AUTHOR]

Increased problems associated with side effects and bacterial resistance of chemical drugs has prompted the research focus on herbal medicines in the past few decades. In the present investigation, the antimicrobial activity of the various parts of Avicennia marina (AM), a mangrove plant, has been evaluated. The plants were collected from the Jazan area of the Kingdom of Saudi Arabia. Primary extracts of roots, stem, leaves, fruits, and seeds were made in ethanol and fractioned in ethanol, ethyl acetate, petroleum ether, chloroform, and water. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the extracts were determined against Bacillussubtilis, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. It has been observed that the chloroform extract of roots of the AM exhibited inhibitory effects against both S. aureus (MIC = 1.5 ± 0.03 mg/mL) and E. coli (MIC = 1.7 ± 0.01 mg/mL). The ethanolic extract of the AM roots has shown antibacterial activity against Pseudomonas aeruginosa (MIC = 10.8 ± 0.78 mg/mL), Bacillussubtilis (MIC = 6.1 ± 0.27 mg/mL), Staphylococcus aureus (MIC = 2.3 ± 0.08 mg/mL), and Escherichia coli (MIC = 6.3 ± 0.28 mg/mL). The leaf extract of the AM in ethyl acetate showed antibacterial activity against S. aureus and E. coli. Antifungal activity of these extracts was also investigated against Aspergillus fumigatus and Candida albicans. Ethanolic extract of roots and seeds of the AM has shown antifungal activity against Aspergillus fumigatus when applied individually. Ethanolic extract of the AM fruits has shown an inhibitory effect on the growth of Aspergillus fumigatus and Candida albicans. It is suggested that the plant extracts of AM have tremendous antimicrobial activity against a group of microbes, and this effect depends on both the plant part and the solvent used for extraction. Therefore, this plant can be considered to treat various diseases caused by antibiotic-resistant bacteria. [ABSTRACT FROM AUTHOR]

Purpose. The prevalence of obesity and the number of bariatric surgeries are increasing in Saudi Arabia. Studies evaluating nutritional knowledge, especially in Middle Eastern countries, are limited. Therefore, this study was conducted to examine the general and postbariatric nutritional knowledge related to dietary recommendations among patients undergoing bariatric surgery. Patients and Methods. In a cross-sectional study, 112 patients aged 18–65 years, of both genders, were recruited from the Surgical Clinics at King Abdul-Aziz University Hospital in Jeddah, Saudi Arabia. Patients' knowledge pertaining to general nutrition and consumption after bariatric surgery was assessed in relation to dietary recommendations, using a preoperative questionnaire. Results. The mean general nutrition knowledge score was 42 of a maximum of 85 points (50%). Approximately 40% and 60% of patients were classified with a low and medium level of nutritional knowledge, respectively. Postbariatric nutritional knowledge among patients was very low (mean: 16/81 points). The level of education was correlated with patients' body mass index (p = 0.045) and the general nutritional knowledge total score (p = 0.05). Conclusion. General and postbariatric nutritional knowledge among Saudi bariatric patients is currently insufficient. A multicenter study involving a larger sample size with different sociodemographic characteristics is warranted to confirm these findings. The purpose of such a study would be to determine the nutritional knowledge of patients undergoing bariatric surgery and inform the implementation of educational strategies. [ABSTRACT FROM AUTHOR]

Background: The present study was undertaken towards the development of SSR markers and assessing genetic relationships among 32 date palm (Phoenix dactylifera L.) representing common cultivars grown in different geographical regions in Saudi Arabia. Results: Ninety-three novel simple sequence repeat markers were developed and screened for their ability to detect polymorphism in date palm. Around 71% of genomic SSRs were dinucleotide, 25% tri, 3% tetra and 1% penta nucleotide motives. Twenty-two primers generated a total of 91 alleles with a mean of 4.14 alleles per locus and 100% polymorphism percentage. A 0.595 average polymorphic information content and 0.662 primer discrimination power values were recorded. The expected and observed heterozygosities were 0.676 and 0.763 respectively. Pair-wise similarity values ranged from 0.06 to 0.89 and the overall cultivars averaged 0.41. The UPGMA cluster analysis recovered by principal coordinate analysis illustrated that cultivars tend to group according to their class of maturity, region of cultivation, and fruit color. Analysis of molecular variations (AMOVA) revealed that genetic variation among and within cultivars were 27% and 73%, respectively according to geographical distribution of cultivars. Conclusions: The developed microsatellite markers are additional values to date palm characterization tools that can be used by researchers in population genetics, cultivar identification as well as genetic resource exploration and management. The tested cultivars exhibited a significant amount of genetic diversity and could be suitable for successful breeding program. Genomic sequences generated from this study are available at the National Center for Biotechnology Information (NCBI), Sequence Read Archive (Accession numbers. LIBGSS_039019). [ABSTRACT FROM AUTHOR]

This study investigated the association between apolipoprotein E ( APOE ) gene polymorphisms (rs429358 and rs7412) and primary angle-closure glaucoma (PACG) and pseudoexfoliation glaucoma (PXG) in a Saudi cohort. Genotyping of 437 DNA samples (251 controls, 92 PACG, 94 PXG) was conducted using PCR-based Sanger sequencing. The results showed no significant differences in the allele and genotype frequencies of rs429358 and rs7412 between the PACG/PXG cases and controls. Haplotype analysis revealed ε3 as predominant, followed by ε4 and ε2 alleles, with no significant variance in PACG/PXG. However, APOE genotype analysis indicated a significant association between ε2-carriers and PACG (odds ratio = 4.82, 95% CI 1.52-15.26, p = 0.007), whereas no notable association was observed with PXG. Logistic regression confirmed ε2-carriers as a significant predictor for PACG ( p = 0.008), while age emerged as significant for PXG ( p < 0.001). These findings suggest a potential role of ε2-carriers in PACG risk within the Saudi cohort. Further validation and larger-scale investigations are essential to elucidate the precise role of APOE in PACG pathogenesis and progression.

Introduction: Multiple studies investigated the endurance and occurrence of symptoms three months after SARS-CoV-2 infection. This study examines the possible effects of COVID-19 vaccination on the persistence of post-recovery symptoms., Patients and Methods: A cross-sectional survey was conducted in Saudi Arabia to evaluate 14 prevalent long COVID-19 symptoms among vaccinated individuals. Patients self-reported their acute COVID-19 experience, demographic information, chronic conditions, vaccine history, and persistent symptoms., Results: Of the 484 patients, four respondents were excluded from the study as they had not received the vaccine, and 111 (23.1%) were vaccinated but did not get infected and were also excluded. The remaining 369 (76.9%) reported COVID-19 and a vaccination and thus they were included in the study. The occurrence of post-COVID-19 symptoms was reported in 59 (16.1%) for ≤ 3 months, 202 (54.8%) experienced persistent symptoms 3-6 months, and 108 (29.1%) reported symptoms lasting > 6 months. In relation to age group, persistent symptoms 3-6 months after recovery was more common in those > 50 years and symptoms lasting > 6 months were more common in 30-50 years of age (p < 0.001). Persistence of symptoms for  3-6 months was more common in those who were infected prior to vaccination compared to those who were infected after vaccination (P < 0.001). Of the included patients, 323 (87.5%) rated their health as good, 41 (11.1%) considered it fair, and 5 (1.4%) described their well-being as poor or terrible., Conclusion: The study provides information of persistent symptoms in vaccinated individuals who had recovered from COVID-19 and highlights the need for targeted interventions to alleviate post-COVID-19 symptoms. The study is limited by its reliance on self-reported data and potential selection bias. Future research is needed to understand the mechanisms underlying persistent symptoms in vaccinated individuals and to identify effective interventions for long COVID., (© 2023. The Author(s).)

The genetic etiology of Keratoconus (KC) in Middle Eastern Arabs of Saudi origin is still unclear. A recent genome-wide study identified two significant loci in the region of PNPLA2 (rs61876744) and CSNK1E (rs138380) for KC that may be associated with KC in the Saudi population. In addition, polymorphisms in the apolipoprotein E ( APOE ) gene, namely, rs429358 and rs7412, responsible for APOE allelic variants ε2, ε3, and ε4, may influence KC via oxidative stress mechanism(s). Thus, we investigated the possible association of polymorphisms rs61876744, rs138380, rs429358, rs7412, and APOE genotypes in KC patients of the Saudi population. This study included 98 KC cases and 167 controls. Polymorphisms rs6187644 and rs138380 were genotyped using TaqMan assays, and rs429358 and rs7412 were genotyped via Sanger sequencing. Although the allele frequency of rs61876744(T) in PNPLA2 was a protective effect against KC (odds ratio (OR) = 0.64, 95% confidence interval (CI) = 0.44-0.93), the p -value ( p = 0.020) was not significant for multiple testing correction ( p = 0.05/4 = 0.015). However, rs6187644 genotype showed a modestly significant protective effect in the dominant model (OR = 0.53, 95% CI = 0.32-0.88, p = 0.013). Polymorphisms rs138380, rs429358, and rs7412 showed no significant allelic or genotype association with KC. However, the ε2-carriers (ε2/ε2 and ε2/ε3 genotypes) exhibited a greater than 5-fold increased risk of KC, albeit non-significantly ( p = 0.055). Regression analysis showed no significant effect of age, gender, and the four polymorphisms on KC. Our results suggest that polymorphism rs6187644 in PNPLA2 might be associated with KC in the Middle Eastern Arabs of Saudi origin but warrant a large-scale association analysis at this locus.

We investigated the association between DICER1 (rs3742330) and DROSHA (rs10719) polymorphisms and pseudoexfoliation glaucoma (PXG) and related clinical phenotypes in a Saudi cohort. In a retrospective case-control study, TaqMan real-time, PCR-based genotyping was performed in 340 participants with 246 controls and 94 PXG cases. The minor (G) allele frequency of rs3742330 in PXG (0.03) was significantly different from that in the controls (0.08) and protective against PXG (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.16-0.92), p = 0.017). Similarly, the rs3742330 genotypes showed a significant protective association with PXG in dominant ( p = 0.019, OR = 0.38, 95% CI = 0.15-0.92), over-dominant ( p = 0.024, OR = 0.39, 95% CI = 0.16-0.95), and log-additive models ( p = 0.017, OR = 0.38, 95% CI = 0.16-0.92). However, none remained significant after an adjustment for age, sex, and multiple testing. Rs10719 in DROSHA did not show any significant allelic or genotype association with PXG. However, a protective effect of the GA haplotype in DICER1 and DROSHA and PXG ( p = 0.034) was observed. Both polymorphisms showed no significant effect on intraocular pressure and the cup-disk ratio. In conclusion, we report a significant genetic association between variant rs3742330 in DICER1 , a gene involved in miRNA biogenesis, and PXG. Further investigation in a larger group of patients of different ethnicities and functional studies are warranted to replicate and validate its potential role in PXG.

Objective: To evaluate students' perceptions of problem-based learning tutorial sessions., Methods: The cross-sectional study was conducted at the College of Medicine, Jouf University, Al-Jawf Saudi Arabia, from March to May 2019, and comprised medical students in their clinical phase. Data was collected using an electronic questionnaire about students' perceptions of problem-based learning sessions, tutors' session facilitation, and tutors' student evaluation fairness. Data was analysed using SPSS 21., Results: Of the 66 students approached, 51(77.27%) completed the questionnaire; 23(45%) males and 28(55%) females. The agreement mean perception score was 4.73±2.13 regarding various statements characterising problem-based learning sessions. Lesser mean score of agreement 1.33±1.07 was observed regarding tutors' facilitation of the sessions and their students' evaluation., Conclusions: Students perceived problem-based learning sessions as effective and interactive, but did not positively perceive tutors' evaluations.

We investigated the association between variants rs12997 in activin A receptor type I ( ACVR1 ) and rs1043784 in BMP6 located in the 3' untranslated region, and primary open-angle glaucoma (POAG). The retrospective case-control study used TaqMan real-time PCR assay to genotype 400 subjects, including 150 patients with POAG and 250 controls. The minor 'G' allele of rs12997 in ACVR1 showed significant association with POAG (p=0.027, OR=1.39, 95% CI=1.03 to 1.87). Likewise, rs12997 genotypes showed moderate association with POAG in recessive (p=0.048, OR=1.80, 95% CI=1.01 to 3.20) and log-additive models (p=0.030, OR=1.39, 95% CI=1.03 to 1.87), but did not survive Bonferroni correction. Rs1043784 in BMP6 showed no associations. Furthermore, rs12997 G/G genotype significantly (p=0.033) increased the risk of POAG (twofolds) independent of age, sex and rs1043784 genotypes in regression analysis. However, clinical variables such as intraocular pressure and cup/disc ratio showed no association with both the polymorphisms. To conclude, the study shows a modest association between rs12997 in the ACVR1 gene, a member of the bone morphogenic protein signaling pathway and POAG. However, the results need further replication in large population-based cohorts and different ethnicities to validate its role as an important genetic biomarker., Competing Interests: Competing interests: None declared., (© American Federation for Medical Research 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: To investigate the association of endothelial nitric oxide synthase (NOS3) gene polymorphisms in patients with primary open-angle glaucoma (POAG) of Saudi origin., Methods: This case-control study included 173 patients with POAG (94 men and 79 women) and 171 controls (98 men and 73 women). Genotyping of rs2070744 (T-786C) and rs1799983 (G894T) variants of the NOS3 gene was performed using TaqMan® assay., Results: Rs1799983 genotypes showed a significant association with POAG but did not survive Bonferroni correction (pcorrection = 0.01). The minor 'T' allele was significantly associated with the risk of POAG among men (p = 0.025, odds ratio (OR) = 1.77, 95% confidence interval (CI) = 1.07-2.94). Likewise, the genotypes were significantly associated with POAG among men in dominant (p = 0.030, OR = 1.92, 95% CI = 1.06-3.48) and log-additive models (p = 0.022, OR = 1.82, 95% CI = 1.08-3.07), and after adjustment for age and smoking. Genotype and allele frequencies of rs2070744 were not significantly different between POAG cases and controls, and after sex stratification. CG haplotype was significantly protective (p = 0.011, OR = 0.52, 95% CI = 0.32-0.87) and CT haplotype conferred significantly increased risk of POAG (p = 0.016, OR = 2.60, 95% CI = 1.16-5.82) among men. Rs1799983 showed trend (p = 0.054) towards risk of POAG independent of age, gender, smoking, and rs2070744 polymorphism in logistic regression analysis. Both the polymorphisms showed no association with POAG phenotypes such as intraocular pressure and cup/disc ratio., Conclusion: Our results suggest that the polymorphism rs1799983 and the haplotypes of rs20707440 and rs1799983 in the NOS3 gene may significantly modulate the risk of POAG in Saudi's, particularly among men. Further larger studies are needed to confirm these findings., Competing Interests: The authors have declared that no competing interests exist.

Background: Surgical site infection (SSI) is one of the most common complications of abdominal surgery and is associated with substantial discomfort, morbidity and cost. The goal of this study was to describe the incidence, bacteriology and risk factors associated with SSI in patients undergoing abdominal surgery., Methods: In this prospective cohort study, all patients aged 14 years or more undergoing abdominal surgery between Feb. 1 and July 31, 2016, at a single large academic hospital were included. Patients undergoing vascular, gynecological, urological or plastic procedures were excluded. Patients were followed prospectively for 30 days. Wound assessment was done with the Centers for Disease Control and Prevention definition of SSI. We performed multivariate analysis to identify factors associated with SSI., Results: A total of 337 patients were included. The overall incidence of SSI was 16.3% (55/337); 5 patients (9%) had deep infections, and 25 (45%) had combined superficial and deep infections. The incidence of SSI in open versus laparoscopic operations was 35% versus 4% (p < 0.001). The bacteria most commonly isolated were extended-spectrum β-lactamase-producing Escherichia coli, followed by Enterococcus species. Only 23% of cultured bacteria were sensitive to the prophylactic antibiotic given preoperatively. The independent predictors of SSI were open surgical approach, emergency operation, longed operation duration and male sex., Conclusion: Potentially modifiable independent risk factors for SSI after abdominal surgery including open surgical approach, contaminated wound class and emergency surgery should be addressed systematically. We recommend tailoring the antibiotic prophylactic regimen to target the commonly isolated organisms in patients at higher risk for SSI., Competing Interests: None declared., (© 2019 Joule Inc. or its licensors)

Objective: Plexin domain containing 2 (PLXDC2), a cell surface transmembrane protein receptor for pigment epithelium derived factor, is expressed in many tissues including the eye. Polymorphism rs7081455 flanking PLXDC2 has been associated with primary open angle glaucoma (POAG) and its clinical phenotypes and may have a role in POAG. Rs7081455 was genotyped in POAG cases (n = 188) and non-glaucomatous controls (n = 164) of Saudi origin using Taq-Man ® to determine any association of this variant with POAG and its endophenotypes., Results: The risk variant, 'G' allele, frequency was 0.56 and 0.52 in controls and POAG cases, respectively (p = 0.197) with was no significant deviation from Hardy-Weinberg equilibrium. Genotype analysis between cases and controls revealed no significant distribution under additive (p = 0.482), dominant (p = 0.590) and recessive models (p = 0.228). In addition, glaucoma specific phenotypic traits such as intraocular pressure (IOP) and cup/disc ratio; and number of anti-glaucoma medications, used to assess severity of the disease, were also statistically non-significant. Furthermore, regression analysis showed no significant effect of age, sex and genotype on disease outcome. Rs7081455 was not associated with POAG or its clinical phenotypes such as IOP and cup/disc ratio and hence may not be a significant risk factor for POAG patients of Saudi origin.