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An accurate prediction of fetal birth weight is crucial in ensuring safe delivery without health complications for the mother and baby. The uncertainty surrounding the fetus's birth situation, including its weight range, can lead to significant risks for both mother and baby. As there is a standard birth weight range, if the fetus exceeds or falls below this range, it can result in considerable health problems. Although ultrasound imaging is commonly used to predict fetal weight, it does not always provide accurate readings, which may lead to unnecessary decisions such as early delivery and cesarian section. Besides that, no supporting system is available to predict the weight range in Saudi Arabia. Therefore, leveraging the available technologies to build a system that can serve as a second opinion for doctors and health professionals is essential. Machine learning (ML) offers significant advantages to numerous fields and can address various issues. As such, this study aims to utilize ML techniques to build a predictive model to predict the birthweight range of infants into low, normal, or high. For this purpose, two datasets were used: one from King Fahd University Hospital (KFHU), Saudi Arabia, and another publicly available dataset from the Institute of Electrical and Electronics Engineers (IEEE) data port. KFUH's best result was obtained with the Extra Trees model, achieving an accuracy, precision, recall, and F1-score of 98%, with a specificity of 99%. On the other hand, using the Random Forest model, the IEEE dataset attained an accuracy, precision, recall, and F1-score of 96%, respectively, with a specificity of 98%. These results suggest that the proposed ML system can provide reliable predictions, which could be of significant value for doctors and health professionals in Saudi Arabia. [ABSTRACT FROM AUTHOR]

The purple-spotted bigeye, Priacanthus tayenus, is a marine benthic fish native to the Indian and Pacific Oceans, including the Arabian Gulf in Saudi Arabia. This study identified a myxozoan parasite infecting wild P. tayenus from the Saudi Arabian Gulf. These parasites produced spherical to ovoid-shaped, white plasmodia enclosed within pseudocysts in the fish musculature. The annual infection rate was 5.1%, with the highest prevalence in summer (7.6%), followed by spring (6%), and autumn (2.5%), while no infections were observed in winter. The number of plasmodia per fish ranged from 100 to 150 (135.1 ± 16.2). Their dimensions were 4–4.7 mm (4.3 ± 0.3 mm) in length and 4.5–7 mm (6 ± 1.1 mm) in width. Milky-colored exudates within the plasmodia contained mature spores measuring 8–9 μm (8.6 ± 0.4 μm) x 6–7.5 μm (6.9 ± 0.5 μm). The polar capsules of the spores exhibited dimensions of 2–5 μm (3.5 ± 0.5 μm) x 2.5–4.5 μm (3 ± 0.45 μm). Both morphological and genetic analyses confirmed these plasmodia as a novel Kudoa species. Histopathological examination revealed atrophy in the surrounding muscles without an inflammatory response. This study documents the first occurrence of a novel Kudoa sp. in P. tayenus at the Jubail landing site in Saudi Arabia, emphasizing the need for further surveillance and investigations to elucidate its pathogenesis and implications for wild fish stocks. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the presence of Sarcotaces sp. in Epinephelus epilistictus (the dotted grouper) in Saudi Arabia. So, during our routine clinical examination of fish health conditions at Jubail province in the eastern region of Saudi Arabia (Arabian Gulf), nine grouper fish species were examined for Sarcotaces sp. (Copepoda: Phylichthyidae). Only the dotted grouper (Epinephelus epilistictus) harbored parasitic Sarcotaces spp. with an incidence of 9.06% of 1600 clinically examined fish samples. The collected Sarcotaces sp. was Sarcotaces arcticus (S. arcticus). The copepods were completely encapsulated cysts with a pyriform or pear-like shape, small to large, white-grayish, fluid-filled with thick black ink beneath the skin, or fully embedded in the muscular layer. The cysts present in the lateral aspect of trunk muscles, flank, caudal peduncle, near the anal opening, or pelvic and pectoral fin with an infestation rate (1–6 cysts) per fish. The cyst histopathology reveals the capsular layer of the cyst consisting of fibrous connective with pressure atrophy of the adjacent muscles associated with dilated blood vessels. The absence of infestation in other kinds of grouper fish species from the water of the Arabian Gulf in Jubail province may indicate parasitic host specificity and geographic locality distribution. [ABSTRACT FROM AUTHOR]

Purpose: Workplace violence is common throughout the world. It causes many serious problems in the healthcare sector, where it significantly impacts healthcare workers, the services provided, and organizations as a whole. However, few studies have investigated these issues in Saudi Arabia. This study examined the prevalence of violence against healthcare workers at primary care centers in Dammam and Al Khobar, in the Eastern Province of Saudi Arabia. The study also assessed the types, perpetrators, perceived causes, and consequences related to such violence. Here, the aim was to understand how healthcare workers responded to violence and gauge their awareness of a reporting system. Patients and Methods: A total of 360 healthcare workers (180 each from primary care centers in Dammam and Al Khobar) were invited to complete structured, self-administered questionnaires. As such, this study employed a cross-sectional analytical design. Results: The prevalence of workplace violence among all participating health workers was 46.9%, with approximately 90% of these workers reporting verbal violence, 34.3% having been subject to intimidation, and 3% reporting physical violence. Approximately 75% reported that violent events were initiated by patients, while 45.6% reported that the events were initiated by patients' companions. Healthcare workers' reactions included reporting events to their supervisors or the police, but 46.7% said they did nothing; the most common reason was perceived inefficacy. Finally, only 36.4% of all participants were aware of a violence reporting system. Conclusion: This study showed that healthcare workers were commonly exposed to different forms of violence, but often either did not react to it or did not report it. Further, there was relatively little awareness of how to manage and report workplace violence, thus indicating the need for healthcare workers to receive relevant education and training. A national program should also be established to track and prevent workplace violence. [ABSTRACT FROM AUTHOR]

Foot‐and‐mouth disease (FMD) is a highly contagious vesicular disease that is caused by the FMD virus (FMDV). This disease affects both wild and domestic cloven‐hoofed animals, and the latter of which includes cattle, swine, sheep and goats. FMD is endemic to Jordan and has a severe impact on the productivity of domestic livestock. In January 2017, FMD outbreaks were detected in different animal species across Jordan, resulting in high mortality rates among young lamb and goat populations as well as causing classic FMD symptoms in cattle. In this study, clinical specimens were collected from animals affected by FMD. The results obtained from sequencing the VP1 gene place the studied FMDV isolate within the FMDV O/ME‐SA/ Ind2001e sublineage. Phylogenetic analysis of VP1 suggests that the O/JOR/1/2017 isolate is very similar to that of viruses isolated from Saudi Arabia in 2016. The possible introduction of this strain to Jordan might occur through transboundary animal movement or other transmission routes from Saudi Arabia, a neighbouring country. [ABSTRACT FROM AUTHOR]

The basal Qusaiba hot shale member of Qalibah Formation is considered to be an important source rock in the Paleozoic petroleum system of Saudi Arabia and an exploration target for tight shale as one of the Unconventional resources of petroleum. This work has been carried out to understand the fractures network of Qusaiba shale member in outcrops located to the west of Qusayba' village in Al-Qasim area, Central Saudi Arabia. The main objective of this study is to understand the distribution of natural fractures over different lithological units. Description data sheets were used for the detailed lithological description of Qusaiba shale member on two outcrops. Spot-7 and Landsat ETM+ satellite images were used for lineament mapping and analyses on a regional scale in a GIS environment. Fractures characterization in outcrop-scale was conducted by using linear scanline method. Qusaiba shale member in the study area consists of 5 main lithofacies, divided based on their sedimentary structures and petrographical properties, from base to top in the outcrops, the lithofacies are; fissile shale, very fine-grained micaceous siltstone, bioturbated mudstone, very fine to fine-grained hummocky cross-stratified sandstone, and fine to medium-grained low/high angle cross-stratified sandstone lithofacies. Lineaments interpretation of the Spot-7 and Landsat ETM+ satellite images showed two major directions in the study area; 320° that could be related to Najd fault system and 20° that could be related to the extensional activities which took place after Amar collision. Fractures are much denser in the fissile shale and mudstone lithofacies than sandstones lithofacies, and average spacing is smaller in the fissile shale and mudstone lithofacies than sandstones lithofacies. Lineaments and large-scale fractures are Non-Stratabound fractures and they deal with the area as one big mechanical unit, but small-scale fractures are Stratabound fractures that propose different mechanical units within Qusaiba shale member in the study area. The fractures network in the study area has a wide range of properties related to fractures density, length, spacing, height, and termination degree. The conceptual multi-scale model divides the fractures in the study area into 4 orders depending on the available data that have been observed from satellite images and field. The multi-scale fractures model that was generated in this study could help to understand the distribution of stratigraphically controlled fractures when integrated with flow simulation models. Overall, this work could have a significant contribution to tight shale exploration plans in the subsurface by providing some knowledge about the fractures mechanical behavior of the lower part of Qusaiba shale member of Qalibah Formation. [ABSTRACT FROM AUTHOR]

Abstract: The objective of the current paper is the evaluation of the progress of occupational safety and health in the manufacturing sector in Jeddah Industrial Estate (JIE), Saudi Arabia over a 20-years period. A study was conducted on 2010 for the appraisal of occupational safety and health performance in JIE and the results are compared to a similar study conducted in 1990. The 1990 study had been based on a sample of 52 plants employing 5830 workers, while that of 2010 was conducted on 135 plants employing 18351 workers. In both studies, evaluation was performed by walk-thorough survey and using detailed survey forms. Comparing the results of both studies reveals that there are considerable improvements in some issues such as exposure to physical and chemical factors, applying engineering controls, and occupational medical services. However, these improvements are much less than what is anticipated or required after two-decade period. On the other hand, a considerable decline in the performance as related to many safety elements and fire protection is observed. Interpretation of these changes and some recommendations are presented. [Copyright &y& Elsevier]

The initial stages of formation of the Arabian shield are depicted in its ophiolites, which belong to two domains: an older (~ 800 Ma) oceanic domain of the western shield, and a younger (~ 700 Ma) pericontinental domain of the eastern and central shield. The oceanic domain ophiolites occur along the Yanbu and Bir Umq sutures, which juxtapose the ensimatic island arc terranes. The pericontinental domain ophiolites lie along the Ad-Dafinah, Halaban, and Al-Amar sutures. Ophiolites of the Ad-Dafinah suture were formed from volcanic islands on the western periphery of the Afif microcontinental terrane. Ophiolites of the Halaban and Al-Amar sutures developed above an Andean type subduction zone. Apart from these suture-associated ophiolites, certain ultramafic-mafic bodies (~ 627 Ma) occur along a later fault zone within the Asir terrane. Although displaced by major faults, ophiolites are the best available criteria for suture demarcation. The Arabian shield ophiolites are prominent among other contemporary ophiolites, which are lessabundant and lesser-known ophiolites. Certain primary features and chemical parameters are maintained even after their multistage histories of alteration, strain and metamorphism. The petrological attributes of these Neoproterozoic oceanic lithosphere sections compare well with Mesozoic ophiolites of the same (Arabian) plate. However, certain aspects are unique to the former, such as crust / mantle thickness ratios, the abundance of isotropic gabbros, and scarcity of layered gabbros. The scarce occurrences of segregated chromite are relatively more abundant in the oceanic domain ophiolites than in the pericontinental ophiolites. Pericontinental chromites with higher Cr / (Cr+Al) ratios, reflect higher degrees of partial melting of the mantle source, corroborating their island arc-related environments as postulated earlier, despite no reports on blueschists in the shield. However, a fore-arc regime for most ophiolites as stated previously, is not supported. The ophiolitic rocks show extensive alteration, including hydration of the ultramafic rocks, and rodingitization and chloritization of the basic rocks. Like arc-related rocks, the Ti-contents of oceanic ophiolites are low in most samples, but slightly higher in a few. The trace elements in volcanic rocks, as well as rare earth element patterns in different lithological components of some ophiolites indicate composite tectonic settings. Mantle heterogeneities may have caused the components with diverse geochemical signatures that are indicative of calc-alkaline rocks, mid-ocean ridge basalts and the enriched rocks of the oceanic islands or seamounts. A seawater effect is noticeable as a negative Ce anomaly in many bulk-rock REE patterns. Adakite in the Al'Ays ophiolite supports its formation in a small ocean basin. [ABSTRACT FROM AUTHOR]

Abstract: A newly identified skarn occurrence is described from the Neoproterozoic rocks of the SW Arabian shield. It is exposed to the SE, E and NE of the Al-Madhiq town. The skarn attributes correspond to those typical of the calcic skarns that host W-deposits. It is characterized as an exoskarn of the proximal type, related to a granitoid contact close to an impure quartzite bed within the regional metamorphic rocks of mixed sedimentary and volcanic derivation. The skarn is localized along a shear zone parallel to the regional faults and other major shear zones. Samples from the studied area contain characteristic skarn minerals that include both the prograde (brownish red grossular, ferrosalite, aluminian titanite-grothite, albite-oligoclase, scapolite), and retrograde (epidote, quartz, hornblende, calcite) assemblages. The pyroxenes are ferrosalites, Mn-bearing, and more like those from “oxidized” skarns; although garnets indicate it to be a “reduced” type skarn. Epidote mimicks that from typical skarns, as it bears a pistacite content of 15.9–20.7%. Grossular composition reflects a largely reduced genetic environment; as it is in solid solution with 6.5–21.6% andradite, 0–0.15% uvarovite, 0–0.47% pyrope, 4.33–18.75% almandine, and 0.4–8.58% spessartine molecules. Titanite composition varies from aluminian titanite to grothite, that may be analogous to the newly described Al-rich titanite from the low-pressure calc-silicate rocks. [Copyright &y& Elsevier]

Objective: Brain tumors are the most challenging of all tumors and accounts for about 3% of all cancer allied deaths. The aim of the present review is to examine the brain tumor prevalence and treatment modalities available in the Kingdom of Saudi Arabia. It also provides a comprehensive analysis of the application of various nanotechnology-based products for brain cancer treatments along with their prospective future advancements. Methods: A literature review was performed to identify and summarize the current status of brain cancer in Saudi Arabia and the scope of nanobiotechnology in its treatment. Results: Depending upon the study population data analysis, gliomas, astrocytoma, meningioma, and metastatic cancer have a higher incidence rate in Saudi Arabia than in other countries, and are mostly treated in accordance with conventional treatment modalities for brain cancer. Due to the poor prognosis of cancer, it has an average survival rate of 2 years. Conventional therapy includes surgery, radiotherapy, chemotherapy, and a combination thereof, but these do not control the disease's recurrence. Among the various nanomaterials discussed, liposomes and polymeric nanoformulations have demonstrated encouraging outcomes for facilitated brain cancer treatment. Conclusions: Nanomaterials possess the capacity to overcome the shortcomings of conventional therapies. Polymer-based nanomaterials have shown encouraging outcomes against brain cancer when amalgamated with other nano-based therapies. Nonetheless, nanomaterials could be devised that possess minimal toxicity towards normal cells or that specifically target tumor cells. In addition, rigorous clinical investigations are warranted to prepare them as an efficient and safe modality for brain cancer therapy. [ABSTRACT FROM AUTHOR]

• A comprehensive environmental sensitivity index was prepared and ESM maps generated. • Impact of Gulf War Oil Spill in 1991 impact on a mangrove habitat was assessed using Landsat imageries. • Impact probability of oil spill are calculated through General NOAA Operational Modeling Environment/Automated Data Inquiry for Oil Spills (GNOME/ADIOS) model simulation. • Areas with the highest priority for protection in case of an oil spill were demarcated for the development of immediate response plans. [ABSTRACT FROM AUTHOR]

Understanding root canal morphology is essential for successful endodontic treatment. This study aimed to investigate morphological variations in root and canal systems of anterior and premolar teeth across different age groups and genders in a Saudi Arabian subpopulation using a novel classification system. A total of 3573 maxillary and mandibular anterior and premolar teeth in 209 patients were examined using cone-beam computed tomography (CBCT) in a Saudi subpopulation. The number of roots was identified, and root canal configurations were classified according to Ahmed et al. coding system (Int Endod J 50(8):761-770, 2017). Demographic data including gender (male and female) and age (divided into 6 groups-10-20, > 20-30, > 30-40, > 40-50, > 50-60, > 60-70) were recorded. The Chi-square test was used for statistical analysis, and the significance level was set at 0.05 (P = 0.05). Results showed that maxillary and mandibular central incisors, lateral incisors, and canines predominantly exhibited the 1 TN 1 configuration. Maxillary first premolars had a higher prevalence of double-rooted variants with code 2 TN B 1 P 1 . Maxillary second premolars more frequently displayed the 1 TN 1-2-1 configuration. No significant gender and age differences were observed in maxillary anterior and premolar teeth (p > 0.05). A number of supplemental configurations such as 2 TNB 1-2 P 1 , 3 TN MB 1 DB 1 P 1 , and 3 TN 1 (MB 1 DB 1 ) P 1 were noted in maxillary premolars. For mandibular anteriors, results showed no significant difference by gender, but for age, mandibular incisors showed more prevalence of complex canal configurations up to 40 years. However, the difference with other age groups (> 40-70 years) was not statistically significant (p < 0.05). For mandibular premolars, the code 1 TN 1 was observed in more than 90% of the teeth with no significant differences in gender and age groups (p > 0.05). Several supplemental configurations such as 1 TN 1-2-3 , 1 TN 1-2-3-2 , 2 TN B 1 /L 1 , and 2 TN 1 B 1 /L 1 ) were noted in mandibular first premolars. This study identified a wide range of root and canal anatomical variations in anterior and premolar teeth within a Saudi subpopulation. The findings revealed that while age influenced the complexity of root canal systems in mandibular incisors, no significant association between gender and canal complexity was observed. The Ahmed et al. classification system offered a detailed analysis of these complex variations, providing a clear understanding of the root canal morphology in this population., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: This study was conducted according to the guidelines of the Declaration of Helsinki and the current study obtained independent approval from the Institutional Review Board of Prince Sattam bin Abdulaziz University, Al-Kharj, with the reference number PSAU2020024. The CBCT images were sourced from the College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia. These images were initially captured for various purposes unrelated to this study, such as for assessing traumatic injuries and conducting surgical procedures. The informed consent was obtained from all subjects and/or their legal guardian(s)., (© 2025. The Author(s).)

Identifying the prolactin threshold that necessitates pituitary magnetic resonance imaging (MRI) in patients with hyperprolactinemia remains challenging. Therefore, developing standards for serum prolactin level criteria to predict prolactinoma is critical. This study aimed to investigate the correlation between hyperprolactinemia and the presence of pituitary adenoma among Saudi female patients with verified prolactin levels. A retrospective multicentric study, including 4 regions from western Saudia Arabia between July 2020 and September 2023, included 168 female patients with abnormal prolactin levels who underwent brain MRI for the pituitary gland evaluation. The prevalence of pituitary adenoma and its associated factors and the relationship between blood prolactin levels and pituitary adenoma on brain MRI, as well as establishing the cutoff value of serum prolactin concentration linked to the existence of pituitary adenoma, were investigated and analyzed. The mean prolactin level was 72.7 ± 63.2 ng/mL. MRI findings were microadenoma in 77 (46.1%), macroadenoma in 17 (10.2%), Empty sella syndrome (ESS) in 7 (4.2%), and normal in 66 (39.5%) patients. In the ROC curve analysis, prolactin levels demonstrated a moderate degree of accuracy in predicting the existence of a pituitary adenoma (AUC = 0.640; 95% CI = 0.563-0.713; P = .0010], and the sensitivity and specificity were 40.59% and 83.33%, respectively. The ideal cutoff prolactin level for diagnosing pituitary adenoma was > 38.71 ng/mL with a sensitivity of 77.23% and specificity of 40.91%. It is prudent to perform pituitary imaging in most cases of hyperprolactinemia without event etiology, even if the condition is minor, due to the high prevalence of pituitary anomalies in female patients with hyperprolactinemia at serial sampling. A multidisciplinary strategy is necessary for a comprehensive diagnosis, treatment, and follow-up approach to improve the clinical outcomes of these individuals., Competing Interests: The authors have no funding and conflict of interest to disclose., (Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.)

In this study, 10 fish species, Jayan flounder (Pseudorhombus javanicus); Oriental sole (Eurgglossa arientalis); Oange-spotted grouper (Epinephelus coioides); Blacktip trevally (Caranx heberi); Towbar seabream (Acanthopagrus bifascia); Smalltooth emperor (Lethrinus microdon); Spangled emperio (Lethrinus nebulous); Sharptooth hammer croaker (Johnius vogleri); Bigeye croaker (Pennahia anea) and Redspine thread bream (Nemipterus nemurus), were examined in El-Jubail province, Saudi Arabia, Arabian Gulf region over three years from 2017 to 2020. The examined fish species showed muscular atrophy in a total percent of 1.1%, but with variable percentages of affections in each species. The highest incidence (2.06%) was oberved in Spangled emperior (Lethrinus nebulous) while the lowest incidence (0.40%) was in Orange spotted grouper (Epinephelus coioides) and Smalltooth emperor (Lethrinus microdon). The affected fishes appeared with sunken eyes, severe emaciation, and prominent loss of skeletal muscle mass. During dissection, the muscular tissue in some examined species was rough while in others, it was edematous and gelatinous, and the internal organs of all fishes were atrophied. For routine histopathological examination, the tissue samples were fixed in 10% buffered neutral formalin. The examined tissue sections of the affected muscles showed variable degrees of histopathological changes depending on the species. Vacuolation of muscle fibers, Zenker's necrosis and myophagia were common in some species, while melanophores aggregation, edema, and hemorrhages were the most commonly observed changes in others. This study focused on the impact of this myodegenerative disease on the marketability of these edible fish species. Further investigation is needed to understand the impact of genetic predisposition, environmental pollution and other etiological agents on the occurrence of this phenomenon in this location., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical standards: All authors declare that, the study was a field study not an experimental study and no live experimental animals were used, the study was conducted on fish in fish markets in accordance with guidelines for the Use of Fishes in Research, field activities, the procedures were parallel with the ARRIVE guidelines54, and the protocol has been presented and approved by the Department of Pathology Council, Faculty of Veterinary Medicine, Cairo University, on 31 October 2018. Informed consent: Informed consent was obtained from all individual participants included in the study., (© 2024. The Author(s).)

During routine veterinary inspection of fish from fishing boats, fish auction yards, and fish landing stations, as well as the large fish market for detection of fish diseases, abnormalities and/or overgrowth in body surfaces and evaluation of hygienic conditions and fish quality at El-Jubail Province, Saudi Arabia., external neoplastic overgrowths were observed in two fish species, giant sea catfish (Arius thalassinus) and Delagoa threadfin bream (Nemipterus bipunctatu). In both fishes, the neoplasms appeared as bony masses, and it was hard in its consistency. In the giant sea catfish (Arius thalassinus), the tumor appeared as three multifocal hard swellings at different locations (in the head region, at the dorsal fin, and near the caudal fin). The tumor mass in the head region of this fish was observed at the base of the right angle of the lower jaw, and it was hard, bony, nodular to round, and of 0.7 cm in diameter. The second one was observed at the dorsal fin and appeared as a small oval to rod hard mass of 0.5 cm in diameter, while the third mass appeared as a large and irregular wart-shaped bony swelling, about 3 cm in diameter, that extended laterally on the left aspect of the caudal peduncle near the caudal fin. In radiographic examination, the neoplasm appeared small, round to large, irregular, dense bony overgrowth with variable sizes. In histopathological examination, evidences of fibro-osteosarcoma associated with prominent multiple rounded eosinophilic apoptotic bodies in the neoplastic bony trabeculae were observed. On the other side, the Delagoa threadfin bream (Nemipterus bipunctatus) showed only one yellowish to reddish, pedunculated, irregular, and very hard swelling at the base of the median site of the dorsal fin, and it was firmly connected to the spine of the dorsal fin; it was about 1 cm high with a wide base of 0.5 cm. In histopathological examination, the bony neoplastic masses in this fish appeared with massive edematous fibrous connective tissue and newly formed blood capillaries; abnormal mitosis, hemorrhages, and hemosiderin pigment deposition in the central and peripheral parts of the neoplasm were observed. New bone formation was confirmed using histochemical staining. Our results indicated that these two species are vulnerable to fibro-osteosarcoma. Further environmental investigations as well as immunohistochemical and molecular studies are required to indicate the potential impact of the environmental pollution on the incidence of the neoplasms in this locality and to correlate the cellular evidence of the neoplasms to a specific fish species., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: According to previous reports, very high percentages of individuals in Saudi Arabia are undiagnosed for type 2 diabetes mellitus (T2DM). Despite conducting several screening and awareness campaigns, these efforts lacked full accessibility and consumed extensive human and material resources. Thus, developing machine learning (ML) models could enhance the population-based screening process. The study aims to compare a newly developed ML model's outcomes with the validated American Diabetes Association's (ADA) risk assessment regarding predicting people with high risk for T2DM., Research Design and Methods: Patients' age, gender, and risk factors that were obtained from the National Health Information Center's dataset were used to build and train the ML model. To evaluate the developed ML model, an external validation study was conducted in three primary health care centers. A random sample ( N  = 3400) was selected from the non-diabetic individuals., Results: The results showed the plotted data of sensitivity/100-specificity represented in the Receiver Operating Characteristic (ROC) curve with an AROC value of 0.803, 95% CI: 0.779-0.826., Conclusions: The current study reveals a new ML model proposed for population-level classification that can be an adequate tool for identifying those at high risk of T2DM or who already have T2DM but have not been diagnosed.

The neurometabolic disorder known as biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare autosomal recessive condition linked to bi-allelic pathogenic mutations in the SLC19A3 gene. BTBGD is characterized by progressive encephalopathy, confusion, seizures, dysarthria, dystonia, and severe disabilities. Diagnosis is difficult due to the disease's rare nature and diverse clinical characteristics. The primary treatment for BTBGD at this time is thiamine and biotin supplementation, while its long-term effectiveness is still being investigated. In this study, we have generated two clones of induced pluripotent stem cells (iPSCs) from a 10-year-old female BTBGD patient carrying a homozygous mutation for the pathogenic variant in exon 5 of the SLC19A3 gene, c.1264A > G (p.Thr422Ala). We have confirmed the pluripotency of the generated iPS lines and successfully differentiated them to neural progenitors. Because our understanding of genotype-phenotype correlations in BTBGD is limited, the establishment of BTBGD-iPSC lines with a homozygous SLC19A3 mutation provides a valuable cellular model to explore the molecular mechanisms underlying SLC19A3-associated cellular dysfunction. This model holds potential for advancing the development of novel therapeutic strategies., (© 2024. The Author(s).)

Introduction: Oral hygiene is paramount for maintaining optimal oral and physical health, especially among children who are particularly susceptible to dental caries and issues due to dietary habits and inadequate hygiene practices. This study aimed to evaluate the awareness and knowledge of oral health among public school children, analyse their oral hygiene habits, educate parents on the importance of oral health for their children, and implement an oral hygiene educational program in Al-Kharj City, Saudi Arabia., Methods: Four public elementary schools were selected for the study, with a sample size of 200 school-going children participating. A structured questionnaire was used to assess awareness and knowledge of oral health among the participants. SPSS software version 26 was used for data analysis. Multiple regression analysis and correlation tests was employed to explore the relationships between the different variables measured in the study., Results: The findings revealed a significant lack of awareness regarding oral health among school children. Oral hygiene habits were found to be inadequate in many participants. Overall, the findings highlight the need for targeted interventions aimed at promoting regular dental visits, addressing dental fear, and fostering positive oral hygiene practices among school-going children to improve oral health outcomes in the studied population., Conclusion: The study highlighted a critical gap in oral health awareness among school children, underscoring the need for targeted interventions. While the oral hygiene educational program has been implemented and future data will shed light on its effectiveness, preliminary observations suggest that such programs could potentially improve oral health outcomes and overall engagement among students., (© 2024. The Author(s).)

Background: Ischemic injury is a common mechanism in both ischemic stroke (IS) and acute coronary syndrome (ACS). Matrix metalloproteinase 9 (MMP-9), an endopeptidase that degrades extracellular matrix, is important in the pathogenesis of IS. The purpose of this study is to evaluate the association between the SNP rs17576 in MMP-9 gene with (1) the risk and severity of acute ischemic stroke in Saudi Arab individuals with recent acute coronary syndrome, and (2) the risk of acute coronary syndrome in Saudi Arab individuals without ischemic stroke., Methods: A case control study of 200 IS patients, 520 ACS patients (without IS), and 500 aged-matched healthy controls were genotyped to detect the MMP-9 polymorphism rs17156., Results: Our study demonstrated a non-significant difference in the genotype and allele frequencies of the MMP9 rs17576 polymorphism between the patients with IS and patients with ACS without IS (P = 0.31 for the GA genotype, 0.25 for the AA genotype and P = 0.20 for the A allele). AA genotype was found to be statistically significant between IS and control groups; [OR=1.84, 95 % CI (1.08-3.14), p =0.015]. A allele showed a significant difference between the two groups [OR=1.28, 95 % CI (1.00-1.64), p =0.028]. By comparing ACS without IS and controls, AA genotype was significant [OR=1.46, 95 % CI (1.01-2.12), p =0.029]. Stratification by NIHSS score revealed higher mortality and early neurologic deterioration in IS patients with NIHSS score ≥ 16 (p < 0.001, 0.044 respectively)., Conclusion: We deduced the lack of association either with allele or genotype frequencies (p>0.05) between the IS cases and the cases of ACS without IS. In contrast there was a significant association of mutant genotype AA between either the IS group or ACS (without IS) group, and the control group. In addition, different rs17576 genotypes were not associated with raised mortality or a tendency to develop early neurologic deterioration., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Background: Following transient ischemic attack (TIA) and minor stroke, the risk of recurrent stroke can be significantly reduced with short-duration dual antiplatelet therapy (DAPT). We wish to investigate whether 10 days of DAPT is as effective as 21 days' treatment., Study Design: This is an open-label, randomized, parallel-group study comparing whether 10 days of DAPT treatment (ASA + clopidogrel) is non-inferior to 21 days of DAPT in patients with acute ischemic stroke (AIS) or high-risk TIA. In both groups, DAPT is started within 24 hours of symptom onset. This study is being conducted in approximately 15 study sites in the Kingdom of Saudi Arabia. The planned sample size is 1932., Outcomes: Non-inferiority of 10 days compared to 21 days of DAPT in the prevention of the composite endpoint of stroke and death at 90 days in AIS/TIA patients. The primary safety outcome is major intra-cranial and systemic hemorrhage., Study Period: Enrolment started in the second quarter of 2023, and the completion of the study is expected in the fourth quarter of 2025., Discussion: The trial is expected to show that 10 days of DAPT is non-inferior for the prevention of early recurrence of vascular events in patients with high-risk TIAs and minor strokes., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population., Methodology: An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies., Results: The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology., Conclusion: This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations., (© 2024. The Author(s).)

The most prevalent form of epileptic encephalopathy is Dravet syndrome (DRVT), which is triggered by the pathogenic variant SCN1A in 80% of cases. iPSCs with different SCN1A mutations have been constructed by several groups to model DRVT syndrome. However, no studies involving DRVT-iPSCs with rare genetic variants have been conducted. Here, we established two DRVT-iPSC lines harboring a homozygous mutation in the CPLX1 gene and heterozygous mutation in SCN9A gene. Therefore, the derivation of these iPSC lines provides a unique cellular platform to dissect the molecular mechanisms underlying the cellular dysfunctions consequent to CPLX1 and SCN9A mutations., (© 2023. The Author(s).)

Purpose: To obtain clinical data about disease activity and severity of thyroid eye disease (TED) in a tertiary eye hospital in the Eastern Province of Saudi Arabia and to correlate this data with vitamin D levels., Methods: A clinical observational study was conducted in a specialized eye hospital in Saudi Arabia. It included prospective enrollment of Saudi patients with confirmed TED to evaluate activity and severity according to Clinical Activity Score (CAS) and European Group on Graves' Orbitopathy (EUGOGO), respectively, and also for blood investigation, including thyroid profile and vitamin D levels. In addition, some retrospective data collection included previous medical and surgical treatment and complications., Results: A total of 74 TED patients were included, with a median age of 42 years and a female predominance of 64.9%. Smokers were 18.9%. A family history of thyroid disease was noted in 12.16% of patients. There were 10.8% of patients with active TED. A moderate to severe severity level was observed in 71% of the cases, mild in 15%, and sight-threatening in 6%. Smoking and older age were associated with the active form of TED. There was a 48.4% prevalence of vitamin D deficiency among TED patients and it was not associated with TED severity or activity., Conclusions: This is the first study demonstrating the clinical profile of TED among Saudi patients. Smoking and older age were associated with TED. Vitamin D deficiency among TED patients was not worse than that of the general Saudi population.

Background and Aim: Spiral computed tomography (CT) scans, which are considered a high-contrast resolution, quick and cross-sectional imaging technique, have grown in popularity as a result of technological advancements. However, these advancements have brought with them the potential for significantly increased radiation doses to the patient. Consequently, many organizations recommended optimization and establishing diagnostic reference levels. The aim of the current study was to assess CT radiation dose and propose a local diagnostic reference level (LDRL) for the adult trunk [chest and abdomen] using CT dose parameters such as CT dose index volume (CTDI vol ) and dose length product (DLP) as well as to compare the practices for aforementioned examinations between two hospitals in Taif and Abha cities in Saudi Arabia., Materials and Methods: Data from 428 patients (216 for abdomen and 212 for chest) who were examined in two hospitals in Taif and Abha City in Saudi Arabia from December 2022 to March 2023, are used in this study. The data for hospitals in Taif and Abha are presented as 'T' and 'A' throughout this manuscript. The parameters of exposure and slice thickness were recorded in a specially designed data sheet together with the gender, age and patients morphometric. Microsoft Excel version 2010 was used to analyze results and plot the figures. The LDRL was achieved from the third quartile of CTDIvol and DLP for each hospital and examination., Results: The average DLP (mGy-cm) and CTDI vol (mGy) for the chest and abdomen were 243 mGy cm, 5.8 mGy and 549 mGy cm, 8.6 mGy respectively. The average effective dose (ED) for chest and abdomen were 5.10 and 21.10 mSv, respectively. The proposed LDRL for the chest and abdomen were 6.9 mGy (CTDIvol), 375 mGy-cm (DLP), 7.8 mGy (CTDIvol), and 747 (DLP) mGy-cm, respectively., Conclusion: Hospital 'A' irradiated patients with a higher dose for the abdomen exam than Hospital 'T', but both hospitals agreed on the amount of radiation dose received by patients for chest imaging. The proposed LDRL for two examinations was less than the DRL obtained from the literature., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Human iPSCs' derivation and use in clinical studies are transforming medicine. Yet, there is a high cost and long waiting time associated with autologous iPS-based cellular therapy, and the genetic engineering of hypo-immunogenic iPS cell lines is hampered with numerous hurdles. Therefore, it is increasingly interesting to create cell stocks based on HLA haplotype distribution in a given population. This study aimed to assess the potential of HLA-based iPS banking for the Saudi population., Methods: In this study, we interrogated the HLA database of the Saudi Stem Cell Donor Registry (SSCDR), containing high-resolution HLA genotype data from 64,315 registered Saudi donors at the time of analysis. This database was considered to be a representative sample of the Saudi population. The most frequent HLA haplotypes in the Saudi population were determined, and an in-house developed iterative algorithm was used to identify their HLA matching percentages in the SSCDR database and cumulative coverage. Subsequently, to develop a clinically relevant protocol for iPSCs generation, and to illustrate the applicability of the concept of HLA-based banking for cell therapy purposes, the first HLA-based iPS cell line in Saudi Arabia was generated. Clinically relevant methods were employed to generate the two iPS clones from a homozygous donor for the most prevalent HLA haplotype in the Saudi population. The generated lines were then assessed for pluripotency markers, and their ability to differentiate into all three germ layers, beating cardiomyocytes, and neural progenitors was examined. Additionally, the genetic stability of the HLA-iPS cell lines was verified by comparing the mutational burden in the clones and the original blood sample, using whole-genome sequencing. The standards set by the American College of Medical Genetics and Genomics (ACMG) were used to determine the clinical significance of identified variants., Results: The analysis revealed that the establishment of only 13 iPSC lines would match 30% of the Saudi population, 39 lines would attain 50% coverage, and 596 lines would be necessary for over 90% coverage. The proof-of-concept HLA-iPSCs, which cover 6.1% of the Saudi population, successfully demonstrated pluripotency and the ability to differentiate into various cell types including beating cardiomyocytes and neuronal progenitors. The comprehensive genetic analysis corroborated that all identified variants in the derived iPSCs were inherently present in the original donor sample and were classified as benign according to the standards set by the ACMG., Conclusions: Our study sets a road map for introducing iPS-based cell therapy in the Kingdom of Saudi Arabia. It underscores the pragmatic approach of HLA-based iPSC banking which circumvents the limitations of autologous iPS-based cellular therapies. The successful generation and validation of iPSC lines based on the most prevalent HLA haplotype in the Saudi population signify a promising step toward broadening the accessibility and applicability of stem cell therapies and regenerative medicine in Saudi Arabia., (© 2023. The Author(s).)

Objective: This study aimed to assess the appropriateness of direct oral anticoagulants (DOACs) utilization in a Saudi tertiary hospital., Patients and Methods: Adult inpatients and outpatients diagnosed with atrial fibrillation, deep vein thrombosis, or pulmonary embolism were included in a retrospective cohort study. Patients received at least one month of apixaban, rivaroxaban, or dabigatran. The duration of the study at the Armed Forces Hospital Southern Region in Khamis Mushait, Saudi Arabia, was from January 1, 2019, to December 31, 2021. The study assessed the appropriateness of DOACs dosing, initial and follow-up monitoring, the presence of clinically significant interactions, and treatment duration adherence., Results: 778 patients were included in the analysis (mean age 71.34 ± 15.98 years, equal male and female representation). Rivaroxaban was administered to 40.8% of the patients, while apixaban and dabigatran were administered to 31.02% and 28.18% of the patients, respectively. The most prevalent indication for DOACs was atrial fibrillation (72.84%), followed by deep vein thrombosis and pulmonary embolism (27.16%). The most prevalent category of medication errors was inappropriate maintenance dose (41.7%), followed by inappropriate initial dose (37.97%) and lack of laboratory parameter monitoring (36.42%). 31.5 percent of the study sample lacked baseline renal functions, while 24.5% of patients lacked baseline liver functions. 115 patients (14.8%) had potential clinically significant interactions. Regarding treatment duration, 232 patients (29.8%) were improperly prescribed DOACs based on their indications., Conclusions: In a significant proportion of DOAC patients, the prescribed rational DOAC utilization parameters were not implemented. The results of the study provide specific improvement areas and objectives for Anticoagulation stewardship programs.

Malnutrition could profoundly affect older adults' oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician's Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 ( p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94-0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults.

Background: Human teeth and nails have demonstrated similar factors genetically, embryologically, and morphologically. The fingernail form may be used as a post-extraction guide for selecting the tooth form., Aim: To evaluate the correlation between the maxillary left central incisor tooth form with the left index, middle, and ring fingernails in the Saudi Arabian population., Materials and Methods: A descriptive cross-sectional study with purposive sampling was done among 200 Saudi participants. The maxillary left central incisor and the left index, middle, and ring fingernail were scanned using an intraoral scanner. The 3D digital images were converted to 3D models. The tooth form (tooth length, tooth width, and tooth shape) and nail form (nail length, nail width, and nail shape) were measured using the CAD software. Pearson's correlation coefficient and T-test were used for statistical analysis (P < 0.05)., Result: A significant correlation exists between tooth length and nail length, with a maximum correlation toward index nail length (P = 0.015). A significant correlation exists between tooth width and nail width, with a maximum correlation toward ring nail width (P = 0.002). A significant correlation exists between tooth length and nail length in females with a maximum correlation toward index nail length in females (P = 0.001). The mean percentage of similarity between tooth and nail shape (index, middle, and ring) in males and females shows a highly significant difference between them (P = 0.001). The results indicate that the tooth and nail shape are similar (70 to 90%) based on the criteria set by the software., Conclusion: A definite correlation exists between maxillary central incisor tooth form and fingernail form. The fingernail form may be used as a post-extraction guide for selecting the maxillary central incisor tooth form in the Saudi Arabian population., Competing Interests: None

In well logging, sophisticated tools are inserted into a borehole to measure physical and geological properties of rocks surrounding the well. Some of these, known as nuclear logging tools, contain radioactive sources and are used to obtain useful information. When logging tools containing radioactive sources are inserted into the well, there is a risk that they may get stuck. If this occurs, a recovery operation, known as fishing, is used to attempt retrieval. If fishing fails to recover the radioactive sources, they are abandoned following an established protocol, which is in accordance with international, national and corporate standards, in addition to industry best practices. This paper provides an overview of radiation protection requirements for well logging operations in Saudi Arabia, to ensure the safety and security of radioactive sources, and the protection of workers and the public without impacting operational productivity., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Infection with SARS-CoV-2 may perturb normal microbiota, leading to secondary infections that can complicate the viral disease. The aim of this study was to probe the alteration of nasopharyngeal (NP) microbiota in the context of SARS-CoV-2 infection and obesity and to identify other respiratory pathogens among COVID-19 cases that may affect patients' health., Methods: A total of 107 NP swabs, including 22 from control subjects and 85 from COVID-19 patients, were processed for 6S amplicon sequencing. The respiratory pathogens causing secondary infections were identified by RT-PCR assay, using a kit that contained specific primers and probes combinations to amplify 33 known respiratory pathogens., Results: No significant (p > 0.05) difference was observed in the alpha and beta diversity analysis, but specific taxa differed significantly between the control and COVID-19 patient groups. Genera of Sphingomonas, Kurthia, Microbacterium, Methylobacterium, Brevibacillus, Bacillus, Acinetobacter, Lactococcus, and Haemophilus was significantly abundant (p < 0.05) in COVID-19 patients compared with a healthy control group. Staphylococcus was found in relatively high abundance (35.7 %) in the COVID-19 patient groups, mainly those treated with antibiotics. A relatively high percentage of Streptococcus was detected in COVID-19 patient groups with obesity or other comorbidities. Respiratory pathogens, including Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Salmonella species, along with Pneumocystis jirovecii fungal species were detected by RT-PCR mainly in the COVID-19 patients. Klebsiella pneumoniae was commonly found in most of the samples from the control and COVID-19 patients. Four COVID-19 patients had viral coinfections with human adenovirus, human rhinovirus, enterovirus, and human parainfluenza virus 1., Conclusions: Overall, no substantial difference was observed in the predominant NP bacterial community, but specific taxa were significantly changed between the healthy control and COVID-19 patients. Comparatively, an increased number of respiratory pathogens were identified in COVID-19 patients, and NP colonization by K. pneumoniae was probably occurring in the local population., Competing Interests: Competing interests None declared., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The Global Leadership Initiative on Malnutrition (GLIM) is a new approach established for the assessment of malnutrition. This study aimed to validate the GLIM for the diagnosis of malnutrition in patients with type 2 diabetes mellitus (T2DM) in Saudi Arabia, using the Subjective Global Assessment (SGA) as a reference. In addition, the association between the GLIM criteria and vascular complications in those patients was examined. A cross-sectional study was conducted on 101 patients with T2DM. The level of agreement between the GLIM and SGA tools was calculated using the kappa coefficient (κ). A receiver operating characteristic curve was used to determine the sensitivity and specificity of the GLIM. In addition, binary logistic regression was performed to investigate the association between each GLIM criterion and T2DM vascular complications. According to both the GLIM and the SGA, malnutrition was found in 15.8% and 17.8% of patients, respectively. The GLIM criteria achieved a very good level of accuracy (AUC = 0.877). The agreement between the tools was substantial (κ = 0.778). The 'disease/inflammation' criterion of the GLIM was significantly associated with macrovascular complications. To conclude, the GLIM criteria for diagnosis of malnutrition presented satisfactory levels of validity, and as such are acceptable for assessing the nutritional status of patients with T2DM.

The study aimed to assess the prevalence of tobacco use among dental professionals and their attitudes and behaviors about tobacco cessation counseling in Saudi Arabia. A total of 359 male and female dental professionals participated in this cross-sectional study. A pretested self-administered questionnaire was administered among study participants by visiting dental hospitals and clinics in Saudi Arabia. In the study, 15.9% of the participants were current tobacco users and 50.4% had a tobacco user at home or the workplace. Most participants reported that tobacco use is associated with bad breath (88.9%), oral cancer (88.3%), dryness of the mouth (80.8%), and bad taste (79.9%). Most participants asked patients about their tobacco habits (86.6%), mentioned tobacco habits in patient records (71.3%), and explained the benefits of quitting tobacco (79.9%). Less than half the sample (47.1%) referred patients to tobacco quitting services/programs. Male gender (Adjusted odds ratio (AOR) 5.50, 95% CI 2.48−12.23, p < 0.001), having a tobacco user at home/the workplace (AOR 3.18, 95% CI 1.57−6.45, p 0.001), and believing that tobacco cessation counseling was a waste of time (AOR 2.32, 95% CI 1.13−4.76, p 0.021) were associated with significantly increased odds of tobacco use among dental professionals. The study concluded that tobacco use was common among dental professionals despite their awareness of the adverse effects of tobacco. Reduction in tobacco use and promotion of counseling skills among dental professionals should be achieved through public health measures.

Introduction: Coronavirus infectious disease 2019 (COVID-19) had a significant impact on healthcare workers (HCWs) worldwide. Understanding the dynamics of infection transmission is important to develop strategies to prevent its spread., Methods: A retrospective study of a cohort of HCWs with COVID-19 from a single tertiary care hospital during the first wave of the pandemic. Epidemiological investigations and identification of clusters of infection were done prospectively., Results: A total of 326 HCWs had COVID-19 based on positive polymerase chain reaction tests for SARS-CoV-2. Ten clusters of infection were identified; nine clusters had HCWs as the index cases while one cluster had a patient as the index case. The largest cluster involved 15 transmissions, and one cluster included a secondary transmission. Sharing accommodation and social gatherings were the commonest epidemiological links. The majority of infected HCWs had mild infections, 23 (6%) required hospital admission and 3 (1%) required intensive care; all fully recovered. Majority of infections (80%) were community-acquired. Living in shared accommodation was associated with COVID-19 (120/690 versus 206/1610, P value = .01) while working in COVID-19 designated wards/units was not associated with COVID-19 (52/297 vs 274/2003, P value = .13)., Conclusions: Clustering of COVID-19 was common among HCWs and related to shared accommodation and social gatherings, infection was of mild severity, and was not associated with caring for COVID-19 patients., (Copyright © 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Blastomycosis is a disease caused by the fungus Blastomyces-a thermally dimorphic fungus that can cause granulomatous and/or purulent infection., Case Presentation: We report here a case of chronic blastomycosis infection in a 24-year-old male patient from Saudi Arabia who presented with recurrent skin abscesses associated with deep-seated and multilevel paraspinal (dorsal and lumbar) collections and bilateral empyema with pulmonary involvement and bilateral psoas abscesses. The diagnosis was made after a CT-guided pleural biopsy revealed the characteristic histopathological findings of blastomycosis. The patient underwent several drainage procedures and was successfully treated with a long-term course of oral itraconazole., Conclusions: Chronic blastomycosis may have clinical and radiologic features similar to thoracic tuberculosis or malignant disease. There is no definite clinical symptom of blastomycosis, and thus a high degree of suspicion is required for early diagnosis. This case is a rare form of blastomycosis with chronic multifocal purulent infection and is the second case of blastomycosis reported in Saudi Arabia., (© 2022. The Author(s).)

Background : Caries risk assessment is a useful tool in caries prevention and management. Using a tool such as CAMBRA, every individual can be assessed according to his or her disease indicators, risk factors, and protective factors for the current and future caries. Aim : This study aimed to assess caries risk among the general population of Sakaka, Saudi Arabia using the CAMBRA protocol. Methods : This cross-sectional study was conducted at university dental clinics using a questionnaire that was formulated using the CAMBRA caries risk assessment tool; afterwards, all 160 participants were intra-orally examined to assess oral hygiene status and presence of disease. Independent t -tests, ANOVAs, and chi-square tests were performed for analysis. Results: The majority of participants had one or more disease indicators, with white spots and visible cavities (71.3%), and the most commonly present risk factor was visible heavy plaque on teeth (82.5%). The use of fluoridated toothpaste (92.5%) was the most common protective factor. The majority of participants (85%) were in the 'High' category of Caries risk assessment. The prevalence of high caries risk was significantly higher among the rural participants compared to the urban ( p <0.05), and significantly fewer of those with a primary school education level or lower were in the high dental caries risk group compared to the other educational categories ( p <0.001). Conclusion : The caries risk among the general population of Sakaka, Saudi Arabia, is high, with significant variation among age groups, education levels, and geographical locations.

Background: Thrombotic events can increase the COVID-19 associated disease mortality. The administration of prophylactic anticoagulants had been shown to decrease the incidence of thrombosis, mortality, and ICU admission rates in COVID-19 patients., Aims: The present study investigates the rate of thrombosis with early anticoagulation prophylaxis, the various risk factors for thrombotic events, and the overall survival rate in hospitalized COVID-19 cases., Methods: In this prospective observational study, 425 patients aged ≥14 years were included in the study who were hospitalized with COVID-19 related symptoms from March to October 2020 at two tertiary care hospitals in the Kingdom of Saudi Arabia. Venous thromboembolism (VTE) score was evaluated, and VTE prophylaxis was administered according to the hospital guidelines. Patients' demographics, comorbidities, disease presentation, and sequential hematological profiles were also recorded. Samples were collected at different time points to determine the hematological profiles., Results: Out of 425 with positive COVID-19 subjects, eight (1.9%) patients developed thrombosis during admission, with pulmonary embolism being the most common type. VTE prophylaxis was administered to 394 (92.7%) patients. These anticoagulants included enoxaparin (86.3%), heparin (12.7%), warfarin (0.8%) and apixaban (0.3%). Comorbid conditions were recorded in 253 (59.5%) patients. ICU admission rate was 28% (n = 119), with a median time to transfer to ICU of 1 day (r: 0-33 days). A trend of high VTE score (5.0) with ICU admission and mortality ( P  = <.001) was observed. The observed mortality rate for our cohort was 5.9% (25 events out of 425); however, for patients admitted in ICU, it was 16% (19 events out of 119 admissions)., Conclusion: We are reporting a low incidence of thrombosis in COVID-19 patients. We have demonstrated that the early administration of prophylactic anticoagulants might reduce the risk of thrombotic events and the associated mortality. We observed a higher VTE score and thrombosis in patients admitted to the ICU.

Background: Saudi Arabia embarked on transforming its primary health care system in 2016 to meet international standards, gain the people's trust and respond to the growing burden of noncommunicable diseases, as proposed in the Saudi Vision 2030., Aims: This review aims to highlight the progress, identify challenges and prospects for Saudi Arabia's PHC reform process in order to make recommendations to facilitate strengthening of the PHC system., Methods: A review of previous studies and governmental reports was undertaken to extract, analyse, synthesize and report the findings., Results: The review has indicated that by mid-2019, the reform has contributed to an increase of 37.5% in the rate of PHC visits and 4.7% increase in patient satisfaction, enhanced coverage of rural communities (from 78% to 83%), and contributed to increasing the screening rate for prevalent chronic diseases. However, the country still faces gaps and challenges pertaining to human resources issues, cultural and lifestyle behaviour, geography, intersectoral collaboration and PHC infrastructure., Conclusion: PHC reform process in Saudi Arabia has demonstrated that positive change is achievable. This has been aided by building on previous accomplishments and the wealth of experience gained throughout the PHC journey in Saudi Arabia. However, despite improvement in the quality of services, continuous improvement is required to meet the rising expectations of the population., (Copyright © World Health Organization (WHO) 2021. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

In this study we isolated and enriched erythroid progenitor cells (EPCs) from a 10 ml peripheral blood sample from a 37-year old healthy Saudi donor. After expansion, these EPCs were reprogrammed using episomal plasmids to generate an induced pluripotent stem (iPS) cell line, KAIMRCi001-A. The pluripotency of this line was confirmed by measuring the expression of typical pluripotency markers and assessing differentiation potential in vitro., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objectives: To evaluate the impact of home isolation on feelings and behaviors of children aged 6-14 years during COVID-19 pandemic in Tabuk, Saudi Arabia., Methods: A cross-sectional study was conducted between June and August 2020 in Tabuk, Saudi Arabia. A snowball sampling was applied, parents with children aged 6-14 years participated in this survey (N=361). questionnaires were distributed electronically., Results: Four out of ten children reported severe psychological impact on feelings (41.3%), while a majority of the children demonstrated mild psychological impact on behavior (74.8%). Age was associated with risk of psychological impact on behavior (OR: 7.24, 95% CI: 1.35-16.18). Being male was associated with risk of psychological impact on feelings (OR: 2.38, 95% CI: 0.67-6.43), and behavior (OR: 3.50, 95% CI: 0.42-6.00). Living in a small house or without an outside play area was associated with risk of psychological impact on feelings and behaviors., Conclusion: This study revealed that children experienced mild-to-severe psychological impact on behaviors and feelings during home isolation during COVID-19 pandemic. Priority should be given to boys, older age, children of low-income families, living in small houses and those without outside play areas., (Copyright: © Saudi Medical Journal.)

Severe acute respiratory viral infections are frequently associated with multiple organ failure, including acute kidney damage. The present study aimed to investigate the associated influence of COVID-19 on renal function in patients admitted to the intensive care unit in Asir region, Saudi Arabia. Thirty patients infected with COVID-19 who were referred to the intensive care unit during November and October 2020 at Asir central hospital, Asir region, Saudi Arabia were recruited. The age of patients ranged between 30 and 90 years old. Renal function tests exhibited dramatic changes in the renal biomarkers in patients with COVID-19. Blood urea levels in COVID-19 patients were significantly higher than in the control group. In addition, significantly lower albumin levels with abnormally decreased total protein levels were found in COVID-19 patients. Among the different electrolytes analyzed, a significantly lower calcium level was observed in COVID-19 patients' groups than in the controls. Renal function tests for COVID-19-infected ICU patients revealed significant changes, indicating the major impact of COVID-19 on kidney function. Monitoring renal function tests may assist in the early prognosis of COVID-19 patients. It is, therefore, crucial to increase the understanding of renal function tests in COVID-19 patients who were admitted to the hospital before their condition deteriorated.

Bleeding disorders are a common cause of unexplained menorrhagia in adolescents. However, there is lack of information provided on Arab girls. To estimate the prevalence of coagulation factor deficiencies and platelet dysfunction among Saudi university students with unexplained menorrhagia. In this cross sectional study, 463 adolescent girls surveyed for having heavy menses for further evaluation of underlying bleeding tendencies using screening standardized questionnaire. Only 109 girls out of the total 463 girls reported menorrhagia and were included in the evaluation. All girls with menorrhagia were evaluated by Pictorial blood assessment chart (PBAC) for precise evaluation of menstrual blood loss (PBAC score >100), had underwent pelvic ultrasonography and screening of hemostatic abnormalities (complete blood count, PFA-100, PT, aPTT, vWF:RCo, vWF:Ag, coagulation factors assay). On the basis of the score of PBAC more than 100, 25.6% (28/109) of adolescent women (age ranged: 17-25 years old) had confirmed menorrhagia. In 30.8% of them, an ultimate diagnosis of bleeding tendency or hemostatic abnormality was detected [five cases of probable von Willebrand disease (vWD) or low level of vWF:Ag and/or vWF:RCo, two cases of probable platelet dysfunction, and one case of factorV (FV) deficiency]. Anemia was found in 39.28% (11/28) of them; however, only 4 (36%) had received iron supplements. Our study demonstrated that hemostatic defects are not uncommon in Saudi adolescent women presenting with menorrhagia but mostly unrecognized and untreated. It is probably advisable to screen women with menorrhagia for these defects., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Endodontic treatment failure is one of the most common problems encountered in dentistry., Aims: This study aimed to evaluate the causes of failure of endodontic treatment among patients in the Saudi Arabian city of Al-Kharj., Subjects and Methods: A total of 250 patients of both genders were involved in the study. Criteria confirming the failure of the endodontic treatment were pain, tenderness on pressure, periapical radiolucency, and sinus tract. Patients were selected by convenience sampling methods. A diagnostic chart was prepared to complete the investigation in three different hospitals, during a six-month period (October 2018 - March 2019). The results were analyzed statistically using Chi-square test and use of simple arithmetical methods to determine percentage and frequencies., Results: The main cause for endodontic failure was poor quality adjunctive treatment. 147 out of 179 male patients and 53 out of 71 female patients received poor quality treatment. There was a statistically significant difference between gender versus adjunctive treatment (P = 0.009) and between hospital versus adjunctive treatment (P = 0.005), and quality of adjunctive treatment between private hospital as compared to government hospital which was also statistically significant (P = 0.008). In quadrant wise distribution, first molars were the most commonly involved teeth. Inadequate filling of the root canal was (36.8%), missed canals (14.4), over-extension root canal fillings (12.8%), perforations (9.6%), instrumentation related (8.8%), and endodontic access preparation related (2.4%) in the decreasing order of frequency were seen as the most common causes of failure of endodontic treatment., Conclusion: First molars were the most commonly affected tooth in the failure of endodontic treatment. Poor adjunctive treatment and inadequate filling of the root canals were the most common causes of endodontic failure, more commonly seen in male than female patients and in private clinics/hospitals than government hospitals., Competing Interests: None

Introduction: X-linked hypophosphatemia (XLH) is a rare inherited cause of hypophosphatemic rickets and osteomalacia. It is caused by mutations in the phosphate-regulating endopeptidase homolog, X-linked (PHEX). This results in increased plasma fibroblast growth factor-23 (FGF23), which leads to loss of renal sodium-phosphate co-transporter expression leading to chronic renal phosphate excretion. It also leads to low serum 1,25-dihydroxyvitamin D (1,25(OH) 2 D), resulting in impaired intestinal phosphate absorption. Chronic hypophosphatemia in XLH leads to impaired endochondral mineralization of the growth plates of long bones with bony deformities. XLH in children and adolescents also causes impaired growth, myopathy, bone pain, and dental abscesses. XLH is the most frequent inherited cause of phosphopenic rickets/osteomalacia. Hypophosphatemia is also found in calcipenic rickets/osteomalacia as a result of secondary hyperparathyroidism. Thus, chronic hypophosphatemia is a common etiologic factor in all types of rickets., Results: There is considerable overlap between symptoms and signs of phosphopenic and calcipenic rickets/osteomalacia. Wrong diagnosis leads to inappropriate treatment of rickets/osteomalacia. Nutritional rickets and osteomalacia are common in the Gulf Cooperation Council countries which include Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Due to high levels of consanguinity in the region, genetic causes of phosphopenic and calcipenic rickets/osteomalacia are also common., Conclusion: This guideline was developed to provide an approach to the diagnosis of XLH, especially where there is no family history of the disease, and that other related conditions are not mistaken for XLH. We also guide the medical management of XLH with conventional treatment and with burosumab, a recombinant human IgG1 monoclonal antibody to FGF23.

Objective: To assess the emotional intelligence and identify the perceived sources of stress among female dental students and interns at King Khalid University College of Dentistry (KKUCOD), to investigate whether specific stressors were related to the year of study and gender, and to evaluate the relationship between emotional intelligence (EI) and perceived stress (PS)., Materials and Methods: Total of 150 female undergraduates from 5 th and 6 th years and dental interns were invited to complete a questionnaire using face-to-face interview. Data on EI was collected using a scale developed by Schutte et al. while a modified version of the Dental Environment Stress (DES) was applied to assess the stress perceived by dental students., Results: 120 students agreed to join the study with a response rate of 84%. Mean EI score for the sample was 120 (SD = 11.56), and the mean PS score was 70.37 (SD = 16.19). One-way ANOVA revealed a significant difference between different age groups and the educational, environmental score (P < 0.05). Correlational analysis showed that the PS scale and its factors correlated positively with each other (P < 0.01) and directly with the total EI score (P > 0.01); except for the living accommodation factor, negative correlations with overall EI score were significant., Conclusion: The present study showed that female interns and undergraduate students in clinical years of study at College of Dentistry reported higher EI and PS. The educational environmental score was found to be significantly different among different age groups. In contrary to most published literature, a direct association between EI and PS scores was found, except for the living accommodation factor. This might be attributed to the fact that the study was conducted 1 month prior to final exams. Living accommodation, personal factors, educational environment, academic work and clinical factors were identified as significant predictors of PS., Competing Interests: None

&lt;b&gt;Background and Objective:&lt;/b&gt; In recent years, respiratory tract viral infections have caused many pandemics that impact the whole world. To investigate the seropositivity of &lt;i&gt;Toxoplasma gondii&lt;/i&gt;, rubella, CMV, HSV-1 and group A &lt;i&gt;Streptococcus&lt;/i&gt; in recovered COVID-19 patients and correlate these findings with vitamin D levels. &lt;b&gt;Materials and Methods:&lt;/b&gt; A total of 417 COVID-19 patients with diarrhoea were enrolled in this study. Vitamin D and seroprevalence for &lt;i&gt;Toxoplasma gondii&lt;/i&gt;, rubella, CMV, HSV-1 and group A &lt;i&gt;Streptococcus&lt;/i&gt; were evaluated and correlated. &lt;b&gt;Results:&lt;/b&gt; It was found that recent infection in COVID-19 patients with HSV-1, rubella, &lt;i&gt;Toxoplasma&lt;/i&gt; and CMV, respectively. IgG was detected indicating the development of adaptive immunity with all microbes. &lt;b&gt;Conclusion:&lt;/b&gt; Current study detected a correlation between vitamin D levels and HSV-1 and no correlation between this infection and vitamin D deficiency with the other microbes.

&lt;b&gt;Background and Objective:&lt;/b&gt; Coronavirus disease 2019 (COVID-19), also known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), became a global health issue that influenced the lives of billions of people all over the world. The goal of this study was to investigate the clinical findings and routine laboratory evaluations of COVID-19 patients in both average- and high-altitude settings in Saudi Arabia. &lt;b&gt;Materials and Methods:&lt;/b&gt; A comparative study to explore the clinical characteristics and Laboratory tests results of COVID-19 patients at both high and average altitudes in Saudi Arabia has been conducted. The study included a total number of 103 patients (53 patients comprising the high-altitude group living in Taif, Saudi Arabia and 50 patients comprising the average-altitude group living in Al Ahsa, Saudi Arabia) were included in the study. Patients were diagnosed with SARS-CoV-2-positive by PCR test. Clinical characteristics, laboratory test results and symptoms of adult patients were collected and expressed as mean and standard deviation. Statistical analysis was done using SPSS software to compare between both groups and significance was considered when the p-value is less than 0.05. &lt;b&gt;Results:&lt;/b&gt; Approximately 55.3% of the total cases were male with a mean age of 40.16±12.47 years. There were highly statistically significant differences between the groups in age, heart rate (p<0.001). There were also statistically significant differences between the groups in temperature, SpO&lt;sub&gt;2&lt;/sub&gt;, fever, myalgia, shortness of breath and loss of smell and taste. &lt;b&gt;Conclusion:&lt;/b&gt; The current study provides an understanding of the clinical and laboratory investigations of COVID-19 patients in two regions (high altitude and average altitude) in Saudi Arabia.

Background: Saudi Arabia doubled its tobacco tax in June 2017., Aims: To examine the association between an increase in tobacco prices and consumption behaviour among current male smokers in Riyadh., Methods: We conducted a community-based study using a self-administered questionnaire distributed to current male smokers aged 15+ years in Riyadh in 2018. The survey included questions on sociodemographic characteristics, tobacco consumption and self-reported chronic health conditions., Results: A total of 1481 participants were included in the final data analysis. After the tobacco tax was doubled, 25.6% of the participants reduced their cigarette consumption and 1.0% quit smoking. The average daily cigarette consumption after enforcing the tobacco tax [19.77, standard deviation (SD) 10.7], was statistically significantly lower than before taxation (21.19, SD 10.8) (P < 0.0001). The calculated price elasticity of demand was -0.20 (inelastic). Employment status (P = 0.002) and per capita gross domestic product purchasing power parity (P = 0.001) were the only statistically significant factors associated with the change in smoking habits., Conclusions: Increasing tobacco prices reduced tobacco consumption by 26.6% among Saudi Arabian male smokers., (Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

A consensus platform is provided by the experts of the Gulf Cooperation Council (GCC) countries' respective osteoporosis societies, on which specific guidelines can be developed further for regional use on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis., Introduction: Guidance is provided in a Gulf Cooperation Council (GCC) country setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis, which is an adaptation of the European guidance by Kanis et al., jointly published by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). The respective osteoporosis societies of the Gulf Cooperation Council (GCC) countries assembled for a unifying consensus on the diagnosis and management of osteoporosis in postmenopausal women for the region., Methods: The Chair for Biomarkers of Chronic Diseases (CBCD) in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA), in cooperation with the Saudi Osteoporosis Society (SOS), hosted regional experts and respective leaders from different GCC osteoporosis societies, together with an adviser from the ESCEO. An assembly of experts representing the different osteoporosis societies from Saudi Arabia, the UAE, Bahrain, Oman, and Kuwait gathered on February 15-16, 2019 in Riyadh, KSA for the formulation of a general osteoporosis consensus for the region., Results: The following areas were covered: diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; and hip fractures, vitamin D, recommendation on which FRAX tool to follow, and the importance of country-specific FRAX® and fracture liaison services for secondary fracture prevention., Conclusions: A platform is provided on which specific guidelines can be developed for regional use in GCC.

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic coronavirus that has a tendency to cause significant healthcare outbreaks among patients with serious comorbidities. We analyzed hospital data from the MERS-CoV outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 using the susceptible-exposed-infectious-recovered (SEIR) ward transmission model. The SEIR compartmental model considers several areas within the hospital where transmission occurred. We use a system of ordinary differential equations that incorporates the following units: emergency department (ED), out-patient clinic, intensive care unit, and hospital wards, where each area has its own carrying capacity and distinguishes the transmission by three individuals in the hospital: patients, health care workers (HCW), or mobile health care workers. The emergency department, as parameterized has a large influence over the epidemic size for both patients and health care workers. Trend of the basic reproduction number (R 0 ), which reached a maximum of 1.39 at the peak of the epidemic and declined to 0.92 towards the end, shows that until added hospital controls are introduced, the outbreak would continue with sustained transmission between wards. Transmission rates where highest in the ED, and mobile HCWs were responsible for large part of the outbreak.