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Objective: Depression is a common comorbidity in patients with asthma with a significant impact on clinical management. However, little information is available about physicians' perceptions and current practices in identifying and managing depression in individuals with asthma in Saudi Arabia. Thus, this study aims to assess physicians' views and current practices of identifying and managing depression in patients with asthma in Saudi Arabia. Methods: A cross-sectional study was employed. Between September 2022 and February 2023, an online survey was distributed to physicians (general practitioners and family, internal and pulmonary medicine specialists) in Saudi Arabia. Descriptive statistics were performed to analyze the collected responses. Results: Out of 1800 invited participants, a total of 1162 physicians completed the online survey. Nearly 40% of the respondents received adequate training for managing depression. More than 60% of physicians reported that depression interferes with self-management and worsens asthma symptoms, while 50% viewed the importance of regular screening for depression. Less than 40% (n=443) aim to identify depression during patients' visits. Of those, only 20% always screen for depression in asthma patients. Physicians show a low level of confidence when asking patients about their feelings (30%), being able to recognize depression (23%), and knowing if patients have depression (23%). The most common barriers linked to recognizing depression are high workload (50%), lack of time to screen for depression (46%), limited knowledge about depression (42%), and poor training (41%). Conclusion: The rate of recognizing and confidently managing depression in asthmatic patients is significantly low. This is attributed to high workload, poor training, and limited knowledge about depression. There is a need to support psychiatric training and implement a systematic approach to depression detection in clinical settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Respiratory therapists (RTs) provide many types of patient care in different clinical settings. Burnout can have an undesirable effect on RTs and their patients. Managing the COVID-19 pandemic, specifically in hospitals, could induce stress in RTs and increase the likelihood of burnout. Therefore, this study aimed to measure the level of burnout among RTs during the COVID-19 pandemic. METHODS: A validated cross-sectional questionnaire was used to identify the prevalence and characteristics of burnout among RTs. The questionnaire was administered by the respiratory care department of a tertiary health care center in Riyadh, Saudi Arabia. The data analysis included descriptive, inferential, and correlational tests. RESULTS: The survey was distributed among 100 RTs, with a response rate of 66%. Most respondents reported high burnout levels in the 3 domains of burnout: 77% reported emotional exhaustion; 98% reported depersonalization, and 73% reported low personal achievement. Univariate analysis revealed that emotional exhaustion was significantly higher among RTs who were male, married, or working in critical care settings. Female RTs and those working in general care settings reported feelings of reduced personal achievement. Furthermore, the analysis revealed a moderate positive correlation between the years of experience and emotional exhaustion (r = 0.6, P < .001). CONCLUSIONS: A high prevalence of burnout was observed among RTs in one Saudi tertiary hospital. Burnout is associated with several factors, and interventions should target all domains of burnout. RT management and staff are responsible for addressing their needs and collaboratively working together to overcome burnout. Further investigations focusing on techniques and strategies to alleviate burnout are required. [ABSTRACT FROM AUTHOR]

Miticidal action of hexythiazox has been investigated against three mites, Citrus Rust Mite, Phyllocoptruta oleivora (Ashmead) (Acari: Eriophyidae), False Spider Mite, Brevipalpus californicus (Banks) (Acari: Tenuipalpidae) and Citrus Brown Mite, Eutetranychus orientalis Klein (Acari: Tetranychidae), infesting citrus trees in the region of Al Qassim, Saudi Arabia. Three concentrations of hexythiazox, half of the recommended dose (HRD), the recommended dose (RD) and double recommended dose (DRD) were used against the selected mite species at immature and adult stages. Mortality data was recorded after regular intervals of a day till seven days of post-treatment application. Larvicidal action of the pesticide was observed in terms of post spray percentage of egg hatching. Trails regarding mortality of immature and adult mites were carried out under laboratory and field conditions. A maximum of 72.88% and 64.41% mortality was observed in immature mites of P. oleivora at RD under laboratory and field conditions respectively. The highest mortality of adult mites at RD was recorded again in P. oleivora that was 18.97 and 20.39% under laboratory and field conditions respectively, showing that mortality percentage was insignificant in adults. Under the same conditions, mortality of mites observed at HRD was non-significant and there was negligible increase in mortality when concentration was increased from RD to DRD. Success of hatching for the treated eggs of the three selected mites was observed in the range of 5.00 to 12.50% at the recommended dose. This indicated that hexythiazox has the significant potential of inhibiting hatching process. For the successful control over citrus mites, the appropriate time of spray is prehatching stage. [ABSTRACT FROM AUTHOR]

INTRODUCTION Recently, Saudi Arabia has extensively reformed its tobacco control policies and extended its smoking cessation services. A public outrage on social media among smokers was witnessed, especially after the implementation of plain cigarette packaging, which might have discredited the significant efforts of tobacco treatment services and tobacco control policies. However, it is not known how the credibility of the tobacco control regulatory body among Saudi smokers might affect their smoking behavior. METHODS Saudi tobacco smokers (n=511) were recruited using a convenience sampling technique. A cross-sectional survey was conducted comprising questions related to the credibility of the tobacco control regulatory body (modified Food and Drug Administration Tobacco Credibility Scale), quit attempts, use of nicotine replacement therapy (NRT), and motivation to change smoking behavior in the future. Logistic and linear regression models were used for the analysis. RESULTS The public interest subscale of the credibility of the tobacco control regulatory body, was positively associated with confidence in changing smoking behavior (β=0.204; 95% CI: 0.078--0.713; t=2.449, p=0.015) and readiness to change smoking behavior (β=0.237; 95% CI: 0.127--0.727; t=2.802, p=0.005). Moreover, the subscale of expertise was positively associated with confidence in changing smoking behavior (β=0.190; 95% CI: 0.006--0.697; t=1.999, p=0.046) and readiness to change smoking behavior (β=0.225; 95% CI: 0.063--0.710; t=2.352, p=0.019). However, public interest in the credibility of the tobacco control regulatory body was negatively associated with NRT use among smokers who tried to quit (adjusted odds ratio, AOR=0.691; 95% CI: 0.526--0.909). The credibility of the tobacco control regulatory body, however, was not associated with the last month's or ever quit attempts. CONCLUSIONS The credibility of the tobacco control regulatory body was positively associated with motivation to change smoking behavior but negatively associated with NRT use. Optimizing communication tools with the public is a potential avenue for improving smoking treatment and prevention in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. Methodology: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. Results: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual's ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. Conclusion: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains. [ABSTRACT FROM AUTHOR]

Rhizoctonia solani and Fusarium solani were found to have an association with damping-off and complex wilt and root rot symptoms of tomato seedling plants gathered from various greenhouses in Qassim region, Saudi Arabia. The acquired isolates were found virulent enough to attack tomato plants (cv. Tres Cantos) causing complex wilt/rot diseases as well as pre and post emergence of damping-off diseases. These isolates present more virulence in the pathogenicity tests. Huwa-San TR50, a hydrogen peroxide solution that has been stabilized by adding a small amount of silver and has been used extensively as a germicide. Biocide agent Huwa-San TR50 (hydrogen peroxide with 3% silver), was examined for biological control of root wilt/rot and damping-off as well as growth augmentation of tomato plants in vitro and in vivo. The hostile biocide agent hampered growth of the tested morbific fungi and recorded highest inhibited growth in vitro. Under growth chamber condition, all treatments notably decreased root rot/wilt and damping-off intensity and resulted into an increase in the number of surviving plants. Moreover, under growth chamber conditions, these remedies caused an increase in growth parameters (height of plants, and weights when fresh and dry) of the surviving plants which were kept in pots rather than in control conditions. Tomato soil drenching with Huwa-San TR50 in concentration 12000, 14000 and 16000 ppm achieved the ideal results for combating root wilt/rot and damping-off diseases, as well as the highest growth parameters were recorded in growth chamber conditions with the addition of enhanced plant growth and higher yield constituents. [ABSTRACT FROM AUTHOR]

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Olive is a blessed and therapeutic fruit cultivated all around the globe in relatively temperate and dry regions. Keeping in view the quality and yield of the crop, use of pesticides is indispensable. Traditional pesticides used against crop enemies are effective but unsafe to environment, humans and predators. Olive fields of Saudi Arabia are the biggest in the world and facing infestation due to rapidly increasing number of diverse mite species. Recently, four mite species, Tegelophus hassani, Aceria olive, Oxycenus niloticus and Tetranychus urticae found to be causing severe damage to the plants, have been identified in the olive fields of Saudi Arabia. Huwa-San TR50 is a well-known water disinfectant and considered to be safe as its adverse effects on plants have not been reported as yet. The present study has been conducted to evaluate the use of Huwa-San TR50 as an acricide against four olive mites and two of their predators under laboratory and field conditions. Five different concentrations of Huwa-San TR50; 1000, 2000, 3000, 4000 and 5000 ppm were used based on previous studies to observe mortality of the selected phytophagous mites namely T. hassani, A. olive, O. niloticus and T. urticae. Gradual increase in mortality was observed when mites were treated with Huwa-San TR50 in the concentration range of 1000 - 5000 ppm. Optimum concentration of Huwa-San TR50 to be used against the mites was found to be 4000 ppm as there was negligible increase in mortality beyond this concentration. T. urticae was relatively resistant to Huwa-San TR50 with mortality of 76.58% at optimal concentration. Huwa-San TR50 has effectively impacted egg hatching especially in case of O. niloticus, where successful hatching was only 20%. Eggs of T. urticae are relatively resistant showing 57.97% hatching. The same trend and similar results of mortality and egg hatching were obtained under laboratory and field trials. As an essential part of this research, effect of Huwa-San TR50 was also observed on two predatory mites namely; Phytoseius plumifer and Agistemus exertus and it was found to be relatively safe to predatory mites showing mortality of 30 to 34% at optimum concentration. Again there was insignificant difference in mortality and egg hatching under field and laboratory conditions. Huwa-San TR50 being ecofriendly, safe to predatory mites and an effective acaricide against olive mites and their eggs is recommended for its commercial use in olive orchards. [ABSTRACT FROM AUTHOR]

The predatory phytoseiid mite, Phytoseius plumifer (Canestrini & Fanzago) (Acari: Phytoseiidae), has shown promising traits for biological control of four mite species, Aceria olivi, Oxycenus niloticus, Tegolophus hassani (Acari: Eriophyidae) and Tetranychus urticae (Acari: Tetranychidae), the major pests of olive trees in Saudi Arabia. In the present study, reproduction and population growth parameters of P. plumifer on moving stages of four mite species were studied in the laboratory at 35±1°C, 55±5% RH and a photoperiod of 12: 12 (L: D) hours. The predatory mite, P. plumifer demonstrated that it is capable of developing successfully from egg to adult stage throughout its entire life history consuming only four preys. The total immature developmental time was 5.67, 5.87, 5.92 and 5.77 days for females and 5.18, 5.32, 5.49 and 5.50 days for males when the predator consumed A. olivi, O. niloticus, T. hassani and T. urticae, respectively. The sex ratio of P. plumifer was 0.73, 0.70, 0.70 and 0.60 (females/females + males). Mated females laid on average 2.83, 2.70, 2.38 and 1.72 eggs per day and 57.46, 50.80, 50.02 and 33.95 eggs during their mean ovipositional period of 20.25,18.77, 20.95 and 20.88 days, respectively. The net reproductive rate (R0) was 37.65, 35.18, 33.59 and 26.38 females/female/generation, the intrinsic rate of increase (rm) was 0.298, 0.288, 0.277 and 0.179 females/female/day, the finite rate of increase (λ) was 1.937, 1.861, 1.785 and 1.212 population multiplication/day, and the mean generation time (T) was 14.25, 15.78, 15.22 and 16.56 days when a predator consumed A. olivi, O. niloticus, T. hassani and T. urticae, respectively. The adult predatory female consumed an average of 110.66 A. olivi, 103.71 O. niloticus, 99.75 T. hassani and 14.35 T. urticae/day. These findings imply that the four mites, especially A. olivi, proved to be acceptable nourishment for P. plumifer, as a facultative predator, where P. plumifer does well and is widely and successfully used for biocontrol of A. olivi, O. niloticus, T. hassani and T. urticae associated with olive trees. [ABSTRACT FROM AUTHOR]

Introduction: Management of pulpally involved primary teeth has recently gained importance inspite of the barriers faced by general dentists such as limited exposure to paediatric dentistry, skill and chair-side time. The advancements in technological and material sciences necessitate a practicing dentist to update themselves to deliver comprehensive dental care in most effective way. Aim: The study was aimed to assess and compare the perspective of pulpal treatment of primary teeth among general and paediatric dentists of Saudi Arabia. Materials and Methods: Close-ended, multiple-choice questionnaire evaluating their preferences towards pulp therapy in primary teeth was designed as part of a survey and mailed to 100 general dentists and 50 paediatric dentists across Kingdom of Saudi Arabia. Descriptive statistics followed by χ² -test was applied to test of variables in the questionnaire to determine their association. Results: Paediatric dentists (68%) performed pulpal treatment in primary teeth more frequently under rubber dam isolation than general dentists (47%) (p=0.025). Traditional indirect pulp capping was preferred to Indirect Pulp Treatment (IPT) by both groups under local anaesthesia. Caries detector dye was used to facilitate precise caries removal more frequently by Paediatric dentists than general dentists (p=0.001). Pulpotomy was preferred over IPT by both groups when there was a probability of pulp exposure following complete caries excavation. Pulpectomy was infrequently performed. Zinc oxide eugenol was the material preferred for obturation in both groups. Paediatric dentists preferred stainless steel crown whereas General dentists preferred glass ionomer restoration after pulp therapy (p=0.004). There was no significant difference between follow-up schedule followed by general and paediatric dentists even though most dentists recalled their patients immediately and after 3 months follow-up. Conclusion: The survey helps in refining the approaches of dentists towards pulp therapy in primary teeth and ascertains whether they are according to recent trends. [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]

Myasthenia gravis (MG) is a rare autoimmune disease of the neuromuscular junction. MG has been shown to be associated with many HLA antigens in different populations. Here we have analysed the frequency of HLA-A, B, DR and DQ in a group of Saudi MG patients and compared their results to a group of healthy controls. MG in Saudi patients is found to be associated with HLA-A*23, B*08, B*18, DRB1*16 and DRB1*13. The strongest association was with HLA-B*08, which was associated with young age at onset and female gender. Our results are in line with other published results from around the world and warrant fine mapping of the area using microsatellite to map the disease gene. [ABSTRACT FROM AUTHOR]

Introduction The Kingdom of Saudi Arabia (KSA) is one of countries with the world's highest number of deaths per 100,000 populations from road traffic accidents (RTAs). Numerous trauma victims sustain abdomino-pelvic injuries, which are associated with considerable morbidity and mortality. The purpose of this study was to describe profile, outcomes and predictors of mortality of patients with abdomino-pelvic trauma admitted to the intensive care unit (ICU) in a tertiary care trauma centre in Riyadh, KSA. Methods This was a retrospective analysis of prospectively collected ICU database. All consecutive patients older than 14 years with abdomino-pelvic trauma from March 1999 to June 2013 were included. The followings were extracted: demographics, injury severity, mechanism and type of injury, associated injuries, use of vasopressors and mechanical ventilation, and worst laboratory results in the first 24 h. The primary outcome was hospital mortality. We compared profile and outcomes between survivors and non-survivors and reported predictors of mortality. Results Of the 11,374 trauma patients who were admitted to the hospital during the study period, 2120 (18.6%) patients had abdomino-pelvic injuries, out of which 702 (33.1%) patients were admitted to the ICU. The mean age was 30.7 (SD 14.4) years and the majority was male (89.5%). RTA was the most common cause of abdomino-pelvic trauma (70.4%). Pelvis (46.2%), liver (25.8%), and spleen (23.1%) were the most frequently injured organs; and chest (55.6%), head (41.9%), and lower extremities (27.5%) were the most commonly associated injuries. Mechanical ventilation was required in 89.6% with a mean duration of 9.1 (SD 9.2) days and emergency surgery was performed in 45.0% of the patients with prolonged ICU and hospital length of stay (10.8 [SD 10.8], 56.9 [SD 96.7] days; respectively). Of the 702 patients with abdomino-pelvic trauma, 115 (16.4%) patients did not survive. Associated head trauma and retroperitoneal haematoma, higher level of lactic acid on admission and ISS, and advanced age were potential risk factors for hospital mortality. Conclusions Abdomino-pelvic injuries are common in trauma patients, affecting mainly young male victims, and are associated with significant morbidity and mortality, and resource utilisation. [ABSTRACT FROM AUTHOR]

This study is a retrospective investigation to determine the species of yeasts causing fungemia in a university hospital in Saudi Arabia during the years 1991-2000. A total of 189 episodes of fungemia were encountered, of which 121 (64%) occurred during 1991-1995, whereas only 68 cases (36%) were found between 1996 and 2000. Overall, 50.3% episodes were due to Candida albicans including five episodes of C. dubliniensis, followed by C. tropicalis (27%), C. parapsilosis (7.9%), C. glabrata (7.4%), C. krusei (3.2%), C. famata (1.0%); 3.2% were due to other species, namely Blastoschizomyces capitatus, Hansenula anomala, Rhodotorula rubra, and Trichosporon beigelii. The percentage of episodes of fungemia caused by C. albicans ranged from 36.4% in 1991 to 71.4% in 2000, revealing an increase in recent years. The incidence of non-C. albicans fungemia decreased from 63 (33.3%) during the first 5 years (1991-1995) to 31 (16.4%) episodes during the second 5 years. Moreover, no fungemia due to C. glabrata and C. krusei were observed during the last 3 years. Overall, during the years of the study, a decreasing incidence of yeast fungemia was observed. Fungemia occurred more frequently in patients with leukemia (24%), prematurity (16%), postsurgery (10.6%), and lymphoma (9.5%). Patients with respiratory infections and preterm infants more often had C. albicans fungemia, whereas C. tropicalis predominated in patients with hepatic disorders and leukemia. The study reports for the first time the involvement of C. dubliniensis in yeast fungemia occurring in Saudi Arabia.

Background: Yeast vaginitis is a common infection. Data on the identity and prevalence of the etiological species would serve both epidemiological and therapeutic ends. Proteinase secretion by the invading yeast has been implicated in facilitating infection. Hence a prospective study was conducted to determine the species causing vaginitis in women from Saudi Arabia and the yeast's ability to produce proteinase., Material/methods: The subjects were patients with clinical signs of vaginitis. A high vaginal swab specimen from each patient was cultured, and only women yielding heavy yeast growth were enrolled. The isolated yeasts were identified by routine procedures, then evaluated for proteinase production in a medium containing bovine serum albumin., Results: A total of 500 patients were studied. Candida albicans was the major species to cause vaginitis (59%), followed by C. glabrata (31%), C. tropicalis (4%), C. krusei (3.2%), Saccharomyces cerevisiae (1.6%), C. parapsilosis (0.6%), and C. kefyr (0.6%). All isolates of C. albicans and C. parapsilosis and 95% of C. tropicalis produced proteinase, while isolates from the remaining species did not., Conclusions: These results indicate that 59.6% of yeast vaginitis in women from Saudi Arabia is caused by C. albicans, and 31.6% by C. glabrata. Of relatively low prevalence were C. tropicalis and C. krusei. The study also revealed that both proteinase producers and non-producers were involved in causing vaginitis, indicating that proteinase secretion is not an essential factor in the pathogenesis of yeast vaginitis.