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The study aimed at identifying the association between Bandura's four hypothesized self-efficacy sources and metacognitive reading strategies by employing reading self-efficacy beliefs as a mediating variable. A correlational research design was used. A total of 188 Saudi EFL learners were selected from five public universities of Kingdom of Saudi Arabia by employing proportionate stratified random sampling. Three questionnaires including 'questionnaire for sources of reading self-efficacy', 'reading self-efficacy beliefs questionnaire', and 'survey of reading strategies' were used to collect the data. Structural equation modelling by a statistical software, i.e., PLS 3.0 was utilised in order to test the relationships among variables. Findings provided support for the proposed conceptual framework, disclosing that all the four self-efficacy sources were significantly correlated with reading self-efficacy beliefs. Also, reading self-efficacy beliefs were significantly correlated with metacognitive reading strategies. Lastly, reading self-efficacy beliefs mediated the association between self-efficacy sources and metacognitive reading strategies.

Continuing professional development (CPD) is an essential tool for healthcare professionals to remain up-to-date with the latest advancements in their field. In Saudi Arabia, pharmacists are officially registered healthcare professionals by the Saudi Commission for Health Specialties (SCFHS). To uphold their licensure, they must complete 40 h of CPD every two years. This qualitative study aimed to explore hospital pharmacists' perceptions, barriers, and challenges of CPD, as well as their recommendations for improving CPD activities. A qualitative descriptive approach with semi-structured face-to-face interviews was employed. Using purposive sampling, 12 hospital pharmacists were interviewed. The recorded data were transcribed and analyzed using thematic analysis. Pharmacists generally showed positive perceptions of CPD, recognizing its importance for their professional development and the provision of high-quality patient care. However, some pharmacists expressed dissatisfaction with the current system. Several barriers to participation such as heavy workloads, lack of time, and limited financial support were highlighted. The primary motivations for engaging in CPD included fulfilling regulatory requirements. Workshops were the most beneficial CPD activities among others. Additionally, importance of more specialized, practice-oriented programs was highlighted. The study provides valuable insights into the needs and challenges faced by hospital pharmacists in Saudi Arabia regarding CPD. The insights gained can inform theory, policy, and practice relating to pharmacists' CPD at both professional and governmental levels. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) requires patients to take on a high level of responsibility for their daily care. Thus, care for people with diabetes is moving toward patients taking an active role in their own health care. Objective: To evaluate the impact of self‑management care on glycemic control in individuals with DM and determine the correlation between glycated hemoglobin (A1C) levels and self‑management practices. Material and Methods: A cross‑sectional descriptive study was conducted among diabetes patients at a diabetic center in Armed Forces Military hospitals, Southern region. A questionnaire of demographic and clinical information and self‑management measured with the Diabetes Self‑Management Questionnaire was used. Glycemic control was assessed using HbA1c levels. Results: The study involved 255 patients with diabetes, of which 61.2% were females and 81.6% aged ≥41 years. The average diabetic self‑management score was 6.49 on a scale of 10. The mean glucose self‑management subscale score was 7.83 points, while the mean dietary control (DC) subscale score was 4.89. The patients had a mean physical activity (PA) subscale score of 6.31 and 8.75 for healthcare usage. Patients with higher education were significantly less likely to have poor glycemic control. Diabetes duration was significantly and positively correlated with poorer glycemic control. Mean perceived PA and DC scores were significantly associated with glycemic control. Conclusion: Type 2 diabetes patients had satisfactory self‑care practices. Many did not achieve the target glycemic control for diabetes. [ABSTRACT FROM AUTHOR]

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

This study considers the level of critical involvement women professors in Saudi Arabia have in their university and in the larger society. Princess Nourah Bint Abdulrahman University (PNU), Saudi Arabia, the largest women's university in the world, was the site of this investigation. PNU is the first institution in the Kingdom of Saudi Arabia to have women as the principal decision-makers in running and managing a university. This transformed context for leadership of women at PNU has also changed how faculty members participate in institutional governance and in the larger public sphere. Given that PNU's mission is to "contribute to society," we asked in this study how faculty engages in political, cultural and social issues within the public sphere in Saudi Arabia and globally. To consider the level of participation in the public sphere, we selected a sample of nine women professors at PNU. From this investigation, we found that the majority of the PNU professors we interviewed are actively engaged in the public sphere in spite of the inherent problems impeding their participation. Chief among the difficulties in participating in the public sphere identified by these professors are family obligations and a poor and bureaucratic research infrastructure. In addition to the need for an established research infrastructure, the PNU professors pointed to cultural issues related to transportation and international travel that also inhibit their participation in the public sphere. Even with these impediments, many PNU faculty members are still able to engage in the public sphere with support from their families. The most notable women in the public sphere are the 30 Saudi women who are members of the Shura Council. Our conclusions suggest that if PNU is to reach its promise as a global university and to be a full participant in the global public sphere, professors should have the freedom to develop their inquiry unfettered by bureaucratic impediments and, in as much as possible, by cultural restrictions. Similarly, other Arab universities hoping to achieve recognition for their research at the international level can be guided by PNU's efforts at increased international collaboration, promotion of English as the medium of research and establishing a competent research infrastructure.

This case study addresses the transition of a university from a local to a global institution in the unique cultural and economic circumstances of the Kingdom of Saudi Arabia. Specifically, the authors investigate the case of Princess Nourah Bint Abudulrhman University (PNU), the largest women's university in the world with over 39,000 students. Saudi Arabia, and PNU in particular, offers a unique case of higher education development where economic and cultural issues pose both extraordinary opportunities and complications compared to other developed and newly industrialized countries. Although this case is of women's higher education in Saudi Arabia, the study offers a broader application into understanding the developing role of women in other Muslim countries and their participation in the public sphere of a Kingdom guided by Sharia Law. This study of PNU provides a case example for other national universities struggling to maintain a cultural, social, and economic balance between local needs and global influences. The administrators and faculty interviewed for this study indicate PNU's future as a global institution depends on its ability to maintain a delicate balance among the educational, economic, social, and cultural needs of women in the face of changing cultural mores. Herein lies the promise PNU offers other women's universities in the Arab World in their transition from a local to a global institution. The critical message from this study for other universities in transition in both developed and developing countries is the need to preserve cultural identity in the face of globalization.

This case study addresses the international collaboration challenges faced by Princess Nourah Bint Abdulrahman University for women in Saudi Arabia. The objectives of this investigation are to define the challenging sources of international program collaboration between Princess Nourah Bint Abdulrahman University and foreign institutions from the perspective of the university staff who are involved in initiating these collaborations. A total of 27 university staff members who were involved in initiating institutional collaborations participated in semi-structured interviews. A thematic analysis of the interviews suggested that the major sources of challenges to the university's international collaboration efforts are difficulties in making contacts with international institutions, language barriers, faculty resistance to international partnerships, cross-cultural issues, and establishing partnership agreements.

Introduction: Teledentistry is an emerging tool to exchange medical information and clinical images to facilitate the diagnosis, prevention, and treatment of oral diseases and patient assurance and education. Considering the shortage of oral medicine specialists in Saudi Arabia, this study aims to assess the experiences of dental specialists with tele-oral medicine and its potential applicability in addressing this shortage. Materials and methods: This was a pilot, cross-sectional study conducted among specialists in the field of oral medicine from January 2020 to March 2020. A total of 16 preselected cases with oral lesions, including clinical history and images, were developed, validated, and shared via email with study participants. Each case included questions on differential diagnosis, provisional diagnosis, and management. The responses were recorded, analyzed, and presented as means and percentages. Results: A total of 49 subjects participated in this study and more than half were under 40 years of age and two-thirds were women. A total of 23 participants had prior experience with tele-oral medicine, mainly via WhatsApp (95.7%), and these cases were received from patients, their families, friends, or other dentists. For all study cases, the correct diagnosis score ranged between 73.50 and 100%, and correct management ranged between 51 and 98%. Conclusions: Tele-oral medicine is an effective tool that may play an important role in patient management in rural regions with a shortage of oral medicine services. Further studies with larger sample sizes and in collaboration with international centers are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

This study explores the barriers and challenges faced by Saudi women entrepreneurs along with the motivational forces that drives them towards entrepreneurship. This study employs a qualitative research design, and is based on the interview of 11 Saudi women entrepreneurs and includes a review of data on the motivational factors and challenges faced by them using interpretative phenomenological analysis. Research participants' perspectives have been quoted for each distinct theme that emerged from the interview finding. The factors motivating Saudi women towards entrepreneurship have been identified as passion, identification of opportunity, dissatisfaction and family support. Barriers that are exclusive to Saudi women entrepreneurs are difficulty in maintaining work-life balance, lack of business networking, limited access to financial resources, lack of understanding of business-related tasks and functions, fear of deception, lack of trust, reservation about work-related travel, recruitment and training issues like lack of experienced and trained Saudi workers and negative attitude and non-willingness to work under female leadership. Decision-makers in government and other relevant organisations can develop a solid framework of focussed agendas, policies and measures to address the barriers identified in this study. Arab countries especially Saudi Arabia can use these results to fully utilise the entrepreneurial skills of Saudi women to boost economic growth and development. This pioneering study reveals the intricacy of Saudi women entrepreneurs' experiences in the presence of gender-bias and internalising socio-cultural values and attributed gender roles during the formation of their entrepreneurial identities through a unique non-western viewpoint. [ABSTRACT FROM AUTHOR]

Since the emergence of the pandemic of the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the discovery of antiviral phytoconstituents from medicinal plants against SARS-CoV-2 has been comprehensively researched. In this study, thirty-three plants belonging to seventeen different families used traditionally in Saudi Arabia were tested in vitro for their ability to inhibit the SARS-CoV-2 main protease (MPRO). Major constituents of the bio-active extracts were isolated and tested for their inhibition potential against this enzyme; in addition, their antiviral activity against the SARS-CoV-2 Egyptian strain was assessed. Further, the thermodynamic stability of the best active compounds was studied through focused comparative insights for the active metabolites regarding ligand–target binding characteristics at the molecular level. Additionally, the obtained computational findings provided useful directions for future drug optimization and development. The results revealed that Psiadia punctulata, Aframomum melegueta, and Nigella sativa extracts showed a high percentage of inhibition of 66.4, 58.7, and 31.5%, against SARS-CoV-2 MPRO, respectively. The major isolated constituents of these plants were identified as gardenins A and B (from P. punctulata), 6-gingerol and 6-paradol (from A. melegueta), and thymoquinone (from N. sativa). These compounds are the first to be tested invitro against SARS-CoV-2 MPRO. Among the isolated compounds, only thymoquinone (THY), gardenin A (GDA), 6-gingerol (GNG), and 6-paradol (PAD) inhibited the SARS-CoV-2 MPRO enzyme with inhibition percentages of 63.21, 73.80, 65.2, and 71.8%, respectively. In vitro assessment of SARS-CoV-2 (hCoV-19/Egypt/NRC-03/2020 (accession number on GSAID: EPI_ISL_430820) revealed a strong-to-low antiviral activity of the isolated compounds. THY showed relatively high cytotoxicity and was anti-SARS-CoV-2, while PAD demonstrated a cytotoxic effect on the tested VERO cells with a selectivity index of CC50/IC50 = 1.33 and CC50/IC50 = 0.6, respectively. Moreover, GNG had moderate activity at non-cytotoxic concentrations in vitro with a selectivity index of CC50/IC50 = 101.3/43.45 = 2.3. Meanwhile, GDA showed weak activity with a selectivity index of CC50/IC50 = 246.5/83.77 = 2.9. The thermodynamic stability of top-active compounds revealed preferential stability and SARS-CoV-2 MPRO binding affinity for PAD through molecular-docking-coupled molecular dynamics simulation. The obtained results suggest the treating potential of these plants and/or their active metabolites for COVID-19. However, further in-vivo and clinical investigations are required to establish the potential preventive and treatment effectiveness of these plants and/or their bio-active compounds in COVID-19. [ABSTRACT FROM AUTHOR]

People have continued to be petrified by the devastating effects of cancer for decades and thus a pursuit for developing anticancer agents have seen an ever-increasing trend in the past few decades. Globally, breast cancer is the most common malignancy in women and the second most common cause of cancer-related deaths. In Saudi Arabia, breast cancer is the most common type of cancer among women, constituting almost 14.2% of the total cancer burden. Triple-negative breast cancer (TNBC) is a subtype of breast cancer, which is a pathologically diverse disease of higher grade characterized by the absence of the estrogen receptor (ER), the progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) expressions. Despite the considerable advancements achieved in the therapeutic management of cancer, TNBC remains an unbeatable challenge, which requires immediate attention as it lacks conventional targets for treatment, leading to a poor clinical prognosis. The present research goals are directed toward the development and implementation of treatment regimens with enhanced bioavailability, targetability, minimized systemic toxicity, and improved outcomes of treatment options. The present treatment and management scenario of TNBC continues to provoke oncologists as well as nanomedical scientists to develop novel and efficient nanotherapies. Lately, scientific endeavors have addressed the importance of enhanced availability and targeted cellular uptake with minimal toxicity, which are achieved by the application of nano drug-carriers. This review intends to summarize the incidence rates of TNBC patients, the importance of nanotherapeutic options for patients suffering from TNBC, the identification of promising molecular targets, and challenges associated with the development of targeted nanotherapeutics with special reference to the Saudi Arabian context. [ABSTRACT FROM AUTHOR]

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic has transformed our appreciation of healthcare awareness worldwide. The amount of related data accumulated during this time has surpassed any other outbreak of a viral pathogen. Healthcare awareness is related to one of the nine pillars of the "World health organization (WHO) operational planning guidelines to support country preparedness and response". This review is structured around the awareness/knowledge, attitudes, and practices (KAP)-related publications in Saudi Arabia up to date to understand the impact of COVID-19 on these domains. The excellent communication effort response from governments, international, and individuals to keep the public informed about the outbreak is highlighted. Unraveling such impacts on the Saudi communities, including healthcare workers (HCWs)/professionals (HCPs), students, patients with different diseases, and non-professional individuals, is essential in containing the outbreak and planning preventive measures in case of future outbreaks. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives: To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods: A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient's medical records prospectively. Results: ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion: Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations. [ABSTRACT FROM AUTHOR]

Background: The burden of the spread of the COVID-19 pandemic has impacted widely on the healthcare providers physically and mentally. Many healthcare providers are exposed to psychological stressors due to their high risk of contracting the virus. Aims: This study aimed to measure the level of anxiety among healthcare providers during the COVID-19 pandemic in Saudi Arabia. In addition, this study aimed to measure the level of anxiety based on demographic characteristics. Method: A cross-sectional survey was employed to recruit a convenience sample of healthcare providers. A pencil and paper self-administered questionnaires were used to collect data from demographic and generalized anxiety disorder GAD-7 data. However, this study received written informed consent from participants of the study. In addition, the study was approved by the Institutional Review Board at Dr. Sulaiman Al Habib Medical Group (IRB Log No. RC20.06.88-03). Results: A total of 650 participants were recruited, results of GAD-7 showed that 43.5%, 28.9% and 27.5% of healthcare providers in Saudi Arabia experienced mild, moderate and severe anxiety, respectively, during the COVID-19 pandemic. Results indicated that age, health specialty, nationality, and sleeping disorders before COVID-19 were associated with anxiety levels. Conclusion: The generalized anxiety among healthcare providers in Saudi Arabia was mild. Older healthcare providers were found to have a higher level of anxiety compared to other participating healthcare providers. Several factors may contribute to a higher level of anxiety including age, socioeconomic status, marital status, having chronic conditions, and sleeping disorder before the COVID-19 pandemic. To further understand the level of anxiety among healthcare providers during the COVID-19 pandemic in Saudi Arabia, longitudinal and mixed-method research is needed. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the novel Corona Virus Infectious Disease 2019 (COVID-19) has spread rapidly to many countries leading to thousands of deaths globally. The burden of this pandemic has affected the physical and mental health of the frontline health care workers (HCWs) who are exposed to high risk of infection and psychological stressors. Aims: The aim is to measure the level of depression among healthcare workers in Saudi Arabia during COVID-19 pandemic to establish interventional strategies. Method: A descriptive cross-sectional study was used to conduct the current study. The data of this study was recruited between 15 June and 15 July 2020 from healthcare providers who work in both public and private healthcare sectors in Riyadh and Eastern province in Saudi Arabia utilizing a self-administered questionnaire. The study was approved by the Institutional Review Board at Dr. Sulaiman Al Habib Medical Group (IRB Log No. RC20.06.88-2). Data were collected by using The Zung Self-Rating Depression Scale SDS. A total of 900 healthcare providers working in the healthcare setting during COVID-19 pandemic were invited to participate in the study. A total of 650 healthcare providers participated in the study by completing and submitting the survey. Results: Almost 30% suffered from depression which can be divided into three categories; mild depression (26.2%), moderate/major (2.5%) and severe/extreme (0.8%). The finding shows that the level of depression among respondents at the age range of 31-40 years old was significantly higher than the level of depression among respondents with the age above 50 years old. Non-Saudi healthcare workers experienced more depression than Saudi workers. It also shows how nurses suffered from depression compared to their physician colleagues. Those who did not suffer from sleeping disorder perceived more depression as compared to those who are having sleeping disorder. Conclusion: It is recommended that health care facilities should implement strategies to reduce the prevalence of mental health problems among healthcare providers and eventually it will improve their performance in provision of safe and high-quality care for patients. [ABSTRACT FROM AUTHOR]

Teledentistry has emerged as a new communication tool in various dental disciplines around the world. The aim of this study was to investigate the applicability and reliability of teledentistry in the field of diagnostic dentistry and explore the perception of Saudi dentists of its benefits and concerns. An electronic survey with 40 questions was developed, validated and distributed electronically by email and social media channels to dentists from different specialty in Saudi Arabia. Collected data were analyzed for statistical significance. A total of 148 dentists completed the survey. The current data demonstrated that 50% of study participants have had applied teledentistry in their clinical practice. Out of all, 90% have computers in their dental offices and 72% have been using electronic medical records in which radiographs and clinical images are uploaded. Most participants had smart phones (91%), in which they were used more commonly (74.3%) than conventional cameras (54.1%) to capture and share patients' clinical images over communication applications (74.3%) and less likely through emails (62.2%). Overall, 83% were confident that teledentistry can improve daily dental practice, specifically in the fields of oral radiology followed by endodontics and oral medicine. Teledentistry is an emerging tool with potential to improve the delivery of diagnostic dental care for communities with limited or no access to dental specialists. As of today, teledentistry has not been truly implemented by the Saudi dental community. Development of national programs to educate the public and promote teledentistry among dental practitioners are warranted. [ABSTRACT FROM AUTHOR]

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

Background and Objective. Anxiety is an emotional and behavioral disorder that may disturb the student's quality of learning and its outcome. This study is aimed at assessing the prevalence and associated factors among pharmacy students at a university in Saudi Arabia. Methods. We used a cross-sectional design, and data collection was carried out over a period of two months from September 2018 to November 2018 using paper-based self-administered questionnaires. The General Anxiety Disorder-7 (GAD-7) scale was used to measure and classify anxiety among the study participants. Results. The prevalence of anxiety among pharmacy students was 49% (83 students); 44 students (25.9%) had mild anxiety, while 24 (14.1%) students had moderate anxiety, and 15 (8.8%) severe anxiety. There were statistically significant differences in anxiety scores according to faculty type (p = 0.2) and nutritional status (p = 0.4). Conclusion. The findings of this study revealed that half of the pharmacy students suffered from anxiety incidence during their studies at the university. However, the majority of them are experiencing mild to moderate. This may have a significant impact on academic performance and necessitates special attention. [ABSTRACT FROM AUTHOR]

This paper aims to assess the fiscal measures performance in Saudi Arabia initiated in 2016 and onwards in improving fiscal imbalances during the pre-reform period (2012-2015) and post-reform period (2016-2019). In this research, t-Test paired two samples for means has been used to determine the pre- and post-fiscal reform performance. The study finds that there is a significant difference in real gross domestic product, Debt-gross domestic product ratio and Central Government net financial assets over the two periods while fiscal deficit, current account deficit, oil prices and non-oil gross domestic product growth shows no significant difference over the two periods. Therefore, Saudi Arabian policymakers should take extensive steps to finance its budget deficit and should implement suitable policies that accelerate non-oil gross domestic product growth and meet the needs of citizens. The outcome of this research can be used in future research to perceive the impact of Vision 2030 on the Saudi economy. [ABSTRACT FROM AUTHOR]

Purpose: Dietary supplements (DSs) are popular in many countries, and their use among individuals is increasing worldwide. Therefore, this study aimed to assess the prevalence and use of DSs among pharmacy students in King Saud University College of Pharmacy, Riyadh, Saudi Arabia. Methods: This study used a cross-sectional design targeting male senior pharmacy students in their fourth and fifth years of Bachelor and Doctor of Pharmacy courses. The data were collected between August and October 2019 using paper-based questionnaires. Results: A total of 46.8% of the students used DSs. Of all students surveyed, 19% used branded supplements whereas 9.7% used generic or local supplements and 12.3% used both generic and branded supplements. Furthermore, 8.2% students suffered from side effects, including 5.6% who suffered from nausea, vomiting, and diarrhea and 2.6% who suffered from headache, confusion, and disorientation. Approximately 24.6% of students used fiber DSs whereas 19% and 16.4% used DSs for protein and glucosamine/omega 3 fatty acids, respectively. Conclusion: The study findings indicated that the prevalence of DS use is increasing. However, approximately half of the respondents encourage the use of DSs only with a doctor's recommendation. Educating about the safe use of DSs is warranted. [ABSTRACT FROM AUTHOR]

Purpose. The objective of the current study was to determine the prevalence and practice of unused and expired medicine among Saudi adults. Subjects and Methods. The study used cross-sectional web-based design to collect the data, over a period of 4 months among people who are living in Riyadh, Saudi Arabia. Results. A total of 337 questionnaires were obtained during the study period. The majority of respondents were university graduates n = 251 (74.7%). The prevalence of unused medicine was n = 301 (89.3%). The most commonly used drugs were nonsteroidal anti-inflammatory drugs n = 272 (80.7%) and antibiotics n = 164 (48.7%). Of the participants, 186 (55.2%) checked the expiry date of the medicine before they purchase. Most of them n = 305 (90.5%) obtained medicine through prescription. About n = 219 (65%) of them keep the medicine until it expired; 48.1% throw away in the household garbage while only 18 (5.4%) of the respondents said to give it back to the medical store. Conclusion. The study revealed a high prevalence of unused medications among Saudi community. However, the disposable practice among the Saudi community was inadequate. Increasing awareness through education programs about proper disposable guidelines is necessary for controlling the medication wastage. [ABSTRACT FROM AUTHOR]

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

The study aimed at identifying the association between Bandura's four hypothesized self-efficacy sources and reading comprehension by employing reading self-efficacy beliefs as a mediating variable. A correlational research design was used. A total of 351 Saudi EFL learners were selected from eight public universities of Kingdom of Saudi Arabia by employing proportionate stratified random sampling. Two questionnaires including 'questionnaire for sources of reading self-efficacy', and 'reading self-efficacy beliefs questionnaire', and an IELTS reading comprehension test were used to collect the data. Path analysis by AMOS 23 was utilised in order to test the hypotheses. Findings provided support for the proposed conceptual framework, disclosing that all the four self-efficacy sources were significantly associated with reading self-efficacy beliefs. Also, reading self-efficacy beliefs were significantly associated with reading comprehension. Lastly, reading selfefficacy beliefs mediated the association between self-efficacy sources and reading comprehension. This study offered several theoretical and practical implications for EFL learners, instructors, and educational policymakers on the need of inculcating self-efficacy beliefs among learners to facilitate them in English reading comprehension. [ABSTRACT FROM AUTHOR]

PURPOSE: In the Middle East, incidence rate ratios (IRRs) of non-Hodgkin lymphoma (NHL) to Hodgkin lymphoma (HL) are more than 50% lower than the United States. MATERIALS AND METHODS: Age-specific incidence rates (ASIRs), age-adjusted incidence rates (AAIRs), and IRRs of NHL:HL were compared using the cancer registries of Iraq, Jordan, Saudi Arabia, and US SEER. RESULTS: The NHL AAIR (95% CI) per 100,000 population was 4.4 (4.1 to 4.7) for Iraq, 5.4 (4.6 to 6.2) for Jordan, 4.7 (4.4 to 5.1) for Saudi Arabia, and 13.2 (13.0 to 13.4) for the United States. The HL AAIR was 1.8 (1.6 to 2.0) for Iraq, 1.8 (1.4 to 2.2) for Jordan, 2.1 (1.9 to 2.2) for Saudi Arabia, and 2.3 (2.2 to 2.4) for the United States, with respective NHL:HL IRR of 2.4 (2.2 to 2.7), 3.0 (2.4 to 3.8), 2.2 (2.0 to 2.5), and 5.7 (5.5 to 6.0). NHL ASIRs for the Middle East and the United States were similar until 30 to 39 years of age. Thereafter, ASIR of NHL peaked at 20 to 33 per 100,000 at age 70 years in the Middle East regions, all much lower than the US age 70 years rate of greater than 100 per 100,000. Diffuse large B-cell lymphoma (DLBCL) represented 52% of NHL in Sulaimaniyah Province of Iraq and 51% of NHL in Saudi Arabia. Both regions had AAIR for DLBCL less than 42% of DLBCL in US SEER. Pediatric Epstein-Barr virus–related Burkitt's lymphoma at 8% was the second most frequent NHL in Sulaimaniyah but made little contribution to overall NHL rates. CONCLUSION: The incidence of HL was slightly lower than in the United States, but it was the markedly lower rates of adult NHL with advancing age, including the predominant DLBCL, that accounted for the low NHL:HL IRR in these Middle Eastern countries. [ABSTRACT FROM AUTHOR]

Background: Amount of drug in milk depend upon the concentration of drug in the mother's serum. Medications with more half-life time (T1/2) are likely to retain higher levels in breast milk. Also number of times of feeding and amount of milk taken by the infant are significant considerations. The main aim of this study was to evaluate the knowledge and practice about drug use while breastfeeding. Methods: A prospective cohort study was conducted and sample size was determined using Krejcie and Morgan's sample size calculator. A survey was carried in eastern province, Saudi Arabia community by approaching a conveniently selected sample of 545 participants. Results: The maximum percentage of participants were housewives (43.11%) while the least participants were from health care professional (6.97%, p< 0.05). Among all the participants, maximum (90.64%) were from urban residents Approx. 50 % (p< 0.05) of participants are not getting proper information from doctors about the prescribed drugs. Conclusion: Awareness should be raised about the possible side effects of medication use during breastfeeding. [ABSTRACT FROM AUTHOR]

Background: The present study was conducted to discover genetic imbalances such as DNA copy number variations (CNVs) associated with gastric cancer (GC) and to examine their association with different genes involved in the process of gastric carcinogenesis in Saudi population. Methods: Formalin-fixed paraffin-embedded (FFPE) tissues samples from 33 gastric cancer patients and 15 normal gastric samples were collected. Early and late stages GC samples were genotyped and CNVs were assessed by using Illumina HumanOmni1-Quad v.1.0 BeadChip. Results: Copy number gains were more frequent than losses throughout all GC samples compared to normal tissue samples. The mean number of the altered chromosome per case was 64 for gains and 40 for losses, and the median aberration length was 679115bp for gains and 375889bp for losses. We identified 7 high copy gain, 52 gains, 14 losses, 32 homozygous losses, and 10 copy neutral LOHs (loss of heterozygosities). Copy number gains were frequently detected at 1p36.32, 1q12, 1q22, 2p11.1, 4q23-q25, 5p12-p11, 6p21.33, 9q12-q21.11, 12q11-q12, 14q32.33, 16p13.3, 17p13.1, 17q25.3, 19q13.32, and losses at 1p36.23, 1p36.32, 1p32.1, 1q44, 3q25.2, 6p22.1, 6p21.33, 8p11.22, 10q22.1, 12p11.22, 14q32.12 and 16q24.2. We also identified 2 monosomy at chromosome 14 and 22, 52 partially trisomy and 22 whole chromosome 4 neutral loss of heterozygosities at 13q14.2-q21.33, 5p15.2-p15.1, 5q11.2-q13.2, 5q33.1-q34 and 3p14.2-q13.12. Furthermore, 11 gains and 2 losses at 1p36.32 were detected for 11 different GC samples and this region has not been reported before in other populations. Statistical analysis confirms significant association of H. pylori infection with T4 stage of GC as compare to control and other stages. Conclusions: We found that high frequency of copy number gains and losses at 1p36.23, 1p32.1, 1p36.32, 3q25.2, 6p21.33 and 16q24.2 may be common events in gastric cancer. While novel CNVs at 1p36.32 harbouring PRDM16, TP73 and TP73-AS1 genes showed 11 gains and 2 losses for 11 different GC cases and this region is not reported yet in Database of Genomic Variants may be specific to Saudi population. [ABSTRACT FROM AUTHOR]

Aims: [1] Identify the percentage of undergraduate students who are interested in academic medicine (AM) careers, [2] Explore the relationship between students’ characteristics, previous experiences and interest in AM careers and [3] Determine students’ perceived barriers toward AM careers at Alfaisal University - College of Medicine. Methods: An online, anonymous, random, self-rating survey was administered during spring 2013-2014 to second-year and third-year students (n = 302). Chi-square test was used to correlate between interest in AM careers and students’ characteristics. Mann-Whitney U-test was used to compare the mean 5-point Likert scale responses between male and female students. Results: A total of 231 students participated in the survey (response rate: 76.5%). A total of 32 students (13.9%) expressed interest in AM careers, and this percentage significantly differed by gender, academic year, interest in teaching and research and previous research experiences (p < 0.05). The top three barriers were “lower income” (77.5%), “competing pressures to fulfill clinical-teaching-research duties” (73.6%) and “lack of career advising” (69.7%). As opposed to males, females achieved higher statistically significant differences of means regarding: “competing pressures to fulfill clinical-teaching-research duties” (p < 0.001) and “lack of same-gender role models in AM careers” (p < 0.000). Conclusions: AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma. [ABSTRACT FROM AUTHOR]

Background and Objectives. β-Thalassemia and sickle cell disease are genetic disorders characterized by reduced and abnormal β-globin chain production, respectively. The elevation of fetal hemoglobin (HbF) can ameliorate the severity of these disorders. In sickle cell disease patients, the HbF level elevation is associated with three quantitative trait loci (QTLs), BCL11A, HBG2 promoter, and HBS1L-MYB intergenic region. This study elucidates the existence of the variants in these three QTLs to determine their association with HbF levels of transfusion-dependent Saudi β-thalassemia patients. Materials and Methods. A total of 174 transfusion-dependent β-thalassemia patients and 164 healthy controls from Eastern Province of Saudi Arabia were genotyped for fourteen single nucleotide polymorphisms (SNPs) from the three QTL regions using TaqMan assay on real-time PCR. Results. Genotype analysis revealed that six alleles of HBS1L-MYB QTL (rs9376090C p=0.0009, rs9399137C p=0.008, rs4895441G p=0.004, rs9389269C p=0.008, rs9402686A p=0.008, and rs9494142C p=0.002) were predominantly associated with β-thalassemia. In addition, haplotype analysis revealed that haplotypes of HBS1L-MYB (GCCGCAC p=0.022) and HBG2 (GTT p=0.009) were also predominantly associated with β-thalassemia. Furthermore, the HBS1L-MYB region also exhibited association with the high HbF cohort. Conclusion. The stimulation of HbF gene expression may provide alternative therapies for the amelioration of the disease severity of β-thalassemia. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to estimate the prevalence of medical information discrepancies between dental and medical records of cardiac patients at AlHada Armed Forces Hospital in Taif and to identify the factors contributing to these information discrepancies. Materials and Methods: The study applied a descriptive retrospective medical and dental records review of a stratified proportional sample of 289 cardiac patients, which was extracted from 1154 cardiac patients who visited both the cardiology and dental clinics at the AlHada Armed Forces Hospital between 2007 and June 2012. Data were analyzed using the Statistical Package for the Social Sciences version 19. Results: The main results of this study are the following: The mean and standard deviation of patient's age was 56 ± 16.9, female patients represented 47.8% of the study population. A total of 78.5% of dental records were documented by dental residents whereas 48.4% of the dentists had more than 6 years of experience. Two hundred and seventy-nine (96.5%) of the 289 dental records had medical information discrepancies compared to the corresponding medical records. One hundred percent of systemic lupus erythematosus and rheumatic fever cases were not documented in the dental records followed by 93% of medications, 92% of stroke, and 88.5% of hyperlipidemia, whereas the least prevalent were cardiac disease (26%) and diabetes mellitus (22.2%). Conclusion: Approximately 75% of the patients who directly or indirectly accessed the dental services showed discrepancies. The researcher concludes that critical information gaps exist between dental and medical records that mostly attributed to system level problems. A well-established model for efficient communication among medical and dental care providers caring for cardiac patients does not appear to exist. The absence of such a model can threaten the overall health of patients. [ABSTRACT FROM AUTHOR]

Objectives: Maladaptive stress-coping strategies have been linked to reduced quality of life, psychiatric disorders, and reduced work performance among residents or physicians. This study aimed to examine stress-coping strategies among medical residents in Saudi Arabia and their association with stress levels and important personal characteristics. Methods: This cross-sectional study was conducted between May and October 2012. Residents of different specialties were recruited from a national database. Stress-coping strategies were assessed using the 28- item brief coping scale (BCS), while stress was assessed using the perceived stress scale (PSS). Results: Nine hundred seventeen residents completed both BCS and PSS assessments. Almost 55% of participants were males, 88% were Saudi, 58% were married, and 15% had positive history of psychiatric disorders. The adaptive stress-coping strategy with the highest score was religion, followed by planning, acceptance, and active coping. The maladaptive stress-coping strategy with the highest score was self-blame, followed by self-distraction, and venting. Maladaptive stress-coping strategies were associated with high stress level, female gender, and history of psychiatric disorders. Stress-coping strategies were not correlated/associated with age, presence of major medical illnesses, or stress management education/training. Conclusion: Adaptive stress-coping strategies were more frequently used among a sample of residents in Saudi Arabia than maladaptive stress-coping strategies, with higher use of religion in coping than previously reported. To avoid potential negative impact on resident well-being, future studies among residents should aim to identify the type of stress management program that most positively impacts stress-coping skills. [ABSTRACT FROM AUTHOR]

The physical school environment has been shown to be important in helping children fulfill their academic potential and in providing appropriate working conditions for staff. However, few tools have been developed that enable multi stakeholder consultation which takes into account the opinions of young students. In Saudi Arabia there has been widespread investment in schools, but few guidelines have been provided to assist design or continuous evaluation. A Post Occupancy Evaluation (POE) method was developed and used to evaluate three international primary schools in Saudi Arabia. The methods identified weaknesses in the three schools and differences in responses from the three groups consulted (children, teachers and parents). Conclusions drawn from the study are that greater efforts need to be made to draw together research about how school facilities can support teaching and learning, increase effectiveness and levels of satisfaction. POE, when used in conjunction with checklists could be used as a means of driving up standards of educational facilities [ABSTRACT FROM AUTHOR]

Tourism is vital to the success of many economies worldwide and has been a widely researched area for many years. Unfortunately, an insufficient number of studies have been conducted on this subject in the context of Saudi Arabia. Therefore, this research investigates the role of tourism in promoting economic growth in the Kingdom of Saudi Arabia by using annual time series data from 2003 to 2019. The study uses basic statistics, correlation coefficients, the unit root test, the Johansen co-integration test, the co-integration regression test and the Granger causality test to check the relationship between tourism and economic growth. The results show that economic growth has a long-run relationship with tourism receipts, tourism expenditures and the number of tourist arrivals; the number of tourist arrivals has a strong relationship with economic growth, compared to other parameters. The empirical results validate the concept that tourism promotes economic growth in the kingdom of Saudi Arabia. [ABSTRACT FROM AUTHOR]

Rabigh Lagoon, located on the eastern coast of the Red Sea, is an ecologically rich zone in Saudi Arabia, providing habitat to Avicennia marina mangrove trees. The environmental quality of the lagoon has been decaying since the 1990s mainly from sedimentation, road construction, and camel grazing. However, because of remedial measures, the mangrove communities have shown some degree of restoration. This study aims to monitor mangrove health of Rabigh Lagoon during the time it was under stress from road construction and after the road was demolished. For this purpose, time series of EVI (Enhanced Vegetation Index), MSAVI (Modified, Soil-Adjusted Vegetation Index), NDVI (Normalized Difference Vegetation Index), and NDMI (Normalized Difference Moisture Index) have been used as a proxy to plant biomass and indicator of forest disturbance and recovery. Long-term trend patterns, through linear, least square regression, were estimated using 30 m annual Landsat surface-reflectance-derived indices from 1986 to 2019. The outcome of this study showed (1) a positive trend over most of the study region during the evaluation period; (2) most trend slopes were gradual and weakly positive, implying subtle changes as opposed to abrupt changes; (3) all four indices divided the times series into three phases: degraded mangroves, slow recovery, and regenerated mangroves; (4) MSAVI performed best in capturing various trend patterns related to the greenness of vegetation; and (5) NDMI better identified forest disturbance and recovery in terms of water stress. Validating observed patterns using only the regression slope proved to be a challenge. Therefore, water quality parameters such as salinity, pH/dissolved oxygen should also be investigated to explain the calculated trends. [ABSTRACT FROM AUTHOR]

Background: over the last two decades, only few dermatology research papers have been published in Saudi Arabia provided the small number of experts -in this field -enlisted in higher education institutions. Hence a compelling need to review the recent publications and define the current prevalence, status and interventions needed. Objective: To present an overview of the common dermatological diseases, particularly eczema and dermatitis, in Saudi community as well as their effects and ways to mitigate them. Methods: Review of Randomized Controlled Trials (RCTs) researches conducted and published in Saudi Arabia. Results: Empirical findings revealed that Acne, Eczema and Psoriasis are the most common dermatological disorders among the Saudi community while Atopic Dermatitis was the most common mostly affecting children. In the meantime, Vitiligo emerged to be the most rampant pigmentary ailment, also viral warts appeared predominant covering up to 12% of the patients in the subject. On the other hand, dermatophytoses occurred commonly among the fungal conditions, while psoriasis arose as the most recurrent papulosquamous condition. Conclusion: The prevalence of dermatological disorders in Saudi Arabia is rather high with the issue being overlooked and deprioritized in favor of graver pathological conditions despite the significant social, psychological and quality of life impact on the patients. Thus, we recommended that proper education and awareness campaigns on skin diseases should be provided at all academic and social levels as one way of prevention and alleviation of skin diseased in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Abstract: Study Objective: To review the clinical presentation of ovarian tumors in children and adolescents treated at the University of Dammam and King Fahad University Hospital. Design: Data of the patients was noted retrospectively from the hospital medical records regarding age, presentation, diagnosis, treatment, and outcome. Setting: The study was carried out in the Ob/Gyn department at King Fahad Hospital of Dammam University, Saudi Arabia between January 1985 and December 2009. Participants: There were 52 patients between 6 and 20 years of age who presented with an ovarian tumor during the study period. Intervention: Preoperative diagnostic approach included history, physical examination, ultrasonography, radiological examination, tumor markers, operative treatment, and histopathological examination of the tumor. Chemotherapy was given to patients where indicated. Results: The main presenting symptom was abdominal pain in 30 (58%) patients. Of the neoplastic tumors, 87% were germ cell tumors, of which 73% were benign while 13% were malignant. Operative procedures included 48 (92%) exploratory laparotomies and 4 (8%) laparoscopic resections. Ovarian cystectomy was done in 23 (44%) patients and salpingoophorectomy in 28 (54%) patients. Of the 7 (13%) patients with malignant tumors, five received postoperative chemotherapy. Three patients with malignancy died in the series. Conclusion: Early diagnosis of ovarian masses in young girls is important. Since most of these masses are benign, operation should be designed to optimize future fertility, while the treatment of malignant tumors would involve complete staging, resection of the tumor, postoperative chemotherapy when indicated, to give the patient a chance for future childbearing. [ABSTRACT FROM AUTHOR]

A few decades ago, the government of Saudi Arabia introduced electronic medical records (EMRs) in some health care facilities. However, the progress in adopting these systems on a national level was slow. In 2008, the Saudi Ministry of Health started an initiative to expand and optimize the use of EMRs in governmental health care institutions. However, some obstacles facing this ambitious plan remain, including negative attitudes of some health care professionals toward EMR systems. Other barriers include poor computer literacy, lack of system customization to hospital needs, and poor support and training from information technology (IT) personnel. Identifying and addressing these barriers is essential for the optimal application of EMR systems in all health care facilities. In this review, the author focused on the benefits of widespread adoption of EMRs in Saudi Arabia, the perceptions of health care professionals, and the challenges and barriers toward improved implementation of this technology.

Objective: To compare two influenza polymerase chain reaction (PCR) methods., Methods: A total of 749 suspected MERS-CoV patients presenting at Johns Hopkins Aramco Healthcare, Saudi Arabia, each submitted a clinical sample for influenza A reflex testing using the on-site Cepheid® Xpert Flu assay and at the Ministry of Health laboratory by the Roche PCR assay., Results: There was 92.12% overall agreement between the two methods. Specificity of the Cepheid® Xpert Flu was 95.8% for H1N1 and 94.4% for total influenza A. Cepheid® Xpert Flu sensitivity for influenza A was 100% for younger patients (0-19-year age group) but significantly lower both for older patients (68.2% for 60-79-year and 50% for ≥80-year age groups) and overall for males compared to females (72.6% and 94.0%, respectively)., Conclusions: Specificity of the Cepheid® Xpert Flu test was high; however, sensitivity for total influenza A was lower particularly in males and older patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: Pregnancy associated with ovarian tumors was reviewed over a 20-year period to determine the maternal and fetal outcome in patients undergoing surgery during pregnancy., Method: A retrospective study of 94 cases of ovarian tumors treated surgically during pregnancy was investigated for incidence, clinico-pathological features and outcome in a teaching hospital between June 1987 and May 2007., Results: The overall incidence of ovarian tumor in pregnant women was 1 in 505 (0.2%) deliveries. Diagnosis of 69.2% tumors resulted in the first and second trimesters of pregnancy. Twenty-two (23.4%) patients presented as an emergency at different periods of gestation and 16 (17.1%) tumors were incidentally discovered at cesarean section which underlines the significance of examining the ovaries routinely at cesarean section. Benign teratoma (39.4%) and serous cystadenoma (24.5%) were the most common types of ovarian tumors found in the study. The incidence of malignant tumors was 5.3%. Tumors with low malignant potential comprised 40% of malignancy. The miscarriage rate after surgery was 44.4% in the first trimester compared with 16.6% in the second trimester. The preterm birth rate was 4.3% in the series., Conclusion: The value of clinical and ultrasound examinations in early pregnancy as a diagnostic aid is highlighted. Whenever an ovarian tumor is detected in pregnancy, malignancy should always be suspected. Treatment of an ovarian tumor in pregnancy should be tailored according to the age, parity, clinical presentation, gestational age and histopathology of the tumor. Removal of persisting or enlarging ovarian masses as soon as possible is important to obtain a final histologic diagnosis and rule out malignancy. Early diagnosis and appropriate treatment of malignant tumors offers the best prognosis for the patient.