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ABSTRACT: Background: The past decade has witnessed a revolution in smartphones owing to their growing importance and various applications. However, excessive usage can lead to addiction and joint pain in the wrist/thumb area. Despite these negative effects, smartphones offer medical students access to the resources they need. Objective: To determine the association between smartphone addiction and thumb/wrist pain among undergraduate students of Jazan University. Methods: A cross-sectional self-administrated, online survey and online convenience sample technique was used. The collected data were analyzed using SPSS Software. Results: This survey included 337 participants, of which two-thirds were female (66.8%) and the rest male (33.2%); 32.6% of the respondents were studying in the College of Medicine. Of the 337 participants, 32% reported experiencing pain in their wrists or at the back of their neck while using a smartphone. The study found an average Smartphone Addition Scale-Short Version (SAS-SV) score of 32.5 ± 8.0 out of 50 and a total Patient-Rated Wrist Evaluation score of 48.8 ± 14.7, with a pain score of 13.3 ± 11.0 and a function score of 35.5 ± 11.7. The study also revealed a significant association between smartphone addiction and thumb/wrist pain (P value = 0.029), with females and students of the College of Applied Medical Science associated with higher SAS-SV scores, thereby indicating higher smartphone addiction. Conclusion: Significant correlation exists between smartphone addiction and thumb/wirst pain among medical students of Jazan University. [ABSTRACT FROM AUTHOR]

The recognition of complementary and alternative medicine (CAM) is increasingly growing worldwide. Positive attitudes toward using CAM may reflect an evidence-based understanding and awareness of its common uses and potential abuses, facilitating its sound integration into the society for positive results. This study aimed to identify the level of knowledge, practices, and barriers associated with the use of CAM among medical and nonmedical students. A cross-sectional study was conducted between April 2023 and July 2023 involving a sample group of medical and nonmedical students from King Khalid University, Abha, Saudi Arabia. A total of 341 students completed the survey. Approximately 53.4% of the participants were medical and 46.6% were nonmedical students. Herbal medicine was the most used among medical students (21%) followed by aromatherapy (12%) and chiropractic (11%), while the most used CAM among nonmedical students was spiritual healing/Quran (19%). The prevalence of good knowledge is higher in medical students compared to nonmedical students in some CAM modalities. In addition, the results show that there are no significant differences in attitudes toward CAM among medical and nonmedical students. Respondents from both groups were keen on gaining more knowledge about all the CAM modalities. It is important to utilize the data from this study for enhancing curricula in university programs and promoting education and practice related to CAM. [ABSTRACT FROM AUTHOR]

Public knowledge about the role of lifestyle in managing type two diabetes (T2D) is an essential preventive strategy. Despite efforts in public awareness, the prevalence continues to rise, with the majority relying on the availability of effective therapeutics, underestimating the role of healthy lifestyle changes. This study aims to assess public awareness of the impact of lifestyle modification in managing T2D in a major metropolitan city in Saudi Arabia, which will help inform the health management authority in the country on the level of public awareness and advise on the development of educational programs. An observational cross-sectional survey study comprising 16 knowledge and 6 attitude questions was conducted among the population over 18 years old using online survey. After validation, the online self-developed questionnaire was distributed through social media. The knowledge and attitude scores were similar between males and females. Participants with a family member or friend with T2D demonstrated higher knowledge scores. However, the attitude scores did not differ significantly based on family or friend relationships. The knowledge and attitude on the role of lifestyle modifications in preventing and managing T2D is moderate, implying an opportunity for innovative strategies to raise public knowledge and attitude. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is highly prevalent among Saudi males and females. Understanding its symptoms, risk factors, and screening is vital. This study aims to gauge CRC awareness in Taif City, Saudi Arabia, based on demographics. An observational study in Taif City surveyed awareness on colorectal screening, gathering data from March-April 2023 via a questionnaire covering demographics, screening knowledge, symptoms, and risk factors. Involving 551 participants, most were 19-40 years old (59.2%), female (65.9%), and had a bachelor's degree (71.3%). Notably, 49.2% hadn't visited a family doctor. Awareness on CRC screening was low. 37.7% knew about fecal occult blood tests, 32.7% about sigmoidoscopy, and 34.8% about colonoscopy. Only 27.6% knew the recommended screening age, and 2.4% the frequency. Participants sought information mainly online (45.7%) or from friends (24.1%). Recognized risk factors included family history (57.0%), blood in stool (58.8%), and abdominal pain (47.9%). The study highlights inadequate awareness about CRC screening in Taif. It underscores the necessity for targeted education campaigns, collaboration with healthcare professionals, and diverse information sources to improve understanding among the population. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak was a serious challenge for countries around the globe. With the objective of mitigating the spread of the virus, both national and international health organizations swiftly enacted quarantine measures across numerous cities around the globe. This presented a unique chance to evaluate the consequences of human actions on the quality of the air. This study aimed to investigate airborne microbial levels in different outdoor locations in Al-Madinah City, Kingdom of Saudi Arabia (KSA), during the COVID-19 pandemic by comparing lockdown against non-lockdown conditions. Twelve outdoor locations were investigated in terms of microbial total counts using the open plate method during and after the COVID-19 lockdown. Environmental factors that could affect the airborne microbial load, including humidity, temperature and wind speed, were recorded during the assessment. The means of the total colony-forming units (CFU) for each cubic meter (m³) of air were calculated. Lockdown restrictions caused significant decreases in the biological contaminants in all locations compared with the numbers after the pandemic. Gram-positive bacteria represented most of the samples, with fewer fungal strains detected. The outdoor average total bacterial counts ranged between 0.00±0.00-8337.50±248.98 CFU/m³, compared with 2903.75±407.60-19722.50±475.03 CFU/m³ after the pandemic. The mean concentrations of total fungi were lower than those of bacteria and ranged between 0.00±0.00-143.75±131.75 CFU/m³ during the COVID-19 lockdown and were elevated after the lockdown to reach 28.75±49.80-776.25±298.78 CFU/m³. Based on the available data, there are no studies comparing outdoor microbial counts during and after the COVID-19 pandemic. Therefore, this research offers additional perspectives on the air quality experienced amidst the COVID-19 pandemic and the subsequent implementation of lockdown measures and could serve as a valuable resource for monitoring and implementing measures to control air pollution. [ABSTRACT FROM AUTHOR]

The current study aimed to determine the pregnancy outcomes complications in patients with SLE and its association with clinical, laboratory variables, disease activity, and medication use in the Saudi population, as well as pregnancy effect on disease activity. Methods: A multicenter study included pregnant female patients with Systemic Lupus Erythematosus (SLE) from three tertiary centers in Saudi Arabia. The demographics, clinical, and laboratory variables, SLE disease activity index (SLEDAI), medication before, during, and after pregnancy, planned pregnancy, pregnancy-related outcomes, and complications in comparison to age-matched healthy female controls were noted. Results: A total of 66 pregnant patients with SLE and 93 healthy age-matched pregnant controls were included in the study. A total of 77.3% had SLEDAI-2K ≤ 4 before conception, and 84.85% of pregnancies were planned. Age of conception, cesarean section, miscarriage, and low birth weight were statistically significant (p < 0.05) higher in SLE patients than in healthy controls. Among all clinical and laboratory variables, SLEDAI-2K > 4 and active lupus nephritis during pregnancy were statistically associated with adverse outcomes (p < 0.05), history of lupus nephritis was not associated with statistically adverse pregnancy outcomes. Higher SLEDAI-2K > 4 was an independent risk at least 4.87 times higher association with adverse pregnancy outcomes. (p < 0.05). Conclusion: SLE is intricately connected with unfavorable pregnancy outcomes. The preconception of high disease activity stands as a pivotal risk factor for adverse outcomes. Despite the disease remission and meticulous planning, SLE patients frequently grapple with disease exacerbations during pregnancy, culminating in unexpected and unfavorable pregnancy-related outcomes. This underscores the intricate and multifaceted nature of managing SLE during gestation. [ABSTRACT FROM AUTHOR]

Background: Cosmetic surgery may help in improving physical appearance and increasing self-esteem. Mass media may contribute to women's preference for cosmetic interventions. The study aimed to assess the social media influence impact on the performing of cosmetic interventions and to evaluate the acceptance level of those interventions among females in Saudi Arabia who rely on the internet as an information source. Methods: The study was a cross-sectional study conducted from December 2022 to January 2023 among females living in Saudi Arabia. Data were collected using a self-administered questionnaire. Participants' acceptance of cosmetic interventions was evaluated using an Arabic version of the validated Acceptance of Cosmetic Surgery Scale (ACSS). Results: The study included 1790 females. Most individuals were single (73.9%), and 59.6% fell into the 18–25 age group. About 14.2% of respondents used Snapchat to get information about cosmetic surgery. Younger females (< 25 years) used TikTok (9.8% vs. 3.6%) and Twitter (13.7% vs. 10%) to gain knowledge about cosmetic interventions (P-value < 0.001). The mean score of the overall acceptance of cosmetic surgery was 42.87. Snapchat platforms significantly increased the acceptability of cosmetic interventions (P-value = 0.032). Conclusions: The present study highlighted the significance of social media's impact on the level of acceptance of cosmetic surgery among participated females. Further investigations are recommended to assess the effects of internet sources, especially social media, on the general population's acceptance level and the rate of performing cosmetic surgery. Level of Evidence: Not gradable. [ABSTRACT FROM AUTHOR]

Measuring patient safety culture in the community pharmacy can help with identifying areas for development. The current study is a descriptive, cross-sectional, electronic survey conducted among pharmacists working in community pharmacies located in the southern region of Saudi Arabia. The community pharmacy version of the "Pharmacy Survey on Patient Safety Culture" (PSOPSC) was used to collect data. The positive response rate (PRR) was calculated as per the guidance provided by the Agency for Healthcare Research and Quality (AHRQ). Based on the PRR, two least-achieved items (<25%) were taken for further analysis to identify the possible predictors. A sum of 195 pharmacists were included in this study and most of them were working in chain pharmacies. The highest PRRs were observed with teamwork (94.99), and patient counseling (94.13), followed by physical space and environment (93.07). The lowest PRRs were observed with staffing, work pressure, and pace (47.70), followed by communication openness (72.60). Specific characteristics, such as experience and the number of working hours, are significantly related to a poor PRR. The current study results indicate that the scope for improving patient safety exists in various areas of community pharmacies. However, it is necessary to prioritize the need based on a positive response rate. [ABSTRACT FROM AUTHOR]

Background and Objectives: obstructed defecation syndrome (ODS) is a common but underestimated condition that may affect the outcomes after hemorrhoidectomy. Therefore, the aim of this study was to determine the prevalence of obstructed defecation syndrome (ODS) among patients who underwent hemorrhoidectomy and to assess the correlation between preoperative constipation score and postoperative patients' satisfaction. Materials and Methods: This prospective study included adult patients who underwent hemorrhoidectomy for 3rd and 4th-grade hemorrhoidal diseases. All participant patients underwent an assessment of functional OD severity by the Agachan–Wexner Constipation Scoring System. All patients were subjected to conventional hemorrhoidectomy. At 6 months postoperatively, patients were assessed again for their constipation score and postoperative patients' satisfaction. Results: The study included 120 patients (62 males and 58 females) with a mean age of 38.7 ± 12.1 years. About one-quarter of patients (24.2%) had obstructed defecation (constipation score ≥12). ODS (constipation score ≥12) was found to be significantly more among older patients, female patients, especially those with multiple pregnancies and multiple labors, and those with perineal descent. The postoperative constipation score (5.6 ± 3.3 mean ± SD) showed significant improvement (p = 0.001) compared to (9.3 ± 3.9 mean ± SD) preoperatively. Postoperative patients' satisfaction (mean 12.3 ± 3.0) at 6 months had a negative correlation with preoperative total constipation score (r = −0.035, p = 0.702). Conclusions: The prevalence of obstructed defecation among patients with hemorrhoids was higher than reported among the general population. High preoperative constipation scores had a negative correlation with postoperative patients' satisfaction. Routine preoperative measurement of ODS can allow the detection of this particular group of patients who require a more physical and psychological evaluation, in addition to special preoperative counseling. [ABSTRACT FROM AUTHOR]

Background: Adverse Childhood Experiences (ACEs), such as childhood abuse, neglect, and family dysfunction, prevent appropriate emotional, behavioral, and physical development. They are also a major public health issue, and have been debatably linked to chronic diseases, including type 2 diabetes mellitus (T2DM). T2DM is highly prevalent in Saudi Arabia, and various theories have been raised to explain the epidemiology of diabetes. However, few studies have discussed the relationship between ACEs and T2DM. Thus, we aimed to evaluate the association between ACEs and T2DM in Jazan Province, Saudi Arabia. Methods: This observational, cross-sectional study was conducted using a validated questionnaire distributed among patients with T2DM in a diabetes center. The t-test and Chi-Square test were used for comparison, and the p-value was set at <0.05 for significance. Results: A total of 579 participants were involved in this study, and 303 (52.33%) were female. Among the included participants, 45.25% were diagnosed with T2DM. About 28.71% of participants with diabetes experienced verbal abuse, 16.09% experienced physical abuse, and 30.91% reported that parents beat them. Additionally, 1.58% of participants with diabetes reported living with a family member who abused substances, 8.83% believed that no one would take them to the doctor even if essential, 12.62% of participants with diabetes felt that no one would protect them, and 23.03% reported that they felt no one in their family loved them. All reported ACEs were significantly associated with a high risk of T2DM (p < 0.05), and the more frequent the ACEs, the more the risk of T2DM (p = 0.0001). Conclusions: This study indicated that ACEs are significantly associated with the development of T2DM, and the risk increases with the frequency of ACEs, which aligns with other studies. Further national studies are required to understand how ACEs could contribute to T2DM, and preventive interventions in childhood must be considered to reduce the burden of T2DM. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate Saudi Arabian public perceptions toward influenza and COVID-19 immunization during the flu season. A cross-sectional self-administered, structured, and closed-questionnaire online survey was conducted on the general public. A total of 422 people willingly participated in the survey using several social media platforms from 15 May to 15 July 2021. Residents of Saudi Arabia aged 18 or older (eligible for COVID-19 vaccination) were included in the study and willing to answer questionnaires. The 422 participants who agreed to participate in the study completed the questionnaire. Thirty-seven percent of the participants were youth (18–25 years). More than 80% of the participants in the study agreed or strongly agreed that flu and COVID-19 vaccines must be mandatory for all populations. At the same time, 42.4% considered that the COVID-19 vaccine might positively impact the public and the economy in the future. Participants confirmed to have had COVID-19 or the flu since the beginning of the outbreak totaled 21.3%. Of the participants, 54% had sufficient knowledge about vaccine types and safety. Most of our participants (54.9%) agreed that preventive measures were still required, even with the existence of vaccines. Our study provides an overview of COVID-19′s influence on Saudi Arabia during the flu season. The Saudi Arabian government should consider preventive efforts to strengthen confidence in the health advantages offered by prospective immunization to prevent a twindemic of influenza and COVID-19. [ABSTRACT FROM AUTHOR]

Thyroid disorders constitute one of the major endocrine disorders in pediatric service. It includes a range of congenital versus acquired anatomic and/or functional thyroid diseases in growing children that has a spectrum of severity from severe intellectual disability effect to subclinical mild pathologies. This study was designed to analyze the demographic characteristics, clinical pattern, and severity of thyroid disorders in the pediatric endocrine clinic patients at the teaching hospital of the university over a 7-year duration. A total number of 148 patients with thyroid disorders were seen in pediatric Endocrine clinic during the time between January 2015 and December 2021. Female patients constitute 64% of them. Acquired Hypothyroidism was the commonest disorder; 34% of the cases followed by the congenital hypothyroidism (CH), then Hashimoto's thyroiditis, and 5.8% for others. While a very small percentage was acquired hyperthyroidism. The majority of referrals were from dermatology and other service for the screening of thyroid disease as association with other autoimmune diseases with percentage of 28.3%. Next was neck swelling manifestation in 22.6%. Thyroid disorders in children, both congenital and acquired, constitute an important medical issue for pediatricians to be aware of its variable presentations, and its potential serious health consequences on the affected children if not diagnosed and treated earlier. Acquired hypothyroidism constitutes more percentage of the thyroid disorders followed in the pediatric endocrinology outpatient clinics. Congenital hypothyroidism is the second most common thyroid disorder in the outpatient unit, having the most potential complications. These results support the international studies with the female predominance in most of thyroid disorders. [ABSTRACT FROM AUTHOR]

Effectively triaging incoming patients while preventing coronavirus disease 2019 (COVID-19) spread in any emergency department (ED) is a demanding and critical task that places a huge burden on frontline healthcare workers. The ED at our tertiary hospital utilized a slightly modified version of a formerly efficacious severe acute respiratory infections (SARI) screening tool for triaging patients presenting to the ED with respiratory illness. We conducted a retrospective chart review and included patients who were screened using the SARI screening tool and underwent a combined nasopharyngeal and oropharyngeal reverse transcription polymerase chain reaction swab for severe acute respiratory syndrome- related coronavirus 2 to determine COVID-19 positivity. Results from our study show that it may be warranted to remove the gastrointestinal symptoms (nausea, vomiting, and diarrhea) from the SARI screening tool and potentially adjusting the weights of the components in the screening tool. However, as data from additional studies become available, the current SARI screening tool could continue to be used as a screening tool to predict COVID-19 positivity and in triaging patients. [ABSTRACT FROM AUTHOR]

The kingdom of Saudi Arabia (SA) ranks fifth in Asia in terms of area. It features broad biodiversity, including interesting flora, and was the historical origin of Islam. It is endowed with a large variety of plants, including many herbs, shrubs, and trees. Many of these plants have a long history of use in traditional medicine. The aim of this review is to evaluate the present knowledge on the plants growing in SA regarding their pharmacological and biological activities and the identification of their bioactive compounds to determine which plants could be of interest for further studies. A systematic summary of the plants' history, distribution, various pharmacological activities, bioactive compounds, and clinical trials are presented in this paper to facilitate future exploration of their therapeutic potential. The literature was obtained from several scientific search engines, including Sci-Finder, PubMed, Web of Science, Google Scholar, Scopus, MDPI, Wiley publications, and Springer Link. Plant names and their synonyms were validated by 'The Plant List' on 1 October 2021. SA is home to approximately 2247 plant species, including native and introduced plants that belong to 142 families and 837 genera. It shares the flora of three continents, with many unique features due to its extreme climate and geographical and geological conditions. As plants remain the leading supplier of new therapeutic agents to treat various ailments, Saudi Arabian plants may play a significant role in the fight against cancer, inflammation, and antibiotic-resistant bacteria. To date, 102 active compounds have been identified in plants from different sites in SA. Plants from the western and southwestern regions have been evaluated for various biological activities, including antioxidant, anti-cancer, antimicrobial, antimalarial, anti-inflammatory, anti-glycation, and cytotoxic activities. The aerial parts of the plants, especially the leaves, have yielded most of the bioactive compounds. Most bioactivity tests involve in vitro assessments for the inhibition of the growth of tumour cell lines, and several compounds with in vitro antitumour activity have been reported. More in-depth studies to evaluate the mode of action of the compounds are necessary to pave the way for clinical trials. Ecological and taxonomical studies are needed to evaluate the flora of SA, and a plan for the conservation of wild plants should be implemented, including the management of the protection of endemic plants. [ABSTRACT FROM AUTHOR]

Introduction: Contracting coronavirus disease (COVID-19) during pregnancy has been linked to an increased risk of severe maternal and fetal complications. Mass vaccination is considered a promising solution to successfully combat the COVID-19 pandemic. It includes vaccinating of pregnant and breastfeeding women. The success of a vaccine is determined not only by its efficacy, but also by its acceptability. Therefore, our study aimed to explore the acceptability and reluctance of pregnant and breastfeeding women to receive COVID-19 vaccination in Saudi Arabia. Methods: This cross-sectional study was conducted in Saudi Arabia from March 2022-beginning to June 2022-end. Using an online self-administered questionnaire with a convenience sampling technique, we assessed women for pregnancy, gravidity, parity, high-risk pregnancy, trimester of pregnancy, and current or planned breastfeeding. Furthermore, we assessed patients with preexisting chronic illnesses. The questionnaire comprised sociodemographic data and items drawn from Goncu Ayhan et al, including vaccination history, perception of risk related to the COVID-19 pandemic, impact of the COVID-19 pandemic, and acceptance and attitude toward future COVID-19 vaccination. Results: A total of 854 women (615 pregnant and 192 breastfeeding women) were included. Predictors of COVID-19 vaccination acceptance were found in women with a high level of education, those who lived with an elderly family member, and had close contact with a COVID-19-positive person. The reasons for declining vaccination included COVID-19 diagnosis during pregnancy and concerns about side effects of COVID-19 vaccines. A total of 503 (58.9%) women believed that COVID-19 vaccines had the potential to harm their babies. Only 415 (48.6%) agreed they would take the COVID-19 vaccine if it were recommended for pregnant women. Conclusion: Pregnant and breastfeeding women fear COVID-19 vaccination due to safety concerns for their babies. COVID-19 vaccine acceptance varies among pregnant and breastfeeding women, regardless of whether they receive the COVID-19 vaccine. Our study underlines the importance of public education campaigns to improve the overall quality of information on COVID-19 vaccination, particularly among pregnant and breastfeeding women. [ABSTRACT FROM AUTHOR]

Background. Nursing care is holistic, and missing any aspect of care can be critical to patients' health. However, due to the complex and intense nature of the nursing practice, nurses have to unintentionally prioritize some activities, forcing them to omit some aspects of nursing care. Aim. To explore the dimensions of missed nursing care and its predictors within the Saudi Arabian healthcare system. Methods. Quantitative, cross-sectional study used the MISSCARE survey by utilizing nonprobability convenience sampling to collect the data of 604 staff nurses working in inpatient wards in Jazan, Saudi Arabia. Results. The overall mean of missed nursing care is (m = 1.37, SD = 0.45). Missed nursing care activities were mostly failure to attend interdisciplinary care conferences (m = 1.66, SD = 0.96) and patient ambulation thrice a day (m = 1.63, SD = 0.97). Missed nursing care was mainly caused by human resource shortage (m = 3.53, SD = 0.88). Missed nursing care is predicted by the turnover intention (B = 2.380, t = 3.829, p < 001) and job satisfaction (B = −0.864, t = −4.788, p < 001). Conclusion. Although missed nursing care is evident in Saudi Arabia, it is significantly lower than the international rates, and it is mainly caused by labor resource shortage which directly influences nurses' job satisfaction and intention to leave. Optimizing the recruitment process, resource allocation and effective nurses' retention programs are proposed solutions that may be beneficial to mitigate missed nursing care. [ABSTRACT FROM AUTHOR]

Introduction: Community pharmacists play a key role as vaccinators for COVID-19. They can reduce the burden of the disease worldwide. Objective: This study used a cross-sectional questionnaire to determine whether the Saudi Arabian public was willing to obtain the COVID-19 vaccine via community pharmacists. Results: The questionnaire focused on the satisfaction, concerns, and opinions towards providing vaccination by community pharmacists. The study featured 415 individuals aged 18 and older (eligible for the COVID-19 vaccine). Of the participants in this study, 58.1% were aged 18– 25, with 55.4% female. Most participants (72.8%) have not been exposed to COVID-19 and are not aware of the approval of COVID-19 vaccination by community pharmacists. Of the 415 complete questionnaires, 45% believed that community pharmacists are not experienced in administering vaccines. However, 63% of participants are satisfied with getting the COVID-19 vaccination by a community pharmacist if no other option is available. More than 68% of the respondents agree that community pharmacies should expand their health care services to include vaccinations, prescriptions, checkups, and other forms of preventative medicine. Discussion: The availability of community pharmacist-administered vaccination in Saudi Arabia could be a significant factor in the success of the country's vaccination program. This study may serve as a model to expand the role of pharmacists in other countries' vaccination programs. [ABSTRACT FROM AUTHOR]

Respiratory tract infections are considered the major cause of pediatric hospitalization requiring direct supervision by a clinician. The use of antibiotics that are commonly used for treatment is sometimes associated with the development of antibiotic resistance and less than desirable treatment outcome. Despite limited clinical evidence, complementary and alternative medicine is widely used as an alternative to antibiotics worldwide for treatment of respiratory tract infections in children. Therefore, we decided to explore the parental attitude and awareness regarding the use of the complementary and alternative medicine for the management or prevention of respiratory tract infections in children in Aseer region, Saudi Arabia. Over a 4-month period during influenza season, 1,192 parents were administered two sets of seven questionnaires dealing with attitude and awareness about the complementary and alternative medicine use. The results show that parents who felt that respiratory tract infections in children do need antibiotics supported the use of the complementary and alternative medicine modalities. More than half of the participants agreed that the complementary and alternative medicine would produce fewer side effects on their children's immunity than antibiotics and produce less bacterial resistance. In conclusion, the complementary and alternative medicine use for the treatment of respiratory tract infections in children should be based only on reliable and evidence-based advice. [ABSTRACT FROM AUTHOR]

Introduction: Sustaining a healthy work environment is a major challenge for health care organizations worldwide. Nursing professionals are often exposed to workplace bullying, which imposes serious challenges to nursing retention. Objectives: To determine the prevalence of workplace bullying and turnover intention among nurses, and to investigate the relationship between workplace bullying and nurse turnover. Methods: A cross-sectional correlational design. Convenience sampling was applied, whereby 347 nurses working in a tertiary medical city in Riyadh, Saudi Arabia, were recruited. Data were collected using the Negative Acts Questionnaire and the Anticipated Turnover Scale. Results: The rate of workplace bullying was high, bullying occurred at a cumulative rate of 33.4% (n=116). Work related bullying behaviors formed the most common bullying acts with (34.5%) followed by personal bullying with (31.1%) meanwhile physical intimidating accounted by (25.6%). Among the participants, 31.7% exhibited a high turnover intention. The demographic variable age was revealing an inverse correlation with workplace bullying. There was a positive significant correlation between workplace bullying and turnover intentions (r=.24, p < 0.01). Conclusion: The alarming prevalence of both bullying and turnover intention among participants confirms that when nurses are exposed to workplace bullying, they are more likely to demonstrate an increased intention for turnover. Managers are urged to use proper enforcement of anti-bullying policies along with education and training to create a healthy environment and mitigate workplace bullying. [ABSTRACT FROM AUTHOR]

Introduction: Social media platforms are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination. Purpose: The objective of this study is to understand the influence of social media on the attitudes and willingness of the general public of the Aseer region of Saudi Arabia to receive COVID-19 vaccination. Materials and Methods: A cross-sectional self-administrated online survey was conducted in Saudi Arabia Aseer region, where 613 persons willingly took part in the survey in April and May 2021. Residents of Aseer in Saudi Arabia, who are over the age of 18 (eligible for COVID-19 vaccination) and willing to participate in the survey, were included in the study. Results: Overall, 74.6% agreed that the COVID-19 vaccine was misrepresented via social media. However, 37% of those respondents strongly agreed that social media had increased their willingness to get the COVID-19 vaccine. In addition, employees reported (21.8%) or strongly agreed (28%) that the quantity and quality of information on social media has a detrimental impact on their psychological well-being. Additionally, participants also agreed (21.8%) or strongly agreed (28%) that social media had a negative effect on their psychological condition. Conclusion: The study provides that there was a high degree of awareness indicated among Aseer population regarding misleading information about COVID-19 vaccination via social media. Thus, social media that can share up-to-date scientific information about vaccination must be utilized optimally by the government to assist people in making decisions about accepting vaccinations. [ABSTRACT FROM AUTHOR]

Purpose: During examinations, many students use various over-the-counter (OTC) drugs to improve their concentration or treat exam-related medical symptoms. The purpose of this study was to scrutinize the use of OTC drugs during examinations in Saudi Arabia. Materials and Methods: A cross-sectional study was designed, consisting of online, self-administered questionnaires comprising 27 items, including the awareness, knowledge, and attitude of students toward OTC drug use during examinations. A logistic regression model was fitted to determine factors that predict OTC drug use. The data were analyzed using Statistical Package for Social Science (SPSS). Results: A total of 463 (92.6%) completed questionnaires were received from 500 recruited participants. Among participants, 58.5% were women, 47.9% were 22 years or older and completing their final year of study, and 44.1% of students preferred not to disclose their monthly income. The most common cause (35.6%) for OTC drug use during the examination period was headache, followed by pain (21%), fever (16.6%), and cough (8.2%). The most commonly used medication were painkillers, antipyretics, cough and cold medications, and vitamins (57.2%, 16.4%, 11%, and 7.3%, respectively). Male students showed a significant lack of awareness and knowledge regarding the safety and reasons for OTC drug use compared with their female counterparts and were less likely to read the medication leaflet before use (p < 0.001, odds ratio [OR]: 0.36, confidence interval [CI]: 0.23– 0.57) and did not know which drugs require prescriptions (p < 0.001, OR: 0.41, CI: 0.27– 0.63). Other significant factors that predicted OTC drug use included age, university level, and drug income. Conclusion: The most common reported cause for OTC drug use during examinations among students was headache. Sex, age, university level, and monthly income were significant factors affecting OTC drug use during examinations. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore the use of sleeping aids among physicians in Saudi Arabia and its correlation with stress and insomnia during the COVID-19 pandemic. Materials and Methods: A sample of 1313 physicians was collected through an online cross-sectional convenience survey. The survey was E-mailed by the Saudi Commission for Health Specialties to the registered physicians in Saudi Arabia during the COVID-19 pandemic. It includes questions related to personal and sociodemographic characteristics, COVID-19, sleep-aid use, the Insomnia Severity Index, and the Perceived Stress Scale. Results: The participants were from various job levels (398 consultants, 1919 registrars, and 716 residents) and mainly from the central (38.2%) and Western (35%) regions. More than a third of them were using sleep aids (38.6%), which were mostly melatonin (75.7%). More than half of them had insomnia (67.1%), and the majority had moderate to high perceived stress (80.1%). Significant associations were found between insomnia and a number of personal and sociodemographic characteristics: Single status, young physicians, residents, smokers, and involvement in a COVID-19 management team. Other significant associations were found between stress and a number of personal and sociodemographic characteristics: Female sex, single status, young physicians, residents, working in the Ministry of Health, being on call 5-8 times/month, and involvement in a COVID-19 management team. Conclusions: Physicians in Saudi Arabia have had increased insomnia, stress, and use of sleep aids during the COVID-19 pandemic. Single, young physicians need more attention to support their psychological well-being. [ABSTRACT FROM AUTHOR]

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Aim: The dynamics of coronavirus disease 2019 (COVID‐19) pandemic has become of special concern to the rheumatology community. Rheumatic patients are required to engage in effective health management but their behavior is often influenced by intrinsic and extrinsic factors. This cross‐sectional study aims to examine patients' experiences during the current pandemic and its implication on their health perception and behavior. Method: A patient‐centered electronic survey was used, randomly sampling rheumatic patients in Saudi Arabia during March and April 2020. Questions included patients' socio‐demographics, diseases, medications, COVID‐19 knowledge, source of information, fear level, disease activity perception, health care utilization, medication accessibility, and therapeutic compliance (measured using a modified version of Medication Adherence Reporting Scale). Correlation and regression coefficients were used to evaluate associations among the aforementioned variables. Results: A total of 637 respondents were included. The majority were rheumatoid arthritis patients (42.7%). Patients' knowledge about COVID‐19 was correlated with social media use (P =.012). Fear of COVID‐19 infection correlated with healthcare facility for follow‐up visits (P =.024) and fear of disease deterioration if contracting the infection correlated with patients' levels of knowledge (P =.035). Both types of fear did not correlate with patients' perceptions of disease activity. However, patients' perceptions of worsened disease activity were correlated with unplanned healthcare visits (P <.001), medication non‐adherence, and difficulty accessing medication (P =.010 and.006, respectively). Conclusion: The COVID‐19 pandemic and surrounding public health measures could affect rheumatic patients' health management which might contribute to disease flare‐up and subsequently taxing healthcare systems even further. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the knowledge, attitudes, and practice of community pharmacists regarding weight reduction products in Aseer region, Saudi Arabia. Materials and Methods: A questionnaire-based study of community pharmacists in Aseer region, Saudi Arabia, was conducted between March and May 2019. Results: The most commonly prescribed weight reduction agent was green tea followed by oatmeal products and ginseng. The results revealed that almost 85% of the respondents did not know which weight reduction agents are approved as over-the-counter products by the US Food and Drug Administration. Community pharmacists had positive attitudes toward the safety and efficacy of weight reduction products, but 64.91% indicated that they would limit weight reduction agents to obese patients who could not reduce their weight through exercise and diet. More than 80% of the participants agreed that it is very important to counsel patients regarding weight reduction products, and more than 80% also agreed that pharmacists should regularly discuss weight reduction products with other healthcare professionals. Conclusion: Community pharmacists showed positive attitudes and efficient practice towards prescribing weight reducing products. However, there was a deficit regarding the knowledge about which products approved by FDA to manage overweight. That requires to consolidate the role of community pharmacists in weight management in Saudi Arabia with more continuous education and regulation. [ABSTRACT FROM AUTHOR]

Background and Aim. Chronic constipation is frequently underreported as people with obstruction do not generally seek medical advice. This study was aimed at determining the prevalence of chronic constipation and assessing satisfaction with current chronic constipation treatment options. Methods. This study was undertaken in Riyadh City, Saudi Arabia, in April 2019. The study population comprised respondents aged ≥18 years who had been recruited to participate through advertising on social media. Results. Of 532 respondents who completed our questionnaire, 153 (25.4%) had constipation, based on listed criteria, and of these, 121 (22.7%) reported having been constipated for ≥6 months; nearly 48% reported having been constipated for >3 years, while 63.6% of those chronically constipated were female. Bisacodyl was the laxative medication most used to treat chronic constipation, and 17.4% of users reported that they had used laxative medication for >12 months. Complementary and alternative medicines (CAMs) were utilized in 44.4% of respondents with chronic constipation. There was a significant association between the group who used CAMs and age (p = 0.013). Drinking water was the most common CAM adopted for those experiencing chronic constipation, followed by consumption of fiber (35.5%) and senna (19.8%). [ABSTRACT FROM AUTHOR]

Purpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia. Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia. Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study. Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended. [ABSTRACT FROM AUTHOR]

Purpose: To identify medication errors at Aseer Central Hospital (ACH, Abha) in the southern province of Saudi Arabia. Methods: A cross-sectional retrospective study was conducted by reviewing adult patients' records (> 15 years old) at ACH's inpatient and outpatients settings over an 8-week period in October and November 2015. Results: We identified 113 medication errors, including 112 prescribing errors and 1 dispensing error. Most medication errors (91.2%) in this study were for inpatient prescriptions. The most common prescribing error was medication duplication (31.2%) followed by missing patient identifying information (25%). Conclusion: Medication errors, mainly in inpatient prescriptions, have been fully identified at ACH. Educational interventions such as workshops could help minimize and prevent medication errors. [ABSTRACT FROM AUTHOR]

What is known and objective Infections due to multidrug-resistant gram-negative bacteria ( MDR- GNB) are a significant burden to the healthcare system globally. Colistin is the drug of choice for MDR- GNB and recent studies recommend high doses. This study investigated the safety of low-dose colistin and the relationship of minimum inhibitory concentration ( MIC) of colistin with bacterial cure in the treatment for MDR- GNB infections. Methods Computerized dispensing records identified all patients who received colistin during January 2010 and December 2011. Patients who were aged < 12 years old, who received colistin for < 72 h or had moderate to severe renal impairment were excluded. Medical records of the remaining patients were reviewed for the necessary data to determine the bacterial cure and nephrotoxicity of colistin. Multivariate logistic regression analysis was used to determine the predictors of bacterial cure. Results A total of 125 evaluable patients received colistin during the study period. Ninety-four of 125 (75·2%) patients achieved bacterial cure. No statistically significant differences were observed between patients who achieved and failed to achieve bacterial cure with regards to age, gender, site of infection, mg/kg dose or duration of colistin use. The average MIC in the bacterial cure group was significantly lower than the MIC in the bacterial failure group ( P = 0·002). Similarly, 30-day mortality from the last dose of colistin was significantly lower in the bacterial cure group ( P = 0·002). Nephrotoxicity occurred in 12·8% of patients and was not associated with the dose of colistin or concomitant use of nephrotoxic medications. MIC of <1 μg/mL was the only significant independent predictor of bacterial cure in the multivariate logistic regression analysis ( P = 0·015), whereas infection caused by MDR Klebsiella pneumonia was an independent risk factor for bacterial failure ( P = 0·049). What is new and conclusion Low-dose colistin is an effective option in the treatment for infections caused by MDR- GNB with a low incidence of nephrotoxicity. Patients who achieved bacterial cure had significantly lower MIC values of colistin against MDR- GNB than those who failed to achieve it. Colistin dose should be based on the MIC data of a given patient or local antimicrobial sensitivity data to maximize its efficacy. [ABSTRACT FROM AUTHOR]

Background and Objectives: Globally, diabetes Mellitus (DM) is a life-threatening disease that, if it remains uncontrolled, can lead to mortality or serious complications. Despite the noticeable benefits of clinical pharmacist in managing diabetes, some institutions in Saudi Arabia are reluctant to establish a pharmacist-led diabetic clinic for monitoring and follow-up. The objective of this study is to assess the glycemic control by comparing the reduction in hemoglobin A1c (HbA1c) percentage between patients followed in the pharmacist-led diabetic clinics vs. those followed in physician-led diabetic clinics. Materials and Methods: A retrospective observational study with a 12-month follow-up were used to detect the difference in the glycemic control by comparing the reduction in HbA1c percentage from the baseline, and average changes in HbA1c, fasting blood glucose (FBG), blood pressure (BP), and lipid panel between the two groups. The level of self-care was assessed by Summary of Diabetes Self-Care Activities (SDSCA) Questionnaire. Results: The study involved 52 patients who visited the diabetic clinic at a community teaching hospital. Exactly 24 patients were followed by the pharmacist-led diabetic clinics, while 28 were followed by physician-led diabetic clinics. HbA1c baseline was 8.7% and 8.4% for pharmacist and physician, respectively. The average difference in HbA1c for the pharmacist-led diabetic clinics vs. the physician-led diabetic clinics was not statistically significant (8.67 vs. 8.56; p = 0.77). Moreover, no difference in the glucose profile, lipid panel, and blood pressure were seen between the two groups. However, the median HbA1c change from baseline between the two groups significantly favored the pharmacist-led clinic (0.7 vs. 0.003; p = 0.04).The average of responses in all four aspects of the SDSCA (diet, exercise, blood sugar testing, and foot care) was also higher among patients in the pharmacist-led diabetic clinic. Conclusions: Pharmacist-led diabetic clinics for glycemic control and follow-up showed efficient results that encourage the comprehensive and integral inter-professional patient care. [ABSTRACT FROM AUTHOR]

Pregabalin is a first-line therapy for neuropathic pain and for chronic pain. It has abuse potential. This study was conducted to assess community pharmacists' perceptions towards pregabalin abuse and misuse in the Aseer region, Saudi Arabia, and identify predictors and associated factors. A cross-sectional survey using a structured questionnaire following a self-administrative study was conducted across community pharmacies in the Aseer region (Abha, Khamis Mushait, Mahayel, Sarat Abeeda, Ahad-Rufaida, and Bishah). A total of 206 respondents from community pharmacists participated in the study. Over the last six months, 136 respondents (66.0%) suspected pregabalin abuse in community pharmacies; male dominance in pregabalin abusers was also recorded (n = 165, 80.1%). Additionally, 40 (19.4%) respondents stated that a prescription was not issued for pregabalin demands. Over half (61.7%) of community pharmacists recorded an increased change in pregabalin abuse compared to the previous year. This is the first study to explore pharmacists' perceptions in the community of the Aseer region towards customers' misuse and abuse of pregabalin. Further monitoring and regulations on the prescribing and procurement of pregabalin are needed to avoid abuse. [ABSTRACT FROM AUTHOR]

Objective: The present study examined pharmacists' knowledge and practices towards prescribed medications for hemodialysis patients. The impact of a pharmacist's current positions and years of experience on practices and knowledge was also assessed. Methods: A cross-sectional survey was distributed to pharmacists working at King Abdul-Aziz Medical City-Central Region over a period of 4 months from July to October in 2015. Results: Of the 85 approached pharmacists, 66 pharmacists completed the questionnaire, among which 45 (68.2%), 9 (13.6%), and 12 (18.2%) of them were outpatient hospital pharmacists, discharge counselling pharmacists, and pharmacy practice residents, respectively. In total, 47 (55.3%) of the pharmacists sought drug information resources for newly prescribed medications to hemodialysis patients. Among the surveyed pharmacists, around two-thirds of them (63.6%) were completely confident during counselling hemodialysis patients, while 32% were moderately confident, and only 4.5% were not confident. All of the participating pharmacists checked each patient's allergic status before dispensing hemodialysis medications. The majority of the outpatient hospital pharmacists (35; 77.8%), discharge pharmacists (8; 88.9%), and the pharmacy practice residents (11; 91.7%) agreed that oral ciprofloxacin should be given after dialysis session on the same dialysis days, while 18 (40%), 5 (55.6%), and 9 (75%) of the outpatient hospital pharmacists, discharge pharmacists, and pharmacy practice residents agreed that IV route is preferred for hemodialysis patients to administer epoetin alfa, respectively. Sixty-six percent of discharge pharmacists (n = 6), 91.7% (n = 11) of the pharmacy practice residents, and 55.6% (n = 25) of the outpatient hospital pharmacists checked patient laboratory results prior to dispensing medications (p = 0.001). Conclusions: Despite the limited knowledge regarding some prescribed medications, most of the hospital pharmacists showed good practices toward dialysis patients. [ABSTRACT FROM AUTHOR]

Background: There is a lack of data on Saudi domestic air travellers' understanding regarding COVID-19 and their attitude towards the COVID-19 vaccination. Objectives: This study aimed to assess Saudi domestic air travellers' understanding regarding COVID-19 and attitude towards mandating the COVID-19 vaccination for travellers. Methods: A survey using a self-administered, structured, and closed-ended questionnaire was conducted among domestic air travellers in Saudi Arabia. Participants' socio-demographic information, travel history, health status, and attitudes and willingness to accept the COVID-19 vaccination were collected and analysed. Results: Of the 2236 respondents who participated in the survey, 542 (24.25%) had a history of COVID-19, 803 (35.9%) were exposed to a COVID-19 case, 1425 (63.7%) were concerned about catching COVID-19 during air travel, 796 (35.6%) thought the COVID-19 vaccination should be obligatory for travellers, 1105 (49.4%) thought it should be optional, and 335 (15.0%) thought the vaccination was unnecessary. Being of the male gender (adjusted odds ratio [aOR] 1.41, 95% confidence interval [95% CI] 1.14–1.69), being concerned about contracting COVID-19 (aOR 1.34, 95% CI 1.12–2.10) and frequent travelling (aOR 1.40, 95% CI 1.10–3.40) were predictors of vaccination uptake. Conclusion: This study demonstrates that although domestic Saudi travellers were concerned about COVID-19 infection, vaccine hesitancy was prevalent among them. [ABSTRACT FROM AUTHOR]

Objectives: To measure sleep patterns and quality during summer vacation and weeks 1-4 of the academic year among female university students., Methods: This retrospective prospective cohort study included female students at a university in Riyadh, Saudi Arabia. Participants were recruited with convenience sampling and completed questionnaires online. The questionnaire asked about 5 occasions using the Sleep Quality Scale (SQS) and about their sleep schedule during summer vacation and weeks 1-4 of the academic year., Results: There were 385 participants. The number of students who slept before midnight increased over time from n=127 (32.9%) students during vacation to n=172 (44.6%) students in week 4 ( p <0.001). The average sleep hours decreased from 8.97 (standard deviation (SD)=2.6) hours during summer to 7.01 ( p <0.001, SD=2.7) hours in week 4. Students reported poorer sleep quality during the academic year, particularly in week 1 ( p =0.023), than summer. Students reported higher satisfaction with sleep during summer vacation (n=97; 25.2%) than week 1 (n=38; 9.9%) and week 4 (n=36; 9.4%) ( p <0.001). Students experienced daytime fatigue and tiredness (n=79; 20.5%; p =0.002) and low concentration in week 4 (n=79; 20.5%; p <0.001) compared to summer., Conclusion: In the studied population, multiple sclerosis was the most prevalent cause of ON. Women were more likely to have ON. The prognosis for eyesight was substantially connected with the length of ON., (Copyright: © Neurosciences.)

Background: The World Health Organization reports that depression affects more than 280 million people globally. Women are approximately 50% more likely to experience depression compared to men. Depression during pregnancy leads to deterioration of the mother's and the fetus's health. We aim to explore women's perceptions and attitudes toward using antidepressants and to identify the factors that influence decision-making regarding antidepressant use., Method: A cross-sectional survey, employing a convenience sampling method, was conducted on a university campus in Riyadh, Saudi Arabia. The survey was developed by the investigators and validated by health practitioners. Answers were reported using a 5-point Likert scale. The responses were summed up to give a total score for each respondent. Respondents who scored above or equal 75% of the total score was considered positive perception or favorable attitude. Binary logistic regression analysis was used to identify factors influencing participants' perception and attitude toward taking antidepressants., Results: A total of 991 subjects were surveyed. The majority of women had negative perceptions and favorable attitudes towards using antidepressants during pregnancy reaching 64%. While women with positive perceptions and favorable attitudes represented about 20% of the study subjects. Participants reported that social stigma, religious beliefs, and fear of addiction significantly influenced their attitudes toward antidepressant use., Conclusions: This study explores women's perceptions of depression and antidepressant use, revealing that a significant proportion of Saudi women have a negative perception. The research emphasizes the need for tailored awareness programs to promote informed decision-making regarding antidepressant usage among Saudi women., (© 2024. The Author(s).)

Objectives: To examine the association between the number of non-communicable diseases (NCDs) and physical activity (PA) in older adults visiting primary healthcare centers (PHCCs) in Jizan, Saudi Arabia., Methods: This cross-sectional study was carried out on men and women aged ≥60 who visited PHCCs, Jizan City between June and September 2021. Eleven self-reported NCDs were identified and summed to produce a single score, and PA scores were calculated based on the self-reported PA Scale for the Elderly (PASE). Multiple linear regression models were used to examine the association between the number of NCDs and PA in the included population., Results: In total, 94 participants were included in this study. Of these, 62 were men, and 32 were women. The mean age was 67.29±6.58 years, and the mean PASE score was 53.67±29.72. A significant negative association was found between the number of NCDs and PA, even after a fully adjusted analysis., Conclusion: This study found a significant inverse association between the number of NCDs and PA in older adults. In addition, age was associated with lower PA, even among older adults. PA should be recommended to older adults to prevent or reduce the number of NCDs. Future research should focus on examining cause-and-effect associations at a national level., (Copyright: © Saudi Medical Journal.)

Background: Emergency medical services (EMS) play an essential role in treating and transporting patients to hospitals or between hospitals. EMS providers must be distributed wisely across all regions of the country to meet healthcare needs during normal times and disasters. No previous study has investigated the characteristics and distribution of the EMS workforce in Saudi Arabia., Objectives: Examine the characteristics and distribution of the EMS workforce in Saudi Arabia to identify gaps and areas in need of improvement. Also, explore the sociodemographic and educational characteristics of licensed EMS providers in Saudi Arabia., Design: Cross-sectional SETTINGS: EMS in Saudi Arabia METHODS: We included all licensed EMS providers in Saudi Arabia as of 23 December 2020 who were registered in the Saudi Commission for Health Specialties (SCFHS) database. Sociodemographics, where they earned certification, and their job affiliations were collected and categorized., Main Outcome Measures: EMS workforce distribution, gender, and EMS provider-to-population ratio., Sample Size: 18 336 EMS providers; 8812 (48.1%) with documented job affiliations., Results: The EMS provider-to-population ratio is very low. In Saudi Arabia, in general, the ratio is 1:3871 (based on n=8812 providers), which is low compared to the 1:1400 ratio for Australian EMS provider-to-population, for example. That makes it a challenge for EMS providers to meet the population's needs, especially in times of disaster. The low ratio may have contributed to the delayed response time in Saudi Arabia (13 minutes for critical cases) which does not meet the international standard response time (8 minutes maximum). Also, only 3.5% of the total EMS providers registered were females, and the clear majority of all EMS providers were technicians., Conclusions: The growth in the EMS workforce, including the recruitment of more females into the workforce and more EMS specialists compared to EMS technicians and health assistants, is critical to reaching a satisfactory EMS provider-to-population ratio., Limitations: Most noteworthy of the limitations of this research are the insufficient statistics describing EMS distribution in Saudi Arabia, the lack of previous studies on the research topic in Saudi Arabia, and job affiliation not accurately recorded in the SCFHS database., Conflict of Interest: None.

This article focuses on the diagnosis and management of neuromyelitis optica spectrum disorder (NMOSD). NMOSD is an autoimmune, demyelinating condition characterized by inflammation of the optic nerve and/or the spinal cord, with symptoms that can range from mild impairment of movement to paralysis. The newly approved diagnostic criteria have improved the accuracy of NMOSD diagnosis. The management of NMOSD is under major revolution due to the many new therapeutic options. The role of the antibodies directed at aquaporin-4 (AQP4) has materialized as a biomarker for NMOSD. Several new treatments that target variable aspects in immunopathology such as IL-6, complement, or depletion of B cells are emerging. The management of AQP4-negative patients remains challenging., (Copyright © 2022. Published by Elsevier B.V.)

Background and Objectives: Neural tube defects are congenital anomalies which canlead to infant death and serious disability. They are initiated during embryogenesis, between the 23rd and 27th day of fetal life, and can be prevented by the administration of folic acid. Therefore, this study aims to evaluate the knowledge and practice of Saudi women at childbearing age regarding NTDs and FA supplementation., Methodology: This is a cross-sectional study on Saudi women of reproductive age who were asked to complete an online survey to examine their knowledge and practice regarding folic acid supplementation and neural tube defects. Descriptive and simple linear regression analyses were conducted using SPSS v.26 (SPSS Inc., Chicago, IL, USA)., Results: A total of 613 women have completed the questionnaire, from which the majority (46.7%) were aged between 36 and 40 years. About 94% of women heard about folic acid and 80% indicated that its deficiency has some relation to neural tube defects. Approximately 37%, 25.3%, and 23.2% of women reported the proper time for folic acid intake to be during first trimester of pregnancy, before pregnancy, or throughout pregnancy, respectively. Linear regression analysis revealed that increase age and education were significantly correlated with a decrease in folic acid administration ( p = 0.008) and ( p = 0.001), respectively. However, there was no association between time of folic acid administration and income or number of parities., Conclusion: Despite the acceptable level of awareness about the relation of folic acid and neural tube defects, our results revealed that more education is required towards the proper time of supplementation among Saudi childbearing women.

Introduction: When it comes to non-communicable diseases like diabetes, inadequate knowledge, attitude, and practice are often linked to poor health outcomes. This study aims to assess the patients' knowledge, attitude, and practice (KAP) of diabetes in the outpatient department of a university teaching hospital in Saudi Arabia., Methodology: In this cross-sectional study, diabetes type 2 patients attending outpatient departments at a university teaching hospital, Riyadh, were assessed regarding their knowledge, attitude, and practice toward diabetes using a validated KAP scale. Descriptive and inferential analysis was done to determine the factors associated with KAP score using SPSS version 26.0 software (SPSS Inc., Chicago, IL, U.S.)., Results: Males made up 69.7% of the sample (n = 165), while 56.9% were between the ages of 41 and 75. The level of knowledge and practice had "good" in 37.6%, and 47.9%, respectively, but level of attitude had "positive" in 30.9% of patients. The association between knowledge tier and gender (p0.014) and insurance status (p0.008), respectively, was shown to be significant. However, the attitude tier was only significantly associated with gender ( P = .003). The practice tier also showed a significant age association ( P = .049). As regards, the mean scores for diabetes-related knowledge were higher only among insured participants ( P = .03) than for other participants' sociodemographic factors. Meanwhile, the mean attitude scores were also higher among males ( P = .006) than for other sociodemographic characteristics. A comparison of the participants' sociodemographic characteristics found no statistically significant variations in practice scores., Conclusion: Unfortunately, this study found that outpatient diabetes patients had insufficient knowledge, practice, and a negative attitude toward diabetes type 2. This imposes a great burden on healthcare workers and hence the healthcare system to improve patient scores via diabetes education programs or pharmacist-led patient counseling initiatives.

Objective: Diabetes mellitus is one of the main devastating causes of mortality and morbidity due to its detrimental complications. We aimed to evaluate the pulmonary functions and respiratory muscle strength in relationship with glycemic control and gender in type 2 Diabetes Mellitus (T2DM)., Materials and Methods: This cross-sectional study was performed at King Saud University and King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from June 2107 to June 2019. We evaluated pulmonary functions, respiratory muscle strength, body composition and glycemic control in T2DM (n=110) and control group (n=119). Gender differences were also evaluated in T2DM., Results: Subjects with T2DM have significantly decreased forced vital capacity (FVC) (3.6±0.7 vs 3.3±0.9, p = 0.012), forced expiratory volume in first second (FEV1) (3.3±2.2 vs 2.7±0.6, p = 0.019), peak expiratory flow (PEF) (127.4±210.9 vs. 49.2±133.6, p = 0.003), FEF25-75 (3.6±1.3 vs. 3.1±1.1, p-value = 0.025), and maximum inspiratory pressure (MIP) (99.3±26.9 vs. 87.4±19.3, p=0.001). However, no significant difference between control and diabetes was found in maximum expiratory pressure (MEP) (132.5±34.9 vs 126.2±30.0, p = 0.202). Significant reduction in FVC (male=3.7±0.8 vs female = 3.0±0.7 p = 0.000), FEV1 (3.3±1.9 vs 2.6±0.5 p = 0.000), FEF25-75 (3.6 ± 1.3 vs 2.9 ± 1.0 with p-value = 0.000), MIP (96.9±23.1 vs 87.5±27.1 with p = 0.017), and MEP (134.0±32.2 vs. 120.1±33.5 with p = .011) were observed in females compared to males in T2DM subjects., Conclusions: Decline in the pulmonary function and inspiratory muscle strength are associated with poor glycemic control in T2DM. Moreover, there are significant differences between male and female in lung parameters and inspiratory as well as expiratory muscles strength. The exact pathophysiological mechanism to explain this association requires further investigations.

Background and Aims: The survey aimed to assess COVID-19 vaccine acceptance and hesitancy rate among patients with diabetes and address barriers and beliefs that affect acceptance to take COVID-19 vaccine., Methods: A quantitative research approach with cross-sectional design was used to collect data from March-May'2021. Saudi residents with diabetes, aged ≥18 years were included., Results: Of the total 709 participants, 42.2% had family member with COVID-19, 14.7% had COVID-19, 34.0% had been with someone who had COVID-19. 34.7% of participants taken COVID-19 vaccination, 36.2% were willing to take, while 79.0% supported COVID-19 vaccine. Main reasons behind uncertainties towards vaccinations were relatively fast production, not many trials done and about genetic component. 44.6% got information about COVID-19 and vaccination through television, social media, and ministry website. On adjusting models, female gender, longer duration of diabetes and no history of influenza vaccine significantly associated with COVID vaccine uptake., Conclusion: Participants are willing to vaccinate but show some fear and misinformation. It is imperative that due efforts are made for increasing vaccine willingness, and availability of precise information holds key to success. Otherwise, state will have to continue to funnel in resources towards post-on-set disease management, consuming a lot more resources than preventive measures like vaccination., (Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

The present study aimed to explore the biocomponents of Murraya koenigii leaves through hot continuous percolation method using methanol as solvent. The spectral analysis by GC-MS and FTIR study demonstrated the presence of alkaloids, tannins, fatty acids, and steroids. The extract was characterized by the presence of unique compounds such as epiyangambin, stigmasterol, α-terpineol, eucalyptol, ethyl cinnamate, fatty acids, and other steroids.

The objective of the present study was to analyse the bioactive compounds of the leaves of Conocarpus lancifolius (C. lancifolius). The GC-MS analysis of the hot methanolic extract of the leaves (HMEL) of C. lancifolius exhibited the bioactive compounds such as 1-(3-Methoxy-2-nitrobenzyl) iso quinoline, morphin-4-ol-6,7-dione, 1-bromo-N-methyl-, phytol, hexadecanoic acid, 2,3-dihydroxypropyl ester, 2,2':4',2"-terthiophene, ethyl iso-allocholate, caryophyllene oxide, campesterol, epiglobulol, cholestan-3-ol, 2-methylene-, (3á,5à)-, dasycarpidan-1-methanol, acetate (ester) and oleic acid, eicosyl ester. The FT-IR analysis of HMEL of C. lancifolius showed a unique peak at 3184, 2413, 1657 cm-1 representing coumaric acid, chlorogenic acid and ferulic acid. The HMEL of C. lancifolius was actively inhibiting the proliferation of breast cancer cells MCF-7 ATCC at the concentration of 72.66 ± 8.21 µg/ml as IC50 value. The HMEL of C. lancifolius also revealed a good spectrum of activity against Gram-positive and Gram-negative bacterial cultures screened in this work. The activity observed has shown more or less similar effects against screened bacteria. However, the magnitude of potentiality was significantly lesser compared to standard ciprofloxacin disc at p< 0.001 level (99% confidence intervals). Furthermore, the study demonstrating the bioactive compounds can be isolated from the leaves of C. lancifolius.

Objectives: The safety and efficacy of treatment approaches in patients with type 2 diabetes mellitus (T2DM) after the failure of two oral hypoglycemic agents (OHAs) was studied., Methods: A combination of the ambispective study was conducted between June 2013 to June 2014 at the Asir Diabetes Center, Abha, Kingdom of Saudi Arabia (KSA). Patients with poorly controlled T2DM who were administered two OHAs for at least 6 months and had HbA1c levels greater than 7.0% were included. Subjects were treated with three OHAs (Group I), biphasic insulin and metformin (Group II), two existing OHAs and basal insulin (Group III), and insulin monotherapy (Group IV). Relevant data were collected at baseline at the interval of 3 months for one year., Results: Amongst 255 patients enrolled, 20.8, 29.8, 32.5, and 16.8% were in Groups I, II, III, and IV, respectively. The mean (Glycated hemoglobin) HbA1c levels were decreased significantly in the groups where insulin was an add-on therapy with the OHAs. Acceptable level of HbA1C (7 %) was significantly higher amongst patients in groups II and III, whereas hypoglycemic events were higher in Group IV., Conclusion: Insulin as add-on therapy with OHAs is an option for the management of T2DM where glycemic control is insufficient with two OHAs., (© 2020 John Wiley & Sons Ltd.)

This study used a descriptive cross-sectional methodology to measure healthcare workers' knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals' ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts.

Background and Objective: Pain is a bothersome issue that is common among newborns and children of all ages. Pain can be managed using various pharmacological and/or non-pharmacological strategies, which can be delivered by healthcare providers or parents. The aim of this study is to assess the attitude of mothers toward their children's pain and its management., Methods and Materials: A descriptive cross-sectional web-based study was conducted using a developed self-reported questionnaire, from March 2018 to April 2018. Participants involved were Arabic-speaking mothers of children aged between 0 and 12. The data collected included pharmacological and non-pharmacological treatment methodologies utilized to treat pain and the mothers' attitude towards pain management. Statistical Package for Social Sciences, version 25 was applied to analyze the data, and descriptive statistics were performed., Results: As per the results of this study, the most common site of children's pain as reported by the mothers was mouth/throat (211; 52.9%), abdomen (199; 49.9%), followed by head (58; 14.5%), and finally, ears (69; 17.3%). The frequency of children's pain, as stated by the mothers, was less than once a month (196; 49.1%), once in a month (137; 34.3%), and once in a week (48; 12%). The non-pharmacological methods used by mothers at home for the management of their children's pain were as follows: letting them take rest or sleep (250; 62.6%), feeding them with fluids (228; 57.1%), applying cold packs (161; 40.4%), providing massage therapy (147; 36.8%), using warm packs (141; 35.3%), and taking them to play (119; 29.8%)., Conclusion: The misconceptions about pediatric pain management among Saudi mothers that can affect the children's quality of life are quite noticeable. Implementing educational and awareness programs about the management of child pain could play a major role in making the parents understand the impacts of their misconceptions.

Objectives: To determine the prevalence of shunt malfunction without change in ventricle size in imaging modalities, and its clinical presentation., Methods: A cross-sectional study conducted at King Abdulaziz Medical City, Riyadh, from June 2015 to May 2019. Patient's demographics, clinical presentation and changes in ventricle size were collected. Statistical analysis was done using SPSS version 23., Results: The study included 42 patients who underwent shunt revision. Imaging showed no change in size in 10 (24%) patients, mild enlargement in 8 (19%), and obvious enlargement in 24 (57%). The mean age of diagnosis was 22±16.7. 55% of the patients were males, 45% females. The cause of the malfunction was ventricular catheter occlusion in 14 (34%) patients, 10 (24%) patients had valve-related malfunction, and peritoneal catheter occlusion was present in 6 (14%) patients, and 12 (28%) patients had a combination of the previously mentioned causes. Analysis of the association between ventricular size and headache, vomiting, seizure, confusion, and loss of consciousness in patients with unchanged ventricular size and those with increased ventricular size has shown no statistical significance., Conclusion: Shunt malfunction without ventricular size change was observed in 24% of all shunt malfunction patients. In addition, there was no relationship between ventricular size and patient symptoms., (Copyright: © Neurosciences.)

Objectives: Assess the survival of hospitalized coronavirus disease 2019 (COVID-19) patients across age groups, sex, use of mechanical ventilators (MVs), nationality, and intensive care unit (ICU) admission in the Kingdom of Saudi Arabia., Methods: Data were retrieved from the Saudi Ministry of Health (MoH) between 1 March and 29 May 2020. Kaplan-Meier (KM) analyses and multiple Cox proportional-hazards regression were conducted to assess the survival of hospitalized COVID-19 patients from hospital admission to discharge (censored) or death. Micro-costing was used to estimate the direct medical costs associated with hospitalization per patient., Results: The number of included patients with complete status (discharge or death) was 1422. The overall 14-day survival was 0.699 (95%CI: 0.652-0.741). Older adults (>70 years) (HR = 5.00, 95%CI = 2.83-8.91), patients on MVs (5.39, 3.83-7.64), non-Saudi patients (1.37, 1.01-1.89), and ICU admission (2.09, 1.49-2.93) were associated with a high risk of mortality. The mean cost per patient (in SAR) for those admitted to the general Medical Ward (GMW) and ICU was 42,704.49 ± 29,811.25 and 79,418.30 ± 55,647.69, respectively., Conclusion: The high hospitalization costs for COVID-19 patients represents a significant public health challenge. Efficient allocation of healthcare resources cannot be emphasized enough.