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Objective: The primary goal of this study was whether the clinical psychiatric training of already employed primary care physicians would favourably change their attitudes towards psychiatry. Design, setting, and subjects: The sample of this case-control research was comprised of general practitioners who were randomly selected from different primary health care centers of Al-Qassim Region, Kingdom of Saudi Arabia. Intervention and main outcome measures: They took a one week intensive psychiatric training course during the year 1989 and were requested to complete a standardized questionnaire encompassing the attitudes towards the psychiatric profession, mental hospitals, mentally ill people, and other related aspects of psychiatric practice, in order to evaluate their attitudes towards psychiatry pre-and post-psychiatric training conducted in Buraidah Mental Health Hospital. Results: The analysis of data showed some statistically significant attitudinal changes of GPs following their psychiatric training reflecting more favourable attitudes to psychiatry (p<0.05). Conclusions: It was concluded that a condensed psychiatric training could engender an immediate favourable change in attitudes of primary care physicians towards psychiatry. The other most important implication of this research might be that adequately psychiatric trained primary care physicians would be better equipped from psychiatric perspectives to screen the population attending different primary health care centers. [ABSTRACT FROM AUTHOR]

The article reflects on the United Nations' Educational, Scientific, and Cultural Organization's initiative. It comments on the conservation of cultural heritage and goes on to discuss the issue of identity construction, which is emerging as a more esoteric topic as the effect of globalization. It believes that the initiative should be treated as an intervention program.

Background. The sciatic nerve is the largest and thickest branch of the lumbosacral plexus. It separates into numerous branches and exhibits multiple anatomical variations that may result in nerve compression, a factor that is attributed to its location in the pelvis. This study aims to detect sciatic nerve branch variation and its association with the piriformis muscle and to establish the prevalence of each variant using routine pelvic MRI examinations. Methods. This was a cross-sectional retrospective study of patients who underwent pelvic MRI studies from January 2018 to December 2020. Collected data included patient demographics, anatomical type of sciatic nerve (according to the Beaton and Anson classification system) and history of radiculopathy or sciatic nerve symptoms. Data was collected, and descriptive statistics were analyzed with a p < 0.05 considered as statistically significant. Results. A total of 188 patients were included in the study. The majority (95.7%) of the patients exhibited the type 1 variant, while type 2 and type 3 variants exhibited a prevalence of 3.2% and 1.1%, respectively. No statistically significant difference in history of radiculopathy and sciatica was identified between the different anatomical variants. Conclusions. The sciatic nerve's anatomical variation in relation to the piriformis muscle can be identified on routine pelvic MRI scans, with most of the detected variants being type 1. This study confirms the anatomical variations of the sciatic nerve in the pelvic region which can be detected on routine MRI. [ABSTRACT FROM AUTHOR]

Background. The coronavirus disease-19 (COVID-19) pandemic caused a major impact on blood donation process and supply globally. A lockdown management procedure was launched nationally in Saudi Arabia to manage this global health crisis. The main aim of this study was to determine the effect of COVID-19 lockdown on blood donation services and supply in different regions of Saudi Arabia. Study Design and Methods. A retrospective cross-sectional study was conducted in the blood bank centers of 5 major cities including Riyadh, Jeddah, Dammam, Hail, and Jizan in Saudi Arabia. Demographic and blood characteristics were retrieved from the first 6 months of 2019 (January–June) and compared to the same period of 2020. Results. Our findings showed variation in the characteristics of blood donation and supply among the centers surveyed, as some of these centers were adversely affected, while others showed an increase in the availability of blood products during the pandemic. For example, Jeddah's center was significantly affected by COVID-19 lockdown whereas Hail's center showed a significant increase in the analyzed characteristics of blood donation services in 2020 compared to 2019. Overall, there was no major difference among the surveyed centers between 2020 and 2019, and this might be due to the effective management of blood supply and transfusion. Discussion. Although blood supply and transfusion practice was slightly affected at various degree among the surveyed centers, the whole process did not show a significant effect on the overall outcome. This is in fact due to the proper preparedness, management of blood requirements and supplies, and efficient response of the surveyed centers in Saudi Arabia. [ABSTRACT FROM AUTHOR]

A total of 227 Plasmodium falciparum isolates from Jazan region, southwestern Saudi Arabia were amplified for the P. falciparum multi-drug resistance 1 (pfmdr1) gene to detect point mutations 11 years after the introduction of artemisinin-based combination therapy (ACT) in Saudi Arabia. The pfmdr1 86Y mutation was found in 11.5% (26/227) of the isolates while the N86 wild allele was detected in 88.5%. Moreover, 184F point mutations dominated (86.3%) the instances of pfmdr1 polymorphism while no mutation was observed at codons 1034, 1042 and 1246. Three pfmdr1 haplotypes were identified, NFSND (74.9%), NYSND (13.7%) and YFSND (11.4%). Associations of the prevalence of 86Y mutation and YFSND haplotype with participants' nationality, residency and parasitaemia level were found to be significant (P < 0.05). The findings revealed significant decline in the prevalence of the pfmdr1 86Y mutation in P. falciparum isolates from Jazan region over a decade after the implementation of ACT treatment. Moreover, the high prevalence of the NFSND haplotype might be indicative of the potential emergence of CQ-sensitive but artemether-lumefantrine-resistant P. falciparum strains since the adoption of ACT. Therefore, continuous monitoring of the molecular markers of antimalarial drug resistance in Jazan region is highly recommended. [ABSTRACT FROM AUTHOR]

The Industrial Internet of Things' (IIoT) ongoing growth has provided engineers with a wealth of prospects for improving machine throughput. Due to advancement, owing to the unreliable aspect of the communication route, many business managers still hesitate to operate their equipment online. Security is critical in the IIoT, as certain IIoT devices gather sensory data for vital societal production and living. If the entities are authenticated and confidence is established, the use of the Internet to manage industrial activities can become widely embraced. The hyperchaotic neuronal coordinated vector-valued key exchange presented in this study enables safe Wireless Sensor Network (WSN) transmission in the IIoT. Key coordination in IIoT is the main issue. As a part of the security protocols for IIoT, this study presented a vector-valued neuronal coordination-based key synchronization. How well the ANNs on the collaborating edges synchronize instead of each other's weights is a key factor in neural coordination. Existing techniques take too long to evaluate collaboration, endangering the secrecy of neural synchronization. In addition, minimal studies have been conducted on the reciprocal training of a set of ANNs and the use of a robust PRNG to provide a common input. The suggested approach has a lot of benefits: (1) This research describes the fast evaluation of the coordination of a group of ANNs using a hyperchaotic framework to coordinate ANNs for key agreement. (2) ANNs are coordinated via bidirectional training to spread the neuronal key over a communication link. (3) The measure in which the ANNs have provided similar outputs in previous rounds is used to determine synchronization. (4) The input sequencing for ANN are produced using a collaboratively created 4D, 5D, and 6D hyperchaotic-guided PRNG. (5) The IIoT network's session key is created via a reciprocating neuronal synchronization of vector-valued ANNs. (6) In compared to earlier methodologies, the proposed technique accelerates the procedure through which participated ANNs achieve perfect synchronization. The suggested approach works better than comparable methods that have been published. [ABSTRACT FROM AUTHOR]

Modern software systems are frequently required to be adaptive in order to cope with constant changes. Unfortunately, service-oriented systems built with WS-BPEL are still too rigid. In this paper, we propose a novel model-driven approach to supporting the development of dynamically adaptive WS-BPEL based systems. We model the system functionality with two distinct but highly correlated parts: a stable part called the base model describing the flow logic aspect and a volatile part called the variable model describing the decision logic aspect. We develop an aspect-oriented method to weave the base model and the variable model together so that runtime changes can be applied to the variable model without affecting the base model. A model-driven platform has been implemented to support the development of adaptive WS-BPEL processes. In-lab experiments show that our approach has low performance overhead. A real-life case study also validates the applicability of our approach. [ABSTRACT FROM AUTHOR]

Objective: Addressing ethnic-cultural topics during the process of psychotherapy, i.e. broaching , is considered highly important for ethnic minority clients who consult mental health care services. Surprisingly little is known, however, about clients' perception of a therapist's broaching qualities, and how clients' mental construction of broaching translates into behavioural broaching acts a therapist may display., Method: Based on previous work and nine in-depth interviews with ethnic minority clients, a client-rated measure of therapists' broaching behaviour was developed and psychometrically evaluated in two samples. Sample 1 ( N  = 252 UK ethnic minority clients) was used to empirically delineate the factor structure of an initial item set. Participants were then resolicited to complete a revised item pool., Results: The empirical structure resulted in a final 25-item broaching instrument with five subscales probing into therapists' broaching behaviour. This Broaching Assessment Scale (BrAS) was validated in Sample 2 ( N  = 239 US ethnic minority clients). Strict measurement invariance of the factor structure was observed across the two samples and distinctive correlational patterns with therapeutic process measures were found., Conclusion: The BrAS provides new insights on how sensitivity to ethnic-cultural topics can be targeted along its concrete features, and is a promising tool for conceptualizing culturally sensitive mental healthcare assessment.

Sign language is an essential means of communication for individuals with hearing disabilities. However, there is a significant shortage of sign language interpreters in some languages, especially in Saudi Arabia. This shortage results in a large proportion of the hearing-impaired population being deprived of services, especially in public places. This paper aims to address this gap in accessibility by leveraging technology to develop systems capable of recognizing Arabic Sign Language (ArSL) using deep learning techniques. In this paper, we propose a hybrid model to capture the spatio-temporal aspects of sign language (i.e., letters and words). The hybrid model consists of a Convolutional Neural Network (CNN) classifier to extract spatial features from sign language data and a Long Short-Term Memory (LSTM) classifier to extract spatial and temporal characteristics to handle sequential data (i.e., hand movements). To demonstrate the feasibility of our proposed hybrid model, we created a dataset of 20 different words, resulting in 4000 images for ArSL: 10 static gesture words and 500 videos for 10 dynamic gesture words. Our proposed hybrid model demonstrates promising performance, with the CNN and LSTM classifiers achieving accuracy rates of 94.40% and 82.70%, respectively. These results indicate that our approach can significantly enhance communication accessibility for the hearing-impaired community in Saudi Arabia. Thus, this paper represents a major step toward promoting inclusivity and improving the quality of life for the hearing impaired.

Cutaneous leishmaniasis (CL), a neglected tropical disease (NTD), is a major public health problem in Yemen with widespread distribution in rural areas. Evaluating the knowledge and understanding of people's beliefs towards the disease is essential to the implementation of effective control measures. This study aims to assess the knowledge, attitudes, practices (KAP) and treatment-seeking behaviour concerning CL among rural populations in the western highlands of Yemen. A community-based cross-sectional study was conducted among 289 household heads in four rural areas of the Utmah District. Data were collected using a pre-tested questionnaire. All the participants had heard about the disease; however, only 9.3% attributed it to sandflies. Nearly half (48.1%) of the participants could not mention any preventive measures for CL, and nearly two-thirds (65.4%) could not do so for sandflies. The overall 'good' knowledge about CL was found to be 51.2%, and it was 33.9% for sandflies. The participants' attitude and prevention practices towards CL were not satisfactory, as only 38.1% and 16.3% had a positive attitude and good CL-related prevention practices, respectively. Moreover, 45.7% believed CL to be a stigmatising disease, and 50% had used traditional remedies to treat suspected CL lesions. Multivariate analyses showed that age, sex, presence of CL-confirmed cases in the same household, residency, occupation and monthly household income were the significant predictors associated with KAP concerning CL among the participants. The findings support an urgent need for integrated health education and community mobilisation interventions to improve awareness of these vulnerable populations about this devastating disease., (© 2024. The Author(s).)

Background: Diabetic nephropathy (DN) is a complication of chronic hyperglycemia associated with diabetes mellitus (DM). Several studies have demonstrated the positive impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on kidney outcomes. The objective of the study was to evaluate the effects of dapagliflozin, an SGLT2 inhibitor, on kidney outcomes in Saudi patients with type 2 DM., Materials and Methods: Study included all Saudi patients with type 2 DM who visited our center from August 1, 2021, to July 31, 2022, and had been on dapagliflozin for at least 3 months. Data was abstracted through chart review for all patients included in the study. Paired t-test or Wilcoxon signed-rank test were used to compare the results before and after treatment for continuous variables and the McNemar test was used to compare the results for categorical data., Results: Study included 184 Saudi patients with type 2 diabetes with a mean age of 61.32 years (SD=9.37). Dapagliflozin 10 mg/day significantly reduced hemoglobin A1C (HbA1C) from a mean (SD) of 9.00 to 8.40 ( P < 0.001). Among a subgroup of patients with significant proteinuria ( n = 83), dapagliflozin significantly reduced ACR from a median of 93.1 to 64.9 mg/g ( P = 0.001). Following treatment, the estimated glomerular filtration rate improved from a mean of 69.83 to 71.68 mL/min and the mean arterial pressure (MAP) fell from 90.03 to 89.06 mmHg, both were not statistically significant. Despite a statistically insignificant increase in the episodes of urinary tract infections (UTIs), the hospitalization rate declined. No episodes of amputations or ketoacidosis occurred during the study period., Conclusion: SGLT2 inhibitors had beneficial effects among Saudi patients with type 2 diabetes by improving diabetic control and lowering proteinuria. Dapagliflozin did not result in significant harm, including UTIs, amputations, and ketoacidosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family and Community Medicine.)

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Objectives: Post-cholecystectomy syndrome (PCS) refers to the continuation or recurrence of biliary colic and any other gastrointestinal symptoms present prior to cholecystectomy. Given that PCS is rare and underestimated in Saudi Arabia, this study aimed to determine the prevalence of PCS among Saudis., Methods: This cross-sectional study included randomly gathered subjects who self-administered the validated European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire from September 6 to October 7, 2022., Results: A total of 518 participants who underwent cholecystectomies were included; most were female (73.6%), 153 (29.5%) were 19 to 25 years old, and the vast majority were Saudi Arabian (91.1%). The average preoperative weight was 71 ± 20.7 kg (range 20 to 258), and the mean current weight was 69 ± 19.4 kg (range 30 to 257). About 137 (26.4%) had a chronic disease, most frequently hypertension (37.2%). In the past week, most participants experienced some trouble doing strenuous activities (42.9%), slight pain (37.6%), fatigue (32.2%), insomnia (37.5%), and weakness (38.2%). There were no significant associations between age, nationality, or residence with the QLQ-C30 score (P-value = 0.152, 0.262, 0.071, respectively). A significant association was observed between gender and QLQ-C30 score (P-value < 0.001), with females scoring higher than their male counterparts. Females also reported having a higher quality of life than males., Conclusions: The prevalence of PCS was higher than reported elsewhere., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mahfouz et al.)

Headache is one of the most frequent complaints in the outpatient department. The types of headaches can be broadly classified into primary and secondary. The primary headaches have benign intrinsic causes and include tension, migraine, and cluster headaches. A detailed history and appropriate physical examination are essential in assessing patients with headaches.  We present the case of a 33-year-old woman who presented to our primary care clinic with three days history of worsening frontal headache. She had been experiencing this headache daily for the last three months; however, the current episode is more severe. The headache episode was not associated with fever, neck stiffness, or loss of consciousness. She often became nauseated with the headache. There was no history of weakness, numbness, or visual disturbances with the headache. There was no family history of migraine headaches. On examination, no focal neurological deficit was noted. The head CT scan showed the presence of two highly hyperdense foci in the frontotemporal region, one of them was related to the dura. Such foci were not causing midline shift or brain edema. The preliminary diagnosis was calcified meningioma. Surgical excision of the lesions was planned. The patient underwent right craniotomy under general anesthesia. The two osseous lesions were observed and successfully resected. Histopathological examination of the lesions was consistent with osteoma. Intracranial osteoma is a very rare benign neoplasm of the mature bone tissue. The typical clinical manifestation of intracranial osteoma is a chronic headache. Head CT shows a well-defined, hyperdense structure. However, this is often mistaken as calcified meningioma., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Aldandan et al.)

Background: Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged in 2019 and caused a global pandemic in 2020, manifesting in the coronavirus disease 2019 (COVID-19). The majority of patients exhibit a mild form of the disease with no major complications; however, moderate to severe and fatal cases are of public health concerns. Predicting the potential prognosis of COVID-19 could assist healthcare workers in managing cases and controlling the pandemic in an effective way. Therefore, the objectives of the study were to search for biomarkers associated with COVID-19 mortality and predictors of the overall survival (OS)., Methods: Here, clinical data of 6026 adult COVID-19 patients admitted to two large centers in Saudi Arabia (Riyadh and Hafar Al-Batin cities) between April and June 2020 were retrospectively analysed., Results: More than 23% of the study subjects with available data have died, enabling the prediction of mortality in our cohort. Markers that were significantly associated with mortality in this study were older age, increased d-dimer in the blood, higher counts of WBCs, higher percentage of neutrophil, and a higher chest X-ray (CXR) score. The CXR scores were also positively associated with age, d-dimer, WBC count, and percentage of neutrophil. This supports the utility of CXR scores in the absence of blood testing. Predicting mortality based on Ct values of RT-PCR was not successful, necessitating a more quantitative RT-PCR to determine virus quantity in samples. Our work has also identified age, d-dimer concentration, leukocyte parameters and CXR score to be prognostic markers of the OS of COVID-19 patients., Conclusion: Overall, this retrospective study on hospitalised cohort of COVID-19 patients presents that age, haematological, and radiological data at the time of diagnosis are of value and could be used to guide better clinical management of COVID-19 patients., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The prevalence of obesity is on a continuous rise worldwide, with major studies clearly correlating obesity with the development of chronic metabolic disorders including type 2 diabetes. Bariatric surgery has proven to be beneficial in the management of this condition; however, a limited number of studies exist on its effect on type 1 diabetes., Objective: The objective of this study is to evaluate the outcome of laparoscopic sleeve gastrectomy for the management of patients with type 1 diabetes (DM1)., Setting: This is a retrospective cohort study conducted in a university hospital and private practice in Kuwait., Research Design and Methods: Analysis was conducted on 10 patients diagnosed with type 1 diabetes that underwent bariatric surgery from October 2008 until December 2016 at Amiri Hospital and Royale Hayat Hospital, Kuwait. Primary parameters included body mass index (BMI), % excess weight (%EWL) loss at follow-up, glycosylated hemoglobin (A1C), and basal insulin requirements. Total cholesterol readings and fasting blood glucose (FBS) levels were considered secondary outcomes. Statistical analysis of the data was carried out using Statistical Package for the Social Sciences (SPSS) software., Results: Mean BMI showed a reduction from 41.9 ± 5.4 to 31.4 ± 8.4 kg/m 2 . Mean %EWL after the follow-up period was 74.4 ± 25.3%. A1C levels failed to show a significant difference 12 months post-op (p = 0.189). Cholesterol levels did not display a significant decrease either (p = 0.447). When it came to insulin requirements, a significant difference was perceived, with the mean number of units of insulin required dropping from 76.6 to 18.2 (p = 0.026). FBS readings also showed a drop from 15.1 ± 3.8 to 7.8 ± 2.9 mmol/L (p = 0.001)., Conclusions: Laparoscopic sleeve gastrectomy resulted in significant weight loss, comorbidity resolution as well as reduction in their insulin doses post-op. However, glycemic control does not seem to show significant improvement in these patients. Larger, more long-term studies are needed to reach a definite conclusion on this topic.