Identifying the Challenges of Child Abuse Detection Among Emergency, Pediatrics, and Family Medicine Practitioners in Saudi Arabia.

BACKGROUND: Child abuse is a significant issue across many countries. Despite the situation's innate understanding, many children are not reported to authorities and continue to experience abuse, sometimes even death. Healthcare professionals must be alert for abuse in any child who appears with injuries that are out of the ordinary because it is easy for indicators of child abuse to go unnoticed in a busy emergency department. The current study aims to evaluate and detect the challenges in diagnosing and reporting cases of child abuse among healthcare practitioners in emergency, pediatrics, and family medicine. METHODS: A self-administered online disseminated questionnaire was used for data collection during the period from October 1 to December 30, 2022. A cross-sectional study was conducted on emergency, pediatrics, and family medicine healthcare practitioners working in hospitals in healthcare centers in Riyadh, Saudi Arabia. All data were collected, tabulated, and statistically analyzed using SPSS 23.0 for (IBM Corp., Armonk, NY) Windows. RESULTS: The study sample constituted 200 physicians working in the front lines of healthcare like emergency, pediatrics, and family medicine primary care services, 50.5% were males and 49.5% were females. 36.5% of participants were 31-39 years old. 42% were family medicine physicians, 36.5% were pediatricians, and 21.5% were emergency medicine. About 43% of participants attended an educational workshop on child abuse. Nineteen percent of participants are very familiar with the diagnosis of child abuse and 36% of participants reported one to three cases of child abuse in the emergency department in the last year, 5% reported four to six cases and 56.5% reported none. Forty-seven percent of participants reported diagnosing one to five cases of child abuse throughout their whole career, 13% reported 11-15 cases, 6.5% reported six to 10 cases and 28.5% reported none. Causes of underdiagnosis of child abuse by healthcare providers were reported as 63% inexperience, 59% inadequate time for physical examination, 59% lack of diagnosis protocol, 51% lack of confidence in communicating with parents, 36% physicians' cultural background, and 38% lack of confidence in the diagnosis. 93.5% of participants think that healthcare practices need further education for child abuse. CONCLUSION: In conclusion, physicians in Saudi Arabia who participated in the study had good knowledge to diagnose a case of child abuse. Inexperience, inadequate time for physical examination, lack of diagnosis protocol, lack of confidence in communicating with parents, and physicians' cultural background were the main identified challenges for diagnosing child abuse. Familiarity with cases of child abuse was significantly associated with physicians' age, specialty, and level of training.

The role of blood groups, vaccine type and gender in predicting the severity of side effects among university students receiving COVID-19 vaccines.

On March 11th, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) a pandemic. To control the pandemic, billions of vaccine doses have been administered worldwide. Predictors of COVID-19 vaccine-related side effects are inconsistently described in the literature. This study aimed to identify the predictors of side effects' severity after COVID-19 vaccination among young adult students at Taif University (TU) in Saudi Arabia. An online, anonymous questionnaire was used. Descriptive statistics were calculated for numerical and categorical variables. Possible correlations with other characteristics were identified using the chi-square test. The study included 760 young adult participants from TU. Pain at the injection site (54.7%), headache (45.0%), lethargy and fatigue (43.3%), and fever (37.5%) were the most frequently reported COVID-19 vaccine-related side effects after the first dose. The most frequent side effects were reported among the 20-25-year-old age group for all doses of all vaccines. Females experienced remarkably more side effects after the second (p < 0.001) and third doses (p = 0.002). Moreover, ABO blood groups significantly correlated with vaccine-related side effects after the second dose (p = 0.020). The participants' general health status correlated with the side effects after the first and second doses (p < 0.001 and 0.022, respectively). The predictors of COVID-19 vaccine-related side effects in young, vaccinated people were blood group B, female gender, vaccine type, and poor health status.

The impact of telemedicine on patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia: Findings and implications.

INTRODUCTION: Routine diabetes care changed during the COVID-19 pandemic due to precautionary measures such as lockdowns, cancellation of in-person visits, and patients' fear of being infected when attending clinics. Because of the pandemic, virtual clinics were implemented to provide diabetes care. Therefore, we conducted this study to assess the impact of these virtual clinics on glycaemic control among high-risk patients with type 2 diabetes mellitus (DM). METHODS: A prospective single-cohort pre-/post telemedicine care intervention study was conducted on 130 patients with type 2 DM attending a virtual integrated care clinic at a chronic Illness center in a family and community medicine department in Riyadh, Saudi Arabia during the COVID-19 pandemic. RESULTS: The mean age of the participants was 57 years (standard deviation (SD) = 12) and the mean (SD) duration of diabetes was 14 (7) years. Over a period of 4 months, the HbA1c decreased significantly from 9.98 ± 1.33 pre-intervention to 8.32 ± 1.31 post-intervention (mean difference 1.66 ± 1.29; CI = 1.43-1.88; P <0.001). In addition, most in-person care visits were successfully replaced, as most patients (64%) needed only one or two in-person visits during the 4-month period, compared with typically one visit every 1-2 weeks in the integrated care programme before the pandemic for this group of high-risk patients. DISCUSSION: The current study found a significant positive impact of telemedicine care on glycaemic control among high-risk patients with DM during the COVID-19 pandemic. Moreover, it showed that telemedicine could be integrated into diabetic care to successfully replace many of the usual in-person care visits. Consequently, health policy makers need to consider developing comprehensive guidelines in Saudi Arabia for telemedicine care to, ensure the quality of care and address issues such as financial reimbursement and patient information privacy.

Blood cancer in children infected with COVID-19: A comprehensive systematic review (preprint)

Background: Blood cancer is the most common type of cancer and the leading cause of death by disease past infancy among children. Children with blood cancer are vulnerable population to viral infections such as coronavirus disease 2019 (COVID-19). Objectives: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in blood cancer children and analyse the demographic parameters, clinical characteristics and treatment outcomes in blood cancer children with COVID-19 illness. Methods: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with blood cancer, published from December 1, 2019 to April 30, 2023, with English language restriction. Results: Of the 3077 papers that were identified, 155 articles were included in the systematic review (83 case report, 54 cohort and 18 case-series studies). Studies involving 1289 blood cancer children with confirmed COVID-19 were analysed. Leukaemias (1141 cases) were the most frequent types of blood cancer observed in children who developed COVID-19, followed by non-Hodgkin’s lymphomas (59 cases), Hodgkin’s lymphomas (36 cases), Langerhans cell histiocytosis (7 cases), myelodysplastic syndrome (7 cases) and myeloid neoplasm (1 case). Among all 1289 blood cancer paediatric cases who transmitted SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 175, 13.6%), intubated and placed on mechanical ventilation (n = 111, 8.6%), suffered acute respiratory distress syndrome (n = 144, 11.2%) or died (n = 111, 8.6%). Overall, COVID-19 in children with different types of blood cancer resulted in no or low severity of disease in more than 78.6% of all included cases (COVID-19 severity: asymptomatic = 239, mild = 603, or moderate = 171). Treatment for COVID-19 was not necessary in a high number of blood cancer children (n = 94, 7.3%). Fatality in blood cancer children with COVID-19 was reported in any of the included blood cancer categories for leukaemias (n = 99, 8.7%), non-Hodgkin’s lymphomas (n = 7, 11.9%), Hodgkin’s lymphomas (n = 2, 5.5%), myelodysplastic syndrome (n = 1, 14.3%) or myeloid neoplasm (n = 1, 100%). Fatality rate in blood cancer children infected with SARS-CoV-2 was the highest in patients with Hispanic ethnicity (n = 44/111, 39.6%) and COVID-19–related fatality was highest in male patients (76.5% of deceased patients). Most studies reported to alter the intensity and regimen of anticancer treatment in blood cancer children during course of SARS-CoV-2 infection, however, many studies have reported to successfully treat COVID-19 without any changes to the anticancer treatment. Conclusion: Globally, leukaemias were the most prevalent and myeloid neoplasms were the least prevalent blood cancer types in children who developed SARS-CoV-2 infection. Children with blood cancer tend to have milder COVID-19 symptoms and are less likely to be hospitalized and have better prognosis when compared to adults. Continuation of anticancer treatment in individual paediatric blood cancer patients with COVID-19 seems to be possible.

The Distribution of Fecal Contamination in an Urbanized Tropical Lake and Incidence of Acute Diarrheal Disease

Aquatic ecosystems of tropical countries are vulnerable to fecal contamination that could cause spikes in the incidences of acute diarrheal disease (ADD) and challenge public health management systems. Vembanad lake, situated along the southwest coast of India, was monitored for one year (2018-2019). Escherichia coli, an indicator of fecal contamination, was prevalent in the lake throughout the year. Multiple antibiotic resistance among more than 50% of the E. coli isolates adds urgency to the need to control this contamination. The high abundance of E. coli and incidence of ADD were recorded during the early phase of the southwest monsoon (June-July), prior to the once-in-a-century floods that affected the region in the later phase (August). The extent of inundation in the low-lying areas peaked in August, but E. coli in the water peaked in July, suggesting that contamination occurred even prior to extreme flooding. During the COVID-19-related lockdown in March-May 2021, fecal contamination in the lake and incidence of ADD reached minimum values. These results indicate the need for improving sewage treatment facilities and city planning in flood-prone areas to avoid the mixing of septic sewage with natural waters during extreme climate events or even during the normal monsoon.

Acute Disseminated Encephalomyelitis Post COVID-19 Pneumonia.

Acute disseminated encephalomyelitis (ADEM) is a monophasic condition characterized by inflammation of the central nervous system. Besides multiple sclerosis, optic neuropathy, acute transverse myelitis, and neuromyelitis optica spectrum disorder, ADEM is a primary inflammatory demyelinating disorder of the central nervous system. It is estimated that approximately three-quarters of cases of encephalomyelitis occur after an infection or immunization, where the onset of neurological disease is coincident with a febrile event. Here, we report an 80-year-old woman with coronavirus disease pneumonia who developed sudden onset of decreased level of consciousness, focal seizure, and right-side weakness. Magnetic resonance imaging (MRI) of the brain showed a multifocal hemorrhagic lesion with surrounding edema, suggesting ADEM. An electroencephalogram (EEG) revealed moderate generalized encephalopathy. The patient received alternating pulse steroids with plasma exchange for five days. Subsequently, her Glasgow coma scale score continued to decrease, and thus, she required inotropic support until she expired.

Efficacy of Alveolar Type II Epithelial Cell Transplantation for Pulmonary Fibrosis: A Meta-Analysis

It is difficult to maintain social distancing in highly populated areas where people live in proximity. This study aimed to qualitatively explore experiences of COVID-19 recovered patients residing in one such area. We employed semi-structured face-to-face interviews. An interview guide was developed, validated, piloted, and minor changes were made. People living in this area, above 18 years of age, and recovered from COVID-19 were approached for the interviews, 11 of them were recruited to be interviewed, and their verbal informed consent was audio recorded. The interviews were conducted in the Arabic language in a semi-private area of the community center, audio-recorded, transcribed verbatim, and thematically analyzed later. Thematic analysis generated 30 subthemes, which were categorized into seven overarching themes: information about COVID-19;life during COVID-19 illness;spreading of COVID-19;precautionary measures;interventions that helped in recovery;impact of COVID-19 on life;support received during COVID-19 illness. Experiences of people from the hotspot who had recovered from COVID-19 highlighted what life had been like in the hotspot under lockdown, especially with having been afflicted with the infection, factors that facilitated their recovery, and the way their lives were and have been affected due to COVID-19.

The role of teleradiology during COVID-19 outbreak: Saudi radiologists' perspectives.

OBJECTIVES: To evaluate the role of teleradiology during the COVID-19 pandemic from Saudi radiologists' perspectives to improve the radiology quality service. METHODS: A cross-sectional study was carried out in Saudi Arabia among radiologists working at local hospitals from October to November 2021. It contains 21 questions involved demographic information; general information on teleradiology services; and the impact of teleradiology during COVID-19. One-way ANOVA was used to compare demographic groups. Chi-square test was used to compare demographic groups regarding their distribution of responses. All tests were carried out <0.05 level of significance. RESULTS: A total of 102 radiologists participated in this study (56% males, 44% females), 58.8% of them were sub-specialized in chest radiology. Regarding the general status of teleradiology, 69.6% of participants believed that teleradiology is a helpful tool for imaging interpretation. However, 44% of them were uncertain on the impact of teleradiology on patients' confidentiality. Approximately 87% of participants agreed that there is a positive contribution of teleradiology during COVID-19, which enables decreasing risk of infection and workload. There was a significant difference between professional degrees and overall participant responses (p<0.05). Academicians agreed that it enhances radiology departments' work (mean=17.78, SD=1.86). CONCLUSION: Concerns raised on complicated cases that require physical presence of patients, cannot be performed by teleradiology. Additionally, it might provide insufficient communication with other professionals to discuss images.

The Distribution of Fecal Contamination in an Urbanized Tropical Lake and Incidence of Acute Diarrheal Disease

Aquatic ecosystems of tropical countries are vulnerable to fecal contamination that could cause spikes in the incidences of acute diarrheal disease (ADD) and challenge public health management systems. Vembanad lake, situated along the southwest coast of India, was monitored for one year (2018-2019). Escherichia coli, an indicator of fecal contamination, was prevalent in the lake throughout the year. Multiple antibiotic resistance among more than 50% of the E. coli isolates adds urgency to the need to control this contamination. The high abundance of E. coli and incidence of ADD were recorded during the early phase of the southwest monsoon (June-July), prior to the once-in-a-century floods that affected the region in the later phase (August). The extent of inundation in the low-lying areas peaked in August, but E. coli in the water peaked in July, suggesting that contamination occurred even prior to extreme flooding. During the COVID-19-related lockdown in March-May 2021, fecal contamination in the lake and incidence of ADD reached minimum values. These results indicate the need for improving sewage treatment facilities and city planning in flood-prone areas to avoid the mixing of septic sewage with natural waters during extreme climate events or even during the normal monsoon. © 2023 American Chemical Society.

Students' perception of asynchronous versus synchronous distance learning during COVID-19 pandemic in a medical college, southwestern region of Saudi Arabia.

BACKGROUND: COVID-19 preventive measures required a drastic shift to online teaching-learning in most of countries. Institutions used different combinations of live online lectures (synchronous) requiring students to attend the class in real-time, as well as recorded lectures uploaded by the instructors to be accessed by students as per their own convenience (asynchronous). We undertook this study to assess and compare the perceptions of students regarding their learning experiences in the synchronous versus asynchronous mode of instruction using  their teaching-learning during the compulsory online mode of instruction at the peak of the COVID-19 pandemic. METHODOLOGY: This cross-sectional questionnaire-based study received responses from 122 final-year medical students studying at the College of Medicine, King Khalid University, Abha, Saudi Arabia. An online 5-point Likert scale-based questionnaire was used to collect data regarding experience and perception towards synchronous and asynchronous learning. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P-value less than 0.05 was considered significant. RESULT: All the students found both synchronous and asynchronous learning to be equally satisfying, enjoyable and comfortable. No statistically significant difference was found when both the methods were analyzed for enhancement of knowledge. The students opined that asynchronous learning helped them manage their time better whereas synchronous learning encouraged more interaction during the live lectures. CONCLUSION: Overall, the students' perceptions regarding both synchronous and asynchronous online learning were positive. As both methods have their advantages/limitations, a mix of both synchronous and asynchronous methods may be adopted depending upon the content of the topic and the desired learning outcomes.

Impact of quarantine on sleep quality and psychological status in COVID-19 suspected cases in Riyadh, Saudi Arabia.

Aim: The purpose of this study was to investigate into mental health outcomes such as stress, anxiety, and depression, as well as sleep quality in suspected COVID-19 quarantined cases. Methods: This is a cross-sectional study that used an online survey to target suspected COVID-19 cases in quarantine facilities. Data were collected on several aspects of participants' sociodemographic characteristics, sleep disturbance, and mental health status. Depression, anxiety, stress scale and Pittsburgh Sleep Quality Index were used to measure both the psychological impact and mental health status. Results: Of the 362 people who took the survey, 234 (64.6%) were men, and 148 were between the ages of 26-35. Poor sleep was found to be prevalent in 65% of study participants. The rates of individuals reporting severe depression, anxiety, and stress symptoms were 14.6%, 15%, and 15%, respectively. According to the findings, there were significant gender differences in depression and anxiety (p = 0.001). When compared to the other age groups, participants aged 26-35 reported the highest level of stress (p = 0.001). Being male [OR = -1.23, 95% CI (-2.75-1.95) P = 0.050], single [OR = 0.98, CI (0.15-4.20), P = 0.001], and a healthcare worker [OR = -2.20, 95% CI (-2.59-1.82), P = 0.001] were all associated with poor sleep quality. Conclusion: Approximately-one-third of quarantine COVID-19 patients had poor sleep quality with mild-moderate depression. Both anxiety and stress scales were prevalent in nearly half of the studied samples.

Motivators, Barriers, and Acceptance of COVID-19 Vaccination among Residents of Western Saudi Arabia.

BACKGROUND: There are limited studies that have assessed COVID-19 vaccine acceptance and side effects, both globally and in the western region of Saudi Arabia (SA). OBJECTIVE: This study assessed the acceptance of vaccination against COVID-19, determined motivators and barriers for taking these vaccines, and assessed vaccine side effects in the western region of SA. STUDY DESIGN: The study was an online cross-sectional study conducted among the people who lived in the western region of SA during the period from December 2021 to March 2022. Participation was voluntary for participants who were above 18 and lived in the Western region of SA. Children and those living in other countries were excluded from the study. METHODS: The study tool was a self-administered questionnaire which assessed COVID-19 vaccine acceptance, determined motivators and barriers for taking the vaccines, and assessed their side effects among 1136 participants in the western region of SA. Data gathered were analyzed by the SSPS version 22 software. RESULT: A total of 1136 individuals, aged 18 years and above, participated in the study, with 50.7% (n = 567) being males. Most of the participants were from Taif city (68.4%; n = 777), and 57.6% (n = 654) were unmarried. Pfizer was the most frequently administered vaccine (72.8%; n = 823). Most participants explained that their vaccine administration protected themselves and their families (70.5%; n = 835). The acceptance showed that 55% (n = 626) of the participants had either very high or high confidence in the efficacy of the COVID-19 vaccines, while 14.7% (n = 167) of them had low/very low confidence in its efficacy. The side effects showed that 80.8% (n = 918) of the participants showed that they did not have any difficulties attributed to COVID-19 vaccine administration. Positive attitudes and practices were apparent, and most of the participants (78.3%; n = 889) tended to be actors in the fight against COVID-19. CONCLUSIONS: The current study showed a high level of acceptance of COVID-19 vaccination among people living in the western region of SA. Health education and communication from authoritative sources will be important to alleviate public concerns about COVID-19 vaccine safety.

Global Coinfections with Bacteria, Fungi, and Respiratory Viruses in Children with SARS-CoV-2: A Systematic Review and Meta-Analysis.

BACKGROUND: Coinfection with bacteria, fungi, and respiratory viruses has been described as a factor associated with more severe clinical outcomes in children with COVID-19. Such coinfections in children with COVID-19 have been reported to increase morbidity and mortality. OBJECTIVES: To identify the type and proportion of coinfections with SARS-CoV-2 and bacteria, fungi, and/or respiratory viruses, and investigate the severity of COVID-19 in children. METHODS: For this systematic review and meta-analysis, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus, and Nature through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies on the incidence of COVID-19 in children with bacterial, fungal, and/or respiratory coinfections, published from 1 December 2019 to 1 October 2022, with English language restriction. RESULTS: Of the 169 papers that were identified, 130 articles were included in the systematic review (57 cohort, 52 case report, and 21 case series studies) and 34 articles (23 cohort, eight case series, and three case report studies) were included in the meta-analysis. Of the 17,588 COVID-19 children who were tested for co-pathogens, bacterial, fungal, and/or respiratory viral coinfections were reported (n = 1633, 9.3%). The median patient age ranged from 1.4 months to 144 months across studies. There was an increased male predominance in pediatric COVID-19 patients diagnosed with bacterial, fungal, and/or viral coinfections in most of the studies (male gender: n = 204, 59.1% compared to female gender: n = 141, 40.9%). The majority of the cases belonged to White (Caucasian) (n = 441, 53.3%), Asian (n = 205, 24.8%), Indian (n = 71, 8.6%), and Black (n = 51, 6.2%) ethnicities. The overall pooled proportions of children with laboratory-confirmed COVID-19 who had bacterial, fungal, and respiratory viral coinfections were 4.73% (95% CI 3.86 to 5.60, n = 445, 34 studies, I2 85%, p < 0.01), 0.98% (95% CI 0.13 to 1.83, n = 17, six studies, I2 49%, p < 0.08), and 5.41% (95% CI 4.48 to 6.34, n = 441, 32 studies, I2 87%, p < 0.01), respectively. Children with COVID-19 in the ICU had higher coinfections compared to ICU and non-ICU patients, as follows: respiratory viral (6.61%, 95% CI 5.06-8.17, I2 = 0% versus 5.31%, 95% CI 4.31-6.30, I2 = 88%) and fungal (1.72%, 95% CI 0.45-2.99, I2 = 0% versus 0.62%, 95% CI 0.00-1.55, I2 = 54%); however, COVID-19 children admitted to the ICU had a lower bacterial coinfection compared to the COVID-19 children in the ICU and non-ICU group (3.02%, 95% CI 1.70-4.34, I2 = 0% versus 4.91%, 95% CI 3.97-5.84, I2 = 87%). The most common identified virus and bacterium in children with COVID-19 were RSV (n = 342, 31.4%) and Mycoplasma pneumonia (n = 120, 23.1%). CONCLUSION: Children with COVID-19 seem to have distinctly lower rates of bacterial, fungal, and/or respiratory viral coinfections than adults. RSV and Mycoplasma pneumonia were the most common identified virus and bacterium in children infected with SARS-CoV-2. Knowledge of bacterial, fungal, and/or respiratory viral confections has potential diagnostic and treatment implications in COVID-19 children.

Lessons Learned from Using Twitter Chat for Educational Research

The current pandemic has allowed us to tap the resources we might not have explored otherwise. While we were under lockdown in Saudi Arabia, we considered how Twitter could be used as a part of potential research methodology in educational research. We used the Twitter chat to explore, from pharmacy students' point of view, how the suspension of on-campus learning activities and shifting to online mode affected their learning experience and how they would like to see their education shaped in the future. Due to the wide use of Twitter, we could reach out to a significant number of respondents from different regions of the country, inviting different perspectives. The pros and cons we have derived from our experience can be applied to a wider context for utilising Twitter chat in educational research. © 2022 Penerbit Universiti Sains Malaysia. All right reserved.

Public acceptance of COVID-19 vaccination among residents of Saudi Arabia: a cross-sectional online study.

OBJECTIVES: The acceptance of the COVID-19 vaccine is essential for protecting the world population and stopping the COVID-19 pandemic. This paper aimed to measure public acceptance of the COVID-19 vaccination and the factors that may play an important role in increasing the acceptance of vaccinations in future pandemics. DESIGN: A cross-sectional, observational study was conducted through a survey designed using the Google Forms platform. In this study, a logistic regression analysis was used to study and detect the variables linked to the acceptance of COVID-19 vaccination. To meet inclusion criteria, participants had to be 18 years or older at the time of collecting the data, reside in Saudi Arabia at the time of the survey, agree to the consent form and be able to complete the survey in Arabic. SETTING: Randomly selected residents of Saudi Arabia. NUMBER OF PARTICIPANTS: 1658. RESULTS: In general, the population of Saudi Arabia is supportive of the COVID-19 vaccine (72.0%) and has one of the highest acceptance rates, according to global studies. We found that men (OR 0.73; 95% CI: 0.55 to 0.97) were less likely to hesitate with regard to taking the vaccine, whereas previously infected individuals were more likely to hesitate (OR 1.77; 95% CI: 1.25 to 2.50). Those with a lower monthly income (<3000 Saudi riyal) were more likely to refuse the vaccine (OR 3.54; 95% CI: 1.81 to 6.91), while those living in cities (OR 0.62; 95% CI: 0.39 to 0.99) and the unemployed (OR 0.52; 95% CI: 0.33 to 0.83) were less likely to refuse it. Participants' history of viral infection and trust in the healthcare system were found to be important factors in the public's acceptance of the vaccine. CONCLUSION: In general, acceptance of the COVID-19 vaccination is high in Saudi Arabia. Several factors have shown a method for predicting those who might reject the vaccine or hesitate to take it; thus, the healthcare system should target those residents throughout the campaign. Based on the conclusions of the current research, the acceptance of vaccinations could be increased.

Computer Aided COVID-19 Diagnosis in Pandemic Era Using CNN in Chest X-ray Images.

Early detection of abnormalities in chest X-rays is essential for COVID-19 diagnosis and analysis. It can be effective for controlling pandemic spread by contact tracing, as well as for effective treatment of COVID-19 infection. In the proposed work, we presented a deep hybrid learning-based framework for the detection of COVID-19 using chest X-ray images. We developed a novel computationally light and optimized deep Convolutional Neural Networks (CNNs) based framework for chest X-ray analysis. We proposed a new COV-Net to learn COVID-specific patterns from chest X-rays and employed several machine learning classifiers to enhance the discrimination power of the presented framework. Systematic exploitation of max-pooling operations facilitates the proposed COV-Net in learning the boundaries of infected patterns in chest X-rays and helps for multi-class classification of two diverse infection types along with normal images. The proposed framework has been evaluated on a publicly available benchmark dataset containing X-ray images of coronavirus-infected, pneumonia-infected, and normal patients. The empirical performance of the proposed method with developed COV-Net and support vector machine is compared with the state-of-the-art deep models which show that the proposed deep hybrid learning-based method achieves 96.69% recall, 96.72% precision, 96.73% accuracy, and 96.71% F-score. For multi-class classification and binary classification of COVID-19 and pneumonia, the proposed model achieved 99.21% recall, 99.22% precision, 99.21% F-score, and 99.23% accuracy.

Knowledge, Attitudes, and Practices of COVID-19 Safety Measures Among Type 1 Diabetes Mellitus Patients at King Abdulaziz University Hospital: A Cross-Sectional Study.

BACKGROUND: Coronavirus disease 2019 (COVID-19), an infectious disease caused by an enveloped RNA beta coronavirus, has become a pandemic, with a mortality rate ranging from 0.7% to 10.8%. Although older adults with comorbidity are more likely to suffer severe disease and eventual mortality, diabetes mellitus (DM) is one of the most frequently reported noncommunicable diseases shown to predict poor prognosis in COVID-19 patients. AIM:  To determine the knowledge, attitudes, and practices (KAP) of COVID-19 safety measures and factors associated with poor knowledge and practice among type 1 diabetes mellitus (T1DM) patients at King Abdulaziz University Hospital (KAUH), Jeddah. METHODOLOGY:  This cross-sectional study included 267 patients with T1DM aged 18-65, admitted to the hospital from January to June 2020. Data were collected via phone interviews during September 2020. The questionnaire consisted of 15 questions for knowledge, five for attitude, and eight concerning practices, and some questions were based on diabetes and COVID-19 specifically. RESULTS:  Overall, 64 participants with a median age of 53 years were studied. The median COVID-19 knowledge score showed poor (11.50%), average (43.75%), and good knowledge (6.25%). Most of the participants practiced precautionary measures outside their homes. CONCLUSION:  In conclusion, half of the population had poor COVID-19 knowledge, 60.9% of the participants felt anxious, and most of them performed precautionary measures, including wearing a facemask, maintaining a 1-m distance, and washing their hands regularly.

Students’ Perception of Asynchronous versus Synchronous Distance Learning during COVID-19 Pandemic in a Medical College, Southwestern Region of Saudi Arabia (preprint)

Background:The Covid-19 pandemic has forced educational institutes to shift from conventional in-campus learning to online learning. Two common modes adopted are giving real-time online lectures (synchronous) or providing recorded lectures and reading material to the students (asynchronous). This study was done to determine medical students’ satisfaction with the online learning experiences both synchronous and asynchronous during the COVID-19 Pandemic. Methodology:This cross-sectional questionnaire-based study was conducted on 122 final-year medical students studying at the College of Medicine, King Khalid University, Abha, Saudi Arabia. An online 5-point Likert scale-based questionnaire was used to collect data regarding experience and perception towards synchronous and asynchronous learning. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P-value less than 0.05 was considered significant. Result:All the students found both synchronous and asynchronous learning to be equally satisfying, enjoying and comfortable. No statistical significance was found when both the methods were analyzed for enhancement of knowledge. The students opined that asynchronous learning helped them manage their time better whereas synchronous learning encouraged more interaction during the live lectures. Conclusion:  Overall, the student's response to both synchronous and asynchronous learning was positive. As both methods have their advantages, an integrated approach of both synchronous and asynchronous methods may be adopted depending upon the content of the topic and the learning outcomes.

Impact of COVID-19 severity on health-related quality of life among Saudi adult patients.

COVID-19 patients may experience varying degrees of symptom severity, significantly impacting the health-related quality of life. As a result, the current study examines the impact of symptom severity on health-related quality of life among Saudi adult COVID- 19 patients. In this cross-sectional study 310 adult COVID-19 patients were recruited through a snowball technique in Saudi Arabia. We used a questionnaire (SF-12 RAND tool questionnaire) that included three parts: sociodemographic factors, perception of degree severity of COVID-19 symptoms, and health-related quality of life (HRQoL). Out of 310 COVID-19 adult patients, 200 (64.5%) were female, 110 (35.5%) were between 30-49 years old. The mean scores of the HRQoL, physical components summary (PCS), and mental components summary (MCS) were 58.11±17.02, 71.32±23.72, and 44.91±17.94, respectively. Patients with very severe symptoms had the lowest HRQoL mean rank (120.39, P=0.023). There was a strong positive correlation between HRQoL and PCS (0.852) and HRQoL and MCS (0.730). However, PCS and MCS had a weak positive correlation (0.292). The severity of COVID-19 symptoms had a significant impact on HRQoL. Thus, it is essential to enhance the uptake of vaccines to decrease the risk of infections and avoid impact on quality of life.

Burnout Among Saudi Radiological Sciences Undergraduate Students During COVID-19 Pandemic: A Cross-Sectional Study.

Background: The novel Coronavirus Disease 2019 (COVID-19) pandemic has posed unprecedented new stressors and challenges to the applied health sciences' education. This study explored the prevalence of burnout among Saudi radiological sciences students at King Saud bin Abdulaziz University for Health Sciences during the COVID-19 pandemic. Methods: A cross-sectional study was conducted between November and December 2020 among 176-Saudi radiological sciences students, using the 16-item questionnaire of Maslach Burnout Inventory-General Survey for Students and through non-probability convenient sampling technique. The 16 items of the questionnaire were scored on a 7-point frequency rating scale ranging from 0 (never) to 6 (every day) and consisted of three distinct burnout dimensions/subscales: a) emotional exhaustion (5-items), cynicism (5-items), and professional efficacy (6-items). The means of individual items that make up each scale of burnout were calculated, and statistical analysis was performed using the Mann-Whitney U-test. Results/Observations/Findings: From the 176-radiological sciences students approached, 96 (54.5%) completed the questionnaire. The percentage of students who were at moderate to high risk of burnout was 70.8% for emotional exhaustion, 75% for cynicism, and 74% for professional efficacy subscales. Emotional exhaustion was significantly higher among fourth-year students (P = 0.042), than third-year students. Cynicism was significantly higher among fourth-year female students (P = 0.035), than third-year female students. The professional efficacy was significantly lower among fourth-year female students (P = 0.007) than males. Conclusion: Our study shows 73.3% moderate to high burnout rates among Saudi radiological sciences students during the COVID-19 pandemic. Burnout increases as students advance to the fourth year. A block/modular curriculum structure for fourth-year courses may be necessary to reduce burnout among fourth-year students. Academic counseling can ease students' emotional stress and reduce burnout risk.