The Impact of Sickle Cell Disease on Academic Performance among Affected Students.

BACKGROUND: Sickle cell disease (SCD) is a genetic disease that is highly prevalent in Jazan Province, Saudi Arabia, and is mostly characterized by many complications such as vaso-occlusive crises (VOC), acute chest syndrome (ACS) and well-documented neurological complications. These complications may affect patients' academic performance. METHODS: An observational, cross-sectional, retrospective study was conducted in Jazan Province. General and demographic data were collected and questions about academic performance of students with SCD were answered. Both t-tests and chi-square tests, along with multiple logistic regression, were used for analysis. RESULTS: 982 participants were selected for this study with a mean age of 23 years (SD: 7). Most of the participants were female (64%). The number of participants with SCD was 339 (36%), of whom 42% were male. Students with SCD recorded lower grade point averages (GPA) and more absences compared to healthy participants. Further, about 60% of students with SCD thought they performed better than 40% of the participants without SCD during the COVID-19 pandemic when most of the educational activities were online. CONCLUSION: As has been previously reported, this study suggested that the academic performance of students with SCD is negatively affected compared to healthy individuals, and this is mostly due to complications associated with the disease. Further, students with SCD acknowledged better performance with online education, an option that should be considered to improve their academic performance. National studies on a larger population are required by health and education officials, and supportive online educational programs are warranted to enhance the academic performance of this population.

Determining the Effect of COVID-19 on the Menstrual Cycle Among Women of Reproductive Age Group in the Jazan Region: A Cross-Sectional Study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has gravely affected the world in various ways. COVID-19 is a major health crisis, with long-term physical and mental health consequences. Many women reported menstrual irregularities during and after the pandemic. The study aimed to assess the effects of COVID-19 on menstrual cycles in females of reproductive age in the Jazan region. METHODOLOGY: A descriptive cross-sectional research design was utilized to conduct the study in Jazan, Saudi Arabia. A structured questionnaire was used to collect data from 346 women aged 18-44 years who had normal menstrual cycles for more than a year before the outbreak and had a history of COVID-19 infection. RESULT: The questionnaire was completed by 346 women. Only 144 (41.6%) of the study's respondents were aged 25-34 years. Of the respondents, 283 (81.8%) were university students, and 219 (63.3%) were married. The majority of women (337, 97.4%) were vaccinated against COVID-19. A total of 301 (87.0%) were healthy. Before being infected with COVID-19, 19.70% of the responders had irregular periods, which increased to 59.50% during infection and 33.20% after getting better. There was a relationship between the regularity of menstrual periods during COVID-19 infection and the duration of menstrual periods after COVID-19 (p = 0.035); the frequency of menstrual periods before (p = 0.001), during (p = 0.009), and after (p = 0.001) COVID-19; menstrual period regularity before (p = 0.001) and after (p = 0.001) COVID-19 infection; and pain severity level during (p = 0.001) and after (p = 0.004) COVID-19 infection. Regarding the perception of the impact of COVID-19 on menstrual changes, there was an association between COVID-19 infection and variation in days during two consecutive menstrual cycles (p = 0.001), changes in the duration of menstrual cycles (p = 0.022), delayed or absent menstruation (p = 0.019), and menstruation stopping (p = 0.023). CONCLUSION: The research demonstrated the COVID-19 pandemic is an international health problem that affects women, leading to changes in regularity, duration, frequency, and severity of pain. These changes may have a long-term impact on women's reproductive health.

Medical Students' Perception Towards Choosing Pathology Program at Jazan University, Saudi Arabia.

Purpose: The selection of a specific medical specialty is crucial to medical students and is increasingly associated with future job satisfaction and success in the medical field. We aim to evaluate the perception of medical students at Jazan University towards choosing pathology as a future career and the factors influencing their decisions in order to better the employability of graduates and provide information to both the labor force and curriculum designers. Methods: An observational cross-sectional study was conducted among a random sample of (391) students at the faculty of medicine, Jazan University, from the 2nd to 6th year who registered as a formal student in the academic year 2021/2022. Data was collected via (web-based) a self-administered questionnaire because of COVID-19 pandemic. Chi-squared tests and regression analysis were performed. Results: In this investigation, 92.9% of participants responded. Only 16.2% of undergraduates selected pathology as a future career choice. Among the participants who desired to choose pathology as a career, 28.6% preferred hematopathology as a future sub-specialty. Around 16% considered the most crucial reason for not choosing pathology is the preference for direct patient contact. The differences in age groups, academic level, GPA, and educational level of father between respondents who having a desire to choose pathology as a future career were found to be significantly different. Conclusion: Among the respondents involved in this study, only 16.2% were interested in pathology, while 3.1% chose the field as their first future career choice. Our findings can be applied to help undergraduate better prepare for the future and encourage them to apply to the pathology program to address the shortage of pathologists in the area. Qualitative research is a need to explore the perceptions of current pathology residents and the reasons that can encourage them to choose this important specialization as a future career.

The Association between SARS-CoV-2 Infection and Diabetic Ketoacidosis in Patients with New-Onset Diabetes: A Retrospective Study from a Diabetic Center in Saudi Arabia.

BACKGROUND: Various reports described new-onset diabetes during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with no previous history of diabetes or glucocorticoid use. Further, SARS-CoV-2 could increase the risk of diabetes, including diabetic ketoacidosis (DKA). However, data on the relationship between new-onset diabetes and COVID-19 are still limited in our region. Thus, we aimed in this study to evaluate the association between new-onset diabetes and DKA in patients with COVID-19. METHODS: A retrospective, cross-sectional study was conducted at a diabetic center in Jazan province, Saudi Arabia, between 2020 and 2021. Demographic data, COVID-19 status, and DKA incidence were collected and verified manually from diabetic patients' medical records. Data were analyzed using a t-test and chi-square test. RESULTS: We included 54 diabetic patients diagnosed during the COVID-19 pandemic, with a median age of 17 years. The majority of patients were females (57.4%). About 38.8% were diagnosed with COVID-19, and 16.6% reported having DKA. About 33.3% of the patients who experienced DKA reported being COVID-19-positive. However, only 6% of patients who denied contracting SARS-CoV-2 developed DKA (p-value = 0.020). CONCLUSIONS: Patients with newly diagnosed diabetes due to COVID-19 seem at a higher risk of developing DKA. Further epidemiological and molecular studies are required for a better understanding of the correlation between DKA in patients with diabetes and COVID-19.

Assessment of COVID-19 Symptoms Distribution According to Tobacco Products Consumption and Khat Chewing: A Potential Antinociceptive Role of Nicotine Among COVID-19 Patients.

Purpose: To assess the distribution of COVID-19 symptoms according to the consumption of tobacco products and khat chewing among samples of Saudi Arabian individuals. Methods: This retrospective cohort study was conducted in the Jazan region of Saudi Arabia. Data was collected online via a self-administered questionnaire. The questionnaire measured demographic variables, COVID-19 symptoms and vaccination, comorbidities history, tobacco product consumption, and khat chewing. In addition, logistic regression was performed to assess the association between the clinical presentation of COVID-19 with tobacco product consumption and khat chewing. Results: A total of 1026 subjects were recruited. The mean age of the participants was 31 years, and more than half were male (53%). Among the reported tobacco product consumption, hookah smoking was more frequently reported as a currently consumed tobacco product (14.3%), followed by cigarette smoking (11.5%) and chewing tobacco (3.8%). Thirteen percent (134) were khat chewers at the time of recruitment. The odds of reporting five symptoms or more were higher among patients who have never been tobacco product consumers (OR: 1.6, 95% CI: 1.15-2.35) while accounting for khat chewing, age, vaccination status, and history of comorbidities. Nonetheless, the difference in symptom distribution with khat chewing status was not statistically significant. Conclusion: The findings of the current investigation suggest the presence of a potential impact of nicotine toxicity in masking pain among the subjects infected with COVID-19. Therefore, it is possible to hypothesize that, with the potential masking effect of nicotine, infected smokers may be less likely to suffer from the symptoms and seek official healthcare services, including diagnostic services.

Coronavirus disease 2019 in patients with sickle cell disease: A cross-sectional study from Jazan Province, Saudi Arabia

Objectives: To assess the prevalence of coronavirus disease 2019 (COVID-19) infection among sickle cell disease (SCD) patients in Jazan region and to determine the impact of COVID-19 on the SCD population. Methods: This was an observational, descriptive, cross-sectional study using a self-administrated questionnaire directed to SCD patients in Jazan to assess the prevalence of COVID-19. The data were analyzed using a t-test and Chi-square test. Results: A total of 188 responses were received and only 96 SCD patients were included (mean age is 24 years). About half of the study samples (53%) of the study population were male. About 11% of patients with SCD were diagnosed with COVID-19. Vaso-occlusive crisis was reported in 73% and a single patient presented with acute chest syndrome. About three-fourths of patients (73%) were admitted to the hospital and most of them experienced mild symptoms and one patient was treated in the intensive care unit. Conclusion: SCD patients are at risk of SARS-CoV-2 infection. In the absence of comorbidities, patients with SCD are not at increased risk of COVID-19 mortality, but a higher admission rate is reported. SCD patients with COVID-19 may have a milder clinical course, compared to other populations with comorbidities such as diabetes and hypertension, and this may be due to proinflammatory adaptation of the immune system. Larger studies including epidemiological and molecular details are needed to enhance our understanding of how SARS-CoV-2 could affect patients with SCD. © 2022 Journal of Nature and Science of Medicine. All rights reserved.

Psychological observations of the parents on their children during COVID-19 pandemic social isolation in Jazan, Saudi Arabia.

Background: Social isolation was imposed as the best preventive measure worldwide for the COVID-19 pandemic. We investigated the psychological effects of this measure among Saudi families in the Jazan province to assess its impact on children during this period. Methods: This study was a cross-section investigation conducted in the Jazan province that is located in the southwest part of the country. Data collection was conducted during May 2020 during the country-wise curfew in Saudi Arabia and targeted parents living in Jazan with a minimum of one child above the age of 5 years using a self-administered web-based questionnaire. Results: In total, 408 valid questionnaires were collected. About 50.5% (n = 206) of the parents reported their children as having abnormal psychological observation at the time of their social isolation, which is significantly associated with living status, the number of children (especially when the family has fewer than two children <5 years old), and if any relatives or friends got COVID-19 or quarantined. The psychological effects ranged from anxiety, sleeping disturbance, fear of death, feeling frustrated or bored and violence. Conclusion: Our findings, although limited to observations of parents concerning their children, suggest that social isolation could be a possible risk factor for the development of more serious psychological ramifications in the future such as depression and anxiety.

COVID-19 Vaccine Hesitancy Prevalence and Predictors among the Students of Jazan University, Saudi Arabia Using the Health Belief Model: A Cross-Sectional Study.

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine acceptance among Jazan University students and identify its predictors. In this cross-sectional study, an online questionnaire based on the health belief model (HBM) was sent through social media "WhatsApp" to two strata of students selected by convenient sampling. The overall desire to get vaccinated was noted in 83.6% of participants, and 16.4% reported no desire to be vaccinated. The constructs of the HBM were shown to significantly predict vaccine acceptance with the exception of "perceived susceptibility". In conclusion, the level of acceptance of the COVID-19 vaccine among Jazan University students was relatively high. The HBM constructs are important predictors of the vaccination behavior with the exception of the construct "perceived susceptibility".

Knowledge of COVID-19 Infection Guidelines among the Dental Health Care Professionals of Jazan Region, Saudi Arabia.

BACKGROUND: This study aimed to assess the knowledge about guidelines related to COVID-19 infection control procedures among dental health care professionals (DHCPs) in the Jazan region. METHODS: A cross-sectional study involving DHCPs (dental students, interns, and dentists) of the Jazan region between January and March 2021. A questionnaire with 35 items was developed and circulated online among the DHCPs. The dimensionality of the questionnaire was assessed using exploratory factor analysis (EFA). The level of awareness (LOA) was compared across the genders, level of professional experience, and exposure to guidelines. Participants were considered to have high LOA when they responded to 26 or more items correctly. RESULTS: A total of 363 DHCPs participated in the survey. The questionnaire was found to be valid and reliable. EFA revealed a distinct three-factor structure. Moreover, 61.2% of the respondents had high LOA related to COVID-19 infection prevention. Among those who had high LOA, dentists (65.5%) were relatively more than the students (62.5%) and interns (46.2%). Among the six guideline statements related explicitly to operative dentistry, more than 50% of the respondents were aware of 3 guideline statements, while less than 50% of the respondents were aware of the remaining statements. CONCLUSIONS: Most DHCP had a high LOA for general COVID-19 infection prevention and control guidelines. Dentists, males, and those who read the guidelines had higher LOA than their counterparts.

Knowledge, Attitudes, and Practices Toward COVID-19 Among the General Public in the Border Region of Jazan, Saudi Arabia: A Cross-Sectional Study.

Background: The Saudi government had implemented unprecedented preventive measures to deal with COVID-19. These measures included intermittent curfews, bans on public gatherings, limitations on many services, temporary suspension of Hajj, Umrah, and visit and launching awareness campaigns. Therefore, this study aimed to assess the KAP toward COVID-19 among residents of the border region of Jazan, Saudi Arabia. Methods: An online cross-sectional survey was distributed from May 4 to May 21, 2020, using a Google Form. The survey questionnaire covered demographic characteristics and KAP toward COVID-19. The KAP questions consisted of 17 items on knowledge, four items on attitude, and six items on practice. Results: A total of 597 participants responded to the survey questionnaire. Overall, participants demonstrated a good knowledge of COVID-19, correctly answering 77% of the knowledge questions. Most of the participants exhibited good attitudes and acceptable practices toward COVID-19. Multiple regression analysis revealed that participants with a university education (B = 1.75) or post-graduate education (B = 2.24), those with an income >SR 10,000-20,000 (B = 1.38) or >SR 20,000 (B = 2.07), and those who had received a personal health education (B = 1.19) had higher COVID-19 knowledge scores (p < 0.05). The ordinal logistic regression analysis found that compared to being female, being male was significantly associated with worrying about COVID-19 (p = 0.024, OR = 1.78), willingness to receive a COVID-19 vaccine (p = 0.003, OR = 1.81), and willingness to report potential symptoms of COVID-19 (p = 0.046, OR = 2.28). Worrying about COVID-19 was significantly associated with pre-university education vs. post-graduate education (p ≤ 0.001, OR = 7.94) and university education vs. post-graduate education (p ≤ 0.001, OR = 4.17). The binary logistic regression analysis found that compared to being female, being male was significantly associated with less face mask wearing in public (p = 0.009, OR = 0.31): Females were 3.23 times more likely to wear a face mask than were males. Conclusions: Most of the study participants had good knowledge, positive attitudes, and effective practices toward COVID-19. The findings of this study may help guide future awareness resources to the groups most in need in the Jazan region, particularly as the COVID-19 situation develops and changes. Further assessment should consider the groups omitted from this study, including immigrants and the elderly who have not adopted social media and technology.

Utilization of Health Applications Among Patients Diagnosed with Chronic Diseases in Jazan, Saudi Arabia During the COVID-19 Pandemic.

PURPOSE: Health applications are employed to aid patients with chronic diseases in effective long-term disease management. This investigation aims to measure the utilization of health applications among patients diagnosed with chronic conditions during the COVID-19 pandemic. METHODS: This cross-sectional investigation was conducted in the Jazan region in Saudi Arabia between October 2020 and March 2021. Data were collected during interviews using a semi-structured questionnaire. The questionnaire collected items about the patients' demographics, morbidity, and use of electronic devices and health applications developed by the Saudi MoH. Logistic regression was used to assess factors associated with odds of reporting use of applications. RESULTS: A total of 658 patients were recruited. The mean age of the patients was 51 years, and 59% of them were females. The most frequently reported diagnosed condition was diabetes (53.5%), followed by hypertension (42.7%). Majority of the patients reported not using any health applications developed by the Saudi MoH (68.2%). Patients with higher educational levels and younger patients were more likely to report use of the applications (ORs: 4.2, 2.6 respectively). Comorbidity history and disease duration did not seem to influence the probability of reporting use of health applications (P-values >0.05). CONCLUSION: Patients diagnosed with chronic diseases in Jazan had low utilization of health applications developed by the Saudi MoH. This indicates a need to encourage the use of these health applications, particularly among patients with chronic diseases and to consider use restriction among older patients with lower educational levels.

Community-based observational assessment of compliance by the public with COVID19 preventive measures in the south of Saudi Arabia.

BACKGROUND: At the end of August 2020, a surge in the number of cases in the Jazan region has been observed. The number of reported cases by 19th of August in the Jazan region was more than 300, which exceeded the number of reported cases in larger regions such as Riyadh, and Makkah. This study aims to measure compliance by the public with COVID-19 preventive measures. METHODS: This study was a cross-sectional, field-based observational assessment of compliance by individuals in public settings with COVID-19 preventive measures in the Jazan region of Saudi Arabia. The assessment was performed in the last week of July 2020. The assessment was based on observing the actual compliance of individuals and different establishments in the Jazan region with COVID-19 preventive measures. To perform the field observations, a standardised check-list was adopted from COVID-19 preventive measures in the community, which was developed by the Saudi Centre for Disease Prevention and Control (CDC). RESULTS: A total of 1096 individuals were observed in 69 different locations in the Jazan region. Compliance by the observed individuals was variable depending on the age group, the setting and the recommended preventive practice. The findings indicate very low compliance of specific precautionary measures within public parks in comparison to other measured settings. Proportions of individuals not compliant with mask-wearing instructions varied according to settings and age group from 5% in malls and shopping areas to nearly 83% in public parks. Additionally, Proportions of children not compliant with mask-wearing instructions was higher in comparison to adults in all observed settings. CONCLUSIONS: The findings of this study identified variability in the levels of compliance with specific preventive measures against COVID-19. Further assessment is needed to explore factors associated with the limited observed compliance, in particular with regard to limited compliance to precautionary measures applied in specific settings and compliance of children to mask-wearing instructions.