Prevalence of antibiotic misuse in cases of pneumonia and diarrhea in Saudi Arabia.

Background: Antibiotic misuse is a major public health issue with long-term repercussions. Objective: The purpose of this investigation was to evaluate the effects of pneumonia and diarrhea, with an emphasis on antibiotic misuse. Methodology: This study included 410 participants (217 fathers and 193 mothers), of whom 239 purchased antibiotics for their children without a prescription, whereas 171 had a prescription or were unsure if one was required. Results: Antibiotics were used incorrectly by 58.1% of respondents. About 51.2% of participants said they were taking two antibiotics at the same time. Around 30% of people admitted to using antibiotics inefficiently. The most prevalent reason for use was "viral and bacterial," followed by "viral," and then "bacterial," with 35%, 21%, and 20%, respectively. In addition, 22.4% of patients have used antibiotics for an unknown reason. Conclusion: Saudi parents of children with pneumonia and diarrhea abuse antibiotics. Saudi legislation banning medications without a prescription has helped reduce antibiotic abuse, but more community-based education and awareness are needed.

Practice, Knowledge, and Awareness of the Diverse Effects of Diagnostic Radiology among Radiology Staff and Students in Saudi Arabia.

BACKGROUND: Diagnostic radiology has been linked to several health consequences. Thus, the present study aimed to assess the practice, knowledge, and awareness of the diverse effects of diagnostic radiology among radiology staff and students in Saudi Arabia. METHODOLOGY: In this study, 107 participants were recruited from August to December 2020. The study included 56 radiology personnel (staff from Hail City Hospitals) and 51 radiology medical students (students from the University of Ha'il). RESULTS: To the question, "Have you ever been informed of radiation and its effects?" about 6/107 (5.6 %) answered "No," among which 5/6 (83.3 %) were the staff. In response to the question, "In your opinion, how hazardous is radiation to your body?" about 8/104 (7.7 %) indicated it as nonhazardous (3 were staff and 5 were students). To the question, "Do you believe that radiation in medical sites is harmful?" about 20/104 (19.2 %) answered, "No" (8 were staff and 12 were students). CONCLUSION: There is a lack of awareness, knowledge, and practice towards ionizing radiation protection measures among radiology medical students and radiology department staff in Northern Saudi Arabia. The paper notifies the health system advisors to include stressing guidelines regarding radiation hazards. More actions are deemed necessary for the safety of patients and radiation workers.

Patterns and grades of presentation of colon cancer in Northern Saudi Arabia.

INTRODUCTION: The primary concern related to colon cancer in Saudi Arabia is the presentation of many patients with advanced disease stages. AIM: To determine the patterns and grades of colon cancer presentation in Northern Saudi Arabia. MATERIAL AND METHODS: Retrieved data and tissue blocks related to 50 colorectal patients from King Khalid Hospital, Hai'l province, Northern Saudi Arabia were used. The sample represented all available colorectal specimens (full coverage of cancer cases within 10 years). The retrieved data included a full histopathology report, gender, and age. All tissues were retrieved in the form of formalin-fixed paraffin wax processed blocks. The tissues were found to be obtained in the form of colonoscopy or/and biopsy. RESULTS: The diagnosed colon cancers included conventional adenocarcinoma 36 (72%), mucinous adenocarcinoma 4 (8%), carcinoma-in-situ 4 (8%), and invasive adenocarcinoma 6 (12%). Moderately differentiated and poorly differentiated stages were confirmed in 46 (92%) and 4 (8%), respectively. CONCLUSIONS: Conventional adenocarcinoma is the most common presenting colon cancer at and relatively younger age. Mucinous adenocarcinoma is frequently presented in female patients of a somewhat more youthful generation. Most patients are diagnosed with moderately differentiated adenocarcinoma, followed by poorly differentiated adenocarcinoma. The findings necessitate the urgent intervention of national policies for early detection by implementing sustainable screening programs.

Is sputum cytology reliable for detection of atypical lung epithelial proliferative changes triggered by cigarette smoking?

BACKGROUND: In recent years, Saudi Arabia has witnessed major tobacco smoking-related disease, such as cardiovascular disease and cancer, particularly among the younger population. METHODOLOGY: The present study aimed at evaluating the effect of cigarette smoke on lung epithelial cells. RESULTS: This was a cross-sectional case-control study involving 300 apparently healthy volunteers living in Ha'il, Northern Saudi Arabia. Cigarette smokers (N = 100) were used as cases, and non-smokers (N = 200) were used as controls. A sputum specimen was obtained from each participant, employing all necessary safety precautions and sample adequacy measures. RESULTS: Among 300 study subjects, cytologic atypia was identified in 14/300 (4.7%). Among the 14 cases with atypical cytologic changes, 13/14 (92.9%) were in smokers and 1/14 (7.1%) was in a non-smoker. The risk of lung cytologic atypia associated with cigarette smoking, was OR (95% CI) = 29.73 (3.82-230.87), P = 0.0001. Out of 300 study subjects, metaplasia was identified in 45/300 (15%). Among 45 cases with metaplastic changes, 26/45 (57.8%) were in the smokers and 19/45 (42.2%) were in non-smokers. The risk of lung epithelial metaplasia associated with cigarette smoking was OR (95% CI) = 3.34 (1.74-6.41), P = 0.0003. CONCLUSION: Cigarette smoking is a significant risk for developing lung epithelial atypia, lung metaplasia, and inflammatory cell infiltrate (especially chronic inflammation). Sputum cytology is a simple, non-invasive method that can be used in screening at-risk populations for early detection of lung proliferative changes associated with tobacco smoking.

Assessment of the knowledge, attitude, and practice towards sun-exposure and skin cancer in Riyadh city, Saudi Arabia.

BACKGROUND: Although there is an emergent increase in the epidemiology of skin cancer in Saudi Arabia, yet knowledge, attitude, and awareness towards skin cancer prevention measures is still poor. Therefore, the present study aimed to assess the knowledge and attitudes and practice towards skin cancer among the Saudi population, as well as, to evaluate the level of awareness relating to exposure to sunlight. METHODS: This cross-sectional survey involved 438 participants who were randomly selected from Riyadh city, Saudi Arabia. A standard questionnaire was used to collect data regarding skin cancer. The questionnaire focused on three main aspects knowledge, attitude, and practice. The skin cancer quality of life impact tool (SCQOLIT) was employed. RESULTS: The present study included 438 participants, aged 18 to 55 years old. The response in the present study was 81.9%. Regarding the causes and effects of skin cancer, 61.2% of the respondents have prior knowledge about it. The positive attitude about skin cancer was exhibited by 68.9%, and only 31.1% showed a negative attitude towards it. CONCLUSION: In conclusion, Knowledge, attitude, and practice towards skin cancer still under the desired level to prevent skin cancer and its related conditions in Saudi Arabia. Greater emphasis should be made through awareness campaigns and available media to raise the knowledge about implications related to prolonged exposure to sunlight.

Screening for PIK3CA mutations among Saudi women with ovarian cancer.

The study aimed to screen for PIK3CA gene mutations among Saudi women with Ovarian Cancer. The study included 298 Saudi women with epithelial ovarian cancers (EOC). DNA sequence analysis was employed to screen for the mutations. DNA sequence analysis of a coding region of exon 9 and 20 of PIK3CA gene revealed mutations in 37/298 (12.4%) EOC patients. About 21/37(56.8%) somatic mutations were identified in exons 9, and 16/37(43.2%) in exon 20. All analysed mutations were missense mutations, the frequencies of which varied from 2.7% to 43.2%. PIK3CA mutation was found to be significantly associated with age (p = .023), grade (p = .001) and histological types (p = .032). Only 6.6% of serous carcinomas and 3.8% of endometrioid had PIK3CA mutation. The Mutated PIK3CA gene was significantly involved in the pathogenesis of EOC among Saudi women. PIK3CA gene mutation and overexpression represent important clinical implications for diagnosis, and prognosis, which can be utilised for better EOC management.Impact statementWhat is already known on this subject? The detailed molecular and genetic phenomenon underlying the progression of these tumours is still unclear. Recently, the pathogenesis of ovarian cancer has been attributed to mutations of PIK3CA.What do the results of this study add? Mutation in the PIK3CA gene leads to altered PI3K/AKT signalling pathways responsible for the progression of the epithelial ovarian cancer.What are the implications of these findings for clinical practice and/or further research? The Mutated PIK3CA gene was significantly involved in the pathogenesis of EOC among Saudi women. PIK3CA gene mutation and overexpression represent important clinical implications for diagnosis, and prognosis, which can be utilised for better EOC management.

Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer.

Background Cancer and diabetes have a tremendous impact on health globally. This study aimed to evaluate the KRAS gene in colon cancer tissues obtained from patients with type 2 diabetes mellitus (T2DM). Materials and Methods Data from 315 cases (156 colon diabetics and 159 patients were nondiabetics) were retrospectively retrieved. mRNA from surgically resected colon cancer tumors were also retrieved. Results The expression of KRAS mRNA was significantly higher in patients afflicted with T2DM than nondiabetic patients. The KRAS mRNA levels were significantly amplified from primary to metastatic lesions ( p < 0.001). Conclusion The association between T2DM and colon cancer was well-established in the present study.

The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia.

The Coronavirus Disease 2019 (COVID-19) has resulted in catastrophic consequences in many aspects of life; including negative psychological effects. We aimed to assess the mental health status of a group of Saudi population during this pandemic. Also, we aimed to assess the effect of the intensive media coverage of the pandemic news on mental health status. A questionnaire was distributed online to test depression, anxiety, and stress (using the DASS-21 scale) and their relationship to certain variables. A total of 215 respondents were included. Higher mental health prevalence rates were reported in non-Saudi participants compared to Saudi ones (i.e., 50.74% vs. 30.40%; 34.23% vs. 13.51% and 59.70% vs. 27.70%; for depression, anxiety and stress, respectively). About 55.8% of the participants felt the extensive coverage in the media of COVID-19 news, which caused higher mental sufferings. Higher mental health prevalence rates were reported in females compared to males participants (i.e., 56.97% vs. 23.25%; 30.23% vs. 13.17% and 54.65% vs. 26.35%; for depression, anxiety and stress, respectively). Reasonable following of the COVID-19 news; and less exposure to the pandemic information could help in reducing the mental health issues related to the ongoing pandemic. Special care and attention should be paid to females and younger people who seem to be particularly affected during the era of COVID-19.

Epidemiology of cancer in Saudi Arabia thru 2010-2019: a systematic review with constrained meta-analysis.

BACKGROUND: Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010-2019). METHODS: Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers. RESULTS: The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84-1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81-1.77); prostate cancer 42.6% and 3.2 (0.88-31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01-4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48-6.17); kidney cancer 4.6% and 2.05 (1.61-2.61), and thyroid cancer 12.9% and 6.77 (2.34-19.53). CONCLUSION: Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.

Oral and Oropharyngeal Cancers and Possible Risk Factors Across Gulf Cooperation Council Countries: A Systematic Review.

BACKGROUND: In recent years, there is an emerging increase in the prevalence of oral and oropharyngeal cancers (O-OPCs) across the Arabian Gulf Cooperation Council (GCC) countries. Consequently, this review aimed to explore the epidemiology and possible risk factors of O-OPCs in GCC countries. METHODS: Data published after 2008 related to O-OPCs in GCC countries were obtained through electronic searches in Medline/PubMed, Scopus, Web of Science, EMBASE and Google Scholar. Keywords related to the association between O-OPCs metrics (epidemiology and risk factors) and GCC countries were used for electronic searches. RESULTS: The overall prevalence of OPCs increased significantly over time (40-51%) in some countries (Saudi Arabia and Arab Emigrated) of the Gulf regions. The pooled risk factor was 3.4 (2.5 - 4.7). Among the risk factors, human papillomavirus and the use of smoke and smokeless tobacco revealed odds ratio (OR) 3.31 (3.13 - 4.5) and 0.60 (0.45 - 0.80) at 95% confidence interval (CI). CONCLUSION: A positive correlation between factors like age, diet, hygiene, genetics, viral and bacterial infection, consumption of alcohol and tobacco products with OPC-MFC is suggested.

Skin burns in Saudi Arabia: causes, management, outcomes and quality of life after skin burns.

BACKGROUND: Burn is one of the major global health problem causing trauma and stress. A burn injury can cause functional impairment and psychosocial burdens affecting the quality of life. The purpose of this study was to evaluate the life quality after skin burn and patients' satisfaction on skin grafting outcomes in Saudi Arabia. METHODS: In this cross-sectional community-based survey included 166 participants. Each participant was interviewed using a purposeful questionnaire. RESULTS: The highest incidence of skin burn cases were recorded among female participants (n=133) compared to males (n=33). The highest cause of burn injury was scald (46.4%) and the highest injured parts were hands across all age groups (n=89). Multiple logistic regression models for different parts of skin burn patients showed highly significant values for hands (p < 0.001), CI, 0.181 (0.103-0.259). The maximum injury took place at home (88%). The majority of burns were scald and flame injuries (46.4% and 36.1%). Majority of patients had burns of 0-10% TBSA which is about 62.0% (p < 0.002, R 2=0.289). The mean DLQI scores ranged from < 1 to 27. CONCLUSION: Skin burns are common in Saudi Arabia and more prevalent among females. Most skin burns occur at home and the most causative agent is hot water predominantly affecting hands. The majority of burns are treated using topical creams, and only some of them undergo skin grafting. There is a relatively higher degree of acceptance of skin burns treatment outcomes among the Saudi population.

The common motives for appendectomy in Hail Region Saudi Arabia.

BACKGROUND: Appendectomy remains the most common emergency surgery. With the lack of literature from Saudi Arabia regarding the treatment for appendix disorders, this study aimed to identify the common motives for appendectomy in Northern Saudi Arabia. METHODOLOGY: Data referring to be resected appendix patients who were diagnosed during the period from January 2018 to December 2018 were included in the present study. The diagnosis of the resected appendix was confirmed by conventional histopathology. RESULTS: The most common cause for the appendectomy was acute appendicitis followed by gangrenous perforated appendicitis, chronic appendicitis, and lymphoid hyperplasia, representing 85/129(66%), 33/129(26%), 8/129(6%), and 3/129(2%), in this order. CONCLUSION: Appendectomy is a common procedure for the treatment of a large section of patients with appendicitis and appendicitis like clinical features. Acute appendicitis was the most motive for appendectomy followed by gangrenous perforated appendicitis in Northern Saudi Arabia.

Population insight of the relationship between lifestyle and cancer: A population-based survey.

BACKGROUND: There is a substantial rise in the incidence of cancer in Saudi Arabia. Life style models and lack of awareness are the prime suspect in this substantial increase. Therefore, the objective of the present study was to assess the relationship between lifestyle and cancer in a population-based Survey in Northern Saudi Arabia. METHODOLOGY: This cross-sectional study was conducted in North Saudi Arabia (Hail Region). Data was collected as a part of a community based cancer's awareness movement that covered an area inhibited with approximately 500,000 individuals. RESULTS: In this study, about 2558/3227 (79.3%) and 641/794 (80.7%) believed that tobacco smoking and smokeless are not a risk of cancer development. In this study large section (87.2%) of the study population believe that exposure to diverse occupational or non-occupational chemicals has no role in cancer development. Furthermore, around 59% of the study subjects in the current study believed that repeated exposure to insecticidal chemicals doesn't influence the risk of cancer. CONCLUSION: The present study point to the urgent need for awareness educational programs and preventive measures towards may lifestyle factors that can increase or decrease the overall risk of cancer among Saudi population.

Assessment of levels of awareness towards blood donation in Saudi Arabia.

BACKGROUND: blood products is an interesting term as all blood and blood transfusion procedures carry risk even with advance screening of donors and donated blood. In Saudi Arabia voluntary donors are either the only source or not, the other source is paid donors and the lack of volunteers represents a major challenge. This is usually attributed to low community awareness regarding voluntary blood donation. Therefore, the objective of this study was to assess the levels of awareness towards blood donation in northern Saudi Arabia. METHODOLOGY: in this descriptive cross sectional survey, data about blood donation were obtained from 717 Saudi volunteers living in the city of Hail, Saudi Arabia. A Purposeful questionnaire was designed and used for obtaining of the necessary data. RESULTS: When asking the participants to rate the level of awareness about blood donation in Saudi Society, the majority of participants categorized the levels as good followed by very good and poor, representing 48.8%, 29.3%, and 22% participants, respectively. CONCLUSION: the broad concept of blood donation is still poor in Saudi Arabia. Further educational plans are needed to raise the level of awareness and increase the perception of blood donation among Saudi population. Efforts should be made to involve females in blood donation duties.

Role of human Cytomegalovirus in the etiology of nasopharyngeal carcinoma.

OBJECTIVE: The purpose of this study was to identify human Cytomegalovirus (HCMV) in tissue blocks obtained from patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Formalin-fixed paraffin wax processed NPC tissue were obtained from 150 tissue blocks and retrospectively investigated for the presence of HCMV using polymerase chain reaction. RESULTS: Of the 150 NPC tissue specimens, HCMV was identified in 53/150 (35.3%) of the samples. Out of the 53 samples infected with HCMV, 33/97 (34%) were among males and 20/53 (37.7%) were among females. Of the 53 positive samples, 36/53 (68%) were found to harbor Epstein-Barr virus (EBV). CONCLUSION: The present study has shown a relatively considerable association between HCMV and NPC. The great majority of samples sheltering HCMV were also found to hide EBV, which proposes the potentiality of EBV over HCMV.

Assessment of the levels of awareness toward cardiopulmonary resuscitation: A community-based study in Northern Saudi Arabia.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is a procedure performed in an emergency when the heart stops. Early initiation of CPR can save many lives. Thus, the aim of the present study was to assess the level of awareness toward CPR in a community-based study in Northern Saudi Arabia. MATERIALS AND METHODS: This is a cross-sectional survey conducted in the city of Hail, Northern Saudi Arabia. Data about CPR were obtained from 442 Saudi volunteers living in the city of Hail. RESULTS: A family history of ischemic heart disease was indicated in 148/442 (33.5%) of the participants. On asking the participants whether they have previous information about CPR, about 258/442 (58.4%) persons indicated "Yes," 118/442 (26.6%) replied "May be," and the remaining 66/442 (15%) replied "No." CONCLUSION: The study showed a high level of awareness about CPR, which might be attributed to the majority of highly educated participants. Effective and sustainable public CPR training programs are needed to be implemented to preserve better knowledge and awareness of CPR in the general population.

Knowledge and Perceptions of Common Breast Cancer Risk Factors in Northern Saudi Arabia

Background: Breast cancer is the second leading cause of cancer death in women around the world. The degree of adoption of a preventive lifestyle offers valuable information for planning appropriate intervention programs for improving women's health. The objective of the present study was to assess the levels of breast cancer related knowledge among a Northern Saudi population. Methodology: In this cross sectional study, data were obtained from 566 Saudi volunteers living in the city of Hail, the Kingdom of Saudi Arabia (KSA). Results: With regard to breast cancer risk factors, 427/566 (75.4%) of participants answered in the affirmative to whether breast cancer could be inherited. For early puberty and late menopause, 209/566 (37%) were in agreement with increased risk, for low and delayed child birth, 261/566 (46%), and for overweight and obesity, 210/566(37%). For the question of whether natural breast feeding can reduce the risk of breast cancer, only 35/566 (6.2%) said yes. Conclusion: There is a general lack of knowledge regarding several BC risk factors among the northern Saudi community which necessitates urgent implementation of educational programs.

Prevalence of Human Papillomavirus subtypes 16 and 18 among Yemeni Patients with Cervical Cancer

Background: The Human Papillomavirus (HPV) is a DNA tumor virus that causes epithelial proliferation. There are more than 100 HPV subtypes, of which 13 subtypes are regarded as high risk subtypes that can cause cancers of epithelial mucosal surfaces. High risk human papilloma viruses (HR-HPV) subtypes 16 and 18 plays a major role in the etiology of cervical cancer worldwide. Therefore, the aim of this study was to screen for the existence of HPV16 and HPV18 among Yemeni women with cervical lesions. Methodology: Formalin fixed paraffin wax processed tissue blocks were retrieved for 200 patients (150 were previously diagnosed with cervical cancer and the remaining 50 were diagnosed with different benign conditions). Results: Of the 200 cervical cancer tissue specimens, HR-HPV 16 was identified in 74/200 (37%) samples and couldn't be recognized in 126/200(63%) tissue samples. HR-HPV 18 was identified in 32/200 (16%) specimens and couldn't be recognized in 168/200(84%) tissue specimens. Conclusion: HR-HPV subtypes were prevalent among Yemeni women with cervical cancer, with significant increase of HR-HPV subtype 16 over the HR-HPV subtype 18.

Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium

Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P < 0.016)) and 4.3 (0.93- 20.2), P <0.06)), respectively, in the two sites. Conclusion: Tobacco smoking is a major risk factor for occurrence of cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer.

Prevalence of Cigarette Smoking Usage among Adolescent Students in Northern Saudi Arabia.

BACKGROUND: Cigarette smoking is a major public health issue in the Kingdom of Saudi Arabia (KSA) in recent years, particularly among adolescents. Therefore, the aim of this study was to determine the prevalence of cigarette smoking usage among adolescent students in the north of the country. MATERIALS AND METHODS: This cross-sectional study investigated 305 adolescent students from the Northern KSA population, their ages ranging from 11 to 19 years old. RESULTS: Of the 287 respondents, 56/287(19.5%) were found to be current smokers. Of the 56 current smokers, 14/52 (27%), 29/52 (55.8%), and 9/52 (17.2%) smoked 1-3, 4-10 and 11+ cigarettes/day, respectively. For duration most had smoked for 26-36 months. CONCLUSIONS: The findings of the present study indicate that cigarette smoking use is still an important risk behavior among adolescent students. The findings of this study found a significant association of cigarette smoking usage and adolescents various believes and attitude for initiation of smoking and perception toward knowledge of other factors that contribute to the burden of tobacco use.