Analysis of SARS-CoV-2 genomic surveillance data during the Delta and Omicron waves at a Saudi tertiary referral hospital.

BACKGROUND: Studying the genomic evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may help determine outbreak clusters and virus transmission advantages to aid public health efforts during the pandemic. Thus, we tracked the evolution of SARS-CoV-2 by variant epidemiology, breakthrough infection, and patient characteristics as the virus spread during the Delta and Omicron waves. We also conducted phylogenetic analyses to assess modes of transmission. METHODS: Nasopharyngeal samples were collected from a cohort of 900 patients with positive polymerase chain reaction (PCR) test results confirming COVID-19 disease. Samples underwent real-time PCR detection using TaqPath assays. Sequencing was performed with Ion GeneStudio using the Ion AmpliSeq™ SARS-CoV-2 panel. Variant calling was performed with Torrent Suite™ on the Torrent Server. For phylogenetic analyses, the MAFFT tool was used for alignment and the maximum likelihood method with the IQ-TREE tool to build the phylogenetic tree. Data were analyzed using SAS statistical software. Analysis of variance or t tests were used to assess continuous variables, and χ2 tests were used to assess categorical variables. Univariate and multivariate logistic regression analyses were preformed to estimate odds ratios (ORs). RESULTS: The predominant variants in our cohort of 900 patients were non-variants of concern (11.1 %), followed by Alpha (4.1 %), Beta (5.6 %), Delta (21.2 %), and Omicron (58 %). The Delta wave had more male than female cases (112 vs. 78), whereas the Omicron wave had more female than male cases (311 vs. 208). The oldest patients (mean age, 43.4 years) were infected with non-variants of concern; the youngest (mean age, 33.7 years), with Omicron. Younger patients were mostly unvaccinated, whereas elderly patients were mostly vaccinated, a statistically significant difference. The highest risk for breakthrough infection by age was for patients aged 30-39 years (OR = 12.4, CI 95 %: 6.6-23.2), followed by patients aged 40-49 years (OR = 11.2, CI 95 %: 6.1-23.1) and then 20-29 years (OR = 8.2, CI 95 %: 4.4-15.4). Phylogenetic analyses suggested the interaction of multiple cases related to outbreaks for breakthrough infections, healthcare workers, and intensive care unit admission. CONCLUSION: The findings of this study highlighted several major public health ramifications, including the distribution of variants over a wide range of demographic and clinical variables and by vaccination status.

Impact of COVID-19 pandemic on quality of partner relationship and sexual activity among COVID positive males: a cross sectional study.

OBJECTIVE: Our aim was to assess sexual activity, partner relationships among males who had been infected with COVID-19, to study the impact of COVID-19 infection on partner relationship and to find out the association between partner and sexual relationship during lockdown. MATERIALS AND METHODS: A cross sectional study was conducted in Saudi Arabia through social media platforms via online questionnaire between December 1, 2020 and January 31, 2021 among 871 participants after a pilot study among 20 participants of which 497 were included in the study. Statistical analysis was conducted using SPSS version 20.0 (IBM Inc., Armonk, NY, USA). Responses were presented as frequencies and percentages and the association was studied using Chi squared test/Fisher's exact test. The value of p ≤ .05 was considered significant. RESULTS: Out of the total study participants, nearly 85% of them belonged to the age range of 18 to 39 years, more than half of the participants were married. In the six months prior to the study being conducted, 268 respondents (53.9%) did not have sexual relationships. Respondents with positive COVID-19 infection reported that their partner lived with them in the same house during home isolation and was also found to be significantly associated with having intact sexual relationships in the last six months of the lockdown period (p-value < .001). Moreover, respondents who reported having good relationships with their partners during the pandemic were found to be significantly associated with having intact sexual relationships during the pandemic lockdown (p-value < .001). CONCLUSIONS: Among the COVID-19-positive respondents, sexual activity and partner relationships were largely found to be intact during the pandemic lockdown period.

The Level of Self-Perceived Knowledge Regarding Temporo-mandibular Disorders among the Saudi Arabian Dental Professionals Working in Dental Institutes or Universities vs. Clinics or Hospitals.

Temporo-mandibular disorders (TMDs) are considered as one of the most common type of oro-facial pain. The basic knowledge regarding examining, diagnosing and treating the TMDs is part of the dental curriculum designed by the Saudi Dental Council. But till date it is not reported how the dentists working in dental institutes/universities and clinics/hospital of Saud Arabia make an attempt to diagnose and treat TMDs cases. Therefore, the main aim of the study was to evaluate the level of self-perceived TMD knowledge among the dentists working in Saudi Arabia and to compare the between those working in dental institutes/universities (Group I) and clinics/hospital (Group II). On prior ethical approval from Riyadh Elm University, the participants graduated from various universities of Saudi Arabia with more than two years of experience were randomly selected. They were asked to fill a previously validated questionnaire to evaluate them regarding their knowledge regarding TMDs diagnosis and therapy. It was observed only 9.09% of participants working in dental institutes/universities considered their knowledge as very good whereas it was higher (36.36%) among the participants working in clinics/hospitals. Of all respondents working in dental institutes/universities 7.23% attempted to diagnose and treat TMDs, slightly higher number of respondents (9.09%) working in hospitals/clinics attempt to treat patients with TMDs. A strong relationship was observed for both groups between the knowledge for TMDs and attempt to diagnose/ treat TMD patients (p≤0.05). The level of knowledge for TMDs is better among the dentists working in dental clinics or hospitals than those in dental institutes or universities. But in general it is still insufficient in both groups of dentists. Therefore, it should be considered to raise the level of knowledge regarding TMD among the dentists of Saudi Arabia, particularly to make them able for referring to the right specialist for diagnosis, treatment or interdisciplinary management.

Urinary incontinence among Saudi women: prevalence, risk factors, and impact on quality of life.

OBJECTIVE: This study was done to determine UI prevalence among women in Saudi Arabia and identify the associated risk factors. PATIENTS AND METHODS: This cross-sectional study was conducted from January 2020 to September 2020 in Saudi women who came to the Urology Department at King Khalid Hospital, Majmaah, Saudi Arabia. In the age group of 20 to 50 years, Saudi women who are not seriously ill or pregnant or in the postnatal period or diagnosed with pelvic organ prolapse were included as participants. A semi-structured questionnaire modified from the International Consultation Incontinence Questionnaire-Short Form was used to collect data on frequency, the severity, consequences, and impact of UI on quality of life. Data were analyzed by SPSS 23 (IBM, Armonk, NY, USA) with the calculation of mean and standard deviation for quantitative variables. Logistic regression analyses were applied to determine the predictors of UI. RESULTS: A total of 451 participants were included in the final analysis. The mean age of the study population was 42.52 years (SD 11.75). Among risk factors, 45 (10%) had diabetes, 56 (12.4%) had hypertension, 36 (8%) had asthma, 80 (17.7%) had UTI/STDs. Out of 451 participants, 188 (41.7%) had urinary incontinence (UI). Sociodemographic characteristics and risk factors like family income, urinary and genital infections (UTI/STDs), pelvic/uterine prolapse, any other disease, and cough were found to have a statistically significant association with urinary incontinence (p-value <0.05). CONCLUSIONS: The prevalence of UI was 41.7% among the study population. The various risk factors associated with UI are older age, parity, multiple vaginal deliveries, hypertension, history of asthma, and chronic cough. Poor health-seeking behavior was observed. Creating awareness and the need for early diagnosis with timely intervention is recommended.

Association of indoor air pollution on cognitive dysfunction among elderly.

OBJECTIVE: Cognitive dysfunction among the elderly is a devastating condition preceded by accumulation of neuropathology leading to accelerated cognitive decline. Many epidemiologic studies have reported the relation between indoor air pollution exposure and cognitive impairment. To clarify the nature of the association, a comprehensive systematic review and meta-analysis were performed. MATERIALS AND METHODS: The analysis included all observational studies, including cross-sectional studies, prospective and retrospective cohort studies. Experimental studies, randomized controlled trials (RCTs), and controlled clinical trials were excluded. Studies on the relationships of indoor air pollution and cognition published before 30 April 2021 which are peer-reviewed scientific publications available in English were included after performing a structured literature search through electronic databases, including PubMed, Embase, Cochrane Library, and clinical trial.gov. A total of 146 articles were collected, and after screening thoroughly only, 9 studies were selected. Meta-analysis for the final set of selected studies was performed using the R software. RESULTS: The quality of all the studies was adequate as almost all reported an association between at least one pollutant and cognitive dysfunction. However, relatively few studies considered outcomes that provide the most substantial evidence for a causal effect. In total, 5 studies have reported on cognitive function. The pooled mean of cognitive function was 12.16 (95% CI: 10.73 to 13.58). However, the heterogeneity was very high (I2=100%; chi-square test for heterogeneity = p<0.001). We used a modified JBI structured risk of the bias assessment tool, and it was minimal among the included studies as most of the studies have followed a random sampling method and explicitly mention it in their methods. CONCLUSIONS: Exposure to indoor air pollution through fuels used for cooking and heating was significantly associated with cognitive dysfunction among elderly women. Given the limitations, a more extensive meta-analysis and longitudinal studies are recommended to investigate the biological mechanism behind the impact of indoor air pollution on cognitive health.

"LONG COVID": an insight.

We aimed this systematic review to analyze and review the currently available published literature related to long COVID, understanding its pattern, and predicting the long-term effects on survivors. We thoroughly searched the databases for relevant articles till May 2021. The research articles that met our inclusion and exclusion criteria were assessed and reviewed by two independent researchers. After preliminary screening of the identified articles through title and abstract, 249 were selected. Consequently, 167 full-text articles were assessed and reviewed based on our inclusion criteria and thus 20 articles were regarded as eligible and analyzed in the present analysis. All the studies included adult population aged between 18 and above 60 years. The median length of hospital stay of the COVID-19 patients during the acute infection phase ranged from 8 days to 17 days. The most common prevalent long-term symptoms in COVID-19 patients included persistent fatigue and dyspnea in almost all of the studies. Other reported common symptoms included: shortness of breath, cough, joint pain, chest pain or tightness, headache, loss of smell/taste, sore throat, diarrhea, loss of memory, depression, anxiety. Associated cardiovascular events included arrhythmias, palpitations and hypotension, increased HR, venous thromboembolic diseases, myocarditis, and acute/decompensated heart failure as well. Among neurological manifestations headache, peripheral neuropathy symptoms, memory issues, concentration, and sleep disorders were most commonly observed with varying frequencies. Mental health issues affecting mental abilities, mood fluctuations namely anxiety and depression, and sleep disorders were commonly seen. Further, diarrhea, vomiting, digestive disorders, and Loss of appetite or weight loss are common gastrointestinal manifestations. Therefore, appropriate clinical evaluation is required in long COVID cases which in turn may help us to identify the risk factors, etiology, and to my help, we treat them early with appropriate management strategies.

Family Functioning and Dental Behaviours of Pre-school Children.

OBJECTIVES: To examine the association of family functioning with child dental behaviours and to identify family functioning domains associated with those behaviours. METHODS: Cross-sectional data from the East London Oral Health Inequalities (ELOHI) study were analysed in a subsample of 733 parent-child (3-4-years-olds) dyads. Family functioning was measured with the 60-item Family Assessment Device that yielded a general functioning score and six domain scores (roles, communication, problem solving, affective involvement, affective responsiveness, and behaviour control). Child dental behaviours were sugar intake, dental attendance and toothbrushing frequency. The association of family functioning with each dental behaviour was assessed in logistic regression models adjusted for confounders (parental sociodemographic and child demographic factors). RESULTS: Unhealthy general functioning was associated with greater odds of reporting high child intake of sugars (OR: 1.78, 95%CI: 1.01-3.13) as well as lower odds of reporting frequent child brushing (OR: 0.76, 95%CI: 0.50-1.18) and a child visit for dental check-up in the past year (OR: 0.98; 95%CI: 0.62-1.53), after adjustment for confounders. Unhealthy functioning in roles, affective involvement and behaviour control were associated with high child sugar intake whereas unhealthy functioning in roles was inversely associated with frequent child toothbrushing. No family functioning domain was associated with child dental attendance pattern. CONCLUSIONS: Healthy family functioning was associated with more favourable child dental behaviours. How a family functions, particularly in terms of how they define roles and support each other emotionally, is likely to be relevant to child oral health.

Effect of 1-(3-phenoxypropyl) pyridazin-1-ium bromide on steel corrosion inhibition in acidic medium.

The effect of 1-(3-phenoxypropyl) pyridazin-1-ium bromide, a new pyridazinium derivative, on steel corrosion in a HCl (1 M) solution was analyzed using electrochemical impedance and XPS spectroscopy. Experimental results indicated that the inhibition efficiency increased with an increase in an inhibitor concentration. Electrochemical impedance spectroscopy measurements revealed that an increase in the immersion time of steel in an acidic medium from 1 to 12 h and further to 24 h decreased the charge transfer resistance (Rct) and thus decreased the inhibition efficiency. The SEM and XPS analyses linked the inhibition effect to the adsorption of the inhibitor (1-(3-phenoxypropyl) pyridazin-1-ium bromide) on the steel surface.