Knowledge, beliefs, and attitudes among general population towards bipolar disorders: a cross-sectional report from the Southern region of Saudi Arabia.

OBJECTIVE: The aim of this study was to understand the impact of demographic characteristics and to describe the gender differences in knowledge, beliefs, and attitudes towards bipolar disorders among common residents in the Southern region of Saudi Arabia. SUBJECTS AND METHODS: This cross-sectional survey was conducted between January 2021 and March 2021. The survey was conducted among the common residents in the southern region of the Kingdom of Saudi Arabia. The data were collected by using a structured, self-administered, validated questionnaire comprised of a dichotomous type of questions along with Likert scale. RESULTS: There is a significant difference in the distribution of knowledge scores between male and female study participants (p=0.000). No significant gender differences have been identified in beliefs and attitudes toward bipolar disorder (p=0.229) and in overall score (p=0.159). The traumatic event was reported as the major cause of bipolar disorder. The age group and employment status were found to be the major predictor of knowledge, beliefs, and attitudes about bipolar disorder. CONCLUSIONS: Although the knowledge awareness rate on bipolar disorder is high among public in the Southern region, there is a vast scope for improving it. Education should be disseminated to promote mental health awareness and improve attitudes and beliefs on bipolar disorders and reduce stigma and discrimination against patients with bipolar disorders.

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.

Measuring public awareness about blood donation in Assir, South-Western Saudi Arabia.

OBJECTIVES: Blood transfusion is a life-saving measure in many acute and chronic conditions. Voluntary blood donation by healthy donors has been promoted by the World Health Organization (WHO) to ensure the availability of safe blood. Difficulty in the recruitment of donors and their retention is a problem faced in most populations. A paucity of research to identify barriers to blood donation in the Southwestern region of Saudi Arabia prompted us to explore this important public health issue. MATERIALS AND METHODS: A cross-sectional survey was performed using a pre-tested, structured, self-administered questionnaire comprising of questions on demographical details, awareness regarding blood donations, perceived barriers to blood donations, attitude towards blood donation, etc. was distributed to the general population in Assir region through one to one contact in big malls, hospital area as well as electronically through social media. The data thus collected was statistically analysed using appropriate tests. RESULTS: A total of 844 subjects were surveyed. Most of the respondents (65.0%) reported not having donated blood in the past. The blood donation was found to have a significant relationship (≤0.05) with age, gender, occupation, and education status. Roughly, 40.0% of the respondents suggested that blood donation could be promoted by raising public awareness. CONCLUSION: Gaps were identified in the awareness of the studied population regarding blood donation. Specific awareness drives may help overcome these barriers to voluntary blood donation.

Five years treatment outcomes of postoperative radiotherapy in saudi women with uterine cancers: single institutional experience.

UNLABELLED: We aimed to evaluate long-term treatment outcomes and toxicity profile of postoperative radiotherapy (PORT) in Saudi women with uterine cancers. METHODS AND MATERIALS: Medical records of patients with histopathologically proven uterine cancers were reviewed and identified those who received PORT (45-50.4 Gy in 25-28 fractions) followed by vaginal brachytherapy (15-20 Gy in 3 to 4 sessions) after total abdominal hystrectomy and bilateral salpingo-oophorectomy (TAHBSO) in our center between August 2007 and April 2012. Data regarding the safety profile, locoregional control (LRC) or distant metastases control (DMC) and overall survival (OS) rates were analyzed. RESULTS: Median follow-up period was 60 months (range, 12-70) for 89 patients. Predominant histological type was endometrial (59 patients), followed by carcinosarcoma (17 patients) and leiomyosarcoma (13 patients). Median age at time of diagnosis was 57.6, 56 and 51.1 years for endometrial, carcinosarcoma and leiomyosarcoma respectively. LRC rates were 80.9%, 87.1% and 100% for leiomyosarcoma, carcinosarcoma and endometrial carcinoma respectively (p 0.4). DMC rates were 69.3%, 45% and 16.3% for endometrial, leiomyosarcoma and carcinosarcoma respectively (p 0.0001). Five-year OS rates were 71.1%, 60% and 16.3% for endometrial, leiomyosarcoma and carcinosarcoma respectively (p 0.001). Coxproportional hazard ratio model showed body mass index, FIGO stage, lymphovascular invasion in endometrial carcinoma, tumor size in leiomyosarcoma and histology in carcinosarcoma important prognostic factors for LRC. Acute grade 3 and 4 proctitis/enteritis seen only in 4 patients (4.5%) and late toxicities were minimal. CONCLUSION: PORT in Saudi women with uterine cancers showed better LRC, DMC and OS rates with minimal toxicity.

Optimal prophylactic and definitive therapy for bicalutamide-induced gynecomastia: results of a meta-analysis.

OBJECTIVE: Bicalutamide is approved as an adjuvant to primary treatments (radical prostatectomy or radiotherapy) or as monotherapy in men with locally advanced, nonmetastatic prostate cancer (pca). However, this treatment induces gynecomastia in most patients, which often results in treatment discontinuation. Optimal therapy for these breast events is not known so far. We undertook a meta-analysis to assess the efficacy of various treatment options for bicalutamide-induced gynecomastia. METHODS: The medline, cancerlit, and Cochrane library databases were searched and the Google search engine was used to identify prospective and retrospective controlled studies published in English from January 2000 to December 2010 comparing prophylactic or curative treatment options with a control group (no treatment) for pca patients who developed bicalutamide-induced gynecomastia. Radiotherapy-induced cardiotoxicity was also evaluated. RESULTS: The search identified nine controlled trials with a total patient population of 1573. Pooled results from prophylactic trials showed a significant reduction of gynecomastia in pca patients treated with prophylactic tamoxifen 20 mg daily (odds ratio: 0.06; 95% confidence interval: 0.05 to 0.09; p = 0.09), and pooled results from treatment trials showed a significant response of gynecomastia to definitive radiotherapy (odds ratio: 0.06; 95% confidence interval: 0.01 to 0.24; p < 0.0001). Aromatase inhibitors and weekly tamoxifen were not found to be effective as prophylactic and curative options. For the radiotherapy, skin-to-heart distance was found to be an important risk factor for cardiotoxicity (p = 0.006). A funnel plot of the meta-analysis showed significant heterogeneity (Egger test p < 0.00001) because of low sample size. CONCLUSIONS: Our meta-analysis suggests using prophylactic tamoxifen 20 mg daily as the first-line preventive measure and radiotherapy as the first-line treatment option for bicalutamide-induced gynecomastia. Aromatase inhibitors and weekly tamoxifen are not recommended.

Assessment of three-dimensional set-up errors in head and neck cancer patients treated by intensity modulated radiotherapy using electronic portal imaging device.

BACKGROUND: Set-up errors are an inherent part of radiation treatment process. Coverage of target volume is a direct function of set-up margins, which should be optimized to prevent inadvertent irradiation of adjacent normal tissues. The aim of this study is to evaluate set-up errors and propose optimum margins for target volume coverage in head and neck radiotherapy. METHODS: Twenty six head and neck cancer patients received intensity modulated radiation therapy (IMRT) included in the study. The weekly portal images taken after correction of the systematic error -if any- were evaluated. The systematic error tested and corrected by taking portal images in the 1st 3 days of treatment by using the VARIS offline review system. Three hundred sixty four portal images matched anatomically with anterior and lateral digitally reconstructed radiographs (DRRs). Five hundred forty six points used to evaluate isocenter displacement in antero-posterior direction (AP), supero-inferior direction (SI) and right-left direction (RL). RESULTS: The mean isocenter displacement in AP, RL, and SI directions were 1.5 +/- 1.6 mm, 1.3 +/-1.4 mm and 2.13 +/- 1.6 mm. Ninety six percent of the isocenter deviations were within 4 mm in all three directions. The displacement more than 4 mm (negative or positive) was 4% in the vertical direction, 7% in the longitudinal direction and 1.6% in the lateral direction. There is insignificant increase of the isocenter shift in the last weeks of radiotherapy especially in the vertical and longitudinal directions. CONCLUSION: The current setup for irradiating head and neck cancer patients using IMRT in our department is accurate. The 4 mm CTV-PTV margin is enough.

Primary xanthoma of the acromion: a case report and review of the literature.

Primary "xanthoma" of the bone is a rare lesion of unsettled histogenesis that may pose a diagnostic challenge owing to its wide range of differential diagnosis. Herein, we present a case of primary xanthoma of the right acromion in a middle aged woman who had no aberrant lipid metabolism or evidence of other pre-existing bone lesions. To our knowledge, this is the second reported case of a primary xanthoma involving the acromion in an adult.