Clinical and therapeutic features of brucellosis: An 11-year study at a tertiary care hospital in Riyadh, Saudi Arabia.

To study the varying presentations, risk factors, and treatment outcomes among patients with physician-diagnosed brucellosis. This retrospective analysis evaluated all cases of brucellosis reported at King Khalid University Hospital during 2003-2013. Data were retrieved from patient records and a laboratory information system. Descriptive statistics were generated to summarize the study variables. Fisher's exact test or Pearson's chi-square test was used to compare categorical variables. Out of 163 patients identified with brucellosis, 76.7% of patients were culture positive. Fever was the most frequent symptom (85.9%), followed by arthralgia (46.6%). The most common clinical signs was splenomegaly (12.9%), followed by hepatomegaly (11.0%). Laboratory investigations revealed lymphocytosis and anemia in 66.3% and 55.2% of the patients, respectively. Approximately half of the patients (47.8%) had high erythrocyte sedimentation rates, and 56.4% had neutrophilia. Raw milk consumption and direct contact with animals were reported by 45.4% and 16.0% of patients, respectively. Treatment failure and relapse were observed in 8 (5.7%) cases. All treatment failures and relapses occurred among children <= 10 years of age or adults > 45 years old (11.0% vs. 0%; p = 0.006). Our findings demonstrate that raw milk consumption can be a substantial factor in brucellosis prevention in Saudi Arabia. Laboratory findings, along with the observed pattern in clinical signs and symptoms, can potentially mean underdiagnosis of mild cases. Age was the only factor associated with unfavorable treatment outcomes.

STUDIES ON AEDES AEGYPTI RESISTANCE TO SOME INSECTICIDES IN THE JAZAN DISTRICT, SAUDI ARABIA.

The present study provided information on the susceptibility status of the adult and larvae of Aedes aegypti mosquitoes in Jazan region of Saudi Arabia. Bioassay tests were performed on adults and larvae by using WHO recommended concentrations and test kits. Adults of Ae. aegypti mosquitoes were exposed to test papers impregnated with Lambda-cyhalothrin (0.05%), Cyfluthrin (0.15%), Deltamethrin (0.05%), Permethrin (0.75%), Fenitrothion (1%), Bendiocarb (0.1%) and DDT (4%) insecticides. Ae. aegypti mosquitoes were found to be susceptible only to Cyfluthrin; (mortality rate was 100%), whereas variable resistances were observed from the rest of the other insecticides tested (mortality rates ranged between 93.6 and 17%). Larvae were subjected to different concentrations of Diflubenzuron, Methoprene (IGRs) and Temephos (Organophosphate). Adult emergence inhibition (IE50 & IE95) values for the IGRs and the (LC50 & LC95) for Temephos were determined by log-probit regression analysis. Ae. aegypti larvae were resistant to Temephos (LC50 61.8-LC95 35600.1 mg/l) and showed high susceptibility to Methoprene than Diflubenzuron (IE50 0.49-IE95 10.9 mg/l) and (IE50 0.86 and IE95 93.8 mg/l), respectively. Larvae were more susceptible to Methoprene than Diflubenzuron by 1.8 folds.

ZIKA VIRUS STRATEGIC RESPONSE FRAMEWORK FOR THE GULF STATES-2016: AN URGENT NEED FOR COLLABORATION.

The Zika virus (ZIKV) became the latest threat to global health security when WHO declared on 1t February 2016, that recently reported clusters of microcephaly and other neurological disorders in Brazil constitute a Public Health Emergency of International Concern (PHEIC). These clusters were reported concurrently with an outbreak of ZIKV, which has been ongoing in Brazil and other countries in the America region since 2015. A growing body of clinical and epidemiological data possibly leans towards a causal role for ZIKV as the occurrence of the clusters of microcephaly and other neurological disorders principally the Guillain-Barre' syndrome are associated in time and place with the ongoing ZIKV transmission in the America region. So far, Zika viral transmission has been documented in a total of 69 countries and territories with autochthonous transmission from 20I7 to 10 August 2016. The geographical range of ZIKV has been increasing steadily. Consid'ring the presence of competent vectors that transmit ZIKV in, some parts of the Gulf countries, and the close relationship with Brazil, a local transmission of the virus is plausible once the virus is introduced through travel. This review suggests the integration of epidemiologicalind entomological surveillance for monitoring and control of the vectors of ZIKV. The risks associated with ZIKV infection and the possible threat to the Gulf States was described. A strategic Zika response framework (SRF) for the Gulf States has been developed to meet'their,urgent need for a collaborative and coordinated response for prevention and spread of ZIKV infection. A coordinated response of all partners in the Gulf States across sectors and services at national, as well as, regional levels is required.

A TRAINING PROGRAM ON DENGUE FEVER AMONG SECONDARY SCHOOL STUDENTS, JAZAN, SAUDI ARABIA.

Dengue fever (DE) is commonest rapidly spreading Aedes-bome viral fever worldwide. In the last decade several confirmed dengue cases were reported in Jazan Province. The study assessed the knowledge, attitudes and preventive practices of dengue fever among the secondary schools students in Ja.zan. A cross-sectional study was conducted among students of six secondary schools in Jazan. Multistage stratified random sample method was used and seven hundred forty two (742) were taken as respondents in study. The data on the socio-demographic characteristics of the respondents about their knowledge, attitude and practice towards DF were collected by using a pre-structured and self-administered questionnaire. The results showed a poor DF knowledge arpong the students, regarding attitudes towards DF, prevention and control, the majority of the participants' had good attitudes and believed that DF could be controlled and prevented (93.2%), DF control was the responsibility of government and community (83.1%) and they themselves have an important role to play in DF prevention (78.5%).The most common practice to prevent mosquito breeding were found to be the disposing of water from breeding containers (85.5%) and covering of water containers (68.6%). A significant association between the practice of DE preventive and control measures and sex of the participants' was (P

Determinants of vitamin D deficiency among undergraduate medical students in Saudi Arabia.

BACKGROUND/OBJECTIVES: The objectives of our study were to determine possible factors associated with low vitamin D levels in medical students. SUBJECTS/METHODS: A cross-sectional study was performed among 255 first- to fifth-year male undergraduate medical students of one of the major universities in Saudi Arabia. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using electrochemiluminiscence. Multiple logistic regression analysis was performed. RESULTS: Majority of Saudi medical students (75.2%) had 25(OH)D levels <30 nmol/l, defined as risk for deficiency by the Institute of Medicine. Multivariate analysis showed that the odds of having 25(OH)D serum levels of ⩾ 30 nmol/l were seven times higher both in students who took vitamin D (odds ratio (OR)=7.2, 95% confidence interval (CI)=1.8-29.9, P=0.006) or multivitamin supplements (OR=6.9, 95% CI=1.7-27.3, P=0.006) within 1 year. Students with a history of vitamin D testing >1 year before the study or moderate/vigorous physical activity (PA) had 4.4 (OR=4.4, 95% CI=1.7-11.4, P=0.003) and 2.7-fold (OR=2.7, 95% CI=1.3-5.3, P=0.006) higher odds of having 25(OH)D levels ⩾ 30 nmol/l, respectively. There was no significant association between 25(OH)D serum levels and average time spent outdoors per day (P=0.369) and type of clothing (long-sleeved vs short-sleeved; P=0.800). CONCLUSIONS: Vitamin D deficiency was highly prevalent in Saudi medical students. Modifiable factors such as vitamin D intake and PA could be targeted for intervention. Further studies with standardized laboratory measurements of 25(OH)D are needed to explore the role of vitamin D testing in behavioral change, which may lead to increased serum 25(OH)D levels.