Overweight, Obesity, and Associated Risk Factors among Students at the Faculty of Medicine, Jazan University.

Background and Objectives: This study aimed to determine the prevalence of overweight, obesity, and the associated risk factors among medical students at Jazan University in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among 228 medical students from their second to sixth academic years at the Faculty of Medicine, Jazan University. A self-administered questionnaire was used to collect data regarding sociodemographic characteristics, physical activity, dietary habits, comorbidities, medication use, family history, and lifestyle factors. Anthropometric measurements including height, weight, and waist circumference were recorded. Chi-square test and binary logistic regression were used to identify the risk factors associated with obesity. Results: The prevalence of overweight and obesity among the participants was 13.3% and 15%, respectively. Hence, the combined prevalence of overweight and obesity is 28.3%. The mean weight was 63.39 ± 18.93 kg, and the mean height was 163.48 ± 9.78 cm. On the other hand, 17.3% of participants were underweight, whereas 54.4% had normal BMI. Most of the participants (61%) did not engage in regular exercise. A high proportion consumed fruits (82.9%) and vegetables (58.8%) 3 or fewer days per week, and 84.2% consumed 3 or fewer meals per day. Fast-food consumption more than 3 days per week was reported by 42.1% of participants. Obesity was not significantly associated with sociodemographic factors, physical activity, dietary habits, comorbidities, medication use, or family histories. However, those with a monthly family income of SAR 15,000-24,999 had significantly lower odds of obesity than those in the lowest income group (OR 0.230, p = 0.045). Conclusions: The prevalence of overweight and obesity among medical students at Jazan University is high. Although no significant associations were found between obesity and most risk factors, this study highlights the need for interventions that promote healthy lifestyles among medical students. Further research is needed to identify effective strategies for preventing and managing obesity in this population.

Awareness of Non-alcoholic Fatty Liver Disease and Its Determinants in Jazan, Saudi Arabia: A Cross-Sectional Study.

Background Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis. It is the leading cause of liver-related mortality, end-stage liver disease, and the need for liver transplantation. This study aimed to assess the level of awareness regarding NAFLD among the adult population in Jazan, Saudi Arabia, and to explore the determinants of the awareness level. Method This descriptive cross-sectional study was conducted among the general population of Jazan, Saudi Arabia, under the supervision of Jazan University, excluding those with end-stage liver failure. An online self-administered questionnaire, adopted from the literature, was sent through different social media platforms. A total of 1,034 people participated in this study. The chi-square test and multiple linear regression were used to identify the predictors of NAFLD awareness. Results Fifty-three percent of the participants were aware of NAFLD. The mean score of the participants' awareness was 22.7 ± 4.9 out of 40 points. Employed (95% confidence interval (CI): -1.9, -0.03; p = 0.044) and private business individuals (95% CI: -3.5, -1.1; p < 0.001) had a lower awareness level than students. The higher income level was associated with greater awareness (95% CI: 0.36, 2.4; p = 0.008). Those who had never heard of NAFLD had nearly twice as much awareness (95% CI: -3.0, -0.67; p = 0.002). Conclusions Nearly half the study participants displayed good awareness of NAFLD. However, efforts must focus on awareness campaigns, encouraging health-seeking behaviors, and targeted screening for early detection and treatment, especially in at-risk populations, since many participants were unaware of NAFLD.

A Cross-Sectional Study on the Knowledge and Awareness of Lung Cancer and Screening in Jazan Region, Saudi Arabia.

Background: Lung cancer (LC) is the most common cause of cancer-related deaths worldwide. With lung cancer often diagnosed at advanced stages, understanding the local population's awareness levels is crucial for designing effective preventive strategies. By identifying gaps in knowledge, the research aims to inform targeted health education efforts, optimize resource allocation, influence policy development, and contribute to the limited body of research on lung cancer awareness in the region, ultimately fostering improved public health outcomes. Methods: This was a cross-sectional observational study conducted in Jazan region, Saudi Arabia, from July 2022 to June 2023, 671 participants over 18 years old, encompassing both genders, were gsurveyed. Data was collected through a questionnaire covering sociodemographic characteristics and LC-related awareness. SPSS 23 was used for analysis. Factors associated with knowledge scores were explored using independent t-tests and ANOVA, with the Tukey post-hoc test identifying specific group differences. Results: The study included 671 participants, most participants were between 18 and 35 years (73.5%), with 38.5% males and 61.5% females. Lung cancer (LC) awareness was high (95.1%), with 4.9% reporting a family history. Knowledge assessment revealed a mean score of 14.66, with 41.6% having low, 49.5% moderate, and 8.9% high knowledge levels. Correct responses were notable for recognizing LC as a common cancer, a leading cause of death, and associating smoking and shisha with risk. Symptoms were well identified. Screening awareness was at 63.5%, with 78.8% willing to undergo tests if at risk. Age, marital status, and occupation were associated with knowledge, while factors like gender, nationality, residency, education, income, and smoking status showed no significant associations. Conclusion: The findings indicate that there are knowledge gaps related to LC and its screening in Jazan region in Saudi Arabia. Effective awareness programs targeting specific sociodemographic groups are needed to improve the early detection and outcomes.

Effectiveness of Blood Glucose Time in Range to Reduce Risk of Blood Glucose Extrusion and Improve Blood Glucose Metrics in Type 1 Diabetic Patients.

BACKGROUND: With evolving diabetes technology, continuous glucose monitoring (CGM) and time in range have been advanced as critical measurements to assess complications. They have shown improvement in A1C levels and decreased episodes of blood glucose extrusion. AIMS: This study aimed to assess the awareness and utilization of blood glucose time in range and its effectiveness in reducing the risk of blood glucose extrusion and improving blood glucose metrics among patients with type 1 diabetes mellitus. METHODS: A retrospective study included 342 patients who met the inclusion criteria and were using the CGM, aiming for a TIR of 70% daily. Glycemic control was followed using TIR data, blood glucose extrusion frequency (including hyperglycemia and hypoglycemia events), active sensor time, average blood glucose, and glucose management indicator (GMI) levels. RESULTS: A total of 342 individuals participated in this study, the majority of whom were below 18 years of age (62.3%). The hypoglycemic frequency was significantly increased compared to the baseline, and most participants experienced hypoglycemia events (p = 0.0001). The incidences increased over time, with 90.9% and 93% having hypoglycemia at 60 and 90 days (p = 0.0001), respectively. The active scan and sensor time were not followed, which led to the blood glucose target not being achieved, with no improvement throughout the study. Consequently, no improvement occurred in glycemic control. CONCLUSION: CGM technology has been promising and proven effective in improving glycemic. However, our study did not show these benefits as expected, which could be explained by the underutilization and improper use of the CGM.

Transfusion-Associated Graft-Versus-Host Disease in Adults.

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but fatal complication of blood transfusion that usually develops two to 30 days following a blood transfusion giving rise to graft versus host disease (GVHD) clinical features that are consisting of fever, skin rash, jaundice, diarrhea, and pancytopenia. The disease is fulminant in most patients with a mortality rate of >90% of cases. The main aim of this review is to enhance awareness among medical practitioners about this fatal disease. Data were extracted manually from the main medical databases (Medline, Scopus, and Google Scholar) after the revision of selected articles and assessed for their contribution to the knowledge of TA-GVHD. TA-GVHD occurs when the viable donor T-cells in the blood or blood products attack the recipient's tissues which his/her immune system is incapable to destroy due to several reasons. The recipient's tissues that are usually involved in TA-GVHD include the liver, intestine, skin, lungs, and bone marrow. Any blood component either whole blood, packed red blood cells (RBCs), platelets, or fresh non-frozen plasma that contains viable T lymphocytes can cause TA-GVHD. Host immunodeficiency, transfusion of fresh blood, and partial human leukocyte antigen (HLA) matching between the donors and the recipients represent the major risk factors of TA-GVHD. Partial HLA matching includes immunocompetent recipients who receive blood from a first-degree relative also, seen in genetically homogenous populations because of high rates of consanguineous marriage. The diagnosis of TA-GVHD is mainly suspected based on clinical manifestations. However, a histopathological study of either skin or rectal biopsy is diagnostic. The treatment of TA-GVHD is generally not effective, unless the patient received emergency stem cell transplantation, while prevention via irradiation of blood or blood products represents the standard of care for this disease. In conclusion, medical practitioners should have a high index of suspicion for this disease. Moreover, future clinical trials targeting and comparing the outcomes of the different therapeutic options for TA-GVHD are required.

Irritable Bowel Syndrome: Prevalence and Risk Factors in Jazan Region, Saudi Arabia.

Background The prevalence of irritable bowel syndrome (IBS) worldwide remains heterogeneous. In Saudi Arabia, there are insufficient studies on the prevalence of IBS among the general population, yet the prevalence of IBS in certain professional groups has been reported. This study was conducted to determine the prevalence of IBS and its associated risk factors in the Jazan Region of Saudi Arabia. Methods An online cross-sectional study was conducted from January to March 2020 in the Jazan Region of Saudi Arabia, using a multi-stage stratified sampling technique. The data were collected using a web-based validated Rome IV questionnaire. The Rome IV criteria are used to diagnose functional gut disorders, including IBS. Logistic regression analysis was used to determine the odds ratio (OR) with 95% confidence intervals (95% CI) for the selected risk factors. Results The survey included 1554 participants with an overall IBS prevalence of 16%. Women had a higher incidence of IBS than men (55.3% and 44.7%, respectively). IBS-mixed (32.66%) and constipation-predominant (32.25%) were the most common subtypes. In multiple regression analysis, female gender (OR = 1.503, p-value = 0.037), stress (OR = 2.386, p-value = 0.000), anxiety (OR = 1.943, p-value = 0.000), and tobacco smoking (OR = 2.093, p-value = 0.001) showed a statistically significant association with IBS. Conclusions The prevalence of IBS in the southwest region of Saudi Arabia is high. Female sex, tobacco smoking, stress, and anxiety are the major risk factors associated with IBS.

Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection.

Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from patients with chronic gastritis and minimal or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H-E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR). The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H-E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The sensitivity of IHC staining (87.50%) was higher than that of H-E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H-E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H-E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive. In contrast to routine H-E and modified Giemsa staining, IHC allows for the accurate H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.

Knowledge and attitude towards hematopoietic stem cell transplantation among medical students at Jazan University, Saudi Arabia.

OBJECTIVES: To identify the knowledge and attitudes of medical students at Jazan University towards hematopoietic stem cell transplantation (HSCT). Methods: This cross-sectional study involved all medical students at the Faculty of Medicine, Jazan University, Jazan, Saudi Arabia, between October 2018 and February 2019. Data were collected using a questionnaire that has been  used in a previous study conducted at Mayo Medical School, Minnesota, USA. Results: Out of 800 students, 744 completed the questionnaire (the response rate was 93%). Sixty-seven students (9%) were already registered in the Saudi stem cell donor registry (SSCDR). The participants' knowledge on donor eligibility was 37.4% and the donation process was 23.6%. Registered students were more likely to join the registry if there was a drive in their area (n=65 [97%], p=0.000), and more likely to donate stem cells to any matched patient (n=58 [86.6%], p=0.000). The main concern of the participants was the long-term side effects (48%). Conclusion: Most students lack the knowledge on HSCT. However, the students who registered in SSCDR had better knowledge and attitudes towards HSCT than the unregistered. Long-term side effects of HSCT were the most common concern of the participants. However, time commitment was the major concern of the registered students.

Helicobacter pylori vacA, cagA and iceA genotypes in dyspeptic patients from southwestern region, Saudi Arabia: distribution and association with clinical outcomes and histopathological changes.

BACKGROUND: The aim of this study was to identify the common H. pylori virulence genes among dyspeptic Southwestern Saudi patients and their association with clinical outcomes and histopathological findings to help practitioners and researchers in the region for better management of infections caused by such bacteria. METHODS: Four hundred two gastric biopsy specimens were analyzed using histopathological examination and real time-PCR. The positive 187 specimens by RT-PCR were genotyped using PCR targeting cagA, vacA and iceA genes. RESULTS: One hundred twenty-eight gastric biopsy specimens were positive in genotyping PCRs. The cagA, vacA, iceA1 and iceA2 genes were detected in rates of 49.2% (63/128), 100%(128/128), 42.2% (54/128), 32.8% (42/128), respectively. The vacA s1as1bm2 subtype was the highest 23.4% (30/128), followed by m2 and s1a1b subtypes which were equally detected [16.4% (21/128) for each]. The iceA genes were significantly associated with gastritis and gastric ulcer. Overall, vacA genotypes were significantly associated with gastritis, gastric and duodenal ulcers. The vacA subtypes: s1as1bm2, s1a1b and s2 m2 showed chronic active gastritis in percentages of 90.0, 81, and 84.2%, respectively. All vacA mixed genotypes showed chronic active gastritis. CONCLUSIONS: H. pylori virulence genes are highly prevalent and diverse among patients with dyspepsia in Southwestern region of Saudi Arabia. The iceA genes and the different vacA subtypes are significantly associated with the clinical outcomes and histopathological changes especially chronic active gastritis.

Prevalence and factors associated with H. pylori infection in Saudi patients with dyspepsia.

BACKGROUND: Helicobacter pylori (H. pylori) is a major cause of peptic ulcer disease (PUD) and chronic active gastritis that may progress to gastric cancer. Globally, it has been estimated that 50% or more of the world's population is infected by H. pylori, making it the most widespread infection across the globe. OBJECTIVES: To determine the prevalence of H. pylori infection and to identify factors associated with H. pylori infection in Saudi patients presenting with dyspepsia. METHODS: In this prospective cross-sectional study, a total of 404 gastric biopsies were endoscopically obtained from 404 patients with dyspepsia from September 2014 to April 2016 (Jazan Province, Saudi Arabia). The specimens were analyzed using the real-time polymerase chain reaction (PCR). The data was examined using descriptive statistics as well as determining the prevalence, and employing Chi square and Fisher exact test. A p-value of ≤0.05 was considered statistically significant in examining the research hypotheses. RESULTS: The overall prevalence of H. pylori in Jazan Province was 46.5% (95% CI: 41.7-51.4) and the prevalence was lower among those > 55 years old. Prevalence was higher among urban (50.0%; 95% CI: 43.1-56.8) versus rural (42.1%; 95% CI: 35.1-49.3), but with no significant difference. Prevalence did not show significant difference among different Body Mass Index (BMI) categories, ranging from 40.2% to 47.7%. The prevalence of H. pylori in females was 47.1% (95% CI: 40.4-53.9) versus 45.6% (95% CI: 38.7-52.6) in males. Histopathology findings were associated with H. pylori infection with prevalence of 58.1% among patients with chronic active gastritis, compared to 24.1% and 34.8% among mild and chronic gastritis, respectively. CONCLUSION: Our results indicate that there is a high prevalence of H. pylori among Saudi patients with dyspepsia. Prevalence of H. pylori was high in ages below 55 years. Chronic active gastritis was significantly associated with H. pylori infection. In depth studies are needed to determine associated factors with of H pylori infection in the region.

A Rare Presentation of Hepatocellular Carcinoma in a Young Adult: A Case Report.

Hepatocellular carcinoma is the most frequent type of liver malignancy. Most cases of hepatocellular carcinoma are secondary to either viral hepatitis (hepatitis B, C) or alcoholic cirrhosis. Liver cirrhosis due to any other causes is considered as a risk factor for development of hepatocellular carcinoma; however, hepatocellular carcinoma in a young patient with no cirrhosis or fibrosis is a relatively rare condition. The present case report describes a young 24-years-old male patient who presented with a two-month history of fever, right upper quadrant abdominal pain, and weight loss with no evidence of pre-existing liver disease, initially treated as liver abscess; however, a computed tomography (CT) showed numerous hepatic hypodensities with ring enhancement. Serum alpha-fetoprotein level was high (>1000 ng/L) and histopathological study confirmed the presence of primary hepatocellular carcinoma. The present case findings suggest that multifocal hepatocellular carcinoma can occur in a young patient with no apparent risk factor, and that the clinical presentation of hepatocellular carcinoma can be similar to liver abscess.

Hyper-Reactive Malarial Splenomegaly Syndrome (HMSS).

Hyper-reactive malarial splenomegaly syndrome (HMSS) is a massive enlargement of the spleen due to an exaggerated immune response to repeated attacks of malaria.  Tropical splenomegaly syndrome (TSS) is the most frequent cause of massive tropical splenomegaly in malarious areas [1-2].  It is seen more commonly among residents of endemic areas of malaria.  It occurs mainly in tropical Africa, but also in parts of Vietnam, New Guinea, India, Srilanka, Thailand, Indonesia, South America, and the Middle East. TSS is characterized by massive splenomegaly, hepatomegaly, marked elevations in levels of serum IgM, and malaria antibody.

Celiac Disease Initially Misdiagnosed as Irritable Bowel Syndrome: Case Report.

BACKGROUND:  The increasing availability of serological testing & upper endoscopy has led to more frequent diagnosis of celiac disease & recognition that it may mimic Irritable bowel syndrome (IBS). OBJECTIVE:  The objective of the present case report is to describe the importance of screening those with vague abdominal symptoms (like patients with IBS) and iron deficiency anemia for celiac disease. METHODS:  We report the clinical course of a 30-year-old patient with vague abdominal symptoms initially misdiagnosed as having IBS; when the patient presented in our clinic, he was noted to have iron-deficiency anemia. On work-up for the cause of iron deficiency anemia, he was found to have celiac disease on basis of positive serological tests and small bowel biopsy result. After being placed on gluten-free diet, plus iron supplements, his abdominal symptoms and iron deficiency anemia totally improved. CONCLUSIONS:  Our case demonstrates that routine screening for celiac disease should highly be considered for patients with iron-deficiency anemia and IBS.