Urinary and reproductive tract infection symptoms and menstrual hygiene practices in refugee camps in Jordan: A cross-sectional study.

BACKGROUND: Urinary tract infections and reproductive tract infections pose significant health risks, particularly among women living in challenging conditions. Unhygienic menstrual practices can exacerbate these risks, impacting physical and psychological well-being. OBJECTIVES: This study assessed the association between unhygienic menstrual care and self-reported urinary tract infection/reproductive tract infection symptoms among refugee women. In addition, it explored the association between these symptoms and mental health, specifically depressive symptoms. DESIGN: This study adopted a cross-sectional observational design. METHODS: This study was conducted between January and March 2023, involving 387 reproductive-age refugee women. Data collected included sociodemographic information and urinary tract infection/reproductive tract infection symptoms. In addition, we used the Menstrual Practice Needs Scale to evaluate menstrual hygiene practices and the Patient Health Questionnaire-9 for depressive symptoms. Statistical analysis was performed using Python version 3.9.12. RESULTS: Of 387 refugee women, 92.25% reported having urinary or reproductive tract infection symptoms in the previous 3 months. Factors like older age (odds ratio = 1.764, 95% confidence interval = 1.083-2.873, p-value = 0.023), lower family income (odds ratio = 0.327, 95% confidence interval = 0.138-0.775, p-value = 0.011), lower educational level (odds ratio = 0.222, 95% confidence interval = 0.068-0.718, p-value = 0.012), and being married (odds ratio = 0.328, 95% confidence interval = 0.188-0.574, p-value < 0.001) were significantly associated with urinary or reproductive tract infection risk. Difficulties obtaining menstrual products and thus reusing them increased the odds of urinary or reproductive tract infection diagnosis (odds ratio = 2.452, 95% confidence interval = 1.497-4.015, p-value < 0.001). Women with urinary or reproductive tract infection symptoms exhibited higher Patient Health Questionnaire-9 scores than those without (12.14 ± 5.87 vs 9.99 ± 5.86, p-value < 0.001, respectively). CONCLUSION: This study highlights a high prevalence of urinary or reproductive tract infection symptoms among refugee women residing in camps in Jordan, which was associated with poor menstrual hygiene practices and depressive symptoms. To reduce the urinary tract infection/reproductive tract infection burden in marginalized communities, public health initiatives should enhance healthcare accessibility, provide reproductive education, and promote holistic well-being practices for refugee women.

Nonmedical Use of Stimulants Among Students in Jordan: A Nationwide Study.

OBJECTIVES: Nonmedical use (NMU) of stimulants is an increasingly common phenomenon worldwide. Motivated by enhancing academic performance, peer pressure, and seeking pleasure, students in the Middle East are thought to be a high-risk population. This is especially important in times when the political instability in the region facilitates the production and trafficking of such substances. This study aimed to unveil the burden of NMU of stimulants and examine associated correlates among senior high school and university students in Jordan. METHODS: We describe a cross-sectional study of senior high school and university students in Jordan assessing NMU of stimulants. Data were collected between January and April of 2022 through a survey, which was distributed online leading to a google forms page. The survey queried sociodemographic characteristics, history of NMU of stimulants, use of other illicit substances, attitudes toward NMU of stimulants, as well as a mental health assessment. RESULTS: A total of 8739 students completed the survey (mean age of 20.40 ± 2.45 years), of which 5.1% reported a lifetime NMU of stimulants. Fenethylline (Captagon) was the most widely reported stimulant (2.6%). Living in the southern region, being diagnosed with a personality disorder, and using concomitant illicit substances were associated with the NMU of stimulants. CONCLUSIONS: The NMU of CNS stimulants, especially fenethylline, is prevalent in Jordan. More surveillance ought to be heeded toward the southern borders of Jordan. Students who use stimulants for academic reasons must be made aware of the potential consequences of the NMU of stimulants.

A novel predictive method for risk stratification in acne patients receiving isotretinoin: an analysis of laboratory abnormalities and changes in inflammatory parameters.

INTRODUCTION: Isotretinoin is a widely used, effective medication for moderate to severe acne. It is typically used for several months, which necessitates regular laboratory monitoring. However, consensus on the optimal assessment frequency is lacking. METHOD: This is a single-center retrospective study on 1182 patients who received isotretinoin for acne at the Dermatology Clinic in Jordan University Hospital over 5 years. RESULTS: Of the 1182 patients, 892 (76.57% females) met the inclusion criteria. An increase in the proportion of patients with abnormal triglycerides and total cholesterol levels from baseline to the sixth month was observed (p < 0.05). Conversely, differences in the number of patients with abnormal AST, ALT, and CBC were not found throughout treatment (p > 0.05). Moreover, there was a decrease in the neutrophil-to-lymphocyte ratio (NLR) ratio and systemic inflammatory index (SII) after the sixth month of isotretinoin treatment compared to the baseline (p = 0.012 and p = 0.021, respectively). CONCLUSIONS: We found that a baseline cholesterol level of 163.9 mg/dl and a baseline triglycerides level of 85.5 mg/dL are highly specific and sensitive in detecting grade 1 abnormalities at the one-month follow-up. This novel prediction approach serves as an effective risk stratification method for isotretinoin acne patients.

Knowledge, Attitudes, and Practices Regarding Electrical Burns.

Burn prevention programs can effectively reduce morbidity and mortality rates. In this article, we present the findings of our investigation of the knowledge, attitudes, and practices of the Saudi Arabian population regarding electrical burns. Our study was a cross-sectional online survey that used a five-part questionnaire to assess the participant's demographic information, knowledge of electrical burns, attitudes toward electrical injuries, and practices related to electrical burns and their prevention. Overall, 2314 individuals responded to the survey (males: 41.2%; females: 58.8%). A total of 839 participants (36%) had a personal or family history of electrical burns. Approximately ≥90% of the responses to questions on electrical burn-related knowledge were correct; relatively less responses to questions on the extent of tissue damage from electrical burns and arcs were correct (74% and 29%, respectively). Only 54% of the respondents knew that applying first aid to the burn-affected areas at home could lead to a better outcome; 27% and 19% did not know the correct answer and thought that this would not lead to a better outcome, respectively. The most common source of information was school or college (38.9%), followed by social media (20.8%) and internet websites (16.3%). Enhancing community awareness and practices related to electrical burns is a cost-effective and straightforward strategy to prevent the morbidity and mortality associated with electrical injuries.

Leukemia Cutis Presenting as a Morbilliform Eruption: A Case Report and Literature Review.

Leukemia cutis (LC) is a broad term that describes the infiltration of neoplastic leukocytes into the skin. Classically, LC is characterized by erythematous papules and nodules. However, LC can have a widely variable presentation. Therefore, it is crucial to maintain a high index of suspicion for LC through a complete clinical assessment, histopathology, and immunohistochemistry to distinguish this entity from other clinical mimickers. Herein, we report a case of biopsy-proven LC presenting as a morbilliform eruption that was initially suspected to be a drug eruption in a child with acute monocytic leukemia.

Determinants of breastfeeding attitudes of mothers in Jordan: A cross-sectional study.

Breastfeeding provides the optimal nutrition for an infant. However, breastfeeding practice is on decline globally. Attitude toward breastfeeding may determine the practice. This study aimed to examine postnatal mothers' attitude to breastfeeding and its determinants. A cross-sectional study was conducted, and data on attitude were collected using the Iowa Infant Feeding Attitude Scale (IIFAS). A convenience sample of 301 postnatal women were recruited from a major referral hospital in Jordan. Data on sociodemographic characteristics, pregnancy and delivery outcomes were collected. SPSS was used to analyze the data and identify the determinants of attitudes to breastfeeding. The mean total attitude score for participants was 65.0 ±7.15, which is close to the upper limit of the neutral attitude range. Factors associated with attitude that is positive to breastfeeding were high income (p = 0.048), pregnancy complications (p = 0.049), delivery complications (p = 0.008), prematurity (p = 0.042), intention to breastfeed (p = 0.002) and willingness to breastfeed (p = 0.005). With binary logistic regression modelling, determinants of attitude positive to breastfeeding were highest income level and willingness to breastfeed exclusively (OR = 14.77, 95%CI = 2.25-99.64 and OR = 3.41, 95%CI = 1.35-8.63 respectively). We conclude that mothers in Jordan have neutral attitude to breastfeeding. Breastfeeding promotion programs and initiatives should target low-income mothers and the general population. Policymakers and health care professionals can use the results of this study to encourage breastfeeding and improve breastfeeding rate in Jordan.

The Spectrum of MRI and Electrographic Findings in Pediatric Patients With Seizures: A Retrospective Tertiary Care Center Study.

Background Seizures constitute a serious public health concern, especially in pediatric patients. They are among the most prevalent medical issues affecting children. Magnetic resonance imaging (MRI) is a widely used imaging modality to evaluate, assess, and follow up on brain abnormalities. Objectives The purpose of the study is to explore the clinical findings of pediatric patients with seizures and their associated findings on MRI examinations. Material and methods A retrospective cohort study was conducted between 2021 and 2022 at King Abdulaziz University Hospital (KAUH). A total of 171 pediatric patients (ages 1-14 years old) who had seizures and underwent brain MRI examinations were included in the study. The mean age of the group was two years. Results Focal seizures represented the majority of seizure types in 62 (60.2%) patients compared to 42 patients who presented with generalized seizures and 67 patients who presented with normal findings based on magnetic resonance imaging (MRI) analysis. The most common finding in imaging was the presence of developmental anomalies, which were found in 31 (18.5%) patients. This was followed by hypoxic-ischemic injury in 12 patients, vascular abnormalities in 10 patients, inherited metabolic disorders in nine patients, and infection-related findings in six patients. Conclusion MRI has an invaluable role in managing pediatric patients with seizures. Accurate diagnosis of patients is an essential step for delivering proper care to patients. MRI is considered the main imaging modality to establish a correct diagnosis and thereby improve prognosis, and electroencephalogram (EEG) should be taken into account during standard neurodiagnostic testing.

The Association of Cone-shaped Epiphysis and Poland Syndrome.

Poland syndrome is a congenital anomaly with two clinical features: unilateral agenesis of the pectoralis major and ipsilateral hand symbrachydactyly. We report a rare case of bilateral Poland syndrome with several unique features. Poland syndrome is thought to be due to a vascular insult to the subclavian axis around the sixth week of gestation. Our patient has multiple rare and unique features of Poland syndrome. For the first time in the literature, we associate Poland syndrome with cone-shaped epiphysis of the metacarpals of all fingers. Bilaterality, cleft hand deformity, and dextrocardia were also rare features in our patient.

Inflammatory bowel disease in the elderly: A focus on disease characteristics and treatment patterns.

Background: As the population ages, the number of elderly inflammatory bowel disease (IBD) patients is expected to increase. The clinical features and therapeutic options for young and old patients may differ, as elderly IBD patients are likely to have different comorbidities and disease characteristics. The goal of this study was to examine the clinical aspects and therapeutic choices for elderly Saudi IBD patients. Methods: We conducted a retrospective study aimed at describing the demographic, clinical, and management characteristics of IBD in elderly patients (≥60 years) who followed up at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. The data was extracted from the KAUH inflammatory bowel disease information system (IBDIS) registry. The primary outcome was to describe disease characteristics in accordance with the Montréal classification and the secondary outcomes were to describe treatment patterns and identify significant clinical associations. Results: Our data were collected from 76 patients who fulfilled the study inclusion criteria. Females outnumbered males (53.9% vs 46.1%) and the mean age was 51.5 ± 9.7 years. Essential hypertension (26.3%) was the most common comorbidity followed by diabetes mellitus (23.6%), and malignant neoplasms (9.21%). More than half of the patients with Crohn's disease (CD) had disease onset after forty years of age. The most common form of disease distribution was ileocolonic disease (64.7%). Less than 17% of patients had a penetrating disease phenotype. About 88 percent of patients with UC presented >40 years of age. Approximately, half of the cohort had left-sided ulcerative colitis (UC) (48%), followed by pancolitis (40%). The most prescribed medication class for IBD was 5-aminosalicylic acid (5-ASA) derivatives (56.58%) followed by corticosteroids and immunosuppressive drugs. Conclusions: In Saudi Arabia, age-specific concerns including comorbidities and polypharmacy remain the major challenges in the management of elderly IBD patients.

Burnout among university students during distance learning period due to the COVID-19 pandemic: A cross sectional study at the University of Jordan.

OBJECTIVE: The COVID-19 pandemic led to a deviation from classical face-to-face learning to distance learning. Few studies examined burnout among university students during the distance learning period due to the COVID-19 pandemic. This study that aims to investigate the prevalence of burnout among university students during distance learning and the factors associated with it. METHOD: A cross-sectional study was conducted among undergraduate students at the University of Jordan. The modified version of the Maslach Burnout Inventory for students (MBI-SS) was used to assess burnout. RESULTS: The total number of participants was 587 and the mean total of MBI-SS score was 63.34 ± 8.85. Based on the MBI-SS definition, 6.6% of the study participants were found to have symptoms of burnout. Practicing hobbies, level of satisfaction with distance learning, and thoughts about quitting courses were significant predictors of burnout. CONCLUSION: This study showed a relatively low prevalence of burnout among students during the distance learning period with several factors associated with it. As a result, identifying these factors will help both students and educational institutions to implement strategies that are needed for the primary and secondary prevention of burnout.

Brain Metastases in Adults: A Five-Year Observational Study From King Abdulaziz Medical City.

Background As a well-documented fact, metastatic brain tumors are the most common cause of brain tumors in adults, with an incidence of 9-17%, based on various studies, although it was thought to be higher. The aim of this study was to describe recorded cases of metastatic brain tumors in the adult population of a tertiary care and oncology center in Jeddah, Saudi Arabia. Methods This study was conducted at King Abdulaziz Medical City (KAMC) at King Khalid Hospital in Jeddah, Saudi Arabia, including records from January 2016 to December 2020. The study implemented a retrospective cohort design to fulfill its aim. A data collection sheet containing demographic data such as age and gender, and information pertaining to the primary pathology, multiplicity, and survival outcome was used. Results A total number of 213 patients were enrolled in this study. Overall, 68.1% of the sample comprised of females. Approximately two-thirds (61.9%) of the patients' imaging results revealed multiplicity, whereas the remaining third (38.1%) had solitary lesions. The estimated overall survival median after the diagnosis of brain metastasis was six months (95% CI: 5.5-6.5). Conclusion We recommend conducting a nationwide study to better understand the incidence in accordance to geographical and gender differences. We can further expand our research to include other institutes in Saudi Arabia, and include important predictors such as time from the diagnosis of primary pathology to brain metastasis, disease progression cost, and disease progression in the months prior to the patients' death.

Parents' attitude towards pneumococcal vaccine: an online survey from Jordan.

OBJECTIVES: In developing countries, the pneumococcal conjugate vaccine (PCV) has not been incorporated into the national immunization schedule, and the vaccination rate is low. This study aimed to examine parental knowledge, attitudes, and barriers to children receiving the PCV in Jordan. METHODS: This was a questionnaire-based cross-sectional study. The online survey was written in Arabic and consisted of three main sections. The questionnaire was distributed via social media platforms, such as Facebook, Twitter, and WhatsApp. RESULTS: In total, 720 responses were analyzed. Only 149 (20.7%) of the parents' children were vaccinated with the PCV. However, almost half 356 (49.4%) of the respondents were willing to vaccinate their children. Most (563, 78.1%) parents stated that the vaccine would protect their children from pneumococcal disease. More than two thirds (516, 71.6%) of them strongly agreed or agreed that the cost of the PCV is high. Parents who had vaccinated their children had a higher monthly income than parents who had not vaccinated their children. CONCLUSIONS: This study shows a lack of knowledge regarding pneumococcal infection and the PCV among Jordanian parents. This is the main barrier to vaccinating children. Therefore, improving parental knowledge would increase the rate of vaccination among Jordanian children.

Ablative fractional carbon dioxide laser combined with autologous platelet-rich plasma in the treatment of atrophic acne scars: A systematic review and meta-analysis.

Atrophic acne scars are the most common cutaneous seqaule of acne vulgaris, representing 80%-90% of all acne scars. Ablative fractional carbon dioxide (FCO2 ) laser is the gold standard treatment for atrophic scars. Additionally, platelet-rich plasma (PRP) is suggested to accelerate the healing process and collagen synthesis. The aim of the present systematic review and meta-analysis was to determine the efficacy and safety of PRP combined with Ablative FCO2 laser in the treatment of moderate to severe atrophic acne scars. Randomized controlled trials (RCTs) that have compared PRP in combination with ablative FCO2 laser to ablative FCO2 laser alone with respect to the efficacy and safety measures were included. We have systematically explored Embase, Medline, and CENTRAL databases via Ovid. The outcomes that our systematic review sought to evaluate were clinical improvement, patient satisfaction, and Goodman and Baron's qualitative acne scar score. The dichotomous outcomes were presented as odds ratio (OR) while the continuous outcomes were presented as standardized mean difference (SMD). Eleven RCTs that represents 313 participants were included. The combined use of laser and PRP showed a statistically significant clinical improvement and patient satisfaction compared to the use of laser alone (OR = 2.56, 95% CI 1.37-4.78 and OR = 3.38, 95% CI 1.80-6.34, respectively). Also, a significant improvement in Goodman and Baron's score was achieved by combining PRP with laser (SMD = -0.40, 95% CI -0.65 to -0.14). The combined treatment of laser and PRP was highly synergistic, effective, and safe in treating moderate to severe atrophic acne scars.

Outcomes of Biliary Atresia in a Single Center in Jeddah, Saudi Arabia.

Background Biliary atresia (BA) is a rare but severe cause of obliterative cholangiopathy in neonates. Its incidence differs worldwide varying from 5/100,000 to 32/100,000 live births. The highest incidence is seen in Asia and the Pacific region. Diagnosing this disease is difficult in its early stages; thus, screening is necessary to avoid serious complications that can be minimized with early intervention during the first few months of life. Currently, although there are no medical treatments for BA, once the diagnosis is confirmed, the Kasai procedure may be a treatment option. The earlier the Kasai surgery is performed, the higher the success rate. Liver transplantation may be needed if the operation fails. This study aimed to determine the incidence of BA and the factors influencing the outcomes of the Kasai procedure at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Methodology This retrospective cohort study was conducted in the Pediatric Department at King Abdulaziz University Hospital, Jeddah from January 2019 to July 2019 and included consecutive patients with BA from 2010 to 2018. Results In total, 14 patients (57.1% female) were included in the study. The median age at the time of presentation was 90 (19-720) days, and the median age at the time of implementing the Kasai procedure was 90 (60-150) days. Eight patients underwent the Kasai procedure, and only one patient had a liver transplant. Conclusions Antenatal screening for BA tended to ensure early diagnosis and better outcomes. Delay in diagnosis and intervention is associated with increased morbidity and mortality.

Perspectives on COVID-19 Vaccines and Its Hesitancy Among Jordanian Population.

Background Since the spread of the COVID-19 virus, governments are putting significant resources into ending the pandemic. Vaccination arises as the best solution to get back to our everyday lives. However, we are now facing vaccine hesitancy, which is a critical problem. Methods This cross-sectional study was conducted between December 15, 2020, and March 1, 2021, using a validated online-based questionnaire; participants were compared using the Statistical Package for the Social Sciences (SPSS) program based on multiple factors. Results A total of 1607 participants throughout Jordan have responded to the questionnaire, among which 880 (54.8%) have bachelor's degrees, 236 (14.7%) have a high educational level (master and doctoral), and 491 (30.5%) have a diploma or less. Although this is a non-probable sample, it is not a representative sample as, according to United Nations Educational, Scientific and Cultural Organization (UNESCO), only 33.6% of the Jordan population have a tertiary education. Overall, 892 (55.5%) of the studied subjects had the intention to take the vaccine, distributed as follows: 156 (66.1%) of the high educational participants wanted to take the vaccine, compared to 512 (58.2%) of those who have bachelor's degree and 224 (45.6%) of those who have diploma or less (p < 0.001). Reading scientific articles talking about the vaccines and their effects (55.6%, p < 0.001), knowing the mechanism of action (45.2%, p = 0.007), getting proper medical advice (27.2%, p < 0.001), encouraged by the increasing number of infections and deaths (39.7%, p < 0.001), and the number of people who received the vaccine (16.1%, p < 0.001) were the most critical factors that played a role in taking the vaccine by all of the studied groups. Male gender (OR = 2.02; 95% CI = 1.54-2.64; p < 0.001), high income of more than 1000 JDs (1400 USD) (OR = 3.23; 95% CI = 2.21-4.71; p < 0.001), having an educational level of either high education (OR = 3.39; 95% CI = 2.07-5.55; p < 0.001) or bachelor degree (OR = 1.67; 95% CI = 1.25-2.24; p = 0.001), and being encouraged by the increasing number of infections and deaths caused by COVID-19 (OR = 1.97; 95% CI = 1.46-2.66; p < 0.001) were all significantly associated with the willingness to take the vaccine. Conclusion As the world rushes toward vaccination to end the pandemic, efforts are needed to end this phenomenon of vaccine hesitancy by enlightening people with the precise knowledge regarding the vaccine's mechanism of action, side effects, and efficacy focusing mainly on people with lower educational levels.

Efficacy and safety of apremilast monotherapy in moderate-to-severe plaque psoriasis: A systematic review and meta-analysis.

Psoriasis is a chronic, inflammatory, immune-mediated disease of the skin and joints. Plaque psoriasis is the most common clinical phenotype of psoriasis. Apremilast is an oral phosphodiesterase type 4 inhibitor recently approved by the US Food and Drug Administration (FDA) for the management of plaque psoriasis. The aim of this systematic review was to assess the efficacy and safety of apremilast monotherapy for the treatment of moderate-to-severe plaque psoriasis. This systematic review included randomized controlled trials (RCTs) comparing apremilast 20 mg twice daily (BID) and 30 mg BID with placebo for its efficacy on plaque psoriasis. We searched the Medline, Embase, and CENTRAL databases. We sought to evaluate the following outcomes: psoriasis area and severity index score (PASI)-50, PASI-75, PASI-90, static Physician Global Assessment (sPGA), and adverse events. The risk ratio (RR) was used to represent dichotomous outcomes and adverse events, and the data were pooled using the inverse variance weighting method. Eight RCTs that enrolled 2635 participants were deemed eligible. Apremilast 30 mg BID and 20 mg BID were significantly more efficacious than placebo in achieving PASI-75 over 16 weeks (RR = 4.60, 95% CI 3.29-6.41, and RR = 3.15, 95% CI 1.96-5.07, respectively). Apremilast 30 mg BID showed a significantly higher rate of adverse events than the placebo (RR = 1.24, 95% CI 1.16-1.33), whereas apremilast 20 mg BID did not exhibit any significant difference (RR = 1.13, 95% CI 0.91-1.42). This meta-analysis demonstrated that apremilast monotherapy is an effective therapeutic option for moderate-to-severe plaque psoriasis with acceptable tolerability and safety profile.

The Hidden Cause of Maculopapular Rash in Interleukin-12 Deficiency.

Interleukin-12 RB1 (IL12RB1) deficiency falls under the Mendelian susceptibility to mycobacterial disease. It is a rare genetic disease with autosomal recessive inheritance. It is characterized by recurrent infections with otherwise weak bacteria, such as mycobacteria and Salmonella. Often, when encountering a maculopapular eruption, a drug-related cause comes to mind. However, we report a case of IL12RB1 deficiency presenting with a maculopapular eruption, proven by a skin biopsy to be leukocytoclastic vasculitis. The patient was given antibiotics, which improved her skin lesions. Vasculitis should be considered in the differential diagnosis in patients with IL12RB1 deficiency presenting with a cutaneous eruption.

Assessment of Multiple Sclerosis Awareness and Knowledge among the Community of Jeddah, Saudi Arabia.

Objective Multiple sclerosis (MS) is a degenerative disease of the central nervous system that can lead to lifelong disabilities. There is a significant increase in the global incidence of the disease. In Saudi Arabia (SA), the western region has the greatest number of MS cases. However, there is a lack of studies and research to assess public knowledge in the region. Thus, we aim to assess the public's knowledge of MS in Jeddah, SA. Methodology We conducted a cross-sectional study surveying 468 participants from the general population of Jeddah. A validated MS knowledge questionnaire (MSKQ-25) was used. Results Most participants were female 347 (74.1%) with a mean age of 35.73 ± 14.71 standard deviation (SD). MS was found in 14 (3%) of the participants. The average score of the (MSKQ) was 7.42 SD ± 4.568 versus the average score of people with MS with a mean of 13.92 SD ± 3.33 and a p value > 0.001. No significant variation was found in knowledge between gender and age groups, but there was a significant correlation between the educational level and the knowledge level. Conclusion The mean knowledge score was below average, which indicates poor knowledge of MS. Since the western region has the highest number of MS cases in SA, the level of understanding needs to increase. This can be improved by conducting educational programs using various types of media.

Evaluation of Radiation Exposure in Open Dental Clinics Using Thermoluminescence Dosimeters and Questionnaires.

AIM: The aim of this study was to evaluate radiation exposure in dental open clinics in King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) using thermoluminescence dosimeters (TLDs) to check if it exceeds the annual assigned exposure limit and to assess students' practices regarding radiation protection measures and their knowledge regarding the application of digital remote-control settings and TLDs. MATERIALS AND METHODS: This pilot institutional-based observational study was conducted among the clinical year students and interns at KSAU-HS College of Dentistry open clinical areas using TLDs and questionnaires. Sixteen lithium fluoride TLDs (TLD-100) were distributed evenly in the clinical areas occupied by clinical year dental students and interns for 24 working days from September 15 to October 20, 2019. Each TLD was labeled with a serial number and fixed at the assigned clinic of each specialty. The TLDs were placed in a zigzag manner at the right corner of the selected clinic to prevent overlapping of the area coverage by each dosimeter. RESULTS: The mean monthly TLD readings were found to be 69.265 uSv with a higher mean value in the female clinical area (74.2975 uSv) than the male clinical area (64.234 uSv). Taking into account the 8 months of clinical exposure during the academic year, the expected annual radiation exposure would be 0.554 mSv which is significantly lower than the annual limit of radiation exposure recommended by the International Commission on Radiological Protection, i.e., 1 mSv. CONCLUSION: TLD readings concluded that radiation exposure was within safe limits with an estimation of 0.544 mSv per year. However, students require further education regarding protective and safety measures and the utilization of radiation equipment. CLINICAL SIGNIFICANCE: The lack of studies regarding the amount of radiation exposure from dental imaging and the safety of intraoral radiographic machines present in open clinics in any educational institute necessitates conducting this kind of study.

Papulosquamous Disorders and Pregnancy.

Pregnancy can influence the course of a number of dermatologic disorders. Interestingly, these disorders can also influence pregnancy outcomes negatively, due to a variety of underlying pathogenic mechanisms. These outcomes may range from low fetal birth weight, preterm birth, and miscarriages to perineal lacerations complicating deliveries. Our review highlights the impact that papulosquamous disorders may have on pregnancy and their course throughout pregnancy. We chose papulosquamous disorders due to their relatively high prevalence worldwide compared to other dermatologic disorders. This review also sheds light on any gaps in the literature relevant to this topic that should be addressed.