Correlation analysis between cytokines' profile, autoimmune antibodies and the duration of type 1 diabetes: A case control study in a specialized children's centre in Riyadh.

OBJECTIVE: The aim of this study was to investigate the role of cytokines in children with T1D living in Saudi Arabia and their correlation with disease duration and autoimmune antibody markers. METHODS: A case-control study was conducted in the endocrine clinic of King Abdullah Specialized Children's Hospital in Riyadh. A total of 274 T1D and healthy control children were enrolled in the study. 5 mL of venous blood samples were collected in the morning after 9 to 12 h of fasting in BD Vacutainer® EDTA tubes and centrifuged at 250g for 15 min at. Plasma was then stored at -20°C for detection of anti-islet, anti-GAD antibodies (Abs), and C-peptide using commercial ELISA kits from Thermo Fisher Scientific. The levels of cytokines were measured using commercial sandwich ELISA kits from Abcam. RESULTS: Median differences in cytokine levels (IFN-γ, TNF-α, IL-1ß, IL-2, IL-4, IL-6, IL-10, IL-13, IL-18, IL-21, IL-35, and IL-37) were significantly higher in T1D patients compared with healthy controls (p-value < .001). Spearman's Rho correlation indicated that TNFα, IL-1ß, IL-4, IL-10, IL-13, and IL-21 correlated significantly with T1D Abs (p-value = .01). HbA1C correlated negatively with IL-35 and IL-37, and positively with IL-18 (p-value = .01). Linear regression analysis showed a significant increase in anti-glutamic acid antibodies (GAD) in patients with >3 years of T1D duration. CONCLUSION: Autoantibodies remained positive at high levels in our patients over a 3-year duration of the disease and correlated with specific cytokines. The clear correlations with disease duration and profile of specific cytokines could be targets for future therapeutic interventions.

Assessment of concerns about vaccination among recovered COVID-19 patients in Saudi Arabia.

Background: Vaccine hesitancy re-emerged as a critical public health issue during the COVID-19 pandemic. Aims: This study assessed the concerns of recovered COVID-19 patients about vaccination and the predictors of vaccine hesitancy. Methods: This was a cross-sectional study of 319 adult patients who recovered from COVID-19 in Saudi Arabia. It was conducted during 1 May to 1 October 2020 at King Abdulaziz Medical City, Riyadh. Each participant was interviewed 6-12 months post-recovery using the vaccination attitude examination scale. Data were collected on COVID-19 illness severity, sociodemographic characteristics, history of chronic disease, and post-COVID-19 vaccination. Level of vaccination concern was assessed based on the percentage mean score (PMS). Results: Most (85.3%) of the patients who recovered from COVID-19 expressed moderate overall concern (PMS = 68.96%) about vaccination. Concern was highest for mistrust in vaccine benefits (PMS = 90.28%), followed by natural immunity preference (PMS = 81.33%) and worries about the vaccine side-effects (PMS = 60.29%). Concern over commercial profiteering was low (PMS = 43.92%). The overall PMS for concern about vaccination was significantly higher among patients aged 45+ years (t = 3.12, P = 0.002) and among those who had experienced severe COVID-19 illness (t = 1.96, P = 0.05). Conclusion: Overall concern about vaccination was high, and specific concerns were prevalent. Patient education on how the vaccine protects against reinfection should be targeted at COVID-19 patients before being discharged from hospital.

The use of mobile application in primary health care in Saudi Arabia: A cross-sectional study.

BACKGROUND: Technology implantation, for example, smartphone application, in primary health care (PHC) is an approach to enhance healthcare services via availability and convenient access. This study described the factors contributing for not booking an appointment using the mobile application, and why patients visit PHC physicians. METHOD: This is a cross-sectional study that included 477 participants who visited the PHC physicians. Eligible subjects who present in the patients' waiting area were asked to participate by giving them a self-administered questionnaire. RESULTS: With a total of 477 participants' appointments, 83.5% (N = 398) of them were booked through the mobile application. Out of 398, 54.6% (N = 217) were not booked by the patients themselves. The most common reasons for the visits were follow-up (38.8%), lab/imaging results (34%), and acute complaint (27.3%). Gender, age, and the number of comorbidities the patient has were significantly associated with those who didn't book the appointment by themselves through the mobile application (P-value <0.001). Males were more likely to book for themselves than females. The average age for patients who booked for themselves through the mobile application was significantly low (Mean = 39.4, SD = 14.5). Those who were able to book for themselves had a lower number of comorbidities. CONCLUSION: Age, gender, and number of comorbidities were significant factors contributing to not to book an appointment/use mobile application by the patients themselves. The mobile application might cause difficulties and influence the appointment booking process. The application should be expanded throughout the country with further modification to meet the patient's needs.

Hepatitis B virus sero-prevalence among pregnant females in Saudi Arabia.

BACKGROUND/AIM: Since selective screening for Hepatitis B virus (HBV) in pregnant women has failed to identify a high proportion of HBV-infected mothers, pre-natal HBsAg testing of all pregnant women is now recommended. We aimed to determine the prevalence of HBV infection among pregnant women at the ante-natal clinic of a tertiary care center in Saudi Arabia and to identify the target group for postpartum immunization. MATERIALS AND METHODS: A total of 755 pregnant females who attended the antenatal clinic from June 2005 to June 2006 for the first time - before 38 weeks of gestation - constituted the target of the present study. Blood samples 30-39 were drawn from all subjects and sera were tested for HBV serologic markers including Hepatitis B surface antigen, anti-HBs, and anti-HBc using ELISA technique (third generation). RESULTS: The overall prevalence of sero-positive HBsAg among pregnant women was 1.6%. As age increased, the prevalence of sero-positive HBsAg significantly increased (chi(2) = 116.43, P < 0.001), 30-39 were women aged >or=40 were five times more likely to be positive for HBsAg as compared to those <30 years (OR = 4.78). On the other hand, women aged 40 and over were five times more likely to be susceptible to infection with hepatitis as compared to young women aged <20 (OR = 5.15). Women susceptible to HBV infection constituted about 80% of all pregnant females. CONCLUSION: These findings reflect that the full impact of the Hepatitis B vaccination program that was conducted in 1989 for all Saudi children has not yet reached all pregnant women, with the majority (79.9%) being nonimmune and thus liable to HBV infection. Postpartum HB immunization should be recommended in such cases.