Prevalence and Perception of HPV Vaccination Among Health Science Students in Saudi Arabia.

Objective: This study was carried out to assess the prevalence and perception of human papilloma virus (HPV) vaccination in health science students in Majmaah University, Saudi Arabia. Methodology: A descriptive cross-sectional study was conducted at different health science colleges of Majmaah University on female students. The knowledge of the participants regarding HPV was assessed using a pre-tested questionnaire. The history of vaccination of these female participants was also enquired. Results: More than three-fifth of the participants had heard about HPV. Of these, 83 participants, 59 (71.1%), were aware that it is a disease of women and how to diagnose it. Most participants (86.7%) knew that it can cause cervical cancer, while only 57.8% knew it could be asymptomatic. There were 18% of such participants who thought that HPV and human immunodeficiency virus are the same and that there is no vaccine for the prevention of HPV. Only 14.5% (n = 12) were vaccinated against HPV. Conclusion: A clear gap between knowledge and practice of HPV vaccination was observed, and health education should be planned to educate health professionals to avoid misconceptions.

Gauging the Awareness of Physicians in Saudi Arabia Regarding Risk Factors for Thyroid Cancer.

Background The prevalence of obesity and thyroid cancer (TC) is increasing worldwide, and obesity is a risk factor for TC. Objectives This study aimed to elucidate physicians' awareness of obesity as a risk factor for TC. Materials and methods A cross-sectional, self-report online questionnaire was distributed to physicians in all regions of Saudi Arabia. The questionnaire comprised sociodemographic data and questions concerning the risk factors for TC, including obesity. Results A total of 310 physicians participated in this study. Of the respondents, 35.8% (n = 111) were aged 30-40 years, 40.6% (n = 126) were board certified, and 52.3% (n = 162) had >10 years of experience. Only 36.8% (n = 114) of respondents were familiar with the relationship between obesity and TC risk (P < 0.001). In terms of knowledge of obesity as a risk factor for TC, a significant difference was observed for the following sociodemographic characteristics: sex, educational attainment, and years of experience. A significant difference was also observed with awareness of other risk factors for TC. Conclusions In light of the limited awareness of the correlation between obesity and TC, the most effective approach to address these misconceptions would be to implement diverse and ongoing medical education initiatives.

Regional Prevalence of Hemoglobin C Across Saudi Arabia: An Epidemiological Survey.

INTRODUCTION: HbC is a common structural hemoglobinopathy especially in West Africa. Prevalence and regional distribution of HbC in Saudi Arabia are widely undocumented. Patients with homozygous HbC disease may have mild hemolytic anemia whereas combination with hemoglobin S (HbS) leads to a clinically severe phenotype. AIM: The current epidemiological study, considered the largest from Saudi Arabia, aimed to evaluate the regional prevalence of the HbC variant among the couples participating in the premarital screening program from 2011 to 2018. METHODS: Data from the PMSGC program were obtained for premarital screening and genetic counseling. The collected data were then entered into the SEHA platform, a centralized electronic repository for the 13 designated regions in Saudi Arabia. Hemoglobin electrophoresis samples are analyzed using either HPLC, capillary electrophoresis, or a combination of both methods to confirm the presence of abnormal hemoglobin bands. RESULTS: This study included 1,871,184 individuals from 2011 to 2018. Of those, 49.8% were males and 50.2% were females. 112,618 (6.0%) had an abnormal test. Total number of Hb C cases were 778 (0.04%). HbC trait (HbAC) was detected in 764 participants while homozygous HbC (HbCC) and combined heterozygous (HbSC) were found in 9 and 5 cases, respectively. The regions near the Red Sea have higher rates than the central and eastern regions. CONCLUSION: HbC is a rare variant in Saudi Arabia with varying regional frequencies. HbC variant is more common in Mecca and Madina regions. The geographic area of HbC distribution differs from the areas with high prevalence of HbS, which explains why HbSC disease cases are overwhelmingly rare.

Challenges and insights: Methamphetamine analysis in post-mortem putrefied human tissues in a hot climate.

Background: The production and distribution of methamphetamine (meth) is often associated with illegal and clandestine laboratories, posing significant challenges for law enforcement and public health efforts. Global concern is growing over meth-related fatalities, as its high potential for abuse and detrimental impact on health make it an important issue in the realm of substance abuse and addiction. This concern has notably increased in Saudi Arabia, where the hot climate adds complexity to the analysis due to challenges posed by putrefaction. There is still an urgent need to enhance the screening capabilities of many toxicology laboratories to determine the cause of death, whether it be due to drug use or natural causes. Aim: This research aimed to investigate meth concentrations in post-mortem putrefied human solid tissues in a hot climate and comparing meth metabolite concentrations in cases where signs of putrefaction were observed versus those with no signs of putrefaction. The objective is to assist criminal investigations by analyzing meth and its metabolite concentrations. Methods: This retrospective cohort study involved postmortem samples from human subjects during autopsies conducted between 2016 and 2022. It focused on analyzing meth and its metabolite concentrations using LC-MS/MS analysis. Data on demographics, medical history, age, location, putrefaction, and other drug use were retrieved from medical records. Results: Out of the 27 reported samples of meth and its metabolite amphetamine in both putrefied and non-putrefied biological fluids and tissues, only 8 (30%) exhibited signs of putrefaction between 2016 and 2022. Despite decomposition, detectable concentrations of meth and amphetamine were sufficient to determine the cause of death and the source of amphetamines. Conclusion: This study found no significant difference in concentrations between putrefied and non-putrefied cases, underscoring the importance of multiple sample testing during autopsy for accurate interpretation. Each case is unique and must be considered individually.

COVID-19 in Pediatric Patients: A Study Based on Biomarker Levels.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected people of all ages, but limited data are available on children with mild and severe coronavirus disease 2019 (COVID-19). METHODS: Clinical characteristics, inflammation, and other biochemical biomarkers have been described, but information is scarce in asymptomatic and mild cases. Laboratory investigations were performed with pediatric patients (n=70) for liver function and kidney function, along with C-reactive protein (CRP). RESULTS: Mild clinical characteristics and symptoms were observed in pediatric patients. Even in moderate cases of COVID-19, elevated levels of biomarkers indicate altered liver and kidney function in children. The levels of liver enzymes, bilirubin, creatinine, and CRP varied significantly between the three classes, particularly between asymptomatic and moderate cases. Liver enzymes, bilirubin, and creatinine levels in moderate COVID-19 pediatric cases were twice as elevated as in asymptomatic cases. Liver enzymes and CRP levels were moderately elevated. CONCLUSION: Monitoring blood biomarkers consistently can assist in the accurate identification of infection in young patients as well as in the prevention of its spread and the administration of appropriate treatment.

Awareness and Acceptance for COVID-19 Booster Dose Vaccination among Residents of Saudi Arabia: Findings of a Cross-Sectional Study.

BACKGROUND: In the global effort to combat SARS CoV2 infection, adoption of the vaccination has been an essential component. The goal of this research was to determine the quality of web-based information gathered during COVID-19 and participants' awareness and acceptance for the booster dose for COVID-19. METHODS: This cross-sectional study was carried out to gauge interest in and willingness for a booster dose, as well as the satisfaction with the availability and accuracy of Internet resources. This study included 631 people from the cities of Riyadh, Al Majma'ah, Al Ghat, and Zulfi in the Riyadh Area. Chi-square and Fischer's exact tests, with a 95% confidence interval, and a threshold of p < 0.05, were used to analyze the significance of associations between variables. RESULTS: Out of 631 respondents, 347 people who reported willingness to receive the immunization were women (319, 91.9%), with only 28 (8.1%) being men. There was a statistically significant correlation between individuals who worried about booster dosage adverse effects and those who did not receive the immunization. Knowledge of the efficacy of the vaccine, confidence in the capacity of the vaccine to avert problems, and willingness to receive a third dosage were all shown to be substantially correlated (p < 0.001). Attitude and behavior ratings were substantially correlated with prior COVID-19 immunization status (p < 0.005). CONCLUSIONS: There was a significant correlation between vaccination knowledge, confidence in the capacity of the vaccine to prevent problems, and willingness to receive a third dose. Therefore, our research can help policymakers develop more precise and scientific roll-out strategies for the COVID-19 booster vaccination.

Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment.

Objective: To assess the demographic, clinical, and survival profile of people living with HIV. Methods: A retrospective cohort study was conducted among patients enrolled at a single antiretroviral therapy center in North Karnataka. A total of 11,099 were recruited from April 2007 to January 2020, out of which 3,676 were excluded and the final 7,423 entries were subjected to analysis. The outcome of interest was the time to death in months of people living with HIV on antiretroviral therapy (ART). The clinical and demographic characteristics were examined as potential risk factors for survival analysis. To investigate the factors that influence the mortality of patients using ART, univariate and multivariate Cox regression were performed. Hazard ratio (HR), 95% confidence interval (CI), and p-values were presented to show the significance. The log-rank test was used to determine the significance of the Kaplan-Meier survival curve. Results: Out of 7,423 HIV-positive people, majority were female (51.4%), heterosexual typology (89.2%), and in the age group 31-45 years (45.5%). The risk of death in male patients was 1.24 times higher (95% CI: 1.14-1.35) than female patients. Patients with age >45 were 1.67 times more likely to die than patients ≤30 (95% CI: 1.50-1.91). In the multivariable analysis, the hazards of mortality increased by 3.11 times (95% CI: 2.09-2.79) in patients with baseline CD4 count ≤50 as compared to those who had baseline CD4 count >200. The risk of death in patients who were diagnosed with TB was 1.30 times more (95% CI: 1.19-1.42) than in those who did not have TB. The survival probabilities at 3 and 90 months were more in female patients (93%, 70%) compared with male patients (89, 54%), respectively. Conclusion: This study proved that age, sex, baseline CD4 count, and tuberculosis (TB) status act as risk factors for mortality among people with HIV. Prevention strategies, control measures, and program planning should be done based on the sociodemographic determinants of mortality.

Prevalence of self-medication and associated factors among female students of health science colleges at Majmaah University: A cross-sectional study.

Introduction: Globally, the prevalence of self-medication among young people has increased exponentially. Due to the basic knowledge and easy access to medicines, undergraduate students at health science colleges are likely to self-medicate. This research was undertaken to assess self-medication prevalence and its contributing factors among female undergraduate students in health science colleges at Majmaah University, Saudi Arabia. Materials and methods: A descriptive, cross-sectional study involving 214 female students from the Majmaah University in Saudi Arabia's health science colleges-Medical: (82, 38.31%) and Applied Medical Science College (132, 61.68%)-was conducted. A self-administered questionnaire with sociodemographic information, drugs used, and reasons for self-medication was used for the survey. Non-probability sampling techniques were used to recruit participants. Results: Of the 214 female participants, 173, 80.84 % (medical: 82, 38.31% and applied medical science: 132, 61.68%) confirmed that they were on self-medication. The majority of participants (42.1%) were between the ages of 20 and 21.5 years (mean ± SD: 20.81 ± 1.4). The main reasons for self-medication were quick relief from the illness (77.5%) followed by saving time (76.3%), minor illnesses (71.1%), self-confidence (56.7%), and laziness (56.7%). The use of leftover drugs at home was common among applied medical science students (39.9%). The main indication for self-medication included menstrual problems (82.7 %), headache (79.8%), fever (72.8%), pain (71.1%), and stress (35.3%). The most common drugs used included antipyretic and analgesics (84.4%), antispasmodics (78.9%), antibiotics (76.9%), antacids (68.2%), multivitamins, and dietary supplements (66.5%). On the contrary, the least used drugs were antidepressants, anxiolytics, and sedatives (3.5, 5.8, and 7.5 %, respectively). Family members were the main source of information for self-medication (67.1%), followed by self-acquired knowledge (64.7%), social media (55.5%), and least were friends (31.2%). For adverse effects of the medication, the majority of them consulted the physician (85%) followed by consulting the pharmacist (56.7%) and switched to other drugs or decreased drug dosage. Quick relief, saving time, and minor illness were the main reasons for self-medication among health science college students. It is recommended to conduct awareness programs, workshops, and seminars to educate on the benefits and adverse effects of self-medication.

Assessment of Saudi Society's Knowledge Regarding Hypothyroidism and Its Neuropsychiatric Clinical Manifestations.

Background: This study was conducted to assess the level of knowledge and awareness of hypothyroidism and its neuropsychiatric clinical manifestations among the Saudi population. Methods: This was a cross-sectional study employing a convenient sampling technique, conducted between February and May 2022. A questionnaire was distributed online to all participants in all five regions. Results: In this survey, a total of 2016 Saudi citizens participated. When asked about depression, more than half of the participants (59.6%) correctly identified depression as one of the neuropsychiatric clinical symptoms of hypothyroidism. Nearly half of the participants (47.5%) were unaware that anxiety was not a neuropsychiatric manifestation of hypothyroidism. With a percentage of 91.0%, the majority of participants exhibited poor knowledge. The regression analysis showed that males have significantly reduced knowledge about hypothyroidism than females (coefficient −3.686, p-value < 0.0001). Similarly, those who have "enough income and can save" were more knowledgeable than others (coefficient 0.731, p-value < 0.02). Regarding the source of information, journals provide three times more information (p-value 0.0001), and healthcare practitioners provides four times more information as compared to family and friends (p-value 0.0001). Conclusion: Due to a lack of knowledge about hypothyroidism and its complications, symptoms, risk factors, and treatment, the most viable solution to these misconceptions would be to implement a variety of educational programs to increase public awareness of this issue.

Ethyl glucuronide and ethyl sulfate: a review of their roles in forensic toxicology analysis of alcohol postmortem.

PURPOSE: This review presents the current methods used for determining ethyl glucuronide (EtG) and ethyl sulfate (EtS) concentrations in postmortem specimens, including sample preparation, analysis and the role of EtG and EtS in the postmortem assessment of the extent of alcohol abuse. METHODS: Papers pertaining to postmortem investigation were collected from scientific databases and reviewed. The papers were published between January 2006 and October 2020. RESULTS: Most of the analyses involved postmortem blood and urine samples, with a few reports using other bodily specimens and tissues. The method validation was not conducted for all applications. These reports were mostly intended to present data rather than interpret them, and the lack of effort in relating these ethanol biomarkers with the cause of death and/or determination of the time of deaths due to ethanol intoxication might decrease the applicability of these makers after a promising start between 2006 and 2010. Nevertheless, by the beginning of 2020, papers investigating ethanol biomarkers were still increasing. A considerable number of methods used liquid chromatography coupled with mass spectrometry (LC-MS) techniques that require less sample preparation (e.g., protein precipitation extraction, dilution, filtration, and centrifugation). Although solid-phase extraction can be applied, only three applications were reported. CONCLUSIONS: Matrix effects can be a substantial challenge in analytical methods based on LC-MS because they directly affect the ionization of analytes. However, these problems can be avoided due to the high cutoff values used to identify positive results for these ethanol biomarkers, which are often above 0.1-1 mg/L, and using internal standards. Research on using tissue specimens is recommended as most of the reported results on this type of specimen were promising.

Comprehensive Highlights of the Universal Efforts towards the Development of COVID-19 Vaccine.

The world has taken proactive measures to combat the pandemic since the coronavirus disease 2019 (COVID-19) outbreak, which was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). These measures range from increasing the production of personal protective equipment (PPE) and highlighting the value of social distancing to the emergency use authorization (EUA) of therapeutic drugs or antibodies and their appropriate use; nonetheless, the disease is still spreading quickly and is ruining people's social lives, the economy, and public health. As a result, effective vaccines are critical for bringing the pandemic to an end and restoring normalcy in society. Several potential COVID-19 vaccines are now being researched, developed, tested, and reviewed. Since the end of June 2022, several vaccines have been provisionally approved, whereas others are about to be approved. In the upcoming years, a large number of new medications that are presently undergoing clinical testing are anticipated to hit the market. To illustrate the advantages and disadvantages of their technique, to emphasize the additives and delivery methods used in their creation, and to project potential future growth, this study explores these vaccines and the related research endeavors, including conventional and prospective approaches.

Development of Nonlaboratory-Based Risk Prediction Models for Cardiovascular Diseases Using Conventional and Machine Learning Approaches.

Criticism of the implementation of existing risk prediction models (RPMs) for cardiovascular diseases (CVDs) in new populations motivates researchers to develop regional models. The predominant usage of laboratory features in these RPMs is also causing reproducibility issues in low-middle-income countries (LMICs). Further, conventional logistic regression analysis (LRA) does not consider non-linear associations and interaction terms in developing these RPMs, which might oversimplify the phenomenon. This study aims to develop alternative machine learning (ML)-based RPMs that may perform better at predicting CVD status using nonlaboratory features in comparison to conventional RPMs. The data was based on a case-control study conducted at the Punjab Institute of Cardiology, Pakistan. Data from 460 subjects, aged between 30 and 76 years, with (1:1) gender-based matching, was collected. We tested various ML models to identify the best model/models considering LRA as a baseline RPM. An artificial neural network and a linear support vector machine outperformed the conventional RPM in the majority of performance matrices. The predictive accuracies of the best performed ML-based RPMs were between 80.86 and 81.09% and were found to be higher than 79.56% for the baseline RPM. The discriminating capabilities of the ML-based RPMs were also comparable to baseline RPMs. Further, ML-based RPMs identified substantially different orders of features as compared to baseline RPM. This study concludes that nonlaboratory feature-based RPMs can be a good choice for early risk assessment of CVDs in LMICs. ML-based RPMs can identify better order of features as compared to the conventional approach, which subsequently provided models with improved prognostic capabilities.

Prevalence of generalized anxiety disorder and major depression in health-care givers of disabled patients in Majmaah and Shaqra cities, Kingdom of Saudi Arabia.

INTRODUCTION: Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes such as increased blood pressure, etc. The impact of anxiety and depression on health-caregivers of disabled patients are very important because these psychological disorders effects both the health-caregivers and the patients which lead to unexpected bad events. OBJECTIVES: The current study was aimed to find out the prevalence of generalized anxiety disorder and major depression in health-care givers of disabled patients and to observe associations between demographic characteristics and psychological disorders in Majmaah and Shaqra Cities, Kingdom of Saudi Arabia. METHODS: A cross-sectional community-based study was conducted in rehabilitation centers at Majmaah and Shaqra Cities. The data comprising 100 health-care givers was collected from February to April 2015 through complete enumeration sampling method. A pre-validated "general health quality questionnaire" was used to collect the data. RESULTS: Majority of the participants were male (n = 75, 75%). More than 50% of the participants were holding bachelors' degree. Almost three-fifths of the participants had monthly income between 5000 and 15,000 SAR. The prevalence of somatic disorder was only (2%), anxiety disorder (3%), and depression (1%). However, in psychosocial and stress, the prevalence was (8%), respectively. No significant association was observed between demographic characteristics (nationality, gender, marital status, educational level, occupation, and income) and psychological disorders (somatic, anxiety, psychosocial, depression, and stress) P > 0.05, respectively. CONCLUSION: The prevalence of psychological disorders was very low. Nationality, gender, marital status, educational level, occupation, and income were not significantly associated with psychological disorders.

Risky health behaviors among students in Majmaah University, Kingdom of Saudi Arabia.

INTRODUCTION: Risky behaviors are those that potentially expose people to harm, or significant risk of harm, which prevent them from reaching their potential in life and which can cause significant morbidity or mortality. OBJECTIVES: The objectives of the study were to determine the overall prevalence of risky behaviors among university students; to determine the prevalence of smoking, drifting, fast driving and physical inactivity among university students; and to determine the associations between such behavior and demographic characteristics. MATERIALS AND METHODS: An observational cross-sectional study conducted in three colleges. The data were randomly collected from 340 students aged 18-30 years from February to March 2015 using a self-administered questionnaire in Arabic. The data were entered using SPSS v 22.0. Mean and standard deviation were calculated for quantitative variables, and frequency and percentages were computed for categorical variables. Chi-square or Fisher's Exact test, as appropriate, were used to test for statistical significance. RESULTS: The overall prevalence of risky behaviors (smoking, drifting, fast driving, and physical inactivity) among students was 47.35%. Overall, 28% of the students were smokers, 25.2% were involved in drifting, 60.9% reported driving fast, and 66.4% were physically inactive. The age between 18-20 years was significantly associated with higher rates of drifting, fast driving, and physical inactivity. CONCLUSION: The prevalence of risky behaviors among university students was high. Physical inactivity and fast driving were the most common identified risky behaviors. Increasing awareness of these risks in the youth may significantly decrease related morbidities, complications, and even mortalities.

Frequency of using non-prescribed medication in Majmaah city, Saudi Arabia -- A cross sectional study.

OBJECTIVE: To determine the frequency of using non-prescribed medication in a Saudi Arabian city. METHODS: The cross-sectional study was conducted in Majmaah city, Saudi Arabia, from January to May 2014, and comprised adults of either gender. For data collection, a questionnaire was designed and its reliability was checked by Cronbach Alpha. SPSS 20 was used for statistical analysis. RESULTS: Of the 390 respondents 276(70.8%) were males, while 114(29.2%) were females. The overall mean age was 29.90±11.56 years (range: 18-83 years). Of the total, 363(93.1%) were using non-prescribed medication; and 148(37.9%) said they were using the drugs as they had experienced similar symptoms before and they knew the treatment. Public pharmacies were the main source for obtaining non-prescribed medication for 163(41.8%) subjects. Gender and use of non-prescribed medication was significantly associated (p<0.05). CONCLUSIONS: The frequency of using non-prescribed medication in Majmaah city was high. Pain-killers, antibiotics and antipyretics were the most used non-prescribed medications. Male respondents used non-prescribed medication more than the females.

Depression and anxiety among parents and caregivers of autistic spectral disorder children.

OBJECTIVE: To evaluate the presence of depression and anxiety in parents/caregivers of autistic spectral disorder (ASD) children, and to identify associated factors. METHODS: In this retrospective cohort study carried out between July and December 2011, parents/caregivers of at least one child diagnosed with an ASD (cases group), were recruited through the Saudi Charitable Society of Autism Families and the Autism Clinic in the Pediatric out-patient clinic in King Fahad National Guard Hospital, King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. The parents/caregivers of a normally developed child (control group) were recruited from the Well Child Clinic at King Abdulaziz Medical City, Riyadh. We used a self-reported questionnaire containing questions on demographic data, as well as the Arabic version of the hospital anxiety and depression scale. RESULTS: The study included 100 parents/caregivers, 50 cases and 50 controls. More than 50% of the control group was in the age group 26-30 years (56%), while 42% of cases were in the age group 31-35 years. Time lapsed since autism diagnosis was over 3 years in one-third of cases. Twenty-two percent of cases, and only 2% of control parents/caregivers had a history of psychiatric problems (p=0.002). Both the mean depression score, and the mean anxiety score was significantly higher among cases when compared with controls, p<0.001. CONCLUSION: Autism is associated with burden and stress for parents/caregivers of the affected child. The demands placed by the disability contribute to a higher overall incidence of depression and anxiety among parents/caregivers.