Public awareness and attitudes towards cutaneous leishmaniasis in an endemic region in Saudi Arabia.

BACKGROUND AND AIMS: One of the priorities in public health policy for the control of Cutaneous Leishmaniasis (CL) is to investigate associations between disease distribution, socio-demographical and environmental risk factors, so that rational prevention and control strategies can be developed. Assessment of baseline awareness of the disease amongst the endemic population would be one of the first steps in this direction. This study aims to provide qualitative information on lay perceptions of CL in an endemic area in Saudi Arabia. We also attempted to correlate these perceptions with associated socio-demographical backgrounds. METHODS: This was a cross-sectional descriptive survey carried out in Al-Hassa, located in the Eastern Province of Saudi Arabia. The study included 1824 participants, age ranging from 15 to 63 years (mean 35.86±9.54 years). RESULTS: Over 76% of the studied population recognized the infectious nature of CL. There was also good awareness regarding the clinical features of CL, but the awareness regarding the vector, transmission, risk factors and preventive methods were very poor. Our study demonstrated a significantly higher knowledge score correlated with regard to male gender, higher family income, age and a previous history of CL. CONCLUSION: In our study we found low awareness for important epidemiological aspects like transmission of the disease, risk factors and prevention. Our study provides a baseline to understand and correct deficits in the perceptions and knowledge regarding CL in Saudi Arabia and would provide a template to design interventions.

Effectiveness of a modified tutorless problem-based learning method in dermatology - a pilot study.

BACKGROUND AND AIMS: Problem-Based Learning (PBL) is a student-centred instructional strategy in which students learn in a collaborative manner, the learning process being guided by a facilitator. One of the limitations of conventional PBL in medical education is the need for adequate resources in terms of faculty and time. Our study aimed to compare conventional PBL in dermatology with a modified tutorless PBL in which pre-listed cues and the use of digital media help direct the learning process. METHODS: Thirty-one-fifth year medical students were divided into two groups: the study group comprising 16 students were exposed to the modified PBL, whereas the control group comprising 15 students were given the same scenarios and triggers, but in a conventional tutor-facilitated PBL. Knowledge acquisition and student feedback were assessed using a post-test and a Likert scale-based questionnaire, respectively. RESULTS: The post-test marks showed no significant statistical differences between the two groups. The general feedback regarding the modified PBL was positive and the students felt comfortable with the module. The learning objectives were met satisfactorily in both groups. CONCLUSION: Modified tutorless PBL modules might be an effective method to incorporate student-centred learning in dermatology without constraints in terms of faculty resources or time.

Vitamin D, parathyroid hormone levels and insulin sensitivity among obese young adult Saudis.

OBJECTIVES: To determine alterations of vitamin D and parathyroid hormone levels and their relationship to insulin resistance among a sample of healthy young adult obese Saudis and to identify factors that might predict these alterations. METHODS: Age and gender matched obese young (aged 18-25 years) adult Saudis (N = 76) with body mass index of > or = 30 and their lean controls (N = 84) were recruited after fulfilling exclusion and inclusion criteria from attendees of health facility at King Faisal University, Saudi Arabia. Selected participants were invited to a personal interview to gather information regarding socio-demographics. Fasting blood samples were assessed for the following essays: serum calcium, 25 OH vitamin D, inorganic phosphorus, intact parathyroid hormone (iPTH), serum insulin, fasting glucose, renal and liver function tests. RESULTS: Vitamin D levels were significantly higher in lean controls, and showed significant decline in relation to obesity classes, hypovitaminosis D was found in 30% (38.2% obese vs. 22.7% in lean) and deficiency in 17.5% of subjects; (19% vs. obese 15.8%). iPTH was significantly higher in obese subjects. Secondary hyperparathyroidism was found in 48.1% (60.5% obese vs. 36.9% controls). Regression analysis showed that body mass index, serum calcium and creatinine levels were the main predictors for vitamin D level. Vitamin D is positively associated with fasting blood sugar (r = -.133, P = 0.09) and beta cell function index (r = .192, P = 0.08), negatively associated with HOMA-IR (r = -.122, P = .34) but without statistical significance after controlling of possible confounders. CONCLUSION: Vitamin D level among young adult Saudi obese is negatively associated by body mass index and classes of obesity. Negative associations between vitamin D, iPTH levels and HOMA-IR exist but without statistical signifcance.

Toxoplasmosis among the pregnant women attending a Saudi maternity hospital: seroprevalence and possible risk factors.

In a cross-sectional study to determine the seroprevalence of, and possible risk factors for, Toxoplasma gondii infection in the pregnant women of Saudi Arabia, all of the pregnant Saudi women attending the Al Ahsa Maternity Hospital over a 1-year period were invited to participate. In an interview with each subject, the relevant socio-demographic data and information on housing conditions, previous obstetric history and possible risk factors for Toxoplasma infection (e.g.frequency of consumption of undercooked meat, unwashed raw vegetables and/or unwashed raw fruit, contact with soil, and main sources of drinking water) were collected. Each subject was then checked for anti-Toxoplasma gondii IgG and IgM in commercial ELISA. Of the 554 expectant women investigated, 51.4% were found seropositive for anti-Toxoplasma IgG (indicating chronic infection) and 8.8% for anti-Toxoplasma IgM (indicating acute infection), with 6.1% of the women seropositive for Toxoplasma -specific IgM but seronegative for Toxoplasma-specific IgG. Acute infection was most common among the women who were relatively young, lived in rural areas and had relatively low incomes. The results of a multivariate logistic regression indicated that the significant positive predictors for chronic Toxoplasma infection were increasing age, rural residence, low family income, frequent consumption of undercooked meat, and previous obstetric problems (and/or multiparity). Although of questionable accuracy, the results of the present study revealed a relatively high seroprevalence of (possibly primary) acute Toxoplasma infection in the pregnant women, with the potential for transmission of the parasite to the foetuses.

Relationship between oxidative stress, ferritin and insulin resistance in sickle cell disease.

BACKGROUND: Sickle cell disease (SCD) is a hereditary hemoglobinopathy characterized by hemolytic anemia. The oxidative phenomena play a significant role in its pathophysiology. Blood transfusions are a therapeutic mainstay in SCD and repeated transfusions can result in iron overload. There is little direct information available to confirm the correlation between the oxidative stress, iron overload and insulin resistance in SCD patients. OBJECTIVE: To investigate the relationship between iron overload, the disorders of antioxidants and insulin levels in blood of SCD patients and their matched controls. METHODS: The antioxidant activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px), as well as the malondialdehyde (MDA, the membrane lipid peroxidation products) and carbonyl contents (the oxidative products of proteins) were estimated spectrophotometrically in erythrocytes of patients and control subjects of matched sex and ages. In addition, fasting blood glucose (FBG), ferritin and insulin levels were estimated in the sera of the same subjects. RESULTS: The mean activity values of SOD, CAT and GSH-Px were significantly decreased, whereas the average values of MDA and carbonyl contents were significantly increased in erythrocytes of SCD patients in comparison to the corresponding values of the control subjects. The average levels of FBS, ferritin, insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly elevated in the sera of SCD patients as compared to the controls. In addition, both serum ferritin, and oxidative products (expressed as MDA and carbonyl levels) were significantly correlated with blood glucose, insulin level, and HOMA-IR. CONCLUSION: These findings may explain the role of elevated ferritin and oxidative products (i.e. MDA & carbonyl contents) in the development of insulin resistance and high glucose levels in SCD patients.

Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia.

The study describes the prevalence of different forms of smoking, and the correlates of current smoking, by male students of King Faisal University, Saudi Arabia. A random sample of 1382 students at 9 colleges answered a self-administered questionnaire based on the Global Youth Tobacco Survey plus the modified Fagerström Test for Nicotine Dependence. The prevalence of current smoking was 28.1% (21.6% for cigarettes, 14.6% for waterpipe). Of current smokers, 41.4% were living in homes where others smoke and 17.0% initiated smoking below age 12 years. In logistic regression analysis older age, living away from home, smoking by family and close friends and exposure to tobacco promotion were predictors of current smoking status.

Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia

The study describes the prevalence of different forms of smoking, and the correlates of current smoking, by male students of King Faisal University, Saudi Arabia. A random sample of 1382 students at 9 colleges answered a self-administered questionnaire based on the Global Youth Tobacco Survey plus the modified Fagerstr”m Test for Nicotine Dependence. The prevalence of current smoking was 28.1% [21.6% for cigarettes, 14.6% for waterpipe]. Of current smokers, 41.4% were living in homes where others smoke and 17.0% initiated smoking below age 12 years. In logistic regression analysis older age, living away from home, smoking by family and close friends and exposure to tobacco promotion were predictors of current smoking status

Oral hygiene practices, dental knowledge, dietary habits and their relation to caries among male primary school children in Al Hassa, Saudi Arabia.

OBJECTIVES: To assess the frequency of consumption of cariogenic foods, oral hygiene practices and dental health knowledge among Saudi male primary school children in relation to socio-demographics and to find the possible predictors for dental caries among them. SUBJECTS AND METHODS: The cross-sectional descriptive study included 1115 Saudi male selected by multistage random sample from 18 public primary schools. Subjects were interviewed by closed ended questionnaire gathering data regarding frequency consumption of some cariogenic foods, oral hygiene practices and dental health knowledge. Students were submitted to dental screening to detect the clinically evident caries lesion. RESULTS: The clinically decayed tooth was diagnosed in 68.9% of the included children, more in urban and younger students. Caries affected the subjects consumed cariogenic foods at greater frequency compared with caries-free children. Only 24.5% of the students brushed their teeth twice or more per day, and 29% of them never received instructions regarding oral hygiene practices. Miswak as an alternative and/or additional method of dental cleaning was used by 44.6%. Stepwise logistic regression analysis revealed that maternal working conditions, large family size and poor oral hygiene practices were the chief predictors for dental caries among the included school children. CONCLUSION: The poor oral hygiene practices, lack of parental guidance and appropriate dental health knowledge with frequent exposure to cariogenic foods in addition to socio-demographics are the main risk factors for dental decay among the surveyed students.