Search

BackgroundThe rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU).MethodsThe SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations.ResultsThe SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. ConclusionThe SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available.

Objectives: Vaccination is the provision of a vaccine to initiate immunity trough stimulating immune system to develop protection from a certain disease. When a sufficiently large proportion of a population has been vaccinated, herd immunity initiated. The effectiveness of vaccination has been widely studied and verified. Although the harsh vaccine safety systems, some parents remain minded regarding the safety of the childhood vaccines and immunization schedule. These hesitations pushed some parents to not allow their children to receive some or all the scheduled vaccines. The aim of the study is to assess the general population awareness regarding vaccines and to detect prevalence of vaccine hesitancy in Aseer region, southern of Saudi Arabia. Methods: A descriptive cross-sectional approach was used targeting all parents in Aseer region. Data were collected using structured questionnaire which developed by the researchers after intensive literature review and expert’s consultation. The questionnaire data included parents’ socio-demographic data, parents’ awareness regarding child vaccines safety and efficacy, parents’ attitude and adherence to children vaccination and hesitancy towards vaccines. Results: The survey included 796 participants whose ages ranged from 18 to 55 years old. Two thirds (63.4%) of the participants were females. Regarding vaccination adherence and hesitancy among participants, more than three quarters were completely adherent to the child vaccination schedule and only 3.9% were non adherent. As for participants awareness regarding child vaccination safety and efficacy, 89.3% of the respondents agreed on that vaccination keep child healthy, 84.2% reported that child vaccine is safe and effective, 83.4% said that all Saudi scheduled vaccines are effective. Conclusion: In conclusion, the study revealed that vaccine hesitancy among participants was not low and should be considered irrespective of their high awareness level. The recorded antivaccine action was mostly related to vaccines safety not efficacy. Keywords: Vaccine hesitancy, antivaccine movement, parents, awareness, adherence

Background: Recently, implants have been widely considered as an option for replacing missing teeth. There are several biological conditions that must be considered for the success of an implant. Failure to satisfy any of these factors may result in complications, such as peri-implantitis or failure of the implant. Aim: The aim of this study was to evaluate the general dentist's attitude towards the management of peri-implant diseases in Saudi Arabia. Methods: A multicenter cross-sectional electronic-based questionnaire was formulated based on the validated questionnaire from a previous study. It was targeted towards the general dental practitioners in Saudi Arabia. The study sample consisted of 721 general dental practitioners. The questionnaire consisted of 17 questions divided into five sections. Pearson's chi-square test was used for inferential statistical analysis with Holm's correction, for adjusted p-value, the alpha at 95% confidence interval was 0.05, and all values below alpha were considered statistically significant. Results: The majority of participants had attended an implant training course (51.2%) while the rest had not (48.7%). The majority of the participants (67.3%) thought they need special instruments for the detection of peri-implantitis but only 29.5% thought they do not need any special instruments for the intended purpose. Most participants (79.3%) said they can identify and differentiate between normal and abnormal soft tissue around an implant, while 6.5% of the respondents could not. More than half of the participants (54.8%) could differentiate between peri-implant mucositis and peri-implantitis, and 19.4% had no idea about this. Amoxicillin & metronidazole was considered as the best and most effective antibiotic by the majority of respondents (76%), while only (5%) of dentists selected ciprofloxacin. Conclusion: This study concludes by suggesting that most of the participants have adequate knowledge about peri-implant soft tissue assessment, mechanism of periodontitis and peri-implantitis, its initiation and progression along with its management. Most of the participants found the training courses on peri-implantitis to be efficient. It is recommended to conduct more courses and studies that would aim at understanding the pathogenesis, etiology, diagnosis, and treatment of peri-implant diseases so as to increase awareness among general dentists.

Introduction Immunomodulators, including dexamethasone (DEX), have been recommended by the Infectious Disease Society of America (IDSA) to treat moderate, severe, and critical COVID-19. Tocilizumab (TCZ) was added to the treatment recommendations based on recent data from two large randomized controlled trials and its potential synergistic effect with DEX. Method We included adult patients admitted from June until October 2020 with a PCR confirmed SARS-CoV-2 infection. 135 patients with severe to critical COVID-19 and received TCZ and/or corticosteroid or DEX were retrospectively evaluated and followed until hospital discharge or death. Results The cohort was divided into two different groups of patients; TCZ group received TCZ +/- corticosteroid, N = 100 and DEX group received DEX, N = 35. Groups were analyzed for hospital mortality. The rate of hospital mortality was 36% in TCZ and 37% in the DEX group, p = 0.91. Age of 60 years and above was associated with higher mortality rate with OR = 1.030 and 95% CI = (1.004, 1.057). More than 50% of patients required MV in both groups. Development of bacterial or fungal infection post immunomodulator were similar in TCZ and DEX groups, 29% vs. 31.4%. Conclusion Our study revealed that age of 60 years and above is the only factor associated with higher mortality rate regardless of the type of immunomodulator therapy. Findings of this study also revealed the lack of synergistic effect between TCZ and DEX on the hospital mortality

A number of advancements in the therapy of perforated duodenal ulcers have been made in the recent two decades, suggesting that the disease's morbidity and mortality may be reduced. Recently, there has been a return to a more conservative first approach, with reports of either delayed resection or two-stage surgery, in which a non-radical resection is performed first, followed by lymphadenectomy at a later date. Furthermore, because gastric lymphoma can be cured without resection, many upper GI surgeons recommend performing a biopsy and repair at the index operation and then considering how best to continue if adenocarcinoma is discovered later.

Epigastric pulsation is feeling of pulsation between the xiphoid process and the umbilicu. It can be found normally in population (especially in thin lean people) or abnormally as a sign or a symptom of other diseases, such as heart, liver, and aortic diease.This descriptive study, using a questionnaire, assesses the prevalence of epigastric pulsation among 878-case sample, the association with other diseases especially DM, smoking history and obesity. Prevalence was 51.7%. Most common diease to be associated with epigastric pulsation is gastrointestinal diseaseno. No association was found with DM. Positive association was found between smoking history and BMI, and the feeling of epigastric pulsation.

Background: COVID-19 is newly emerging infectious disease that spread globally at unpredictable and unique pattern to the extent that the World Health Organization announced COVID-19 as a pandemic in the first couple months of 2020. This study aims to describe clinical and demographic features of COVID-19 patients and the influence of various risk factors on the severity of disease. Methods: This research is a retrospective study based on Saudi Arabia's ministry of health's Covid-19 data. The analysis relies on data of all COVID-19 patients recorded in Riyadh between 1st, March 2020 and 30th, July 2020. Statistical analyses were performed to investigate the effect of demographic characteristic, clinical presentation, and comorbidities on infection severity. Results: A total number of 1026 COVID-19 patients were identified based on the demographic data as follows: 709 cases (69% of cases) were males and 559 cases (54% of cases) were Saudi. Most of patients were diagnosed with mild signs and symptoms 697 (68% of cases), while 164 patient (16% of cases) demonstrated moderate signs and symptoms, and 103 cases (10%) were severe and 62 (6%) had critical febrile illness. Fever, cough, sore throat, and shortness of breath were the most common symptoms among patients with COVID-19. Among studied comorbidities in COVID-19 patients, diabetes mellitus and hypertension were the most prevalent. The results from the bivariate logistic regression analysis revealed that older age, diabetes mellitus, asthma, smoking, and fever are associated with severe or critically ill cases. Conclusion: The findings of this study show that old age, fever, and comorbidities involving diabetes mellitus, asthma, and smoking were significantly associated with infection severity. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

This multi-disciplinary, cross-sectional, and descriptive study investigated health care students’ face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere.

Background: Traditionally, Portulaca oleracea Linn. is used for treating abscesses, dysentery and liver diseases. In addition, recent studies have reported its efficacy as an analgesic, as neuroprotective, anti-inflammatory, bronchodilatory, and anticancer agent, besides antioxidant, wound healing and other important pharmacological actions. Aim and Objective: For curing liver diseases, Chinese use juice from the fresh leaves of Portulaca oleracea Linn. Hence, to prove this claim, an in-vivo hepatoprotective study of extracts from Portulaca oleracea Linn. against carbon tetrachloride hepatotoxic rats was carried out. Methods: The in-vitro antioxidant activity by using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay and hepatoprotective activity of extracts of Portulaca oleracea Linn. was assessed against the carbon tetrachloride-induced toxicity rat model. Results: The extracts of Portulaca oleracea Linn produced concentration-dependent percentage inhibition of 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical and most significantly, by methanol extract. Among the extracts, methanol extract showed a significant decrease in Serum glutamic oxaloacetic transaminase (SGOT), Serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP) levels and a significant increase in total protein (TP) levels against carbon tetrachloride-induced liver toxicity Conclusion: From the results obtained, it was concluded that methanol extract of Portulaca oleracea Linn. possesses significant DPPH free radical scavenging and hepatoprotective potential.

The demand for liver transplantation in the Kingdom of Saudi Arabia (KSA) is associated with the country's high burden of liver disease. Trends in the epidemiology of liver transplantation indications among recipients in KSA have changed over 20 years. Non-alcoholic steatohepatitis has eclipsed the hepatitis C virus in the country due to the effective treatment strategies for HCV. Risk factors for NASH, like type 2 diabetes mellitus, obesity, and hyperlipidemia, are becoming a major concern and a leading indication for liver transplantation in the KSA. There is also a significantly increased prevalence and incidence of genetic adult familial liver diseases in KSA. New immunosuppressive agents and preservation solutions, improved surgical capabilities, and early disease recognition and management have increased the success rate of liver transplant outcome but concerns about the side effects of immunosuppressive therapy can jeopardise long-term survival outcomes. Despite this, indications for liver transplantation continue to increase, resulting in ongoing challenges to maximize the number of potential donors and reduce patient mortality rate while expecting to get transplanted. The Saudi Center of Organ Transplant is the recognized National Organ Donation Agency for transplantation, which renders important support for procurement and allocation of organs. This guidance document aims to help healthcare providers in managing patients in the liver transplant setting.

The impact of different sociodemographic and clinical characteristics on the COVID-19-related morbidity and mortality rates have been studied extensively around the world; however, there is a dearth of data on the impact of different clinical and sociodemographic variables on the COVID-19-related outcomes in Saudi Arabia. This study aimed to identify those at high risk of worse clinical outcomes, such as hospitalization and longer length of stay (LOS) among young and middle-aged adults (18 to 55 years). In this questionnaire-based cross-sectional study, 706 patients with real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 infection were interviewed. Patients’ demographic characteristics, dietary habits, medical history, and lifestyle choices were collected through phone interviews. Patients with chronic health conditions, such as diabetes and hypertension, reported a higher rate of hospitalization, ICU admission, oxygen-support needs, and a longer period of recovery and LOS. Multiple logistic regression showed that diabetes, hypertension, and pulmonary disease (e.g., asthma and chronic obstructive pulmonary disease (COPD)) were associated with a higher risk of hospitalization and longer LOS. Multiple logistic regression showed that symptoms of breathlessness, loss of smell and/or taste, diarrhea, and cough were associated with a longer recovery period. Similarly, breathlessness, vomiting, and diarrhea were associated with higher rates of hospitalization. The findings of this study confirm the similarity of the factors associated with worse clinical outcomes across the world. Future studies should use more robust designs to investigate the impact of different therapies on the COVID-19-related morbidity and mortality in Saudi Arabia.

Staphylococcus aureus bacteremia is a life-threatening condition associated with a substantial financial burden on the health care system. The use of the GeneXpert® methicillin-resistant S. aureus ...

Background: Pharmacists and physicians can work together to improve patient compliance especially for the management of hypertension. Medication adherence leads to advance health and reduces hospitalizations (morbidity), death (mortality) and healthcare costs. Objectives: Involvement of pharmacist in treatment intervention can result in improved understanding about hypertension and it can increase medication adherence to antihypertensive therapy which ultimately advance overall quality of life. Study design and methods: A comprehensive research study was conducted using two eminent databases i.e. PUBMED and EMBASE. The research articles from 1996 to 2015 were analyzed. All the selected articles were about pharmacist intervention, hypertensive patient compliance and hypertension medication adherence. Results: Some studies show no control in BP; however, there was significant difference in the systolic and diastolic BP pre and post pharmacist intervention (Systolic from 158.1±14.4 to 143.8 ± 10.7, Diastolic from 100.6 ±11.5 to 89.8 ± 9.7). Conversely, in some studies BP was controlled in about 29.9% of control group and in 63% of the intervention group. Conclusion: Results showed many methods can improve medication adherence and blood pressure including counseling patients in person, collaboration between pharmacists and physicians, and using technology like telecommunication to intensify patients counseling. Pharmacist intervention can significantly increase disease-related knowledge, blood pressure control and medication adherence in patients with hypertension.

Introduction Antiviral drugs have shown limited effectiveness in treating patients with coronavirus disease 2019 (COVID-19). We aimed to assess the effects of a favipiravir and hydroxychloroquine combination on treating moderate-to-severe COVID-19 patients. Methods An investigator-initiated, multicenter, open-label, randomized trial at nine hospitals. Eligible patients were adults with moderate-to-severe COVID-19 defined as oxygen saturation (SaO2) of ≤ 94% while breathing ambient air or significant clinical symptoms with chest x-ray changes requiring hospital admission. Randomization was in a 1:1 ratio to receive standard care (control group) or standard care plus favipiravir and hydroxychloroquine. The primary outcome was time to clinical improvement of two points (from the status at randomization) on a seven-category ordinal scale or live discharge from the hospital within 14 days. Analyses were done in an intention-to-treat population. Results From May 2020 to Jan 2021, 254 patients were enrolled; 129 were assigned to standard of care and 125 to the treatment. The mean age was 52 (± 13) years, and 103 (41%) were women. At randomization, six patients were on invasive mechanical ventilation, 229 (90.15%) were requiring supplemental oxygen only (with or without non-invasive ventilation), and 19 (7.48%) were receiving neither. The time to clinical improvement was not significantly different between the groups: median of 9 days in the treatment group and 7 days in the control group (HR: 0.845; 95% CI 0.617–1.157; p-value = 0.29). The 28-day mortality was not significantly different between the groups (7.63% treatment) vs. (10.32% control); p-value = 0.45. The most prevalent adverse events were headache, elevation in ALT, and the prolonged QTc interval in the treatment group. Conclusion The combination of favipiravir and hydroxychloroquine did not result in a statistically significant clinical benefit in patients with moderate-to-severe COVID-19. Clinical Trial Registration ClinicalTrials.gov (NCT04392973). Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00496-6.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic infection that emerged in December 2019 leading to an outbreak worldwide. We aimed to investigate the hematological parameters and coagulation profiles specifically for the referral of coronavirus disease 2019 (COVID-19) patients to intensive care unit (ICU) due to the severity of illness to determine a pathognomonic association of infection severity and the hematological markers. The pathognomonic markers could assist physicians in better management of the infection to reduce mortality and morbidity. Thirty patients infected with COVID-19 who were receiving treatment during November and October 2020, in the ICU at Asir Central Hospital, Asir Region, Saudi Arabia, were recruited. The age of patients ranged between 30 and 90 years old. COVID-19 patients in the ICU displayed a statistical reduction in red blood cells (RBCs), hemoglobin (HBG), and hematocrit (HCT). Leukocytosis, neutrophilia, thrombocytopenia, and lymphocytopenia were significant in ICU COVID-19 patients.�Hematological parameters and coagulation profiles may be used as signs to predict the severity of the coronavirus infection. COVID-19 cases in the ICU showed a dramatic change in hematological parameters and coagulation profiles, indicating that the virus may interfere with hemoglobin, platelet, and immune cell functions through either inhibition or stimulation, leading to severe complications.

BACKGROUND:Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies.OBJECTIVE:Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children.DESIGN:Retrospective chart review.SETTING:Patients admitted to the tertiary care unit of a hospital in Riyadh.PATIENTS AND METHODS:Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed.MAIN OUTCOME MEASURE:Drowning mortality and morbidity.SAMPLE SIZE:99.RESULTS:Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome (PPCONCLUSION:These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes.LIMITATIONS:The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable.CONFLICT OF INTEREST:None.

Background & aimsNon-invasive tests (NITs) offer a practical solution for advanced fibrosis identification in non-alcoholic fatty liver disease (NAFLD). Despite increasing implementation, their use is not standardised, which can lead to inconsistent interpretation and risk stratification. We aimed to assess the types of NITs and the corresponding cut-offs used in a range of healthcare settings.MethodsA survey was distributed to a convenience sample of liver health experts who participated in a global NAFLD consensus statement. Respondents provided information on the NITs used in their clinic with the corresponding cut-offs and those used in established care pathways in their areas.ResultsThere were 35 respondents from 24 countries, 89% of whom practised in tertiary level settings. A total of 14 different NITs were used, and each respondent reported using at least one (median= 3). Of the respondents, 80% reported using FIB-4 and liver stiffness by vibration-controlled transient elastography (Fibroscan®), followed by the NAFLD fibrosis score (49%). For FIB-4, 71% of respondents used a low cut-off of 7.5 to >20kPa, respectively).ConclusionsThe cut-offs used for the same NITs for NAFLD risk stratification vary between clinicians. As cut-offs impact test performance, these findings underscore the heterogeneity in risk-assessment and support the importance of establishing consistent guidelines on the standardised use of NITs in NAFLD management.Lay summaryOwing to the high prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population it is important to identify those who have more advanced stages of liver fibrosis, so that they can be properly treated. Non-invasive tests (NITs) provide a practical way to assess fibrosis risk in patients. However, we found that the cut-offs used for the same NITs vary between clinicians. As cut-offs impact test performance, these findings highlight the importance of establishing consistent guidelines on the standardised use of NITs to optimise clinical management of NAFLD.

Background: The resin-based materials are used extensively in esthetic restorations but are.prone to color changes over time. Aims: To assess the discoloration effect of red tea, Arabic coffee, and black coffee on the resin infiltrated white spot lesions (WSL). Moreover, to investigate the impact of time (1d, 3d, and 7d) on the discoloration of the resin infiltrated WSLs. Materials and methods: Thirty-three extracted human premolar teeth were used to create WSLs, and ICON resin infiltration treatment was performed to obliterate the enamel pores. Teeth with resin infiltrated WSLs were sectioned into two halves by cutting mesio-distally and cross-sectionally at 1 mm below the CEJ. The resin infiltrated specimens was exposed to control (artificial saliva) and staining subgroups. Colour stability was assessed using the CIE L*a*b* system. Results: Analysis of variance (p

Background/Aim: Appropriate selection of suture material is a crucial step in oral, maxillofacial and periodontal surgery for uneventful healing. We have scarcity of comprehensive studies comparing mechanical properties of commonly used suture material in oral surgeries. The present in vitro study sought to evaluate the effect of saliva on the strength, elongation and stiffness of the commonly used suture material over a period of two weeks. Methods: Three suture materials Silk (SL), polyglactin 910 (PG) and polypropylene (PP) were used in 4-0 gauge. A total of 120 suture samples (40 from each material) were used for the experiment. Artificial saliva was mixed with human serum in 1:1 concentration and maintained at pH of 7.4 to 8.1 to simulate oral environment. All samples were tested at pre-immersion (baseline), 3rd, 7th and 14th day post-immersion periods. Universal testing machine was used to test the selected mechanical properties. The collected data were subjected to statistical analysis. Results: The distribution of mean baseline strength and percentage elongation was significantly higher in PP group (P-value

The present study was carried out to develop cisplatin-loaded chitosan nanoparticles (CCNP) and cisplatin-loaded chitosan nanoparticle surface linked to rituximab (mAbCCNP) as targeted delivery formulations. The two formulations (CCNP and mAbCCNP) exhibited significant physicochemical properties. The zetapotential (ZP) values of CCNP and mAbCCNP were 30.50 ± 5.64 and 26.90 ± 9.09 mV, respectively; while their particle sizes were 308.10 ± 1.10 and 349.40 ± 3.20 z.d.nm, respectively. The poly dispersity index (PDI) of CCNP was 0.257 ± 0.030 (66.6% PDI), while that of mAbCCNP was 0.444 ± 0.007 (57.60% PDI). Differential scanning calorimetry (DSC) revealed that CCNP had endothermic peaks at temperatures ranging from 135.50 to 157.69 °C. A sharp exothermic peak was observed at 95.79 °C, and an endothermic peak was observed at 166.60 °C. The XRD study on CCNP and mAbCCNP revealed distinct peaks at 2θ. Four peaks at 35.38°, 37.47°, 49.29°, and 59.94° corresponded to CCNP, while three distinct peaks at 36.6°, 49.12°, and 55.08° corresponded to mAbCCNP. The in vitro release of cisplatin from nanoparticles followed zero order kinetics in both CCNP and mAbCCNP. The profile for CCNP showed 43.80% release of cisplatin in 6 h (R2 = 0.9322), indicating linearity of release with minimal deviation. However, the release profile of mAbCCNP showed 22.52% release in 4 h (R2 = 0.9416), indicating linearity with sustained release. In vitro cytotoxicity studies on MCF-7 ATCC human breast cancer cell line showed that CCNP exerted good cytotoxicity, with IC50 of 4.085 ± 0.065 µg/mL. However, mAbCCNP did not elicit any cytotoxic effect. At a dose of 4.00 µg/mL cisplatin induced early apoptosis and late apoptosis, chromatin condensation, while it produced secondary necrosis at a dose of 8.00 µg/mL. Potential delivery system for cisplatin CCNP and mAbCCNP were successfully formulated. The results indicated that CCNP was a more successful formulation than mAbCCNP due to lack of specificity of rituximab against MCF-7 ATCC human breast cancer cells.

Nonalcoholic fatty liver disease (NAFLD) is a common but complex chronic liver disease, driven by environmental and genetic factors. We assessed metabolic and dietary risk factor associations with NAFLD liver mortality using the Global Burden of Disease (GBD) 2017 data. NAFLD liver deaths were calculated (per 100,000) as age-standardized rates (ASRs) from 195 countries and territories (21 GBD regions; 7 GBD superregions). Dietary risks included low intake of fruits, vegetables, legumes, whole grains, nuts/seeds, milk, fiber, calcium, seafood omega-3 fatty acids, and polyunsaturated fatty acids, and high intake of red meat, processed meat, sugar-sweetened beverages, trans fatty acids, and sodium. Metabolic risks included high low-density lipoprotein cholesterol, systolic blood pressure (BP), fasting glucose (FG), body mass index (BMI), as well as low bone mineral density and impaired kidney function (IKF). Socio-demographic index (SDI)-adjusted partial Spearman correlation coefficients and multivariable generalized linear regression models/bidirectional stepwise selection (significance level for entry, 0.2; for stay, 0.05) determined the associations. The ASR for NAFLD liver deaths was 2.3 per 100,000 (2017) and correlated with dietary risk factors (0.131, -0.010-0.267) and metabolic risk factors (SDI-adjusted = 0.225, 95% CI 0.086-0.354). High intake of sugar-sweetened beverages and red meat (0.358, 0.229-0.475; 0.162, 0.022-0.296), and low intake of nuts/seed and milk (0.154, 0.014-0.289; 0.145, 0.004-0.280) was significant for NAFLD liver deaths. Other risk factors for liver death included IKF (0.402, 0.276-0.514), increased BMI (0.353, 0.223-0.407), FG (0.248, 0.111-0.376), and BP (0.163, 0.022-0.297). High intake of trans fatty acids (2.84% increase [1.65%-4.03%]) was the largest associated risk of NAFLD liver deaths. In addition to metabolic risks, dietary risks independently drive the global burden of NAFLD-related liver mortality. Conclusion: These data provide additional support for policies to improve dietary environment for NAFLD burden reduction.

Aims: To evaluate and compare changes in salivary flow rate and salivary levels of TIMP-1 and TIMP-2 in individuals taking oral Isotretinoin (INN) with those who do not take INN. To assess the variation in TIMP-1 and TIMP-2 as well as salivary flow rate observed at different stages of periodontal disease in comparison to those observed in the case of healthy periodontium. Materials and methods: An examiner-blind case-control study involving 180 human adults divided into six groups based on their periodontal status. Clinical parameters, including pocket depth, clinical attachment level, and bleeding on probing were measured at six sites per tooth. Whole unstimulated saliva samples were collected from all subjects to evaluate salivary flow rate (SFR). Salivary TIMP-1 and TIMP-2 levels were detected using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using IBM SPSS Software. The Kruskal Wallis test and Mann-Whitney U-tests were employed to verify any significant differences between the groups for all parameters. Multi-regression analysis was performed for each parameter tested in each group. All tests were compared at a significance level of 0.05. Results: SFR was statistically significantly lower among all INN groups in comparison to the control groups (P

© Asian Pacific Association for the Study of the Liver 2023, Background: Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25-30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. Methods and results: A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. Conculsions: The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

Objectives: Recent studies have shown that methicillin-resistantStaphylococcus aureus (MRSA) bacteraemia with vancomycin minimum inhibitory concentration (MIC) >1 μg/mL is associated with a higher rate of treatment failure and a higher mortality rate. Daptomycin is an alternative to vancomycin but has not been as well studied. The aim of this literature review was to evaluate the effect of daptomycin MIC on the outcomes of S. aureus bacteraemia. Methods: We conducted a literature search for the period January 2010 to January 2019 using the MEDLINE and Embase databases. Results: Four studies were included in the review. The outcomes were clinical cure and 30- or 60-day mortality. In two retrospective studies, 60–70% ofS. aureus isolates had a low daptomycin MIC (≤0.5 μg/mL) and patients with MRSA bacteraemia who were treated with daptomycin had a lower mortality rate. In another study, patients with methicillin-susceptible S. aureus bacteraemia with low daptomycin MICs had a lower risk of developing septic thrombophlebitis. One study showed that patients with MRSA bacteraemia had a higher mortality rate if the daptomycin MIC was >0.5 μg/mL. Conclusion: The included studies in this review suggest a possible association between high daptomycin MIC and unfavourable clinical outcomes ofS. aureus bacteraemia. Further prospective studies are required to evaluate the impact of the daptomycin MIC on the clinical outcomes of S. aureus bacteraemia.

Human toxocariasis is a zoonotic infection with global and regional impacts. Worldwide it is underestimated and clinically overlooked. Medical practitioners are generally unaware of the extent of the resulting disease spectrum. The objective of the study was to assess knowledge and disease awareness among medical practitioners in Aseer, south-western Saudi Arabia. A questionnaire addressing knowledge about the parasite, its visceral larva migrans and the disease spectrum generated was used to interview participants. The study included 285 participants. In answer to the question what is toxocara, only 27%, answered correctly that it is a nematode, paediatricians being the majority. With regard to years of experience among participants, 56.8% of those who answered correctly had less than 5-year experience, as opposed to 35.4% for those with more than 10-year experience. The cumulative awareness about the disease manifestations and spectrum, i.e. those who knew, was less than 30% across specialties and years of experiences. Lack of awareness regarding Toxocara infection and the disease spectrum it can generate is evident. The consequence for such lack of knowledge within our practising medical community is simply unacceptable as it might translate into misdiagnosis and consequently misguided treatment.

BACKGROUND: The risk of falling for individuals with stroke is about twice that of healthy older adults. Lack of appropriate initiative to address the fear-related maladaptive behaviour can manifest itself in the form of loss of physical functions resulting in disability and handicap. OBJECTIVE: To examine the effectiveness of the structured balance awareness program (SBAP) in improving the perceived balance confidence, and thereby modifying the fear-related maladaptive behaviour in post-stroke survivors. METHODS: A randomized experimental control design was used on a sample of 97 post-stroke survivors aged between 55 to 75 years. The patients received either the SBAP or health awareness program (HAP) for eight weeks and were compared on Activities-specific Balance Confidence (ABC) Scale, Berg Balance Scale (BBS) and Falls Efficacy Scale International (FESI). RESULTS: A paired t-test demonstrated statistically significant improvement among all the variables in the SBAP group. An independent t-test exhibited a statistically significant improvement on ABC (t = 2.57, p = 0.012*), BBS (t = 3.32, p = 0.001*) and FESI (t = 3.38, p = 0.001*) in the SBAP group. CONCLUSION: The study showed that the SBAP was effective in minimizing the fear-related maladaptive behaviour in post-stroke survivors.

Mohammad Abdul Baseer,1 Nawaf Abdulaziz Almayah,2 Khalid Mirae Alqahtani,2 Marwan Ibrahim Alshaye,2 Meshari Mohammed Aldhahri2 1Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia; 2College of Dentistry, Riyadh Elm University, Riyadh, Saudi ArabiaCorrespondence: Mohammad Abdul BaseerDepartment of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Post Box No 84891, Riyadh, 11681, Saudi ArabiaEmail ma_baseer@riyadh.edu.saPurpose: The objective of this study is to compare the orthodontic patient’s experiences with removable and fixed orthodontic appliances on daily activities, food consumption, and oral symptoms in Riyadh city, Saudi Arabia.Methods: This was a cross-sectional observational study carried out among orthodontic patients. A total of 150 adult patients, including 118 in the fixed orthodontic appliance group and 32 in the removable (Invisalign) orthodontic group, who met the inclusion criteria completed a validated and self-administered questionnaire. In addition, the study participants reported their experience in terms of daily routine, food consumption, and oral symptoms one week after appliance activation. Data were analyzed using the chi-square test and Fisher’s exact tests for the categorical variables. In addition, Mann–Whitney U, Kruskal–Wallis, and Spearman’s tests were also applied to the data.Results: The fixed orthodontic patients compared to the removable orthodontic cases showed significantly higher difficulty in sleeping (1.28± 1.10 vs 0.94± 0.88, p=0.024), sores on the tongue (0.97± 1.00 vs 0.56± 0.76, p=0.042) and cheeks (1.20± 1.11 vs 0.72± 0.81, p=0.027), and the presence of food debris under the appliance (1.53± 1.16 vs.1.00± 0.95, p=0.021). Moreover, the oral health impact score showed a significant positive correlation with the duration of the orthodontic treatment (r=0.339, p< 0.001) and pain intensity (r=0.309, p< 0.001).Conclusion: The fixed orthodontic treatment compared to removable orthodontic treatment resulted in more severe pain, sleeping difficulty, sores on the tongue and cheeks, and food impaction after one week of appliance activation.Keywords: removable appliance, orthodontic treatment, fixed appliance, Invisalign, oral impacts, oral health-related quality of life, OHRQoL

The von willebrand disease (vWD) accounts to be one of the most common hereditary bleeding ailment that amounts its incidence to almost 1.5% of normal population. It is mostly associated with a defect in primary hemostasis as well as secondary defect in coagulation factor VIII as diagnosis of vwd happened to be challenging with earlier diagnostic criteria’s. Testing Vwd in menorrhagia patients was not at ease. A cross-sectional study was conducted in female patients who have visited obstetrics and gynecology clinic at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. The inclusion criteria consist of adult female patients between 16 and 45 years old with menorrhagia. A sample of 45 patients were screened and selected for the above-mentioned study. The SPSS Statistical analysis package was performed to analyze the data’s. The fisher’s exact test was conducted to compare the demographic variables. The independent samples t-test was conducted to compare the means of subjects. The P value of ≤0.05 considered as statistically significant. The cases manifested with a history of bleeding during periods stretching from 7 to 90 days. The vWD was reported in 6.6 % (n = 3) women out of the total 45 patients. The vWF: Ac mean ± SD (51.4 ± 6.3) and vWF: Ag Mean ± SD (93 ± 67) were significantly lesser in vWD patients with that of non-vWD (98.7 ± 22.6) vs (116 ± 42.4) (p = 0.027) (p = 0.032) respectively. WBC, ESR, MCV, MCH, Hemoglobin, PLT count, INR, PT, APTT and FVIII showed no significant difference among the groups (p > 0.05).

Objectives: This study aims to evaluate the effectiveness of topical fluoride application and diode laser-irradiation on the hardness of demineralized enamel and to evaluate the esthetic improvement of the white spot lesions (WSLs) using a visual analog scale (VAS). Materials and Methods: Artificial WSLs (3x3 mm) were created on the enamel surface of 45 human third molars. The teeth were randomly assigned into three groups (n = 15): group A, fluoride only; group B, combined therapy of fluoride and diode laser; and group C, control. Vicker’s hardness number (VHN) was measured at baseline, after demineralization and after treatment. To evaluate the esthetic improvement after treatment, 14 raters evaluated each group’s photographs using a 100-millimeter VAS. A one-way ANOVA or Brown-Forsythe and Games-Howell post hoc procedure were performed for statistical analysis. The level of significance was set at α = 0.05 for all tests. Results: Group A mean VHN was significantly higher than groups B and C, and group B was significantly higher than group C (P

Objective To compare the dimensional changes in the oropharyngeal airway in patients with skeletal Class II and Class III malocclusion before and after orthognathic surgery and treatment with a functional appliance. Methods The protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and was registered to the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42020170901. Furthermore, the reporting of the present SR was performed based on the PRISMA checklist. Results The use of removable functional appliances increased the volume of the oropharyngeal airway in patients with skeletal Class II malocclusion. Furthermore, the increase in the volume of the oropharyngeal airway following the removable functional appliance treatment was more than that observed after fixed functional appliance treatment in growing patients. For patients with skeletal Class III malocclusion, who underwent the bimaxillary orthognathic surgery, resulted in no change in the dimensions of the oropharyngeal airway. Conclusion Growing patients who receive removable functional appliance treatment have a more favorable long-term prognosis with regard to the oropharyngeal airway when compared with those who receive fixed functional appliance. Alternatively, in patients aged from (18–22) years with skeletal class III malocclusion Bimaxillary orthognathic surgery was found to be the recomended and superior method of treatment.

This study investigated the usefulness of iodine-131 (131I) single photon emission computed tomography-computed tomography (SPECT-CT) in conjunction with whole-body scan (WBS) planar imaging for th...

Pseudomonas aeruginosa, a gram-negative opportunistic pathogen, is one of the major species isolated from infected chronic wounds. The multidrug resistance exhibited by P. aeruginosa and its ability to form biofilms that are difficult to eradicate, along with the rising cost of producing new antibiotics, has necessitated the search for alternatives to standard antibiotics. Pyocins are antimicrobial compounds produced by P. aeruginosa that protect themselves from their competitors. We synthesized and purified recombinant P. aeruginosa R2 pyocin and used it in an aqueous solution (rR2P) or formulated in polyethylene glycol (rR2PC) to treat P. aeruginosa-infected wounds. Clinical strains of P. aeruginosa were found to be sensitive (completely), partially sensitive, or resistant to rR2P. In the in vitro biofilm model, rR2P inhibited biofilm development by rR2P-sensitive isolates, while rR2PC eliminated partial biofilms formed by these strains in an in vitro wound biofilm model. In the murine model of excision wounds, and at 24 h post-infection, rR2PC application significantly reduced the bioburden of the clinical isolate BPI86. Application of rR2PC containing two glycoside hydrolase antibiofilm agents eliminated BPI86 from infected wounds. These results suggest that the topical application of rR2PC is an effective therapy for treating wounds infected with R2P-senstive P. aeruginosa strains.

Objectives Identify specific maxillofacial trauma patterns associated with cervical spine injuries. Methods The protocol was developed according to (PRISMA-P) and was admitted to PROSPERO under accreditation code #CRD42020177816. Furthermore, the reporting of the present SR was conducted based on the PRISMA checklist. Results Of the 1,407,750 patients recorded, a total of 115,997 patients (12.13%) had MFF with an associated CSI with a gender proportion (M:F) of 3.63:1 respectively. Motor vehicle accident was the most common cause of the combined Maxillofacial Trauma (MFT) and CSI. The most common CSI location was at the C2, followed by the C5 cervical spines. The most common location of a maxillofacial fracture resulting in a CSI was the mandible. Conclusion The incidence of the association of CSIs with MFT has been low (12.13%). Nevertheless, in cases of an isolated mandibular trauma due to a severe blow presenting with a low Glasgow Coma Scale, maxillofacial surgeons should be at a high alert of an associated CSI.

OBJECTIVES To identify the self-reported vaccine-related side effects among healthcare professionals (HCPs) in the Jazan province, Saudi Arabia, and determine the associated socio-demographic factors. With the recent second and third waves of coronavirus disease -19 (COVID-19) infections worldwide, the race is not only to encourage but also to achieve mass vaccination. METHODS A total of 397 HCPs from across Jazan province participated in an anonymous online cross-sectional survey conducted for a period of 45 days (March 30, 2021 to May 13, 2021) in Jazan province, Saudi Arabia. Data was collected using a validated 22-items self-report survey. RESULTS For both COVID-19 vaccines, majority of reports were related to flu-like symptoms including fever, chills, headache, fatigue, tiredness, and myalgia. Statistically significant associations were observed between the severity of side effects and gender (χ2=73.32; p

The ideal management for end stage liver disease, acute liver failure, and hepatocellular carcinoma (HCC), within specific criteria, is liver transplantation (LT). Over the years, there has been a steady increase in the candidates listed for LT, without a corresponding increase in the donor pool. Therefore, due to organ shortage, it has been substantially difficult to reduce waitlist mortality among patients awaiting LT. Thus, marginal donors such as elderly donors, steatotic donors, split liver, and donors after cardiac death (DCD), which were once not commonly used, are now considered. Furthermore, it is encouraging to see the passing of Acts, such as the HIV Organ Policy Equity (HOPE) Act, enabling further research and development in utilizing HIV grafts. Subsequently, the newer antivirals have aided in successful post-transplant period, especially for hepatitis C positive grafts. However, currently, there is no standardization, and protocols are center specific in the usage of marginal donors. Therefore, studies with longer follow ups are required to standardize its use.

Background: The rapidly ongoing coronavirus disease 2019 (COVID-19) pandemic worldwide is adversely affecting the population, and all health services, hospital visits, and regular check-ups, or even routine childhood immunization programs were disrupted and were not able to commence. The present study aimed at evaluating the impact of the COVID-19 pandemic on childhood immunization status, aiming to increase the awareness of the importance of vaccination to prevent the outbreaks of vaccine-preventable diseases. Methodology: In this cross-sectional study, 548 participants were included and selected via convenience sampling. This study’s desired population was parents ≥18 years old who are caring for children their age limit within the routine childhood immunization in Saudi Arabia. Data were collected using a tailored questionnaire. Results: 75.5% of the participants were aware of the Ministry of Health’s recommendation not to delay children vaccination during the COVID-19 pandemic, 41.4% of the participants said that the COVID-19 pandemic affected their children vaccination schedule. 15% reported a delay in the vaccination without rescheduling it and 24.3% reported a delay but they have been rescheduled, 2.1% canceled the rest of their children’s vaccination, and 42.3% attributed the delay of immunization to avoid catching COVID-19. Also, we found that the most affected age group was children at 21.2 months. The following factors were significantly associated with lower childhood vaccination rates: fathers with intermediate school education, fathers with high school education, and being a student. Conclusion: Our findings in this study showed that more than one-third of the participants had been affected by the COVID-19 pandemic regarding their children’s vaccination schedule; the impact presented as delaying or canceling the vaccination.

Background: Well-baby clinic (WBC) service is implemented in all primary health care centers and is provided based on international standards to all children under 5 years in Saudi Arabia. It is a comprehensive package of health promotion and curative care to improve and maintain the health status and well-being of this age group. Aim: The main aim is to assess parents’ awareness and perception regarding WBC in primary health care centers in Abha sector, Kingdom of Saudi Arabia (KSA). Methodology: A descriptive cross-sectional approach was used in the current study. The study targeted all babies’ caregivers attending WBCs in primary health care centers in Abha city. The children's parents were included using three stages cluster sample technique. The questionnaire included participants’ demographic data such as age, gender, relation to the baby, educational level, work, and monthly income. Awareness regarding the WBC was assessed using two main items covering hearing about the clinic provided services. Results: The study included 1593 participants whose ages ranged from 19 to 55 years old with a mean age of 34.6 ± 11.8 years. About 64% of the respondents knew about the WBC, which was significantly higher among the females than males (P = .003). Also, 71.2% of respondents aged 25–34 years knew about well-baby clinic (WBC) compared to 35% of parents aged less than 25 years (P = .001). Exact 57.1% of the respondents went to the nearest governmental health office at vaccination times. About 46% of the respondents reported that the clinic nurse was the main person who dealt with them. Regarding services provided by a nurse at the vaccination clinic, registering child vaccination was the most reported (66.2%), followed by helping the mother make the child calm (56.8%). Conclusions: In conclusion, the study revealed that proper care is vital for a child's survival as well as optimal physical and mental development. Adequately cared child has proper well-being and happiness. Mothers and children caregivers had adequate awareness and acceptable attitude towards WBCs and provided services. Some barriers were declared including lack of available WBCs within the residence range, not all WBCs usually working, and more information should be provided about WBCs.

Introduction Our research sought to assess the psychological and social wellbeing of paramedics in Riyadh City in Saudi Arabia during the COVID 19 pandemic. It also aimed to assess the therapeutic assistance provided to pre-hospital care givers during the pandemic. Methods In this quantitative cross-sectional analysis an assessment of 106 paramedics was undertaken from data obtained from 28 September to 10 November 2020. The authenticity and durability of Pilot and the Cronbach have been added. Results Of the 106 paramedics surveyed, 60 (56.6%) were 30–39 years of age; 101 were male (95.3%). The mean average psychological wellbeing of the paramedics was 6.41 with the standard deviation of 2.42. Family and friends’ average social support score was 9.2 in norm 2.6 deviation. Conclusion Our study showed that during the COVID-19 pandemic paramedics suffered from social and psychological depression. Paramedics must be protected from the socioeconomic and psychological difficulties they face every day in order to combat the COVID-19 pandemic.

Objectives: To identify demographic characteristics, and types of stroke in Southwestern (Aseer) Region, Saudi Arabia. Methods: This study is a retrospective and hospital-based. The data of all stroke patients (n=562) admitted to the tertiary care hospital in the province, Aseer Central Hospital (ACH) within the period from January 2016 until December 2017 are included. Results: The mean ± SD of stoke patients’ age was 62.6 ± 17.0 years. Male patients were more than female patients (62.6% and 37.4%, respectively). The majority (93.2%) were Saudi, while 91.5% had below university education and 6.4% were smokers. Interestingly, only 2% of patients had a family history of stroke, while 68.1% were diabetic, 80.4% were hypertensive, 91.6% had high serum cholesterol level, and 10.7% had history of transient ischemic attacks (TIA). Despite the lack of awareness, and leading to delay in reaching health care facility, 58.1% of stroke patients, were arriving to emergency department (ED) in less than 24 hours (potential endovascular therapeutic window). Conclusions: In Aseer Region, Saudi Arabia, stroke affects mainly those who are older, less educated, diabetic, hypertensive, with hypercholesterolemia and previous history of TIA. Associated factors for stroke differ significantly according to their nationality.

MATERIALS AND METHODS: A total of 457 blood transfusion requests for 244 patients were received over a 3-month period. Registered demographic characteristics (age, sex, and nationality), ward, type of blood, and hemoglobin concentration before transfusion for all the patients were collected. RESULTS: A total of 1328 blood products were requested, while 780 (59%) units were transfused. The cross-matched packed red cells/transfusion ratio was 1.8, while request/transfusion was 1.7 for the fresh frozen plasma and 1.23 for platelets. Packed red blood cells were the main blood product used in blood transfusion (BT). General surgery/orthopedics and intensive care unit were reported with a greater number of requests. The main indications noted for blood requisition were surgery and anemia. CONCLUSIONS: Current guidelines appear to be respected within services regarding BT decision criteria. However, about half of the requested blood is not transfused which suggest further improvement. Adherence to established guidelines seems variables among different departments. Elective transfusion medicine rotations for all trainees and specialized dedicated sessions for doctors may help in further betterment of utilization of blood bank services.

Background: Given the increase in the numbers of expatriates in Saudi Arabia and the shortage of information about expatriates’ oral health and periodontal disease severity and progression. Objectives: This study aimed to evaluate the effects of the racial differences on oral health and periodontal disease extent, staging, and grading among the multi-ethnic expatriates in the Aseer region, Saudi Arabia. Materials and Methods: This cross-sectional study was carried out on 300 expatriates in Aseer region, Saudi Arabia. They were divided into three equal racial different groups (n = 100), Arabs (AR), Asians (AS), and Africans (AF). The interviews of all participants were completed then the clinical examinations of periodontal diseases extent, staging, and grading parameters were performed. Statistical analysis was done by ANOVA test, Tukey’s test, and Chi-square test. The statistical significance level was determined at p < 0.05. Results: There were statistically significant differences in the comparison between the three ethnic/racial groups in clinical parameters except in GBI, PCR, FI, TFO, and BC, where there were no statistically significant differences in the comparison between the three ethnic/racial groups. There were differences associated with age, gender, smoking, and diabetes, without statistically significant differences among the three racial groups. Conclusion: We concluded that most participants in this study had a generalized severe grade 4 plaque-induced gingivitis and localized periodontitis stage III grade B.

Background: Road traffic accidents are considered to be a leading cause of morbidity and mortality in many countries. Therefore, this cross-sectional study aimed to measure the awareness of the Saudi population in Jeddah about the alarming signs of post-traumatic intracranial hemorrhage and the importance of early presentation. Methodology: A cross-sectional study using an electronic survey questionnaire consisting of 41 questions was conducted in Jeddah for a period of 6 months. The general attitude and awareness of the public toward head injuries were assessed. Results: Data were collected from 310 participants, in which 156 (50.3 %) were male and 154 (49.7%) were female. Findings showed that 56.1% of the people were aware of head injuries. Almost 30% (as a family relative not including the mother) suggested that more education was required about head injuries. Around 208 participants did not know that they should not to drink water after a head injury. Conclusion: There is a need to raise the level of public awareness about head injuries. Many educational awareness campaigns, programs, and seminars are required to build a background of proper actions after head injuries.

Different phytochemicals from various plant species exhibit promising medicinal properties against cancer. Juniperus phoenicea is a plant species that has been found to present medicinal properties. Herein, crude extract and fractions of J. phoenicea were examined to determine its anticancer properties against several cancer cells. The active fraction was chosen to assess its activity on cell cycle progression and apoptosis induction by annexin and propidium iodide (PI) biomarkers. Further, phytochemical screening for possible contents of active fraction using gas chromatography–mass spectrometry (GC-MS) analysis was conducted. It was demonstrated that cell proliferation was suppressed, and the MCF-7 cell line was the most sensitive to J. phoenicea chloroform fraction (JPCF), with the IC50 values of 24.5 μg/mL. The anti-proliferation activity of JPCF in MCF-7 cells was linked to the aggregation of cells in the G1 phase, increases in early and late apoptosis as well as necrotic cell death. Contents analysis of JPCF using GC-MS analysis identified 3-methyl-5-(2′,6′,6′-trimethylcyclohex-1′-enyl)-1-penten-3-ol (16.5%), methyl 8-oxooctanoate (15.61%), cubenol (13.48%), and 7-oxabicyclo [2.2.1] heptane (12.14%) as major constituents. Our present study provides clear evidence that J. phoenicea can inhibit cell proliferation, trigger cell cycle arrest, and induce apoptosis in tested cancer cells.

COVID-19, a pandemic disease caused by a viral infection, is associated with a high mortality rate. Most of the signs and symptoms, e.g. cytokine storm, electrolytes imbalances, thromboembolism, etc., are related to mitochondrial dysfunction. Therefore, targeting mitochondrion will represent a more rational treatment of COVID-19. The current work outlines how COVID-19’s signs and symptoms are related to the mitochondrion. Proper understanding of the underlying causes might enhance the opportunity to treat COVID-19.