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Background and Objective: Self-medication (SM) is an emerging practice in both developing and developed countries. The commonality of this behavior is observed in patients with specific environments. The current study endeavored to determine the prevalence of SM practices and their correlated factors among academic employees in Saudi Arabia. Methods: A cross-sectional study was conducted at King Saud University Hospital, recruiting 383 participants. The participants received an online survey on self-medication practices. The data were analyzed using descriptive statistics and regression analysis. Results: In the study, all the participants reported practicing SM at least one time. Of those who practiced SM, 66.7% (102) were unmarried with a significant difference (P = 0.036) while 68.0% (117) had no children (P = 0.003). Non-Government employees and unemployed participants had the highest percentage of experiencing SM (70.5%, n = 31, P = 0.036). Our results reveal that health perceiving, life satisfaction, and religious reasons were not significantly associated with practicing SM with P value = 0.704, 0.535, and 0.482, respectively. In the univariate model, gender, marital status, and the number of children revealed a significant correlation with SM (P value = 0.136, 0.058, and 0.040), respectively. SM was 1.4 times as likely if the participant was female and 1.3 if the participant was unmarried. The multivariate regression model shows that gender and marital status lost their significance while number of children (P = 0.023) was significantly correlated with SM. Our results also show the main reasons for self-medication were prior knowledge (25%), time-consuming consultations (21.6%), the belief that the condition did not require a doctor (22.4%), and previous experience with similar symptoms (23%) while major causative clinical conditions involved in SM is pain (37.5%) and fever (28.4%). It also shows that 33% experienced no side effects and 34% experienced shortness of breath as a side effect of practicing SM. Conclusion: Our study spotted a significant frequency of SM behavior with high prevalence among University employees. Our study shows that gender, marital status, and number of children have a significant correlation with SM. The pharmacist’s role is pivotal in promoting awareness for the safe utilization of over-the-counter drugs, and their proactive engagement is paramount. Educational health programs should be implemented to minimize SM malpractice.

Background: The correlation of adiponectin and serum tumor necrosis factor alpha (TNFα) with glucometabolic parameters in diabetes mellitus (DM) needs further studies. We aimed in this study to evaluate the relationship between adiponectin and TNFα with glucometabolic parameters in patients with type 2 DM (T2DM). Methods: We conducted a cross-sectional study in the Department of Physiology, College of Medicine, King Saud University, Saudi Arabia. The sample size was 117 from the diabetes clinic of King Abdul-Aziz University hospital through the convenience sampling technique. Subjects were grouped into control (healthy) subjects (53) with no chronic diseases and the diabetic group (64) with confirmed T2DM. Socio-demographic data were collected along with the serum blood sample to analyze the variables. Results: Adiponectin was significantly high in healthy subjects compared to the diabetic group (control: 14.4 ± 4.3, T2DM: 11.0 ± 4.1, P = 0.000), while TNFα was higher in the T2DM group (7.8 ± 2.7) than in the control group (6.6 ± 2.9, P = 0.024). TNFα was negatively correlated with adiponectin in the control group (-0.279) and in diabetic subjects (-0.311) and positively correlated with HbA1c in the diabetic group (0.319) and triglycerides (0.252). Adiponectin was positively correlated with HDL in the control group (0.252) and in diabetic subjects (0.326). There was an inverse correlation between TNFα and adiponectin. Conclusion: Adiponectin is higher in healthy subjects than in diabetic patients, while TNFα is higher in diabetic patients. In addition, adiponectin is positively correlated with HDL in healthy as well as diabetic patients. TNFα is positively correlated with HbA1c and triglycerides.

Hereditary motor and sensory neuropathy (HMSN), also known as Charcot-Marie-Tooth disease (CMT), is a member of the inherited neuropathy family with specific clinical and genetical manifestations. More than twenty genes have been linked to HMSN, and the number might increase. Regarding diagnosis, a healthcare provider should be suspicious if the patient is young with a family history. Integrative diagnosis, which includes electrophysiological, radiological, and genetic screening, is of great value to exclude metabolic, nutritive-toxic, infectious, and inflammatory or autoimmunological causes and to reach the exact subtype of hereditary neuropathy. Nowadays, next-generation sequencing-based analysis is becoming a routine diagnostic tool for inherited neuropathy, but if this facility is not available, electrophysiological and radiological diagnoses are the best diagnostic tools to be used. Differentiation between hereditary neuropathy and diabetic neuropathy is essential for primary care physicians to have the right plan.

Abstract Coronary artery disease is a leading cause of morbidity and mortality worldwide. It occurs due to a combination of genetics, lifestyle, and environmental factors. Premature coronary artery disease (PCAD) is a neglected clinical entity despite the rising number of cases worldwide. This study aimed to investigate the risk factors of premature coronary artery disease. In this study, we searched articles that had studied the risk factors of premature coronary artery diseases from January 2000 to July 2022 in Saudi Arabia in Web of Science, Pub Med, Scopus, Springer, and Wiley databases. The final analysis is based on seven articles. The smoking prevalence was 39%, diabetes mellitus 41%, hypertension 33%, overweight and obesity 18%, family history of coronary artery disease (CAD) 19%, dyslipidemia 37%, and the prevalence range of low-density lipoprotein cholesterol was 33.8–55.0%. The results revealed a mortality prevalence of 4% ranging from 2 to 8% which is similar to the prevalence in older patients which was 2–10%. Smoking, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, and overweight/obesity are significantly and positively associated with premature coronary artery diseases. The health authorities should design and implement an intensive and effective prophylactic plan to minimize the subsequent impact of PCAD on the young population. In addition, early diagnosis of PCAD has great value in providing timely treatment, managing the patients, and minimizing the burden of the disease.

Background: Carpal tunnel syndrome (CTS) is considered to be one of the most common peripheral nerve disorders with female preponderance which significantly reduces work efficacy and needs further research on its preventable factors, especially obesity. We studied the effects of obesity indices on Phalen’s test duration and median nerve conduction study (NCS) parameters in patients presenting with CTS. Methods: We examined 229 female patients presenting with clinical features of CTS. Clinical examinations including Phalen’s test, median NCSs, and body composition were evaluated. Obesity indices and electrophysiological parameters were compared. Results: There were significant associations of both body mass index (BMI) degrees and body fat percent (BF%) with clinical and NCS parameters with a linear relationship. BF% and BMI were strongly negatively correlated with Phalen’s test duration (BF%; r = -0.334, BMI; r = -0.270 P = 0.001). On the other hand, BF% and BMI were positively correlated with median distal latency (BF%; r = 0.338, BMI; r = 0.372, P value = 0.001), M-latency (BF%; r = 0.264, BMI; r = 0.285, P = 0.001), median motor conduction velocity (MMCV) (BF%; r = 0.119, P = 0.072, BMI; r = 0.173, P = 0.009), median sensory conduction velocity (MSCV) (BF%; r = -0.195, P = 0.003, BMI; r = 0.327, P = 0.001), and sensory nerve action potential (SNAP amplitude) (BF%; r = -.239, BMI; r = -0.350, P = 0.001). Conclusions: Nerve conduction parameters are significantly affected by obesity degree defined by BMI and BF%. Therefore, combining BMI and BF% assessments gives more clinical information regarding CTS severity and management. The true predictive value of these indices needs to be elucidated further.

Context: Depression, anxiety, and stress are common among medical students because of hectic and heavy studies. Aim: This study was carried out to determine the magnitude of the Depression, Anxiety, and Stress Scale (DASS) among undergraduate medical students and its relationship with its causative factors in public and private universities. Setting and Design: The study tool was DASS (Depression, Anxiety, Stress Scale-21) which was distributed through the Department of Physiology, College of Medicine, King Saud University, adopting a multistage cluster sampling method for an observational study design. Subjects and Data: Data from undergraduate medical students (N = 337) was collected from public and private medical colleges in Saudi Arabia. Statistical Analysis: Independent t-tests and analysis of covariance were applied to analyze the data. Results: There was a significant difference in depression with a higher mean score in private versus public medical students (8.38±5.93 vs 6.34±5.46, p=0.001), anxiety (9.49±5.12 vs 7.91±5.00, p=0.005), and stress (9.11±5.11 vs 7.93±5.02, p=0.035). There was a significant difference in the level of anxiety between second- and third-years students (p =0.01). Conclusion: Private medical university students have significantly higher depression, anxiety, and stress levels compared to public universities. More studies are needed to explore the causes of this psychological impact.

OBJECTIVE: To evaluate gender difference in non-traditional cardiovascular risk factors among Saudi patients with angiographically defined coronary artery disease (CAD). METHODS: We recruited 144 (male=105, female=39) patients with CAD who underwent coronary angiography. Laboratory analysis of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a) [Lp(a)], and high sensitivity C-reactive protein (hs-CRP) were performed along with echocardiographic evaluation. RESULTS: Systolic blood pressure (SBP) was significantly higher in females (138.65±18.67 vs 129.59±21.03 mmHg; p=0.0363). Although no significant difference was observed in TC (4.30±1.36 vs 4.67±1.07 mmol/L), however significantly higher levels of both HDL and LDL were seen in females (0.86±0.17 vs 0.70±0.23 mmol/L; p=0.0592 and 3.50±0.67 vs 2.72±1.13; p=0.0466 respectively). There were no significant differences in TG, Lp(a) and hs-CRP, however females had comparatively higher Lp(a) (30.43±28.89 vs 24.02±23.42 mg/dl) and hs-CRP (1.14±1.46 vs 0.95±1.25 mg/L). On angiography, greater extent of stenosis was observed in left anterior descending and right coronary arteries among males, while the left circumflex artery was affected more in the female patients without statistical significance (p=0.0797; 0.3890 and 0.5032 respectively). Gensini Score in males & females was 60.46±46.17 and 74.39±39.52 respectively (p=0.3013). Significantly narrower aortic root diameter (ARD) was observed among females (27.30±6.66 vs 29.73±3.40 mm; p=0.0293). CONCLUSION: Female patients have greater risk of cardiovascular diseases due to higher SBP and LDL levels which could lead to a greater Gensini score when compared to male patients. In addition, narrow ARD among females could also be a contributing factor to CAD.

Upper airway obstructions represent a huge burden to the health care system due to its high morbidity and cost to the economic systems. Therefore, it is important to understand the physiological parameters used in diagnosis and prognosis of these diseases. Various physiological lung parameters should be examined simultaneously to make the precise diagnosis of upper airway obstruction. Relying on only one parameter and neglecting others might lead to misdiagnosis and subsequent mismanagement. The shape of the flow-volume loop, Forced Expiratory Flow at 50% of vital capacity/Forced Inspiratory Flow at 50% of vital capacity ratio (FEF-50%/FIF-50%), Forced Expiratory Volume in 1 second /Forced Expiratory Volume after 0.5 seconds (FEV1/FEV0.5), Empey index, and the refined version of the Expiratory Disproportion Index (EDI) are of great value in the diagnosis of different types of upper airway obstructions. The shape of the flow-volume loop changes earlier than other spirometrical parameters and is very useful in detecting early changes in upper airway diseases. This review was aimed to explain and simplify the role of pulmonary function tests and flow volume curve not only for pulmonologists, but also for surgeons, anesthesiologists, and ENT specialists who can utilize and implement usefully these tests in their clinical practice.

Clinical physiology department in well-organized university hospitals has three important roles: 1) it can be considered the best link between the basic sciences that have been taught in the undergraduate curriculum and clinical practice. 2) several techniques are practiced in the clinical physiology department operating in close collaboration with other clinical specialties which are very helpful in providing health care such as Pulmonary Function Test, Electroencephalogram, Nerve Conduction Studies, Auditory Brainstem Response, Electrocardiogram, Exercise-based “stress tests,” etc. 3) it has a strong relation with research disciplines and its participation in this field cannot be neglected. The aim of this viewpoint is to unravel the hidden importance of the clinical physiology department and its utility in both basic sciences and clinical teachings, both for health care and research. Therefore, assuring clinical physiology as an independent part of the basic sciences physiology department with the decision-maker support could guarantee the survival and continuation of the link between undergraduate teaching and clinical practice. The practical sessions of the undergraduate curriculum should be updated so that students get knowledge of techniques utilized in their clinical careers. This is beyond the conventional theory bases irrelevant teaching curriculum. Recruitment of well-qualified and specialized specialists in clinical physiology techniques, technicians, and nurses who can perform and interpret these tests effectively as well as supplying the unit with modern and sophisticated equipment is of great value. Research funds have to be directed toward clinical physiology that can boost the development of medical evolution ahead.

OBJECTIVE: To determine the effect of mobile phone usage on sleep quality and fatigue severity through standard questionnaires in Saudi Arabia mobile phone users. METHODS: This cross-sectional study was conducted in Riyadh, Saudi Arabia on 251 mobile phone users from September 2019 to January 2020. Volunteer mobile phone users aging 15-65 years were selected by nonprobability convenience sampling technique from the Riyadh city community. The subjects were interviewed about the knowledge, attitude and practice of mobile phone use and were assessed through Pittsburg Sleep Quality index (PSQI) and Fatigue severity scale (FSS). Spearman’s correlations and Linear regression were applied for statistical analysis through SPSS V.22. RESULTS: Mean age of study participates was 32.43±12.8 years. There was a significant increase in PSQI and FSS with the increase daily mobile usage. When participants exceeded one-hour daily usage, PSQI (2h=6.85, p= 0.001) and FSS (2h= 3.61, p=0.008) exceeded acceptable scores. Moreover, placing mobile phone inside bedroom was associated with the increase of PSQI (Near Pillow=6.93, Inside Bed=6.16, Outside bed=5.75, p=0.001) and FSS (Near Pillow=3.65, Inside Bed=3.39, Outside Bed=2.58, p= 0.008). There was a significant increase in PSQI (Near Pillow=6.93, Inside Bed=6.16, Outside bed=5.75, p=0.001) and FSS (Near Pillow=3.65, Inside Bed=3.39, Outside Bed=2.58, p= 0.008) its location inside bedrooms. Significant correlation was observed between high PSQI and FSS with daily usage (r=0.213, p=0.001 & r=0.171, p=0.01 respectively). CONCLUSION: Inappropriate and excessive mobile phone usage is associated with poor sleep quality and excessive fatigue in Saudi Arabian population.

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak has caused massive damage to the global healthcare system and economy. To compete with the SARS-COV-2 pandemic, several vaccines have been proposed to immunize the population. The present study aimed to investigate the adverse effects following the three doses of COVID-19 vaccination, Pfizer (BioNTech), (Oxford-AstraZeneca (ChAdOx1 CoV-19), and Moderna among the adult population in the Eastern province of Saudi Arabia. In this study, the total number of participants were 426, among them 277 (65%) were females and 149 (35%) were males. An online survey using Google forms in the English language and translated into the Arabic language was used to record the information. The questionnaire was distributed to participants who received either Pfizer-BioNTech, Oxford-AstraZeneca or Moderna vaccines. The general characteristics of participants were obtained, alongside an evaluation of the vaccination’s adverse effects. The results revealed that Pfizer-BioNTech COVID-19 vaccines caused significantly less adverse effects than Oxford–AstraZeneca (ChAdOx1) and Moderna (p < 0.001), and females experienced more adverse effects after vaccination compared to males. Injection site pain was the most common adverse event among the participants (60.6%), followed by fatigue, headache, and pain (43.9%), muscle and joint pain (32.4%), increased body temperature and shivering (24.2%). In addition, the group of individuals under the age of sixty was more likely to experience side effects than the participants with other age groups. All three vaccines, Pfizer-BioNTech, Oxford–AstraZeneca (ChAdOx1 CoV-19) and Moderna, cause post-vaccinal adverse effects; however, Moderna and Oxford–AstraZeneca (ChAdOx1) causes adverse effects more frequently than the Pfizer-BioNTech.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease caused a highly problematic situation worldwide. Various vaccines were launched to combat the COVID-19 pandemic. This study aims to investigate the adverse effects of first and second doses of the Sinopharm vaccine among vaccinated medical and dental students and healthcare workers. A well-established questionnaire was distributed online, and 414 medical and dental students and healthcare workers (HCW) comprising 355 females (85.7%) and 59 males (14.3%) participated; all were vaccinated with two doses of Sinopharm. The most common side effect was pain at the injection site after dose one in 253 respondents (61.3%) and after dose two in 161 respondents (38.9%). Other symptoms included general lethargy in 168 (40.6%), myalgia/body pain in 99 (23.9%), low-grade fever in 93 (22.4%), and headache in 87 (21%) respondents. Common side effects reported after the second dose of the vaccine following pain at the injection site included general lethargy in 21.3% (88), headache in 10.4% (43), myalgia/body pain in 9.9% (41), and low-grade fever in 6.1% (25) of the respondents. In conclusion, common adverse effects of the Sinopharm vaccine were pain at the injection site, general lethargy, myalgia, body pain, low-grade fever, and headache. These adverse effects were mild in intensity for both doses but slightly more frequent and severe for the first dose than the second dose.

Human monkeypox is an emerging viral zoonotic disease, that has caused highly distinctive, challenging and threatening problems worldwide. The US Food and Drug Administration (FDA) has given interim authorization for the JYNNEOS and ACAM2000 vaccines for the outbreak of monkeypox 2022. The present study aims to highlight the globally derived evidence about the biological and pharmacological features, indications, contraindications and adverse effects of JYNNEOS and ACAM2000 vaccines. Initially, 82 documents were selected and, finally, 14 fact sheets, documents and international organizations were included. The data were recorded from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA) USA, ISI-Web of Science, PubMed, EMBASE and Scopus. The data revealed that the JYNNEOS vaccine has been recommended to children, adults, females during pregnancy and people of all age groups with a dose of 0.5 mL, and the complete vaccination cost per person is about USD 115. It provides immunogenicity, and the mean titer of neutralizing antibodies was 153.5. However, the ACAM2000 vaccine is contraindicated in infants and pregnant females, and recommended to people over 18 years of age and older, with a single dose of 0.0025 mL, and a cost of about USD 139. ACAM2000 provides immunogenicity, and the mean titer of neutralizing antibodies was 79.3. The JYNNEOS vaccine has mild adverse effects including pain, redness, swelling or itching at the site of the vaccine shot, fever, fatigue, headache, nausea and muscle pain. However, the ACAM2000 vaccine can cause pain, redness, edema, headache, fever, fatigue, muscle pain, body ache, nausea, vomiting, diarrhea, shortness of breath and increased risk of myopericarditis and cardiomyopathy. The evidence supports the view that both vaccines are beneficial, but the overall impact of JYNNEOS is better than that of ACAM2000.

The human monkeypox disease is caused by the monkeypox virus (MPXV), which is a zoonotic disease. In the year 2022, the prevalence of monkeypox cases swiftly increased worldwide and the disease has now been declared a global public health emergency. The present study aimed to assess the public’s perceptions and knowledge of and attitudes toward monkeypox in Riyadh, Saudi Arabia. This questionnaire-based cross-sectional study was conducted from 15 May to 15 July 2022. The participants’ perceptions, knowledge, and attitudes were collected via a 28-item-based questionnaire survey. The survey was based on 1020 participants (554 (54.3%) were females, and 466 (45.7%) were males). The results reveal that out of 1020 participants, 799 (78.3%) respondents believed that monkeypox disease has developed into a pandemic situation, and 798 (78.2%) suggested that the disease is most common in Western and Central Africa. Further analysis shows that 692 (67.8%) respondents agreed that monkeypox cases are increasing worldwide, 798 (21.8%) believed that monkeypox is commonly transmitted through direct contact, and 545 (53.4%) of respondents reported that it is easily transmitted from human to human. Moreover, 693 (67.9%) participants mentioned that monkeypox disease is spreading more widely as people travel from one country to another, while 807 (79.1%) participants were aware that smallpox and monkeypox have similar clinical features. Furthermore, the majority of participants (p = 0.033) agreed that health officials should start a vaccination campaign to combat monkeypox. Regarding preventive measures and vaccination campaigns, 641 (62.8%) participants suggested that health officials should take public preventive measures and 446 (43.7%) recommended that health officials start vaccination campaigns against monkeypox. The knowledge of human monkeypox among the general population in Riyadh, Saudi Arabia was satisfactory for all ages, genders, levels of education, and economic groups. Moreover, the majority of participants proposed adopting preventive measures and starting a vaccination campaign to combat monkeypox disease. The knowledge of monkeypox in the public domain is a key factor to improve the public‘s capacity to minimize the disease burden and fight against viral infectious diseases at regional and global levels.

Vaccinating children against COVID-19 is an essential public health strategy in order to reach herd immunity and prevent illness among children and adults. Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. In this study, we aimed to investigate parents’ perceptions and acceptance of the COVID-19 vaccine for their children in Saudi Arabia. A well-designed, pre-validated, Google questionnaire was distributed to parents through social media websites. The selection of the participants was based on the simple random sample technique. The study sample size was 1304 participants, with 342 males (26.2%), and 962 females (73.8%). The personal information, perception about COVID-19, and their children’s vaccination status were obtained. Among the participants, 602 (46.1%) were willing to get the COVID-19 vaccination for their children, whereas 382 (29.3%) were hesitant to inoculate their children for COVID-19 and 320 (24.4%) were unsure. Age (p = 0.004), gender (p = 0.001), occupation (0.004), income (p = 0.030), and vaccination status (p = 0.001) had an influence on the parents’ acceptance of COVID-19 vaccination of their children. On the other hand, education level, number of children, and having been previously infected with COVID-19 had no statistically significant effect on the parent acceptance. The correlation of parents’ knowledge about COVID-19 and their agreement to the vaccination of their children was statistically significant, along with gender (males were more knowledgeable, with p < 0.001), occupation, income (higher income showed a statistical difference, with p < 0.001), and vaccination status (p < 0.001). There was a decrease in parents’ acceptance toward the COVID-19 children vaccine in Saudi Arabia, which requires more attention and focus from health providers to eliminate fear and anxiety among the parents through additional educational programs and events to decrease the resistance toward the vaccination of children. More emphasis is required to increase the awareness of parents and convey the importance of the vaccine for children. In addition, more studies are needed to ensure the vaccine’s safety.