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Patient’s knowledge of medicines and perception on health care services are paramount for high quality patient care. Despite their importance, there is lack of credible research reported from Riyadh city of Saudi Arabia to ascertain the present status on these issues. Therefore, current research was designed to elucidate the patients’ perception and knowledge on dispensed drugs in Riyadh Hospitals through a cross sectional study. A validated pre-tested questionnaire was used to check the knowledge and perception level of 247 patients visiting outpatient's pharmacies of different hospitals of Riyadh city during September to December 2018. The data obtained was analyzed by appropriate statistical tests using SPSS-IBM 23 statistical application. Most of the participants of the current study were in an age group of 16-35 years (64%) with 57% of them was graduates and (48%) were married. Further, 69% of them were employed and most of them (47%) were earning income ranging from 8000 to 15000 SAR/month. Furthermore, 86% of the surveyors were Saudi nationals, 91% were Riyadh city residents and 99.5% were Arabic speakers. Statistical analysis found a significant association between sociodemographic characteristics and knowledge level as well as their perception on health services such as pharmacists interaction, attitude, politeness and their knowledge. Most of the participants had an average to good knowledge on their dispensed drugs. In addition, we noted that there is a significant association between sociodemographic characteristics of patients and their perception on the health services which influence the patient's overall knowledge on their dispensed drugs. In conclusion, the patient’s knowledge on their dispensed medicines depends on factors associated with both patients and health care providers and good interaction between them increases the quality of health care services.

Study aim: This study aims to assess primary care physicians’ utilization of type 2 diabetes screening guidelines and referrals to behavioural interventions in Al-Jouf, KSA. Methods: This study adopted a retrospective longitudinal survey-based study design. In this study, the setting is primary health care setting in Al-Jouf, Saudi Arabia. We included primary healthcare physicians. A pre-designed questionnaire was used for data collection and data was managed and analysed using the Statistical Package for Social Sciences (SPSS) version 26. Results: The study included 395 physician whose age ranged from 25 to 58 years. Of all, 39% of physicians prefer using HbA1C and fasting blood glucose for screening pre-diabetes. The majority (80.3%) of physicians’ screening decisions are influenced by the screening guidelines. ADA (46.3%), and both USPSTF and ADA (46.6%) were the physicians’ most common preferences for diabetes screening. Nearly half of respondents (50.9%) use screening guidelines in 70-90% of their diabetes screening encounters. However, 39% and 37.7% reported utilizing USPSTF and ADA screening guidelines in 70-90% of their encounters, respectively. Conclusion: Our study shows that the majority of primary healthcare physicians are adherent to the diabetes screening guidelines in their practice. However, older doctors, males, those working in rural areas and those receiving highest and lowest number of visits per week require further awareness in order to increase their adherence to diabetes screening guidelines.

Purpose: Numerous studies have shown that students of health professions report higher perceived stress and lower quality of life (QOL) levels than those in other disciplines. The purpose of this cross-sectional survey study is to assess variations in students’ QOL and perceived stress levels by demographic and college-related factors. Methods: The World Health Organization QOL (WHOQOL) – BREF and Perceived Stress Scale (PSS-14) were used to assess QOL and stress levels among students at King Saud Bin Abdul-Aziz University for Health Sciences (KSAU-HS), Riyadh, during December 2015–June 2016. The WHOQOL-BREF comprises four broad QOL domains: physical health, psychological health, social relationships and environment. A total score from responses to the 14 questions in the PSS was computed. Univariate statistical analyses were performed using the Chi-square/Fisher's exact test or the t-test/Mann-Whitney U test, as appropriate. Linear regression models were used to examine the independent effect of numerous demographic and college-related factors on QOL and PSS. Results: A total of 479 students completed the questionnaire, representing a response rate of 95%. Fifty nine percent of the respondents were females. Then vast majority of respondents were single (96%) and reported a household income of SAR 10,000 or higher (82%). The distribution of college enrollment was as follows: Medicine 37%, Applied Medical Sciences 18%, Nursing 16%, Dentistry 13% and Pharmacy 14%. Scores in a number of QOL domains were significantly different by gender, household income, college, academic level and smoking status. Scores in all four QOL domains were negatively correlated with PSS, indicating that better QOL is strongly and highly significantly related to lower perceived stress levels with correlations ranging from −0.27 to −0.58 (p

The concept of resilient cities can be considered as a way of enabling not only dealing with added and severe shocks but also tackling the many challenges that constrain businesses, jobs and livelihoods. Hence, a major part of the building is resilience, which aims to find solutions to reduce poverty levels and find more general solutions to improve the quality of human life. There are more interventions in urban areas - conducted by stakeholders everywhere to achieve a certain level of resilience through the development of housing, infrastructure and services. The objectives are to develop knowledge about the contributions of cities to mitigating the impacts of climate change for urban planners and all those interested in urban development, climate change, environmental sciences and engineering. This research shows the most important factors that cities take, and what actions are taken to mitigate and adapt to climate change. It also identifies promising mitigation and adaptation strategies that promote sustainable development and are geared towards resilience.

Background: Herbal medicine has been widely utilized by pregnant women despite the limited available evidence regarding the safety and efficacy of that practice. The current available studies, from different countries, estimated that the use of herbal medicine during pregnancy range from 7% up to 96%. The aim of this study is to determine the prevalence, attitude, source of information, and reasoning behind the use of herbal medicine among pregnant women in Saudia Arabia. Methods: A cross-sectional study conducted using a convenience sample including pregnant women who visited the obstetric clinics at King Abdulaziz Medical City in Riyadh, Saudi Arabia. A survey was administered in order to evaluate the prevalence and perception toward herbal medicine use among pregnant women in Saudi Arabia. Results: A total of 297 pregnant women completed the survey. The results showed that 56% of the respondents have used some type of herbal medicine during their pregnancy. Olive oil was utilized in 26% of the respondents followed by cumin 20% and garlic 15%. In addition, 37% of the respondents used herbal medicine by their own initiative, while 33% and 12% used herbal medicine based on recommendations from their families and friends, respectively. Furthermore, 19% of the respondents reported a positive attitude toward herbal medicine use during pregnancy. In addition, the percentage of women with positive attitude was marginally higher among respondents with lower educational level. Conclusion: The prevalence of using herbal medicine is considerably high among pregnant women in Saudi Arabia. Unfortunately, the majority of the users relied on informal sources to use herbal medicine during pregnancy. Keywords: Herbal medicine, Supplements, Pregnancy, Prevalence, Attitudes, Saudi Arabia

The scholar in this paper presents a concept inventing model of feeling ashamed. It consists of a literature review across many disciplines, an exploration of many artforms, dialoguing with others, and a distinctive description of feeling ashamed. With the humanbecoming concept inventing model, the scholar explored shame and created a novel idea that could develop approaches in the advancement of nursing knowledge. This exploration advances nursing knowledge within the humanbecoming paradigm. With the use of humanbecoming concept inventing model, the now-truth of feeling ashamed for the scholar was raised as unbearable stillness with desired escape arising with isolating affiliations. The ingenuous proclamation as a theoretical statement was communicated in the humanbecoming sciencing language as languaging the powering of connecting-separating with the artform of Shame by Rosa Gunasingha.

Purpose: retrospectively evaluate patients with a history of ERCP who had the hepatic abscess or cholangitis following TACE or TARE. material and method: It was retrospective chart review study of patients who underwent TACE or TARE after ERCP procedure at the tertiary center, at King Abdulaziz Medical City, between May 2010 and December 2018. Results: A total of nine patients that had undergone TACE or TARE after ERCP were identified. The study includes seven male and two female. The mean age of patient is 64. Five of patients underwent TACE and four patients underwent TARE. The right common femoral artery was punctured under ultrasound guidance followed by placement of 5-F vascular sheath in all the cases. Cholangitis was noted in two male patients and hepatic abscess was not found. Based on our finding, one-year survival rate is increased in patients who undergo TACE or TARE. Conclusion: cholangitis and hepatic abscess are rare to complication after TACE or TARE procedure in patient with history of ERCP despite other co-morbidities.

SummaryThere has been a growing interest in Health Informatics applications, research, and education within the Middle East and North African Region over the past twenty years. People of this region share similar cultural and religious values, primarily speak the Arabic language, and have similar health care related issues, which are in dire need of being addressed. Health Informatics efforts, organizations, and initiatives within the region have been largely under-represented within, but not ignored by, the International Medical Informatics Association (IMIA). Attempts to create bonds and collaboration between the different organizations of the region have remained scattered, and often, resulted in failure despite the fact that the need for a united health informatics collaborative within the region has never been more crucial than today. During the 2017 MEDINFO, held in Hangzhou, China, a new organization, the Middle East and North African Health Informatics Association (MENAHIA) was conceived as a regional non-governmental organization to promote and facilitate health informatics uptake within the region endorsing health informatics research and educational initiatives of the 22 countries represented within the region. This paper provides an overview of the collaboration and efforts to date in forming MENAHIA and displays the variety of initiatives that are already occurring within the MENAHIA region, which MENAHIA will help, endorse, support, share, and improve within the international forum of health informatics.

Background: Folate is a naturally occurring B vitamin, is needed in the brain for the synthesis of norepinephrine, serotonin, and dopamine. Thus, previous researches suggested that folate levels play an important role in the etiology and course of depression. However, the literature has been inconsistent regarding differences in folate level between individuals with and without depression. The present meta-analysis synthesized the results of previous studies to examine whether individuals with depression had lower levels of folate than individuals without depression. Aim of the Study: to assess the relationship between Depression and Folate deficiency. Methods: A review of the scientific literature (PubMed Search 1994 to 2017) Pubmed, Embase and CENTRAL were searched to identify randomized controlled trials that investigated The Correlation between Depression and Folate Deficiency as the primary outcome. Identification of papers and data extraction was performed by two independent researchers. We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to October 2017. Results: 8 studies were included enrolling 173000 participants; 1813 patients with depression and 15487 control subjects. Pooling of all estimates showed a significant correlation between folate status and depression (OR pooled unadjusted = 1.41; 95% CI 1.19 to 1.82), (OR pooled adjusted = 1.39; 95% CI 1.04 to 1.76). Conclusion: Low folate and B12 serum levels seem to be associated with depression Folate has been linked to depression and there is a strong body of evidence suggesting the introduction of folate supplement in the prevention and treatment of depression at the population and individual levels.

BackgroundTablet splitting is often used in pharmacy practice to adjust the administered doses. It is also used as a method of reducing medication costs.ObjectiveTo investigate the accuracy of tablet splitting by comparing hand splitting vs. a tablet cutter for a low dose drug tablet.MethodsSalbutamol tablets (4mg) were chosen as low dose tablets. A randomly selected equal number of tablets were split by hand and a tablet cutter, and the remaining tablets were kept whole. Weight variation and drug content were analysed for salbutamol in 0.1N HCl using a validated spectrophotometric method. The percentages by which each whole tablet’s or half-tablet’s drug content and weight difference from sample mean values were compared with USP specification ranges for drug content. The %RSD was also calculated in order to determine whether the drugs met USP specification for %RSD. The tablets and half tablets were scanned using electron microscopy to show any visual differences arising from splitting.Results27.5% of samples differed from sample mean values by a percentage that fell outside of USP specification for weight, of which 15% from the tablet cutter and 25% from those split by hand fell outside the specifications. All whole tablets and half tablets met the USP specifications for drug content but the variation of content between the two halves reached 21.3% of total content in case of hand splitting, and 7.13% only for the tablet cutter. The %RSDs for drug content and weight met the USP specification for whole salbutamol tablets and the half tablets which were split by tablet cutter. The halves which were split by hand fell outside the specification for %RSD (drug content=6.43%, weight=8.33%). The differences were visually clear in the electron microscope scans.ConclusionDrug content variation in half-tablets appeared to be attributable to weight variation occurring during the splitting process. This could have serious clinical consequences for medications with a narrow therapeutic-toxic range. On the basis of our results, we recommend to avoid tablet splitting whenever possible or the use of an accurate tablet splitting device when splitting cannot be avoided.

A planar ferrite phase shifter is designed to exhibit simultaneous analog and digital phase tuning properties. Analog phase control is achieved by using an external magnetizing field, and digital phase change is realized by switching the phase shifter operation from microstrip to waveguide mode. Simulated and experimental results are presented to demonstrate the impedance matching and dual-phase tuning properties. At 9-GHz, a differential digital phase shift of 100°/bit and an analog phase control of 16°/mT is exhibited. When applied in phased array antennas, these easily integrated low-cost planar phase shifters can produce high-resolution wide-angle beam scan by employing analog/digital phase control circuits.

Design approaches to exoskeletal robots traditionally aimed to achieve mechanical forces many times larger than the level achievable by the corresponding natural musculoskeletal system. This has often obstructed the user's muscles during physical rehabilitation. Moreover, mechanisms designed for excessive force generation are heavy and rigid structures with little compliance and thus are not suitable for many mobile applications. Here, we present a novel biomimetic flexible solenoid-coil artificial muscle (FSAM) fibre with inherent mechanical compliance, a high pulling stroke, and structural flexibility that suit a lightweight wearable exoskeletal robot for rehabilitation use. FSAM consists of a chain of specially designed bobbins of solenoid coils that can slide against each other. The chain allows FSAM to form an arch shape when the coils are energized; this is reminiscent of a natural muscle that bends a joint by a combined contraction of the muscle length and bending in an arch shape. This strategy of bending a joint not only reduces the need for linear contraction but also allows the exoskeletal to be compliant with the contraction morphology of natural muscle.

Background: Vision disorders are the fourth most common disability in children and uncorrected refractive errors are an important cause of visual impairment in many countries. The present study was conducted to identify the prevalence and pattern of refractive errors among intermediate school entrants (12-13 years) at King Abdulaziz Medical City (KAMC) in Riyadh, Kingdom of Saudi Arabia. Methods: The study population consisted of all the intermediate school entrants (n=1,536) who attended the mandatory health examination for intermediate-school entry between February 2009 and October 2009. Every student was subjected to a 10-minute vision and auto-refractive test performed by a qualified optometrist. Students with visual acuity of 20/28 (6/9) or worse in one or both eyes, an eye disorder (such as strabismus, nystagmus, ptosis) or abnormal ocular movement were referred for a 45-minute complete ophthalmic examination that consisted of the following: 1) distance visual acuity (V/A), 2) cover – uncover test and 3) non-cycloplegic retinoscopy. The refractive error cut-off point was defined according to the spherical equivalent refractive error (SERE). Results: Of the 1,536 students, 209 were diagnosed with one or more refractive errors, with an overall prevalence of 9.8% (8.3% in boys and 11.7% in girls, with a significant gender difference) (P=0.033). The prevalence of different refractive errors was as follows: myopia, 4.5% (95% CI, 3.5-.5.5%); hyperopia, 1.5% (95% CI, 0.9-2.1%); astigmatism, 6.5% (95% CI, 5.3-7.7%); and amblyopia, 0.65% (95% CI, 0.25-1.05%). Conclusion: Our results highlight the need for school–based programs that provide prescription of glasses to students when needed at no cost through government and non-governmental collaborative funds. However, there is a need for further studies to evaluate the cultural beliefs and practice surrounding the use of spectacles in Saudi communities.