Search

Objectives: Stress, anxiety, and depression among students have many negative health consequences and may predispose students to poor sleep quality; therefore, this research aimed to investigate the perceived stress, anxiety, and depression and their relation to the level of sleep quality among healthcare students. Methods: A cross-sectional study using a validated survey was conducted among Saudi healthcare students from different regions during the period from 26 September 2022 to 30 October 2022. The Pittsburgh Sleep Quality Index (PSQI) was utilized to assess sleep quality. PSPP Statistical Analysis Software version 1.2.0 was used for all statistical analyses. Results: 701 respondents participated in this research; the response rate was 73.8%. About 60% of the study sample was female, and the average age was 20.9 years. 80.3% of students have poor sleep quality; the participants’ mean sleeping hours per night was 6.81 ± 1.88 h. About three-quarters of students (72.9%) perceive themselves as stressed. A significant positive correlation was observed between sleep quality and perceived stress (r-value = 0.363), anxiety (r-value = 0.387), and depression (r-value = 0.347). Poor sleep quality was more likely among those with stress than those without stress (AOR = 1.79; 95% CI 1.07, 2.99) and two times more likely among students with cases of anxiety than those without anxiety (AOR = 2.07; 95% CI 1.10, 3.94). Conclusions: Our study highlights the high prevalence of poor sleep quality, anxiety, depression, and stress among healthcare students in Saudi Arabia. Students’ reported stress, anxiety, and residence region were associated with poor sleep quality. These results imply the necessity of regular screening and appropriate intervention for sleep problems, stressors, and anxiety among healthcare students.

Background: Since older patients with dyslipidemia frequently receive many prescriptions, medication errors are typical and expected in this population. This risk has increased by using potentially inappropriate medications. The 2019 Beers criteria were used in this study to investigate potentially inappropriate medication use among older individuals with dyslipidemia. Methods: A cross-sectional retrospective analysis used data from electronic medical records from an ambulatory-care environment. Patients with dyslipidemia who were older adults (>65 years old) were included. To describe and find potential determinants of potentially inappropriate medication usage, descriptive statistics and logistic regression were employed. Results: This study included 2209 older adults (age ≥ 65) with dyslipidemia. The mean age was 72.1 ± 6.0 years, and the majority of the study sample had hypertension (83.7%) and diabetes (61.7%), and around 80.0% were using polypharmacy. The prevalence of potentially inappropriate medications to be avoided among older adults with dyslipidemia was 48.6%. A high risk of potentially inappropriate medication usage was found in older patients with dyslipidemia who had polypharmacy and comorbid diabetes, ischemic heart disease, and anxiety. Conclusions: This study showed that the number of medications prescribed and the presence of concurrent chronic health conditions are important indicators of the risk of potentially inappropriate medications in ambulatory older patients with dyslipidemia.

Background: Use of potentially inappropriate medication (PIMs) is a prominent concern that leads to significant medication-related issues among older adults. Notably, older women tend to utilize more medicines than men; older women frequently take more drugs. In addition, some evidence suggests that prescription PIMs vary by gender. This study examines the gender-based variation in prescribing PIM among older adults in Saudi Arabia. Methods: A cross-sectional retrospective analysis of electronic medical records from a large hospital in Saudi Arabia was carried out. Patients over the age of 65 who received ambulatory treatment were included in the study. The utilization of PIM was assessed based on Beers criteria. Descriptive statistics and logistic regression were employed to describe patterns of PIM utilization and identify factors associated with their use. All statistical analyses were performed using Version 9.4 of the Statistical Analysis Software (SAS® 9.4). Results: The study comprised 4062 older people (age 65) who visited ambulatory care clinics; the average age was (72.6 ± 6.2) years. The majority of the study sample was women (56.8%). Among older adults, 44.7% of older men and 58.3% of older women reported having PIMs that should be avoided, indicating a higher prevalence of PIMs among women compared to men. In terms of the PIM categories used, women had a much higher utilization rate of cardiovascular and gastrointestinal drugs than men. In men, the use of PIMs was frequently associated with hypertension, ischemic heart disease, asthma, osteoarthritis, and cancer, while in women PIM use was associated with age, dyslipidemia, chronic kidney disease, and osteoporosis. Conclusions: This study revealed sex differences in PIM prescribing among older adults; PIM use is more common among women. Sex differences exist in clinical and socioeconomic characteristics and factors related to using potentially inappropriate medications. This study revealed essential areas that could be targeted by further interventions to improve drug-prescribing practices among older adults at risk of PIM.

Introduction. Healthcare students are subjected to high-stress levels due to different academic, social, and financial stressors. Persistent and severe stress might predispose students to depression and anxiety. Therefore, this research aims to investigate the level of perceived stress among healthcare students and its relation to anxiety and depression. Methods. A prospective cross-sectional study using a validated questionnaire was conducted among healthcare students in Saudi Arabia. The 14-item Perceived Stress Scale (PSS) was used to evaluate perceived stress, and depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). All statistical analyses were carried out using PSPP Statistical Analysis Software version 1.2.0. Results. A total of 701 respondents participated in this study. The average age of the students was 20.9 years old, and 59.3% were female. Almost three-quarters of students perceive themselves as stressed. Around two-thirds were categorized as having borderline/cases of depression or anxiety. Perceived stress was four times more likely among students with cases of anxiety [Adjusted Odds Ratio (AOR) = 4.83; 95% CI 2.89, 8.06], depression [AOR = 4.79; 95% CI 2.68, 8.53] as compared with those without these conditions. Conclusions. Stress is highly prevalent among healthcare students, and it is strongly associated with female gender and students’ anxiety and depression. Therefore, the mental health of healthcare students is an essential factor affecting perceived stress and at-risk individuals. Therefore, preventative mental health interventions targeting healthcare students are necessary to help improve mental health and cope with stressors in academic education.

Supplemental Material for The Impact of Cancer Relapse and Poor Patient Outcomes on Health Care Providers Practicing in the Oncology Field by Abdulrahman Alwhaibi, Miteb Alenazi, Bana Almadi, Nora aljabali, Sahar Alkhalifah, Wajid Syed, Reem Alsaif, Salmeen D Bablghaith, and Mohammed N Al-Arifi in Cancer Control

Introduction People with dementia (PwD) often have several comorbidities for which medications are prescribed. Consequently, polypharmacy and potentially inappropriate prescribing (PIP) are highly prevalent amongst PwD and have been linked with negative health outcomes (1). To date, no studies have been conducted in Saudi Arabia which describe current prescribing practices, polypharmacy or appropriateness of medications prescribed for PwD. Aim To explore prescribing trends, estimate the prevalence of polypharmacy and PIP, and investigate associations between PIP and polypharmacy, age and gender among PwD in ambulatory care in Saudi Arabia. Methods A cross-sectional, retrospective study was conducted using data from electronic health records in a large tertiary hospital in Saudi Arabia. Patients were eligible to be included if they were aged ≥65 years, had a dementia diagnosis, and had visited the ambulatory care clinic during the study period 01/01/2019 – 31/12/2021. Patients who died during the study period were excluded. Polypharmacy was indicated by use of ≥5 chronic medications. Prescribing appropriateness was assessed by applying a subset of the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria, comprising 78 indicators (2). Descriptive statistics were used to describe the study population. Overall prevalence of PIP and the prevalence per each STOPP criterion were calculated as a proportion of all eligible persons in the dataset. Logistic regression analysis was used to investigate associations between PIP, polypharmacy, age and gender; adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Data extraction and analysis were conducted using SPSS v27. Results The study population included 287 PwD. The majority were female (n=161, 56.0%) and the mean age was 78.8 [standard deviation (SD) ±8.0) years. The mean number of medications prescribed was 9.0 (±4.2) and polypharmacy was observed in 82.6% (n=237) of patients. The overall PIP prevalence during the study period was 61.0% (n=175). The most common instances of PIP were drugs prescribed beyond the recommended duration (n=90, 31.4%), drugs prescribed without an evidence-based clinical indication (n=78, 27.2%), proton pump inhibitors (PPIs) at full therapeutic dosage for >8 weeks (n=75, 26.0%), acetylcholinesterase inhibitors with concurrent treatment with drugs that reduce heart rate (n=60, 21.0%), and anticholinergic/antimuscarinic drug use (n=28, 9.8%). Whilst polypharmacy was found to be strongly associated with PIP (OR 21.9, 95% CI 8.3 – 57.5), no association was observed between PIP and age or gender after adjustments for polypharmacy. Conclusion To our knowledge, this is the first study to evaluate polypharmacy, prescribing appropriateness, and factors associated with PIP for PwD in Saudi Arabia. Findings have revealed a high prevalence of PIP among PwD that is strongly associated with polypharmacy. However, our focus was on PwD in one tertiary care hospital and thus findings may not be generalisable beyond this setting. Future research should involve PwD and other key stakeholders to develop practical interventions to decrease the burden of polypharmacy and PIP and optimise medication use for this vulnerable patient population. References 1. Delgado J, Jones L, Bradley MC, Allan LM, Ballard C, Clare L, Fortinsky RH, Hughes CM, Melzer D. Potentially inappropriate prescribing in dementia, multi-morbidity and incidence of adverse health outcomes. Age and Ageing. 2021;50(2): 457-464. 2. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age and Ageing. 2015; 44(2): 213–218.

Background: Toxoplasmosis is an environmental teratogen that may disrupt fetal development if transferred to the mother during pregnancy, resulting in maldevelopment and newborn mortality. Objective: To assess knowledge of Saudi women in their childbearing period as regards risk factors of Toxoplasmosis infestation, testing, awareness of disease manifestation and prevention. Methods: Anonymous online survey was used to examine the knowledge of Saudi women in their childbearing period about Toxoplasmosis induced teratogenicity. The non-probability sampling yields a calculated size of 600 women. The cross-sectional design of the research required categorizing the questions into two significant portions, one for sociodemographic data and the other for assessing Toxoplasmosis awareness. First, a descriptive statistic summarized the demographic characteristics. In categorical data, chi-square tests were employed to compare groups. Results: A total of 613 women in their childbearing years completed the questionnaire. Most respondents interviewed were 36-40 (46.7%), and Para 1-5 (80%), and 86% were graduates. In addition, 42.2 % had the basic knowledge of Toxoplasmosis, 25.3 % were aware of the manifestations of the disease, and 76.3% correctly identified premature labor or miscarriage as sequelae of the infection. Aside from the frequency of abnormalities and parities and knowledge of toxoplasmosis, no other demographics in our research sample showed a significant association. Conclusion: The basic knowledge of Toxoplasmosis among Saudi women of childbearing age is unsatisfactory (42.6 %). Age, family income, educational level and the number of abortions were significantly associated with knowledge of Toxoplasmosis among Saudi women in their childbearing age.

Aim 1) To investigate the pharmacokinetic profile of sildenafil citrate in Middle Eastern males and, 2) To highlight the impact of ethnicity on its pharmacokinetics parameters through comparing Middle Eastern data to the data estimated from different ethnic groups. Method The study was conducted on 24 Middle Eastern healthy male volunteers. Pharmacokinetic data including Cmax, Tmax, t1/2, AUC0-t, AUC0-∞ were estimated from blood samples collected at several time points within 24 hours post-administration of a single 100-mg tablet of sildenafil citrate (Viagra®). Pharmacokinetic data of sildenafil generic 100-mg tablet (product B) was determined in the volunteers using the same analytical method. Pharmacokinetic data of other studies published on different ethnicities were obtained and compared to our Viagra®-related data. Results Analysis of Middle Eastern data (mean ± SD) revealed Cmax = 398.9 ± 107.7 ng/ml; Tmax = 1.84 ± 0.22 hours; t1/2 = 2.66 ± 0.97 h; AUC0–24 = 1475 ± 515.3 ng.h/ml; AUC0-∞ = 1556 ± 567.58 ng.h/ml. There was no significant difference between Viagra® and product B, confirming the bioequivalence of the two preparation as well as the reliability of utilized analytical method. Data comparisons between Middle Eastern and other ethnicities indicated that Iranian, Mexican, and Thai would potentially have twice the effect observed in Arabs and Caucasians, considering the same prescribed drug formulation and dose. Conclusion There is a considerable difference in the pharmacokinetic profile of sildenafil citrate between Middle Eastern and other ethnic groups. Ethnicity may predispose individuals to unwanted prolonged activity of sildenafil and adverse events. Thus, it should be taken in consideration by clinicians when recommending sildenafil dose.

Background and objectiveNumeracy is the branch of mathematics involved in understanding basic calculations, quantitation, estimation, reasoning, and execution of multistep operations. It is very imperative that pharmacists understand and apply numeracy skills in their routine work in the interest of their profession and patient care. This observational study was designed to assess the pharmacy student's perceptions of numeracy.MethodsA prospective observational study was conducted by the Department of Pharmacy, King Saud University, Kingdom of Saudi Arabia, between December 2021 and February 2022. All the enrolled subjects pursued a 5-year Pharma degree course at the university using a 9-item instrument, which accessed the perception of students toward numeracy. The data were analyzed using the statistical software statistical package for social science (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). Chi-square and Fisher's exact test were used to derive an association between various parameters of the study subjects. A P-value of < 0.05 was taken as statistically significant.ResultsA total of 550 pharmacy students were approached in this study, out of which 21 (3.8%) students were excluded due to incompleteness of the responses; thereupon, 529 students were included in the study. We learned that almost 90.0% of students had excellent and/or good mathematical ability, but at the same time, they were frequent users of calculators. Most of the students endorsed the importance of numeracy and showed their interest in attaining more knowledge of numeracy. Similarly rating the perceptions of mathematical ability is significantly associated with the frequency of use of a calculator for calculations (p = 0.0001).ConclusionPharmacy students showed interest in numeracy and correspondingly showed excellent perceptions toward mathematical ability. Although the role of numeracy has been well accepted, inciting changes in teaching-learning practices through mathematically focused teaching approaches throughout the pharmacy program will increase its applicability in healthcare.

The solubilization and thermodynamic analysis of isotretinoin (ITN) in eleven distinct green solvents, such as water, methyl alcohol (MeOH), ethyl alcohol (EtOH), 1-butyl alcohol (1-BuOH), 2-butyl alcohol (2-BuOH), ethane-1,2-diol (EG), propane-1,2-diol (PG), polyethylene glycol-400 (PEG-400), ethyl acetate (EA), Transcutol-HP (THP), and dimethyl sulfoxide (DMSO) was studied at several temperatures and a fixed atmospheric pressure. The equilibrium approach was used to measure the solubility of ITN, and the Apelblat, van’t Hoff, and Buchowski–Ksiazczak λh models were used to correlate the results. The overall uncertainties were less than 5.0% for all the models examined. The highest ITN mole fraction solubility was achieved as 1.01 × 10−1 in DMSO at 318.2 K; however, the least was achieved as 3.16 × 10−7 in water at 298.2 K. ITN solubility was found to be enhanced with an increase in temperature and the order in which it was soluble in several green solvents at 318.2 K was as follows: DMSO (1.01 × 10−1) > EA (1.73 × 10−2) > PEG-400 (1.66 × 10−2) > THP (1.59 × 10−2) > 2-BuOH (6.32 × 10−3) > 1-BuOH (5.88 × 10−3) > PG (4.83 × 10−3) > EtOH (3.51 × 10−3) > EG (3.49 × 10−3) > MeOH (2.10 × 10−3) > water (1.38 × 10−6). ITN–DMSO showed the strongest solute–solvent interactions when compared to the other ITN and green solvent combinations. According to thermodynamic studies, ITN dissolution was endothermic and entropy-driven in all of the green solvents tested. The obtained outcomes suggested that DMSO appears to be the best green solvent for ITN solubilization.

Objectives: This study was aimed to investigate the knowledge and practice about COVID-19 among adults living in capital of Telangana, India. Methods: A cross sectional web based online study was conducted over a period of 3 months from April to June using structured self- administered online questionnaires. We targeted adults living in Hyderabad using convenience sampling technique. A total of 384 respondents completed the study questionnaires. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.0. Descriptive statistics were used to describe the status of knowledge, attitude, and practices. Results: Most of the respondents were male (65.1%) aged between 21-30 years (220 out of 384). The most common source of information for the COVID-19 was social media (50.7%). Almost 78% of the respondents were known that COVID-19 associated with dry cough, body pains and fever. Also majority of them were knew that disease can transfer from the infected patients (87%), while most of them (85%) were agreed that wearing facemask can help in controlling the infection. Almost all (92%) of the respondents agreed that isolation and treatment of COVID-19 patients may help in controlling the spread of virus. There was a significant difference among the attitudes of the participants about covid-19 (p Key words: COVID-19, Knowledge, Attitudes, Clinical symptoms, Flue, Fever, Respiratory failure.

To systematically review the available randomized controlled trials in the literature concerning the application of virtual reality (VR) rehabilitation interventions compared to conventional physical therapy, in regaining the upper limb motor function among patients with chronic stroke. A systematic electronic database search was conducted for related studies published from inauguration and until June 25, 2020 in nine databases. Another new search was done on February 1, 2021 and no new studies were identified. Six studies were included in the analysis. Significant improvement was seen following the VR therapy in patients with chronic stroke, compared to their scores prior to it (SMD = 0.28; 95% CI = 0.03–0.53; p = .03). There was neither heterogeneity (I2 = 0% and P = .5) nor a risk of bias (P = .8) among the included studies. VR interventions produced a comparable effectiveness to that of the conventional rehabilitation, with no statistically significant difference (SMD = 0.15; 95% CI = −0.14–0.44; P = .3). There was neither heterogeneity (I2 = 40% and P = .1) nor a risk of bias (P = .5) among the included studies. The upper limb motor function of patients with chronic stroke who underwent VR-based rehabilitative intervention showed significant improvement as compared to the pre-treatment state. Our analysis also revealed no superiority of VR interventions over conservative therapies; however, the difference observed did not accomplish statistical significance.

Background: Children with Down Syndrome (C-DS) have language, cognitive and communication difficulties, in addition to consistent physical inactivity that contributes to poor health and higher-disability-adjusted life years. The purpose of this study was to determine the correlation between the use of electronic technology and levels of physical activity in C-DS in the Riyadh region of Saudi Arabia. Methods: A cross-sectional study was conducted with 49 mothers, where each had a child (6–12 years of age) with Down Syndrome (DS), and who were recruited using purposive sampling from three DS centers in Riyadh, Saudi Arabia. The Children’s Physical Activity Questionnaire and Research Questionnaire on the Impact of Technology on Children were used. Descriptive statistics were used to describe the demographics. Pearson’s correlation, Student’s t-test and the Chi-square test were used to assess the association between technology use, physical activity levels and socio-demographic variables. Results: There was no significant correlation between physical activity and the use of technology by C-DS. However, there was a negative correlation between a high level of physical activity and technology use (R = −0.037). Although, no significant correlation between the mother’s characteristics and technology use was found; there was a significantly positive correlation (p = 0.05) between the education level of mothers and the technology use by C-DS. Nonetheless, there was no association between the physical activity level and the gender of the child with DS. Conclusions: This study found that no significant relationship exists between the use of electronic gadgets and the level of physical activity in C-DS.

BACKGROUND: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE: Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN: Retrospective database review. SETTING: Large tertiary care setting in Riyadh. PATIENTS AND METHODS: We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE: The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE: 315 166 prescriptions screened. RESULTS: Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P P CONCLUSION: Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors. LIMITATIONS: Polypharmacy was not considered; the data are from a single healthcare system. CONFLICT OF INTEREST: None.

Background/Introduction Despite advances in the diagnosis and management of breast cancer (BC), it is still associated with high mortality rates. New biomarkers are being developed for the diagnosis, treatment, and prediction of responses of BC. Ceramide (CER), a bioactive sphingolipid, has emerged recently as a useful diagnostic tool in several types of tumors. In this study, we evaluated CER expression in invasive BC and assessed its relation to the molecular subtypes of BC. Materials and methods The clinical data and histopathological slides of 50 patients with invasive ductal carcinoma were retrieved and reviewed. The cases were then stained with a mouse monoclonal anti-ceramide antibody. Pearson correlation was used to assess the correlation between CER percentage and intensity and other clinical and pathological variables. Results CER expression showed a direct relationship with estrogen and progesterone receptors Allred scores. However, it showed an inverse relation with tumor grade, HER2/neu status and Ki-67 index. Conclusions CER expression is likely to be associated with luminal BC molecular subtypes. However, more research is needed to confirm these results and to explore its relation to the different clinical outcomes, including response to treatment and prognosis.

Yazed AlRuthia,1,2 Ghadah S Almuaythir,1 Hala H Alrasheed,1 Wejdan R Alsharif,1 Mohamad-Hani Temsah,3,4 Fahad Alsohime,3,4 Ibrahim Sales,1 Monira Alwhaibi,1 Fahad A Bashiri3,5 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 2Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia; 5Division of Neurology, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi ArabiaCorrespondence: Yazed AlRuthiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +996 114677483Fax +966 114677480Email yazeed@ksu.edu.saBackground: The recent approval of innovative therapies for spinal muscular atrophy (SMA), such as nusinersen, has brought hope to patients and their families.Objective: The aims of this study were to compare the characteristics and HRQoL of SMA patients treated with nusinersen and those treated with the standard of care.Methods: This was a cross-sectional, interviewer-administered telephone questionnaire, which used a purposive sampling of SMA patients through a social support network. EuroQol five-dimensions-3-level (EQ-5D-3L) and the visual analog scale (VAS) have been used to assess the HRQoL. Different descriptive and inferential tests have been performed to compare the characteristics, EQ-5D responses, and mean scores of EQ-VAS between patients on nusinersen and the standard of care.Results: Eleven out of 36 SMA patients (30.55%) have been treated with nusinersen. Patients with type I SMA represented 54% of those treated with nusinersen (P=0.012). Only 12.5% of SMA patients living in the Mecca region are treated with nusinersen in comparison to 50% of patients living in the Riyadh region (P=0.029). No difference was noticed in the proxy-responses for the five domains of the EQ-5D or the mean VAS scores for patients on nusinersen and the standard of care despite controlling for the SMA type and the ability to breathe independently (β= 1.39, 95% CI= – 5.15-7.93, P=0.667). However, the mean VAS score for patients who are unable to breathe independently was significantly lower than their counterparts who are able to breathe independently even after controlling for the SMA type and nusinersen treatment (β= – 31.61, 95% CI= – 51.59 - – 11.63, P=0.003).Conclusion: The results of this study highlight the uncertainty about the impact of nusinersen on SMA patients’ HRQoL. Therefore, the impact of nusinersen on HRQoL should be examined using more robust study designs.Keywords: spinal muscular atrophy, health-related quality of life, nusinersen, health services accessibility, Saudi Arabia

Yazed AlRuthia,1,2 Ghadah S Almuaythir,1 Hala H Alrasheed,1 Wejdan R Alsharif,1 Mohamad-Hani Temsah,3,4 Fahad Alsohime,3,4 Ibrahim Sales,1 Monira Alwhaibi,1 Fahad A Bashiri3,5 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 2Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia; 5Division of Neurology, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi ArabiaCorrespondence: Yazed AlRuthiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +996 114677483Fax +966 114677480Email yazeed@ksu.edu.saBackground: The recent approval of innovative therapies for spinal muscular atrophy (SMA), such as nusinersen, has brought hope to patients and their families.Objective: The aims of this study were to compare the characteristics and HRQoL of SMA patients treated with nusinersen and those treated with the standard of care.Methods: This was a cross-sectional, interviewer-administered telephone questionnaire, which used a purposive sampling of SMA patients through a social support network. EuroQol five-dimensions-3-level (EQ-5D-3L) and the visual analog scale (VAS) have been used to assess the HRQoL. Different descriptive and inferential tests have been performed to compare the characteristics, EQ-5D responses, and mean scores of EQ-VAS between patients on nusinersen and the standard of care.Results: Eleven out of 36 SMA patients (30.55%) have been treated with nusinersen. Patients with type I SMA represented 54% of those treated with nusinersen (P=0.012). Only 12.5% of SMA patients living in the Mecca region are treated with nusinersen in comparison to 50% of patients living in the Riyadh region (P=0.029). No difference was noticed in the proxy-responses for the five domains of the EQ-5D or the mean VAS scores for patients on nusinersen and the standard of care despite controlling for the SMA type and the ability to breathe independently (β= 1.39, 95% CI= – 5.15-7.93, P=0.667). However, the mean VAS score for patients who are unable to breathe independently was significantly lower than their counterparts who are able to breathe independently even after controlling for the SMA type and nusinersen treatment (β= – 31.61, 95% CI= – 51.59 - – 11.63, P=0.003).Conclusion: The results of this study highlight the uncertainty about the impact of nusinersen on SMA patients’ HRQoL. Therefore, the impact of nusinersen on HRQoL should be examined using more robust study designs.Keywords: spinal muscular atrophy, health-related quality of life, nusinersen, health services accessibility, Saudi Arabia

Objectives Purchasing medicinal products from the internet has become more popular in the last three decades. Understanding consumers’ use and perception of the safety of medicinal products obtained online is essential. Therefore, this study aims to evaluate the extent of medicines purchased from the internet in Saudi Arabia, types of products, sources of information, the satisfaction, the motivational factors, and estimate consumers’ vigilance and tendency to report ADRs if occurred. Design A prospective cross-sectional study using a custom-designed questionnaire was conducted among community adults in Saudi Arabia, age ≥ 18. Setting Evaluation of community subjects' perception towards buying medicinal products was done through the internet in Saudi Arabia from 1st July 2020 until the end of August 2020. Main outcome measure(s) The main outcome of the study was purchasing medicinal products from the internet (Yes, No). Results Overall, 36% of the study participants (n = 643) have ever bought medicinal products from the internet ( Table 2 ). Of those, the most obtained was herbal medicine, supplements, or cosmetics (61.3%). Motivational factors towards purchasing medicinal products from the internet were mostly positive, with the most commonly reported agreed motivational factors were lower cost (55.7%), easy online access (54.1%), a wide variety of products (52.6%), and more privacy (43.6%). Around 60.4% of participants believed that buying medicinal products from the internet can be safe. The most perceived risk was the difficulty of distinguishing between registered online pharmacies and other unlicensed commercial websites, with only 32.7% of the participants distinguishing between registered and unlicensed commercial websites. Conclusions This study sheds light on the consumers’ use and perception of the safety and risks of medicinal products purchased from the internet. The study findings noticeably describe the great need to increase safety awareness about obtaining medicinal products from the internet among the Saudi community.

Introduction: Emergency medicine department visits for odontalgia, related to traumatic and non traumatic dental events has seen a shift towards increase in cases. Emergency departments provide palliative care especially for the non traumatic dental injuries Aims: To explore the trends of emergency department (ED) visits for dental-related conditions in Saudi Arabia. The study also aimed to analyze visit management patterns, including procedures, prescriptions, and recall visits. Materials and Methods: A cross-sectional retrospective observational study was done using simple random sampling on dental emergency visit data to the ED at hospitals under renowned university of health sciences in Riyadh and Al-Ahsa between January 2016 and May 2019. Results and Discussion: A total of 5050 charts were included. An increase in dental emergency visits was observed between 2016 and 2017. Pulpal and periapical lesions were the most frequently diagnosed conditions every year (53.83% of all dental-related ED visits), and traumatic injuries were the least frequently (6.37%) diagnosed condition. Conclusion: Dental-related visits to EDs in Saudi Arabia increased remarkably from 2016 to 2019. Pulpal and periapical conditions were the most frequent cause of dental-related ED visits. To ensure better use of ED time and resources, it is imperative to raise public awareness of what types of urgent dental conditions require an ED visit, as well as to increase the number of public health unit dental clinics and their ease of access.

Cerebral palsy is a common motor disorder that results in long-term impairment. The purpose of this study was to find out what factors influence Saudi mothers’ compliance with their Children with Cerebral Palsy (C-CP) Home Exercise Program (HEP). A self-administered online questionnaire was used to perform this qualitative research study on a group of 113 mothers who had children with CP. The study included mothers with children from birth to 12 years old who had received a HEP prescription from a physiotherapist. The measuring instrument tool was a questionnaire with two sections: demographic characteristics and a questionnaire about the parents’ adherence to the HEP. The questionnaire utilized in this study was subjected to a reliability analysis, and the derived Cronbach’s alpha was found to be 0.814 for the questionnaire (which had 17 phrases). These results imply that the questionnaire is reliable. A total of 113 responses were received, with 4 incomplete responses being eliminated. The majority of mothers (66.1%) did not follow the HEP, according to the findings of this survey. The demographics of the mothers revealed that 20–25-year-old mothers were more adherent than the other age groups. The findings of this study demonstrated that the physical therapist’s treatment of the mother influenced exercise compliance.

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity aerobic training with a high-protein diet (Group A; n = 38) and the second group were allowed to do regular physical activities and eat a regular diet (Group B; n = 38) for 8 weeks. Clinical (basal metabolic index (BMI) and muscle-mass-cross-sectional area (CSA)) and biochemical (Adiponectin, leptin, TNF-α, and IL-6) measures were measured at baseline, on the 8th week, and at 6-months follow-up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After eight weeks of intervention, and at the end of 6-months follow-up, the basal metabolic index (BMI) (6.3) (CI 95% 4.71 to 7.88), mid-arm CSA (17) (CI 95% 14.70 to 19.29), mid-thigh CSA (13.10) (CI 95% 10.60 to 15.59), mid-calf CSA (11.3) (CI 95% 9.30 to 13.29), adiponectin (−1.9) (CI 95% −2.13 to −1.66), leptin (5.64) (CI 95% 5.50 to 5.77), TNF-α (0.5) (CI 95% 0.42 to 0.57), and IL-6 (0.21) (CI 95% 0.18 to 0.23) showed more improvement (p < 0.001) in Group A than Group B (p > 0.05). Conclusion: Overall, this trial found that high-intensity aerobic training with a high-protein diet decreased the BMI percentile and muscle mass (arm, thigh, and calf), and positively altered the biochemical variables in children with obesity.