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Background The role of regular physical activity in preventing vascular and non-vascular disease are well established. Chronic kidney disease (CKD) is a major cause of global morbidity and mortality and largely preventable, but it is uncertain if regular physical activity can reduce the risk of CKD. Using a systematic review and meta-analysis of published observational cohort studies in the general population, we sought to assess the association between physical activity and CKD risk. Methods Relevant studies with at least one-year of follow-up were sought from inception until 02 May 2022 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using random effects meta-analysis. The quality of the evidence was evaluated using the GRADE tool. Results A total of 12 observational cohort studies comprising 1,281,727 participants and 66,217 CKD events were eligible for the analysis. The pooled multivariable-adjusted RR (95% CI) of CKD comparing the most versus the least physically active groups was 0.91 (0.85–0.97). The association was consistent across several study level subgroups. Exclusion of any single study at a time from the meta-analysis did not change the direction or significance of the association. There was no evidence of small study effects among contributing studies. The GRADE quality of the evidence was low. Conclusion Habitual physical activity may be associated a lowered risk of CKD compared to those who are not or least physically active in the general population. Systematic review registration: CRD42022327640

Background: The most prevalent foot deformity is Hallux valgus (HV). It is a progressive foot deformity that affects the first metatarsophalangeal joint and is frequently accompanied by severe functional impairment, excruciating foot pain, and a decreased quality of life. Therefore, this study aimed to determine the prevalence, knowledge, and awareness of HV in the population of Saudi Arabia's eastern province. Methods: A cross-sectional study was conducted using an online questionnaire developed under the supervision of consultants in the field of interest. The questionnaire for this study included demographic information, medical history, foot shape, wearing habits, and HV awareness. Results: Around 52.7% of participants had heard about HV, and 20.7% were aware of the risk factors for the appearance of HV, whereas 12.9% were aware of the importance of taking protective measures to prevent HV. Conclusion: This research showed that the risk factors, like wearing high heels and shoes with a narrow or very narrow toe box, are primarily the reason why HV is more prevalent among women. Therefore, educating women about HV risk factors and preventative measures is essential.

Blepharoplasty is an operation where redundant skin and musculature, and excess fat are resected and removed for functional, or aesthetic purposes, or both. Blepharoplasty is one of the most commonly performed cosmetic procedures. No previous studies have explored the factors that affect a patient’s decision to undergo blepharoplasty. We explored the factors that can affect the decision to undergo blepharoplasty in patients of the oculoplastic clinic, and specifically investigated the effect of consultation time on the patient’s decision to undergo blepharoplasty. This research was a retrospective cohort study undertaken in the private oculoplastic clinic Al-Ahsa, Saudi Arabia. The study was conducted on patients seeking blepharoplasty in the oculoplastic clinic of the primary investigator between December 2021 and February 2022. A convenient sampling technique was used for patient recruitment. The Chi-square test, independent t-test and ANOVA were all used to test factors associated with consultation time, and factors associated with patients’ decision to undergo blepharoplasty. A total of 97 participants were included in the study; 57 (58.8%) participants decided to undergo blepharoplasty, whereas 40 (41.2%) decided not to undergo blepharoplasty. Consultation time was not significantly associated with patients’ decision to undergo blepharoplasty. The presence of eyelid deformity or disease was the only factor significantly associated with the patients’ decision to undergo blepharoplasty. No significant association was found between consultation time and patient’ decision to undergo blepharoplasty. Further investigations are recommended to determine the factors that influence patients’ decision to undergo elective aesthetic surgery.

Sickle-cell disease (SCD) is one of the well-known hematological disorders that affects many people around the world. The risk of disease transmission increases with consanguineous marriage. SCD is considered a life-threatening condition, with mortality rates increasing annually because of the large number of comorbidities associated with this disease. The Al-Ahsa region carries the highest rate of SCD in Saudi Arabia. The aim of the study is to evaluate the attitude, knowledge, perceptions, and misunderstandings regarding SCD and its complications. An analytical cross-sectional study was conducted among 387 participants of the Al-Ahsa population. Data was collected using a structured, self-administered questionnaire. The questionnaire contains four important domains: socio-demographical information, knowledge, attitude, and complications of SCD. Of the 387 people sampled, 80% of the participants had heard about SCD, and the major source of information were their friends and families. More than half of the population knew that SCD is inherited, although 40% did not know about the treatment for SCD. Most of the participants showed a positive attitude, being sympathetic toward people with SCD, while half of the participants preferred not to have a child rather than have one with SCD. A high proportion of the population did not know that SCD is a leading cause of life-threatening infections, kidney failure, and stroke. The study indicates that there is a need for awareness programs to address some misconceptions and expand information regarding SCD, which could contribute to improving knowledge about SCD.

Background It is uncertain if initial combination therapy with glucose-lowering agents provides longer-term beneficial cardio-renal outcomes compared to stepwise therapy in patients with newly diagnosed type 2 diabetes (T2D). Using a systematic review and meta-analysis of observational cohort studies and randomised controlled trials (RCTs), we evaluated the efficacy and safety of the initial combination therapy vs a stepwise approach in newly diagnosed T2D.Methods Studies were identified from MEDLINE, Embase, the Cochrane Library, and search of bibliographies to January 2022. Study-specific risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were pooled. Quality of the evidence was assessed using GRADE.Results Eight articles comprising 4 unique RCTs (n=5,527 participants) and one observational cohort study (n=200) that compared initial combination therapy vs stepwise therapy were included. The RR (95% CI) for myocardial infarction comparing initial combination therapy vs stepwise therapy was 1.21 (0.74-2.00). Initial combination therapy reduced levels of fasting plasma glucose and HbA1c: mean differences (95% CIs) of -0.97 mmol/l (-1.41, -0.53) and -0.13 % (-0.20, -0.07), respectively. Initial combination therapy vs stepwise therapy reduced lipid levels, blood pressure and intima media thickness, with no differences in body composition parameters, neuropathy, retinopathy, and adverse events. Single study results showed initial combination therapy reduced creatinine levels and urine albumin excretion rate. The quality of the evidence ranged from moderate to very low.Conclusions Except for improving cardiometabolic and glycaemic parameters, a limited number of studies characterised by small sample sizes show that initial combination therapy for newly diagnosed T2D may be similar in efficacy and safety to stepwise therapy with respect to cardio-renal outcomes. There is a lack of sufficient evidence to recommend initial combination therapy with glucose-lowering agents in newly diagnosed T2D. Definitive RCTs are warranted.

Background. The new coronavirus pandemic, which appeared at the end of the year 2019, was the greatest in recent decades, and it affected almost all countries and economies, causing a highly significant number of deaths. Objectives. This study aimed to evaluate patients’ knowledge and attitude when experiencing potential COVID-19 symptoms toward reporting their illness and following viral preventive precautions. Material and methods. A cross-sectional study conducted among the general population in Al-Ahsa, Eastern region, Saudi Arabia. A self-administered questionnaire distributed among the general population, divided into three parts: Socio-demographic characteristics, previous COVID-19 infection and attitude toward experiencing COVID-19 symptoms. A total of 504 responses collected in this study from December 15, 2020 to January 15, 2021. Results. We found that 31.7% were positive among the participants who did COVID-19 testing (48.8%). The level of knowledge showed that more than half (52.2%) were classified at a low knowledge level, while the rest were classified as good (47.8%). Regarding attitude, nearly two-thirds (64.1%) showed a negative attitude, while 35.9% showed a positive attitude. The workplace during the pandemic and family history of COVID-19 were the factors associated with both good knowledge and a positive attitude. Conclusions. The knowledge and attitude toward reporting potential COVID-19 symptoms were generally suboptimal. Male participants, holders of a university degree in the medical field, health practitioners or having a family member working in the medical field demonstrated better knowledge, while those who had a COVID-19 test and those with a family history of the disease positively influenced the attitude.

Background There are different determinants of health-seeking behaviors. Studying health-seeking behaviors and their factors help governments use the existing health resources properly for a potent healthcare system. This study aimed to evaluate the factors influencing health-seeking behavior in Al-Ahsa. Methods The study is a questionnaire-based observational cross-sectional study of the factors influencing health-seeking behaviors in the general population of the Al-Ahsa governorate. A non-probability convenience sampling technique was used to acquire the sample. The study followed all ethical considerations and received approval from King Faisal University. Results A total sample of 481 participants completed the study questionnaire. 21.2% of people visited the health centers for medical checkups despite having no symptoms, while 29.1% admitted to avoiding the health centers despite knowing they needed medical attention. Additionally, the majority of patients prefer government-run health facilities (58.6%), while 41.4% prefer the commercial sector. When experiencing any health complaints, precisely 70.7 % of women go to a medical facility, compared to 61.8% of men (P=.038). In addition to that, 68.5% of participants with intermediate economic status visit healthcare centers for any symptoms compared to 50% of others with high financial status (P=.049). Specifically, 73.3% of participants diagnosed with a disease or chronic diseases visited healthcare centers for clinical symptoms compared to 64.3% of others without (P=.049). Conclusion This study identified that most participants with chronic diseases seek medical care for any symptom, and the participants with an intermediate economic status are more likely to go to a governmental primary healthcare center for any symptoms. The findings of this research provide insights for the government and policymakers to create effective strategies and manage the existing resources in Al-Ahsa.

Introduction Overweight and obesity are defined as excessive fat accumulation that poses a risk to well-being. In children, a BMI of the 85th percentile to less than the 95th percentile is considered overweight, and the 95th percentile or greater is considered obese. Aim This study aimed to measure the prevalence of childhood obesity in a population of six to 16 years of age and its associated risk factors. Participants and methods This is a cross-sectional study conducted among children aged between six and 16 years old who live in the Eastern province of Saudi Arabia. The data collector in each school distributed envelopes containing an informed consent form and a survey to collect data on the demographics and socioeconomic status to all students. All students whose parents signed the informed consent would undergo measurement of growth parameters which ultimately determined the BMI. Results Six hundred eighty-eight children agreed to participate. The prevalence of overweight and obesity was 15.3% (overweight 10.2%, obese 5.1%). Children who eat four or more meals per day were 29.5% while only 10% were regularly exercising for more than two hours a day. Independent risk factors of obesity and overweight were eating four or more meals per day. Spending more than an hour a day on physical activity was a protective factor against being overweight and obese. Conclusion Increased daily food consumption was the most frequent risk factor for obesity. Physical activity was the protective factor against obesity in children and adolescents. Further intervention measures must be implemented to reduce the prevalence of overweight and obesity. A healthy lifestyle based on effective dietary education and physical activity promotion is required to prevent overweight and obesity among youth.

Foot ulcers and amputations are common conditions in people with diabetes and can considerably impact quality of life, necessitate a lengthy hospital stay and increase mortality. Preventative foot care and examination can prevent or delay ulceration, and individuals may seek information from publicly available social media resources such as YouTube. Therefore, the purpose of this study is to evaluate the educational quality and reliability of publicly available YouTube videos on diabetes foot examinations.A YouTube search for "diabetic foot examination" was conducted, and the first 100 relevant English videos focused on examining the diabetic foot were included for evaluation. The Journal of the American Medical Association (JAMA) standards were used to measure video reliability. The Global Quality Score (GQS) and the Diabetes UK Annual Foot Check (DUK-C) checklist were used to assess video educational quality. Differences in JAMA, GQS, and DUK-C ratings were analysed after videos were sorted by topic and source.The mean number of views per video was 101,311.9 ± 348,383.6, and the mean video power index was 41.6 ± 170.0. The most common upload source was from physicians (28%) and, the most popular material category was diabetes foot examination (58 videos). In terms of video reliability, 36% of videos scored 0. According to the GQS standards, only 5% of the videos are of excellent quality, while 34% are of poor quality, with 24 videos scoring between 0 and 1 on the DUK-C scale.While foot care examination videos have a substantial audience, the majority are considered low in quality and reliability. Videos on comprehensive diabetic foot examination should be accessed on reputable sources that guarantee standardisations of video quality and take into account the simplification of information transmission in order to reach lay audiences.

A tension-type headache (TTH) is a recurrent headache that is mild to moderate in intensity, unlike migraine (MH), which is accompanied by crippling effects of nausea, vomiting, photophobia, or phonophobia. TTH is more frequent than migraine, but it is less likely to cause severe pain and physical dysfunction. TTHs account for more lost workdays due to their prevalence. The study aimed to evaluate the prevalence, frequency, and disability of MHs and TTHs among the general population in the Eastern Region of Saudi Arabia. A cross-sectional study was employed using a validated questionnaire. The questionnaire implemented the HARDSHIP algorithm to diagnose MH and TTH and questions to correlate their prevalence to socio-demographic data, measurement of the level of disability, headache management, and treatment effectiveness using the chi-square test. The study reviewed 877 subjects (46.6% males

This study was conducted to explore the potential barriers to and facilitators of physical activity in Saudi Arabian females living in the East Midlands region of the United Kingdom.A qualitative study was conducted with Saudi Arabian females currently living in the East Midlands, along with the completion of International Physical Activity Questionnaires (IPAQs). The Semi-structured interviews were digitally recorded, transcribed, and analysed using a narrative thematic approach; IPAQ data were descriptively analysed. A total of 12 interviews were conducted. Five refined themes and 19 sub-themes were identified.The results of this research showed that attractive climate, availability of open spaces, easy gymnasium accessibility, low cost, independent student lifestyles, food habits, efficient transportation, and UK culture serve as facilitators, while reduced availability of individual women-only gyms, non-engaging fitness instructors and reduced attention to different age groups serve as barriers to physical activity for Saudi Arabian females in the East Midlands.Although the results concerned Saudi Arabian females in the East Midlands, the participants' perspectives showed that more appropriate action could be taken to raise awareness of the advantages of being active among females in general. Drawing on a service delivery model based on the stages of change and including relevant stakeholders in developing and implementing effective interventions, strategies and policies must be developed to promote the participation of Saudi Arabian females and female expats from other countries in physical activity in the UK.أجريت هذه الدراسة لاستكشاف العوائق والميسرات المحتملة للنشاط البدني لدى النساء السعوديات اللواتي يعشن في منطقة شرق ميدلاندز بالمملكة المتحدة.أجريت مقابلات جزئية الهيكلة مع نساء سعوديات يعشن حاليا في شرق ميدلاندز بالإضافة إلى استكمال استبانات دولية حول النشاط البدني. تم تسجيل المقابلات ونسخها رقميا وتحليلها باستخدام نهج موضوعي سردي؛ تم تحليل بيانات الاستبانات وصفيا. تم إجراء ما مجموعه 12 مقابلة. تم تحديد 5 موضوعات مصقولة و 19 موضوعا فرعيا.تظهر نتائج هذا البحث أن المناخ الجذاب، وتوافر المساحات المفتوحة، وسهولة الوصول إلى الصالة الرياضية، والتكلفة المنخفضة، ونمط الحياة المستقل كطلاب، والعادات الغذائية، والنقل الفعال، وثقافة المملكة المتحدة كميسرين للنشاط البدني، وانخفاض توافر الصالات الرياضية للنساء فقط، وعدم مشاركة مدربي اللياقة البدنية، وانخفاض الاهتمام بالفئات العمرية المختلفة كعوائق للنشاط البدني في شرق ميدلاندز بين النساء السعوديات.على الرغم من أن النتائج من النساء السعوديات، فإنه من منظور المشاركات أنه يمكن اتخاذ إجراءات أكثر ملاءمة لزيادة الوعي بمزايا النشاط بين النساء بشكل عام. بالاعتماد على نموذج تقديم الخدمة على أساس مراحل التغيير وإشراك أصحاب المصلحة المعنيين في تطوير وتنفيذ التدخلات الفعالة، يجب تطوير الاستراتيجيات والسياسات لتعزيز مشاركة النساء السعوديات والمغتربات من البلدان الأخرى في النشاط البدني بالمملكة المتحدة .

Over time, various guidelines have emphasised the importance of physical activity and exercise training in the management of type 2 diabetes, chronic diseases, including cardiovascular disease and musculoskeletal disorders. The aim of this review is to evaluate the effectiveness of physical activity in people with type 2 diabetes and COVID-19. Most research to date indicates that people with type 2 diabetes who engage in both aerobic and resistance exercise see the greatest improvements in insulin sensitivity. Physical activity is now also known to be effective at reducing hospitalisation rates of respiratory viral diseases, such as COVID-19, due to the beneficial impacts of exercise on the immune system. Preliminary result indicates that home-based exercise may be an essential component in future physical activity recommendations given the current COVID-19 pandemic and the need for social distancing. This home-based physical exercise can be easily regulated and monitored using step counters and activity trackers, enabling individuals to manage health issues that benefit from physical exercise.

Background: An integrated treatment based on dieting, physical training and cognitive-behavioural psychotherapy is an effective tool to reduce obesity and its consequences. However, the feasibility of this approach is problematic. This study aims to compare two multidisciplinary programs used to improve weight loss. Methods: Fifty-two obese individuals were subjected to an Enhanced Lifestyle Counselling associated with, according to their own choice, dieting (N = 11), or dieting + aerobic training (n = 18), or dieting + resistance training program (n = 23). The study experiment spanned 16 weeks divided into two phases. The first phase lasted 04 weeks and was oriented to enhance motivation and establishing changes in behaviours related to dietary and sedentary lifestyle. The second phase lasted 12 weeks and was oriented to add aerobic or resistance training. Body compositions, cardiovascular disease risk factors, and cardio-respiratory fitness were assessed. Results: Data demonstrated that all obesity treatment programs were able to improve all studied variables. Weight loss levels were −6.03 ± 2.08, −10.5 ± 2.33, and −9.37 ± 1.99 kg in Dieting, DAT and DRT groups, respectively. Our results noted also that exercise training could play an important role in reducing obesity and its consequences. Nevertheless, modifications were more important in DRT at the explosivity and muscle strength and in DAT at fat percentage, aerobic capacity, SA, and CVR factors. Conclusion: The current evidence noted that both multidisciplinary weight loss programs were efficient in the treatment of obesity and its comorbidity. Moreover, the use of aerobic exercises was more effective in reducing body fat and improving cardiorespiratory fitness. However, using resistance exercises appeared to be more appropriate to enhance the muscle potential. Keywords: Integrated treatment, Enhanced lifestyle counselling, Dieting, Aerobic training, Resistance training, Obesity