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Ahmed Hussein Subki,1 Manal Ismail Bokhary,1 Sultan Abdulrahman Alandijani,1 Mohannad Abdulrahman Aljehani,1 Ahmed Wasel Alharbi,1 May Alzahrani,1 Saud Suliman Almuhammadi,2 Bassim Tahseen Albeirouti,3 Mohamed Abdulmajid Abduljabar,1 Silvio Danese4 1Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 2Department of Surgery, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia; 3Adult Hematology/Bone Marrow Transplant (BMT) Section, Department of Oncology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia; 4Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, ItalyCorrespondence: Ahmed Hussein Subki; Manal Ismail Bokhary, Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, P.O.Box No 40047, Jeddah, 21499, Saudi Arabia, Email subki.research@gmail.com; mbokhary@kfshrc.edu.saIntroduction: Hypereosinophilic syndrome (HES) and immune thrombocytopenic purpura (ITP) have been reported to co-occur with ulcerative colitis (UC). However, the exact pathogenic mechanisms of their occurrence remain elusive. In this article, we aim to describe two cases of UC patients who developed refractory HES and ITP and elaborate on their potential pathogenesis.Case Study: We report two middle-aged patients diagnosed with UC. The first patient developed HES that was refractory to conventional medical therapy of idiopathic HES, and the second developed refractory ITP that failed steroid and immunosuppressive therapy. Both conditions improved considerably following colectomy, suggesting they are of a reactive rather than idiopathic nature.Conclusion: In patients with UC and refractory comorbid HES or ITP, the reactive nature of these comorbidities should be taken into consideration, and colectomy, therefore, should be considered if clinically indicated.Keywords: hypereosinophilic syndrome, immune thrombocytopenic purpura, colectomy, ulcerative colitis

Waleed Ahmed Alghamdi,1 Ahmed Hussein Subki,2 Hazim Abdulkarim Khatib,3 Nadeem Shafique Butt,4 Rahaf Ali Alghamdi,1 Mohammed Saad Alsallum,5 Ahmed A Alharbi,1 Mohammad Nasser Almatrafi,1 Abdullah Ahmed Alobisi,1 Faten Al-Zaben,1 Harold G Koenig1,6,7 1Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Internal Medicine, King Faisal Specialist Hospital & Research center, Jeddah, Saudi Arabia; 3Department of Internal Medicine, King Abdulaziz Hospital, Jeddah, Saudi Arabia; 4Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Neurology, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 6School of Public Health, Ningxia Medical University, Yinchuan, People’s Republic of China; 7Duke University Medical Center, Durham, NC, USACorrespondence: Waleed Ahmed Alghamdi; Harold G Koenig, Email wagalghamdi@kau.edu.sa; harold.koenig@duke.eduBackground: The present study examined the prevalence of and risk factors for symptoms of body dysmorphic disorder (BDD) in the general population of Jeddah, a large port city in Saudi Arabia.Methods: This cross-sectional study surveyed a convenience sample of 520 adults. We used a validated self-screening measure to assess BDD, the body dysmorphic disorder questionnaire (BDDQ).Results: The prevalence of significant BDD symptoms among the general Saudi population was 8.8% (ie, those scoring above the cut off for BDD on the BDDQ). Over half (52%) of all respondents reported concerns about the attractiveness of their body parts, and of those expressing such concerns, 66% were preoccupied with these thoughts. Only 3% of all respondents opted for cosmetic surgery because of these concerns, and most of those individuals (69%) had only one surgery. Nearly 9% of all respondents reported that these concerns affected their relationships with family and friends. Almost 15% of all participants spent an hour or more each day thinking about these concerns. Patients who reported a history of depression were 3.8 times more likely to have BDD. Other variables included in the model predicting high BDD scores (eg, age, job status, and marital status) did not achieve statistical significance.Conclusion: Significant symptoms of BDD (based on the BDDQ) are not uncommon among the general population of Jeddah, Saudi Arabia. Risk factors for this condition were female gender, younger age, being unmarried, and in bivariate and multivariate analyses, history of depression and female gender. These findings underscore the need for increased awareness by clinicians of this disorder, particularly when treating patients with depressive disorder, particularly among women.Keywords: body dysmorphic disorder, body image, prevalence, Saudi Arabia

Human noroviruses (NV) are the most prevalent cause of sporadic and pandemic acute gastroenteritis. NV infections cause substantial morbidity and death globally, especially amongst the aged, immunocompromised individuals, and children. There are presently no authorized NV vaccines, small-molecule therapies, or prophylactics for humans. NV 3 C L protease (3CLP) has been identified as a promising therapeutic target for anti-NV drug development. Herein, we employed a structure-based virtual screening method to screen a library of 700 antiviral compounds against the active site residues of 3CLP. We report three compounds, Sorafenib, YM201636, and LDC4297, that were revealed to have a higher binding energy (BE) value with 3CLP than the control (Dipeptidyl inhibitor 7) following a sequential screening, in-depth molecular docking and visualization, physicochemical and pharmacological property analysis, and molecular dynamics (MD) study. Sorafenib, YM201636, and LDC4297 had BEs of -11.67, -10.34, and -9.78 kcal/mol with 3CLP, respectively, while control had a BE of -6.38 kcal/mol. Furthermore, MD simulations of the two best compounds and control were used to further optimize the interactions, and a 100 ns MD simulation revealed that they form stable complexes with 3CLP. The estimated physicochemical, drug-like, and ADMET properties of these hits suggest that they might be employed as 3CLP inhibitors in the management of gastroenteritis. However, wet lab tests are a prerequisite to optimize them as NV 3CLP inhibitors.

Aims: This study aims to compare the incident rate of sports injuries before and during the COVID-19 quarantine among active and nonactive adults and identify and compare patterns, types and sites of sports injuries. Study Design: Cross-sectional study. Place and Duration of Study: A self-administered online survey was conducted in Riyadh, Saudi Arabia, between June 2020 to November 2020. Methodology: We conducted a descriptive, cross-sectional web-based survey on active and nonactive adults of Riyadh, Saudi Arabia. A total of 537 respondents from Riyadh completed the questionnaire. The study included adults active during quarantine who are also residents of Riyadh. Residents of other cities and respondents younger than age 18 or older than 64 were excluded. Results: A total of 537 participants fulfilled the criteria. More than half of the respondents were aged 18 to 24 years (54.7%). Of those who did not exercise before quarantine, 42.9% (n = 91) started during quarantine, while 26.5% (n = 86) of respondents who exercised before quarantine stopped during the quarantine. Running and walking were the most common sports practiced by 70.9% of respondents during quarantine and 63.1% before the quarantine. Muscle strain/tears were the most common injuries before quarantine (26.2%), while bruises were the most common injury during quarantine (28.6%). Soccer and basketball were the most affected by quarantine. Conclusion: The number of active individuals had increased during quarantine. Paradoxically, the prevalence of sports injuries decreased. Soccer and basketball were the most significantly affected by a lack of participation during the quarantine; both were a common cause of sports injuries. Medical providers should investigate and support preventive measurements on sports that cause most injuries.

Aims: to explore the prevalence of knee symptoms in the general population of Riyadh, Saudi Arabia, and evaluate the impact of sports participation and other demographic variables on the progression of knee symptoms in Riyadh, Saudi Arabia. Study design: Cross-sectional study Place and duration of study: A self-administered online survey was conducted in Riyadh, Saudi Arabia between September 2020 to March 2021. Methodology: A total of 589 participants age 18 or older who reported concerns of knee symptoms and provided written informed consent were enrolled in the study. We excluded respondents who had undergone knee surgery (n = 16) and those diagnosed with rheumatoid arthritis or other types of arthritis (n = 25). We collected demographic information (eg, age, gender, types of engaged sports, sports participation hours, and frequency of participation per week) and knee symptoms and severity using the Lequesne index tool. Results: Advanced age was significantly associated with a higher severity score (P < .001). We found a statistically significant association between body mass index and knee symptom severity. We noted no severe knee symptoms in participants engaging in weightlifting. Most participants (64.7%) reported that walking was their most frequent exercise, and knee symptoms were common. Of respondents who walk as their primary sport, 10.6% of them are considered disabled with a severe form of knee pain according to the Lequesne index (which uses the term “handicapped” rather than disabled). Conclusion: Older and overweight respondents had a high prevalence of knee symptoms. Interestingly, the prevalence rates of individuals without knee symptoms did not differ regarding sport participation. Sports participation frequency did not change the prevalence or severity of knee symptoms, while longer exercise duration was associated with lower knee symptom severity rates.

Faris H Binyousef,1 Shahad A Alruwaili,1 Abdulaziz F Altammami,1 Ahmed A Alharbi,1 Feras A Alrakaf,1 Abdulrhman A Almazrou2 1College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia; 2Ophthalmology Department, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi ArabiaCorrespondence: Shahad A AlruwailiCollege of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi ArabiaTel/Fax +966534479993Email shahadabdullahalr@gmail.comPurpose: To assess the impact of dry eye disease (DED) on work productivity in Saudi Arabia and investigate its effect on daily activities.Patients and Methods: We conducted a cross-sectional study on male and female Saudi workers age 20 years or older. The data were collected via self-administered questionnaires distributed electronically through social media. We used the Ocular Surface Disease Index questionnaire to diagnose DED patients and assess their DED severity as mild, moderate, and severe.Results: A total of 463 respondents qualified for the study. All patients in the DED groups reported a loss of work productivity. Most patients in the severe DED group (59%) reported difficulty focusing on work due to DED, whereas 17.1% of patients with mild DED and 22.7% with moderate DED reported the same. These findings indicate significantly worsening productivity as DED progresses in severity (p< 0.05). Participants with severe DED reported significantly more affected work hours weekly (35.8%) than participants with moderate (6.1%) and mild DED (7.1%).Conclusion: DED has a significant impact on work productivity, with the most pronounced effect among office workers. It is essential to screen office workers for DED and enhance the awareness of its effect on work productivity among the workforce and healthcare providers.Keywords: dry eye syndrome, work performance, office worker, presenteeism, occupation

This paper focuses on the most significant empirical studies on the topic of challenges facing the communicative language teaching approach in Saudi Arabia. The communicative language teaching method has been used for more than two decades in Saudi Arabia and research conducted during this period offers some insight into the main challenges of the implementation. The main goal of this paper is to synthesize findings from research studies conducted in the past and by doing so, suggest the possible avenues for tackling these challenges. Four broad categories of challenges have been adopted from Li’s (1998) comprehensive framework in an attempt to structure the challenges under meaningful labels. This, in turn, enabled us to categorize the challenges according to their source which helped our understanding of how to resolve them. The findings suggest that the most frequently observed policy-related challenges are the current exam system, overcrowded classes, no AV equipment, and low quality of in-house training programs for teachers. Teacher-related challenges mostly relate to conflicting ideas about CLT, low confidence in these methods, preference for the traditional learning model, focus on developing skills that feature in the exams, and deficiencies in teachers’ English. Student-related challenges are found to be their low-level proficiency, passive learning style, lack of motivation to learn the target language, and fear of their marks being negatively affected if they are paired with weaker peers during communicative activities. This paper concludes that these challenges are all interconnected, and a systematic approach is essential in trying to tackle these with the government intervention being a potential first step.

Cervical cancer is one of the most frequently occurring oncological malignancies which in turn is attributed with the chronic persistence of human papillomavirus (HPV). Recent explorations into cancer immunobiology have elucidated that innate immune response are important for proliferation of cancerous cells. Toll-like receptors (TLRs), belonging to the pattern recognition receptors (PRRs) family of innate immune receptors have been reported for their expression in various cancers, where they aid cancer cell proliferation along with tumor development. The present study focuses on investigating TLR9 mRNA within HPV18+ HeLa (cervical cancer cells) and its correlation with angiogenic factors and anti-apoptotic markers. The expression of TLR9 mRNA was substantially higher in HeLa cancer cells in comparison with normal kidney cells. MTT assay demonstrated that treatment with CpG ODN significantly increased the proliferation in dose-dependent manner. Augmented levels of cell percentage within G2/M phase was also recorded post CpG ODN treatment within HeLa cells. qRT-PCR analysis also elucidated elevated levels of Bcl-2, Bcl-XL, COX-2, VEGF, and TLR9 within HeLa cells. Thus, to conclude, our study established that HeLa cells have increased TLR9 mRNA expression concomitant with elevated COX-2, Bcl-2, Bcl-XL and VEGF. These results indicate toward potential applicability of targeting TLR9 as a therapeutical intervention for the treatment and management of this pernicious malignancy.

This paper aims to analysis an English language textbook used in “middle school” (high school) in Saudi Arabia in-depth, to ascertain the type of pedagogy pushed by the teacher’s book. The criteria of analysis are adapted from Communicative Language Teaching (CLT). These criteria are used to analyses the textbook in terms of how communicative it is and personalised, how authentic, how meaningful; its degree of linguistic complexity; whether it is scaffolded, accuracy or fluency oriented; and how much of all each of these categories is in the textbook activities. The methodology of this paper is qualitative and presents only one aspect, textbook analysis, of a broader case study which forms part of a Ph.D. project that explores the factors behind the failure of implementation of CLT in Saudi Arabia. The results of this analysis show that in the textbook there is a careful balance between accuracy and fluency. There are some person, alised and meaningful activities, however most of the activities lack of authenticity which limits freedom for the students in using use the target language.

The cancer is the world's most silent and life-threatening diseases, which may arise in most common people without any indication at any age and result in uncontrolled growth and metastasis. In the current manuscript, we targeted the discovery of novel carbonic anhydrase IX inhibitors. The discovery is based on computational techniques based on direct and indirect drug design. We screened nearly 500000 compounds from the zinc database to identify the top 1000 compounds with indirect drug design techniques while the top 200 were docked for the interactions and scoring functions. The top 12 out of these were reported in the manuscript, which showed higher binding scores than the standard compounds with selectivity based on interaction. These leads may be the future drugs for anticancer agents through carbonic anhydrase inhibitors.

BACKGROUND Currently, non-valved conduits are preferred for extracardiac total cavo-pulmonary connection (TCPC). However, previous work has failed to provide objective data comparing the postoperative outcome between non-valved TCPCs and bovine jugular vein valved xenograft (BJV) TCPCs. Hence, the objective of this study is to compare the postoperative outcomes in extracardiac TCPC patients who received BJV vs synthetic non-valved conduits and evaluate the effect of BJV on liver fibrosis. METHODS Of 206 patients who had extracardiac TCPC from 2002 to 2017 were divided into three groups. Group A (n = 66) received BJV, group B (n = 37) received PET conduits and group C (n = 103) received polytetrafluoroethylene (PTFE) tube. Study endpoints were hospital outcomes, conduits thrombosis, reinterventions, and survival. Liver stiffness and fibrosis were assessed in eight patients with BJV. RESULTS Preoperative parameters were comparable among groups. Thrombosis was significantly lower in group C (P

The current article deals with the in-silico along with enzyme kinetics approach to search for a prominent AChE enzyme inhibitor among the known natural compounds. The computational tools were involved for this purpose and eventual vincamine, a monoterpenoid indole alkaloid, was selected based on several parameters, including free energy of binding (-10.77 kcal/mol) and ADME parameter. Computationally, it confirmed the interaction between vincamine and AChE at an indistinguishable locus from that of substrate AChI (-3.94 kcal/mol) but with much higher binding energy. Interestingly, amino acid residues Gly120, Gly121, Gly122, Glu202, Trp86, Tyr133, Ser203, Phe297, and His447 of AChE were found to be common in these interactions. Further, these findings were approved with wet lab tests where detailed kinetics was studied. It was found that vincamine inhibited AChE with the inhibition constant Ki (239 µM). The value of IC50 (239 µM) and KM (0.598 mM) was determined and further confirmed by Dixon, Lineweaver- Burk reciprocal, Hanes, and Eadie- Hofstee plots, respectively. The mode of interaction of the compound was found to be competitive for AChE. Thus, the present computational and enzyme kinetics studies conclude that vincamine can be a promising inhibitor of AChE for the effective management of AD.

Neurodegenerative disorders cause irreversible damage to the neurons and adversely affect the quality of life. Protein misfolding and their aggregation in specific parts of the brain, mitochondrial dysfunction, calcium load, proteolytic stress, and oxidative stress are among the causes of neurodegenerative disorders. In addition, altered metabolism has been associated with neurodegeneration as evidenced by reductions in glutamine and alanine in transient global amnesia patients, higher homocysteine-cysteine disulfide, and lower methionine decline in serum urea have been observed in Alzheimer’s disease patients. Neurodegeneration thus appears to be a culmination of altered metabolism. The study’s objective is to analyze various attributes like composition, physical properties of the protein, and factors like selectional and mutational forces, influencing codon usage preferences in a panel of genes involved directly or indirectly in metabolism and contributing to neurodegeneration. Various parameters, including gene composition, dinucleotide analysis, Relative synonymous codon usage (RSCU), Codon adaptation index (CAI), neutrality and parity plots, and different protein indices, were computed and analyzed to determine the codon usage pattern and factors affecting it. The correlation of intrinsic protein properties such as the grand average of hydropathicity index (GRAVY), isoelectric point, hydrophobicity, and acidic, basic, and neutral amino acid content has been found to influence codon usage. In genes up to 800 amino acids long, the GC3 content was highly variable, while GC12 content was relatively constant. An optimum CpG content is present in genes to maintain a high expression level as required for genes involved in metabolism. Also observed was a low codon usage bias with a higher protein expression level. Compositional parameters and nucleotides at the second position of codons played essential roles in explaining the extent of bias. Overall analysis indicated that the dominance of selection pressure and compositional constraints and mutational forces shape codon usage.

To compare the effectiveness of subtalar mobilisation technique on pain and functional disability compared to conventional physiotherapy in patients with plantar fasciitis.The randomised controlled trial was conducted at the Prime Care Hospital, Faisalabad, Pakistan, from January to August 2017, and comprised patients of either gender aged 30-60 years presenting with complaints of heel and foot pain, a limited range of motion at the ankle joint due to heel pain, and pain in the morning when taking the first steps or after prolonged rest. The participants were randomly assigned to intervention group A, that received subtalar mobilisation, and control group B treated with therapeutic ultrasound. The groups received two treatment sessions per week over 3 weeks. Patients in both the groups received stretching and rigid tapping as standard treatment. Visual analogue scale and the foot and ankle disability inventory were used to measure pain and functional disability. Data was analysed using SPSS 20.Of the 60 patients enrolled, 8(13.3%) were lost to follow-up, while 52(86.6%) completed the study. Of the 52 subjects, there were 25(48%) in group A with a mean age of 32.40±8.02 years, while in group B there were 27(52%) subjects with a mean age of 32.59±7.00 years. Group A had 11(44%) males and 14(56%) females, while group B had 16(59.3%) males and 11(40.7%) females. Mean body mass index for group A was 25.35±3.8 compared to 25.67±3.25 for group B. There were significant differences in terms of pain between the two groups (p0.05). Group A showed more reduction in functional disability than group B (p0.05).Subtalar mobilisation with movement was found to be effective in reducing pain and functional disability than conventional treatment in patients with plantar fasciitis.20200221046567N2 dated April 18, 2020. URL:https://www.irct.ir/trial/46988.with the World Health Organisation (WHO)-recognised Iranian Registry of Clinical Trials.

Down’s syndrome (DS) is the most common cause of hereditary intellectual impairment in humans. DS is also associated with characteristic facial features that are believed to have oral health effects. This systematic review and meta-analysis aimed to evaluate the prevalence of dental caries among the DS population in Saudi Arabia. A systematic search was conducted on PubMed, Web of Science, and Medline through Clarivate and EBSCO to identify potentially eligible publications. Rayyan QCRI analysis tool was used for duplicate detection, and study screening, whereas Review Manager (RevMan Computer program Version 5.4) the Cochrane Collaboration, 2020. was used to conduct a random-effects meta-analysis on prevalence data and DMFT scores. Data was synthesized, both, qualitatively and quantitatively (presented as forest plots). The search resulted in 267 studies, of which seven studies were included with a total population of 565. The pooled DMFT score among the DS population in Saudi Arabia is 4.88 (95% CI: 3.66 – 6.09), and the pooled prevalence of dental caries was 73% (95% CI: 52% - 93%). High levels of heterogeneity were observed in both analyses (I2 = 91%, and 96%, respectively). Our study reports a relatively high dental caries prevalence among the DS population in Saudi Arabia. Pooled DMFT score for permanent teeth among our study sample was higher than those reported by other meta-analyses conducted on the disease-unrestricted populations in Saudi Arabia. Keywords: Down’s syndrome; dental caries; Saudi Arabia, DMFT, tooth decay, meta-analysis.

Anti-f/ce is a rare antibody but nevertheless associated with Hemolytic Disease of the Fetus and Newborn (HDFN) and Hemolytic Transfusion Reactions (HTR). This antibody shows reaction against products of the seemingly common R0 or r haplotypes. Often detected with other Rh antibodies, these reactions are enhanced against cells pretreated with common protease enzymes. The findings concluded the presence of anti-f/ce using routine procedures. Although seemingly innocuous being 'enzyme only', cases as these must be dealt with proper discernment to avoid risks of HTR and HDFN. The purpose of this article is to report the detection of an anti-f on a 51-year-old female with unknown transfusion history by a routine blood bank and to show how these infrequent antibodies are being misdiagnosed which could be avoided.

Different pedagogies employed in English language teaching (ELT) show varying degrees of use of first language (L1) and second language (L2). The choice is between teaching L2 through L2, teaching L2 through L1, or teaching using a mix of the two. Communicative language teaching (CLT) is a second language teaching approach that aims to create opportunities for the productive use of L2 in the classroom. CLT has been officially implemented in the Saudi Arabian context since 2004, where the use of L2 in the classroom is now encouraged. However, it is important to consider how well teachers’ beliefs align with the specified use of L2 or L1 in the classroom. Importantly, this alignment is not generally taken into account, and so there is potential for resistance to this official pedagogy among teachers. This paper aims to explore the impact of Saudi teachers’ reported beliefs on the use of L2 in CLT in observed practice. The methodology this paper employs is a systematic review of the related studies from 2014 to 2019 that examine teachers’ beliefs and their alignment with their actual practice in the Saudi Arabian education setting. The results of this review of the studies show that SA teachers believe Arabic is still useful in the typical Saudi Arabian classroom where CLT has been officially adopted.

It is well known that progesterone plays a major role in the maintenance of pregnancy, particularly during the early stages, as it is responsible for preparing the endometrium for implantation and maintenance of the gestational sac. The management of pregnant women at risk of a threatened or idiopathic recurrent miscarriage is complex and critical. Therefore, a group of obstetricians and gynecologists practicing in Saudi Arabia gathered to update the 2014 Saudi guidelines for threatened and recurrent miscarriage management. In preparation, a literature review was conducted to explore the role of oral, vaginal, and injectable progestogens: this was used as a basis to develop position statements to guide and standardize practice across Saudi Arabia.

Dundee Ready Education Environment Measure (DREEM) inventory has been exhaustively used to evaluate the education environment (EE), especially in the health sector to identify the strengths and weaknesses of the program. This study was designed to investigate the medical students’ perceptions about the education environment (EE) of the College of Medicine (COM), Jeddah. This cross-sectional study was carried out on medical students and conducted between May and August 2020. A predesigned DREEM questionnaire written in English containing five subdomains was adopted to achieve the purpose of the study. A total of 220 students responded to the dispensed survey with a mean age of 21.97 (SD = 1.28). Male and female students represented 64.5% and 35.5% of the respondents, respectively, while most of them were in the fourth year of medical college (109, 49.5%), and the majority belonged to phase II (basic sciences) of the college (144, 65.4%). The overall total DREEM score for EE was 129.64 (SD = 31.81; 64.82%), and all the five subdomains of DREEM scored above 60% with the highest score by students’ academic self-perception (SASP) (21.22; 66.31%) and the lowest by students’ perception of learning (SPL) (30.16; 62.83%). Also, SASP2 was the highest scoring item with a mean of 3.13 (SD = 0.96), while SPA8 was the lowest with a mean score of 1.99 (SD = 1.38). We also compared our study with the available literature for contextual interpretations. The students’ assessment for EE of the medical program was positive; however, we identified a need for an improvement plan for six-weak scoring areas and one of the weak domains of DREEM i.e., students’ perception of teaching (SPT).

Reverse Transcriptase (RT) inhibitors are highly promising agents for use as an effective anti-retroviral therapy (HAART) which is typically a combination of three or four antiretroviral drugs. We used direct drug design approach to discover new chemical entities for the target protein. The validated template of the protein targeting reverse transcriptase PDB ID 1JKH was extracted for three sites hydrophobic, steric, and electronic parameters explain the interactions at the active site by the inhibitors. We used the Zinc library of compounds to explore the possible leads for HAART through RT inhibition. We report 12 new chemical entities with possible activity against the targeted viral protein. These leads will provide new therapeutic means in antiretroviral therapy.

Background: There is a substantial rise in the incidence of cancer in Saudi Arabia. Life style models and lack of awareness are the prime suspect in this substantial increase. Therefore, the objective of the present study was to assess the relationship between lifestyle and cancer in a population-based Survey in Northern Saudi Arabia. Methodology: This cross-sectional study was conducted in North Saudi Arabia (Hail Region). Data was collected as a part of a community based cancer’s awareness movement that covered an area inhibited with approximately 500,000 individuals. Results: In this study, about 2558/3227 (79.3%) and 641/794 (80.7%) believed that tobacco smoking and smokeless are not a risk of cancer development. In this study large section (87.2%) of the study population believe that exposure to diverse occupational or non-occupational chemicals has no role in cancer development. Furthermore, around 59% of the study subjects in the current study believed that repeated exposure to insecticidal chemicals doesn’t influence the risk of cancer. Conclusion: The present study point to the urgent need for awareness educational programs and preventive measures towards may lifestyle factors that can increase or decrease the overall risk of cancer among Saudi population.

Aim To find out the factors and causes that motivate medical students to choose ear, nose, and throat (ORL head and neck surgery) as a specialty in Saudi Arabian medical universities. Materials and methods A cross-sectional study was conducted at Kingdom of Saudi Arabia by distributing a self-administered questionnaire to 1,516 medical students across all medical universities. Chi-squared test and logistic regression analyses were used to examine the association between the participants' choices and factors motivating their choice of specialty. Results ORL head and neck surgery was chosen as a future specialty by 27% of the participants. Of these, 52% chose lifestyle as the most influential factor determining their choice of specialty. Further analysis of participant preferences revealed that 87.6% listed flexibility within medicine as their main reason for choosing a specialty, followed by reasonable hours of practice in 86%, while 15.9% considered a strong mentor relationship to be important. Students from King Abdulaziz University more frequently chose ORL head and neck, along with those from the eastern kingdom compared with other areas. Student preference for ORL head and neck did not vary significantly with gender, age, or duration of clinical rounds. Conclusion Approximately 27% of students chose ORL head and neck, with lifestyle being the most influential factor, followed by flexibility within medicine. Among students who chose ORL head and neck, the highest percentage was from King Abdulaziz University.

Background The aim of this study was to broaden our knowledge regarding the complications of myomectomy to better understand how to prevent them from occurring. Another aim was to compare surgical approaches, especially with the current research limitations surrounding this topic in Saudi Arabia. Methods This retrospective study was conducted in a cohort of 263 women who underwent surgical myomectomy, without any exclusion criteria. We used our hospital electronic medical records program called Phoenix to obtain all the data regarding clinical presentation, intraoperative findings, intraoperative and postoperative complications, and hospital stay, and then statistically analyzed these findings. Results Results were divided depending on the type of surgery. The mean age of open, laparoscopic, and hysteroscopic myomectomy groups were 40.82 years, 42.05 years, and 44.43 years, respectively. There were 213 (80.98%) open, 34 (12.93%) laparoscopic, and 16 (6.09%) hysteroscopic myomectomies. The most common indication in all groups was bleeding. The mean estimated blood loss and duration of surgery for open, laparoscopic, and hysteroscopic myomectomy groups were: 576.13 mL and 103.05 min, 333.21 mL and 56.91 min, and 306.29 mL and 104.19 min, respectively. The total complication rate for each group was 10.8% in open, 2.94% in laparoscopic, and 6.25% in hysteroscopic myomectomies. Conclusion Laparoscopy is considered the more effective option for myomectomy than both laparotomy and hysterectomy in terms of surgery duration, hospital stay, and prevalence of complications. However, it is a technically challenging operation that requires experienced surgeons to perform. Based on the information we gathered, we recommend our institute to implement laparoscopy instead of laparotomy myomectomy, which is the current standard procedure in our hospital.

Bioactive peptides are actively involved in different biological functions and importantly contribute to human health, and the use of peptides as therapeutics has a long successful history in disease management. A number of peptides have wide-ranging therapeutic effects, such as antioxidant, antimicrobial, and antithrombotic effects. Neurodegenerative diseases are typically caused by abnormal aggregations of proteins or peptides, and the depositions of these aggregates in or on neurons, disrupt signaling and eventually kill neurons. During recent years, research on short peptides has advanced tremendously. This review offers a brief introduction to peptide based therapeutics and their application in disease management and provides an overview of peptide vaccines, and toxicity related issues. In addition, the importance of peptides in the management of different neurodegenerative diseases and their therapeutic applications is discussed. The present review provides an understanding of peptides and their applications for the management of different diseases, but with focus on neurodegenerative diseases. The role of peptides as anti-cancer, antimicrobial and antidiabetic agents has also been discussed.

Background: Rheumatoid Arthritis is one of the most common autoimmune disorders. Drugs used are only to slow the progression and to enhance the quality of life. These therapies have several disadvantages as lack of selectivity and it can cause loss of patient compliance. Aim: To identify the most common type of infection, rheumatoid arthritis patients in our region encountered, while using biologics and/or traditional DMARDs. Method: Cross-sectional study was carried out in Rheumatology clinics at King Abdulaziz University Hospital, included Rheumatic patients who visit the clinics from 2013 to 2017. Data sheet was including demographic, using drug and American College of Rheumatology classification criteria for RA were added. Result: Total of 164 patients were included in this study, 18 (11%) males, and 146 (89%) females. Trends among the target sample showed that 40 (24.4%) had diabetes and 51(31.1%) had hypertension. Patients who had been taking both DMARDs and Biologics, DRMADs only, biologics only were 49 (29.9%), 74(45.1%) and 15(9.1%) respectively. The total number of the infections was 180, among them 62.78% were taking DMARDs only and the most common infection was lower urinary tract infections (UTI) 28(37.38%). Conclusion: UTI have the highest rate of infection in patients using traditional DMARDs and patient using both drug groups. And we recommend conducting a cohort study to identify these infections. It can help in assessing their outcomes.

Background: Menopause is the estimated end of reproductive life. Having a positive attitude towards it has been shown to outcome in a positive experience, whereas a negative attitude is connected with negative experiences and symptoms. Conventionally, women regularly abstain from sex after menopause. Purpose: The study aimed to determine the level of awareness and perceptions about the menopause and sex in perimenopausal women attending a general outpatient clinic. Methods: Women over 40 years were enlisted from the Family Medicine Department of King Abdulaziz Hospital, excluding those who were menopausal. Data analyses were done with chi-square test (P

This study aims to assess the prevalence of illicit use of stimulants and attention deficit hyperactivity disorder (ADHD) among a sample of medical students at the main universities in Riyadh, Saudi Arabia and their motivation for use. We examine the association between the use of stimulants and the students' academic performance. We also look into the possible adverse consequences of illicit stimulant use among students. The competitive nature of medical school might place the students at a higher risk of using stimulant drugs illicitly. Acquiring these stimulants illegally has become easier since the diagnosis and treatment of ADHD have risen. We are unaware of any other study exploring the prevalence of and motivation for illicit use of stimulants among medical students in Riyadh. A cross-sectional web-based survey was the study design we chose as we were targeting medical students in three governmental medical colleges in Riyadh, Saudi Arabia. The total sample population of 1,177 participants was divided into the three following groups: no previous use of stimulant drugs (Group 1), illicit use (Group 2), and medical use (Group 3). Of the 1,177 medical students, 29 (2.46%) were found to be using stimulants illicitly; 39 (3.31%) were using the stimulants medically as they had been diagnosed with ADHD. The ability to prolong study time was reported as the most common motive for illicit use by many students. The present study contributes to the literature by casting light on this serious issue in Riyadh. More educational effort is needed to promote awareness about the adverse effects of ADHD drugs and their illicit use among students.

AIM: The aim of this study was to estimate the effect of obesity on the severity of obstructive sleep apnea (OSA) by assessing the relationship between OSA and body mass index (BMI). MATERIALS AND METHODS: A cross-sectional study was conducted in 2017 among patients who had been referred to the sleep center at King Abdulaziz University Hospital (KAUH, Jeddah, Saudi Arabia) for polysomnography between January 2012 and September 2017. The data were abstracted from the medical records of these patients at KAUH. Initial data analysis included descriptive statistics; Chi-square test, t-test, and one-way ANOVA as appropriate were used to assess the associations between the variables. RESULTS: The study included 803 patients; the average age of the patients was 45.9 years and 56.5% were male. About 70.4% were obese, 54% of whom were classified as having Class 3 obesity. Approximately, 75% patients had OSA. The prevalence of OSA was higher among obese patients (77.7%) compared to nonobese patients (22.3%). Moreover, the severity of OSA was higher in obese patients, with 85.3% of obese patients considered as having severe OSA. CONCLUSION: Obesity is a considerable risk factor for developing OSA and could play a major role in increasing the severity of the disease. We encourage further studies on the impact of sedentary lifestyle and its association with OSA in Saudi Arabia, with an emphasis on the evaluation of the cost-effectiveness and burden of the disease.