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Ahmed M Al-Wathinani,1 Yahia O Dhafar,2 Salah A Aljarallah,3 Muqbil Saad Alqahtani,4 Fahad Abdullah Alamri,5 Awad O Aljohani,6 Majed D Alanazi,7 Turky J Arbaein,8 Amal M Zaidan,9 Mohammed Aljuaid,10 Krzysztof Goniewicz11 1Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11541, Saudi Arabia; 2SEHA Virtual Hospital, Ministry of Health, Riyadh, 1154, Saudi Arabia; 3Department of Family Medicine, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia; 4Department of Dentistry, College of Dentistry, King Faisal University, Alhafouf, 36932, Saudi Arabia; 5Ambulatory Care Administration, Ministry of Health, Riyadh, 11525, Saudi Arabia; 6Fresenius Kabi Scientific Office Alsaif Building, Riyadh, 1141, Saudi Arabia; 7Department of Family Medicine, General Directorate of Health Affairs in Riyadh Region, Ministry of Health, Riyadh, 12822, Saudi Arabia; 8Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia; 9College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Research Center’s (KAIMRC), Riyadh, Saudi Arabia; 10Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia; 11Department of Security, Polish Air Force University, Deblin, PolandCorrespondence: Ahmed M Al-Wathinani, Email ahmalotaibi@ksu.edu.saIntroduction: This cross-sectional descriptive study evaluates the experiences and perceptions of healthcare providers (HCPs) regarding the 937 medical call center in Saudi Arabia, a key telemedicine initiative.Aim: To assess HCP satisfaction, identify challenges, and provide recommendations for improvement.Methods: Conducted from November 20th to December 15th, 2022, the study surveyed 454 HCPs, achieving a 90.5% response rate.Results: A majority (86.8%) of respondents were satisfied with the call center, valuing its ease of use and effectiveness in healthcare delivery. However, challenges such as the accuracy of remote medical assessments, the need for clearer telehealth regulations, and concerns over management support and consultation overlaps were identified. The study also highlights the importance of ongoing support and updates, comprehensive telehealth regulations, integration of more medical specialties, and improvements in system integration and data confidentiality.Conclusion: The study underscores the need for strategic enhancements to the 937 call center to further improve healthcare accessibility and efficiency in Saudi Arabia. These enhancements are vital for aligning telehealth services with Saudi Arabia’s healthcare objectives under Saudi Vision 2030.Keywords: telemedicine, Saudi Arabia, health care providers, patient satisfaction, health services accessibility, telehealth, medical informatics, health policy

Faten A AlRadini,1 Abdulrahman Y Sabbagh,2 Fahad A Alamri,3 Yasir Almuzaini,4 Yousef M Alsofayan,5 Ahmed A Alahmari,4 Anas A Khan,6 Samar A Amer,7 Reem C Alanazi,8 Ibrahim F Alanazi,8 Ahmed A Shubayli,9 Rola M Alkenani,10 Bandr Mzahim,11 Nisreen Maghraby,12 Abdulaziz M Salamah,13 Muna Aljahany1 1Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 2Emergency Medicine, King Fahad Medical City, Second Health Cluster, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 3Global Center of Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia, Family Medicine Department, Primary Health Center, Riyadh, Saudi Arabia; 4Global Center of Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia; 5General Directorate of Data and Research, Saudi Red Crescent Authority, Riyadh, Saudi Arabia; 6Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 7Department of Chronic Diseases, Ministry of Health, Riyadh, Saudi Arabia; 8Vision College of Medicine, Vision Colleges, Riyadh, Saudi Arabia; 9Emergency Medicine Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 10Department of Nephrology Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia; 11Emergency Medicine, EMS and Disaster Department, King Fahad Medical City, Riyadh, Saudi Arabia; 12Emergency Medicine Department, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 13Mohammadiah Primary Healthcare, Ministry of Health, Riyadh, Saudi ArabiaCorrespondence: Muna Aljahany, Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia, Tel +966118238711, Email msaljahany@pnu.edu.saBackground: The likelihood of survival of an out-of-hospital cardiac arrest quadruples with the rapid application of basic life support (BLS). The public’s ability to perform cardiopulmonary resuscitation (CPR) and use automated external defibrillators (AEDs) is extremely important. This study aimed to assess the public knowledge, attitudes, and practices (KAP) of utilizing AEDs and to understand barriers to AED application.Methods: We conducted a cross-sectional study from March 1– 30, 2022. An electronic questionnaire was constructed and validated to measure the KAP for public AED utilization and its barriers.Results: Of the 406 participants, 244 (60.10%) were males. Male respondents had 17% less knowledge and poorer attitude towards using an AED as compared to female respondents. Knowledge and attitudes on using AEDs were low (70.7%) among Saudi nationals compared to those of foreign nationals. Those who were BLS/CPR trained had a 2.5 times greater understanding and willingness to use AEDs in public than those who were not. Barriers to AEDs in CPR/BLS-trained participants were: (1) accidentally hurting the victim (14.3%), (2) duty as a bystander to just call the ambulance and wait for help (12.1%), (3) never taught what to do (n = 41, 18.4%), (4) did not want to be scolded if performed wrong (3.1%), and (5) never witnessed such a situation (51.6%).Conclusion: There is a strong association between knowledge of and willingness to use AEDs in emergency situations among the public. Misconceptions about AEDs hinder their use. This calls for urgent training programs through accessible technology to reach the public.Keywords: automated external defibrillator, AED, public, cardiac arrest

Faten A AlRadini,1 Azza AK El-Sheikh,2,3 Abeer S Al Shahrani,1 Norah M Alzamil,1 Amel A Fayed,1 Eman Alsayed,4 Shatha S Alharbi,5 Msaad A Altulihee,5 Shaimaa A Andijani,5 Wafa K AlShaiddi,6 Fahad A Alamri7 1Department of Clinical Sciences, College of Medicine, Princess Nourah bint ‎Abdulrahman University, Riyadh, Saudi Arabia; 2Department of Basic Sciences, College of Medicine, Princess Nourah bint Abdulrahman ‎University, Riyadh, Saudi Arabia; 3Department of Pharmacology, Faculty of Medicine, Minia University, El-Minia, ‎Egypt; 4Department of Clinical Pathology, Faculty of Medicine, Minia University, El-‎Minia, Egypt; 5Department of Family and Community Health, King Abdullah bin Abdulaziz University ‎Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 6Department of Pathology and Laboratory Medicine, King Abdullah bin Abdulaziz ‎University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ‎Arabia; 7Global Center of Mass Gathering Medicine, Ministry of Health, Family Medicine, ‎Primary Health Center, Riyadh, Saudi ArabiaCorrespondence: Abeer S Al Shahrani, Department of Clinical Sciences, College of Medicine, Princess Nourah bint ‎Abdulrahman University, Riyadh, 11671, Saudi Arabia, Tel +966118239031, Email asalshahran@pnu.edu.sa; drabeer_fm@yahoo.comPurpose: Oxidative and inflammatory pathways play a significant role in the pathophysiology of a wide variety of non-communicable diseases such as type 2 diabetes mellitus (T2DM) and hypertension. However, the effect of serum 25-hydroxyvitamin D ‎‎(25[OH]D) on these pathways is still controversial. To evaluate the association of 25[OH]D on ‎antioxidant and pro-inflammatory biomarkers, reduced glutathione (GSH) and tumor ‎necrosis factor (TNF)-α, in T2DM and hypertensive patients.Patients and Methods: This is a cross-sectional study of a consecutive sample of patients attending the the Family Medicine clinic at King Abdullah bin Abdulaziz University Hospital (KAAUH). Participants were screened for eligibility according to the following ‎criteria: aged above 18 years and diagnosed with T2DM and/or hypertension for at least one ‎year. Patients receiving any kind of vitamin D or calcium supplements within the last three ‎months were excluded, as were those with a history of ‎renal failure, cancer, liver, thyroid, or any other chronic inflammatory diseases.Results: In total 424 T2DM and/or ‎hypertensive patients (mean age 55± 12 years) were recruited. In addition to routine ‎physical and laboratory examinations, levels of serum 25[OH]D, GSH and TNF-α were ‎measured. The prevalence of 25[OH]D deficiency (< 50 nmol/L) was 35.1%, which was ‎independent from GSH and TNF-α levels. In T2DM, hypertensive and patients having ‎both diseases, GSH levels were 349.3± 19, 355.4± 19 and 428.8± 20 μmol/L, ‎respectively. Uncontrolled T2DM and hypertension patients showed significantly higher ‎GSH compared with the controlled group. ‎Males showed slightly higher level ‎of TNF-α compared with females and uncontrolled hypertensive patients had relatively ‎higher TNF-α level when evaluated against controlled hypertensive patients. &#x200EConclusion: 25[OH]D level is independent of oxidative stress and inflammation, ‎assessed by levels of GSH and TNF-α, respectively, in T2DM and hypertensive Saudi ‎patients. &#x200EKeywords: vitamin D, diabetes, hypertension, reduced glutathione, TNF-&#x03B1

Anas Khan, 1, 2 Ahmed Alahmari, 2 Yasir Almuzaini, 2 Nada Alturki, 2 Alhanouf Aburas, 3 Fahad A Alamri, 2 Mohammed Albagami, 4 Mashael Alzaid, 4 Turki Alharbi, 4 Rahaf Alomar, 4 Muath Abu Tayli, 4 Abdullah M Assiri, 5 Hani A Jokhdar 6 1Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Global Center of Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia; 3Health Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 4Saudi Data and Artificial Intelligence Authority, Riyadh, Saudi Arabia; 5Ministry of Health, Riyadh, Saudi Arabia; 6Deputyship of Public Health, Ministry of Health, Riyadh, Saudi ArabiaCorrespondence: Alhanouf AburasHealth Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaEmail Alhanoufaburas@gmail.comIntroduction: The novel coronavirus (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single-chain ribonucleic acid (RNA) virus. As of March 25, 2021, the total number of positive cases and fatalities in the Kingdom of Saudi Arabia (KSA) had reached 386,300 and 6624, respectively, with a case fatality rate of 1.71%. The KSA was among the leading nations to heed the advice of WHO officials and put strict precautionary and preventive measures in place to curb the early spread of COVID-19 before it was declared a global pandemic.Methodology: This was an uncontrolled before–after study following a mixed-method approach for data collection. National and regional data were extracted from the Health Electronic Surveillance Network (HESN), a centralized public health collection system for quantitative and statistical data. Quantitative and qualitative methods have been utilized in studying data derived from tech media.Results: The Saudi authorities utilized different technological tools to aid in managing and combating the COVID-19 pandemic. In the case of Al Madinah Al Mounawarah, after the implementation of several technologies, the most important being Tawakkalna, the number of active daily cases decreased by 61%.Conclusion: The use of the Tawakkalna application was proven to be a successful method in fighting the COVID-19 pandemic in the KSA. This vital and essential experience warrants the use of different digital technology that offers a personalized profile displaying the person’s status (affected, vaccinated, or no history of infection). This application played and will continue to play a crucial and effective role in pandemic containment in Saudi Arabia.Keywords: digital technology, risk management, Saudi Arabia, applications

The Hajj pilgrimage, one of the world's largest and most diverse mass gatherings, poses unique challenges for preventing infectious disease outbreaks. Vaccinations are vital in reducing the risk and spread of diseases during this event. This narrative review examines the impact of vaccination programs on infectious disease mitigation during the Hajj and their broader implications for global health security (GHS). Mandatory vaccination protocols against Meningococcal Meningitis, Yellow Fever, Influenza, pneumococcal diseases, and COVID-19 have demonstrated significant success in controlling infection spread during Hajj. Furthermore, the integration of digital health passports or similar technologies offers the potential to enhance surveillance, streamline vaccination verification, and further minimize risks associated with mass gatherings. This study demonstrates the critical role of vaccination programs in protecting pilgrims. It also explores how technologies can be used to monitor pilgrim health status, enabling rapid identification and mitigation of potential outbreaks, thus contributing to GHS., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system., Competing Interests: Conflicts of Interest The authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

A cesarean scar pregnancy is a rare type of ectopic pregnancy that occurs when a fertilized egg implants in the scar from a previous cesarean section. It is a serious condition that can lead to significant morbidity and mortality if not managed promptly and appropriately. In this literature review and case report, we discuss the etiology, diagnosis, and management of cesarean scar pregnancy. We conducted a comprehensive search of relevant literature using electronic databases and included studies that reported on the diagnosis and management of cesarean scar pregnancy. We also present a case report of a patient with cesarean scar pregnancy who was managed surgically. The diagnosis of cesarean scar pregnancy is primarily done via transvaginal or transabdominal ultrasound, and medical or surgical management can be used depending on the gestational age, hemodynamic status, and patient preferences. The surgical approach, which involves hysteroscopy, laparoscopy, or laparotomy, is usually preferred, since it is associated with fast recovery and lower recurrence rates. However, it is crucial to consider the patient's plans for future fertility when selecting the management approach. In conclusion, cesarean scar pregnancy is a rare but potentially life-threatening condition that requires prompt and appropriate management. Early diagnosis and treatment can prevent significant morbidity and mortality, and surgical management is usually preferred due to its higher success rates and lower recurrence rates.

Objective: Caffeine is the most commonly used psychostimulant compound with a long history of worldwide consumption. Consuming low to moderate doses of caffeine is generally safe and quite beneficial; however, several clinical studies show that high doses could be toxic.  Additionally, caffeine users can become dependent on the drug and find themselves unable to reduce consumption despite impending and recurrent health problems associated with continued use. This study was conducted to explore the prevalence, determinants, and positive and negative effects of caffeine consumption among governmental health care providers (HCPs) who were caffeine users. It aims to determine the frequency of caffeine dependence and addiction in the Kingdom of Saudi Arabia (KSA) in January 2020., Subjects and Methods: This cross-sectional study recruited 600 randomly selected HCPs from all regions of KSA, who fulfilled the selection criteria through a self-administrated, online-validated questionnaire composed of three main parts using the DSM-IV to diagnose dependence and probable addiction., Results: The majority of the studied HCPs were females (67.8%), nonsmokers (82.0%), and Saudis (80.5%), with a mean age of 35 years. According to the DSM-IV, the prevalence of caffeine consumption was 94.3%. Caffeine dependence was reported in 270 (47.7%), while 345 (60.9%) were diagnosed as addicts. The most commonly consumed caffeine-containing substances were coffee and its variants/types (70%), tea (59%), and chocolate (52%), with each person spending about 220 SR per week on them. The main reported adverse effects, in descending order, were sleep disturbances, stomach problems, and cardiac symptoms. The most positive effects reported of caffeine consumption were feeling active, alert, confident, and happy. These findings were significantly affected by sex, occupation, and general health., Conclusions: Caffeine use, dependence, and addiction are common among government HCPs in KSA. Caffeine has both positive and negative effects on this population and further research is necessary to better understand the long-term consequences of caffeine consumption.

Purpose: After the impressive results of the 2020 Hajj management, Saudi authorities decided to expand the quota to 60,000 pilgrims in 2021, which resulted in a convenient and successful experience., Patients and Methods: This was a retrospective pre and post-study study conducted on all pilgrims attending the 2021 Hajj using the polymerase chain reaction (PCR) test surveillance with paired-swab samples (pre-Hajj and post-Hajj) to evaluate the risk potential of COVID-19 among Hajj pilgrims, the effectiveness of preventive measures and the potential effect of the Hajj ritual as a huge mass gathering on the epidemiological situation of the Saudi Arabian population., Result: Forty-one cases had positive COVID-19 infections out of a total of 58,428 pilgrims who attended the 2021 Hajj season, as detected by nonmandatory pre- and post-Hajj PCR. Notably, the 2021 Hajj season achieved a decreasing leg of the COVID-19 pandemic curve. The adjusted incidence rate in KSA from July 11th to August 7th ranged from 19 to 24 cases per 100,000 population. In contrast, the incidence rate for the same duration in Hajj ranged from 3 to 7 cases per 100,000 pilgrims., Conclusion: The Saudi mitigation plan ensured the safety of pilgrims and healthcare workers for Hajj, successfully limited the risk of COVID-19 transmission inside and contributed to global health security. The success story of Hajj in 2020 and 2021 during the pandemic represents a successful model for planning, achieving and managing future mass gatherings by integrating technology with global and national health policies and public health measures., Competing Interests: Conflicts of Interest The authors declare no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Data on SARS-CoV-2 in infants ≤ 90 days are limited with conflicting reports regarding its presentation and outcomes., Methods: We conducted an ambispective cohort study using prospectively collected Health Electronic Surveillance Network Database by the Ministry of Health, Saudi Arabia. Infants of ≤ 90 days of age who had a positive RT-PCR test for SARS-CoV-2 virus were included. Patients were divided in Early neonatal (0-6 days), late neonatal (7-27 days), and post- neonatal (28-90 days) groups and were compared for clinical characteristics and outcomes by contacting parents and collecting information retrospectively., Results: Of 1,793 infants, 898 infants were included for analysis. Most infants in the early neonatal group had no features of infection (tested based on maternal positivity), whereas most infants in the late and post- neonatal groups were tested because of clinical features of infection. Fever and respiratory signs were the most common presenting feature in the late and post-neonatal groups. Hospitalization was higher in the early neonatal group (80%), compared to the two other groups. The overall mortality in the cohort was 1.6%., Conclusion: SARS-CoV-2 infection in infants ≤ 90 days might not be as rare as previously reported. The clinical presentation varies based on age at positive RT-PCR result., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Shaiba, Hadid, Altirkawi, Alnamnakani, Almutayliq, Alharbi, Hijazi, AlMoosa, AlSaud, Murshid, AlMuhanna, Aldawsari, Bin Hadyan, Almaghrabi, Alsofayan, Alahmari, Almuzaini, Alamri, Khan and Shah.)

Hypothyroidism is one of the most common chronic endocrine conditions. However, as symptoms of hypothyroidism are non-specific, up to 60% of those with thyroid dysfunction are unaware of their condition. Left untreated, hypothyroidism may contribute to other chronic health conditions. In the Arabian Gulf States, hypothyroidism is thought to be common, but is underdiagnosed, and management approaches vary. An advisory board of leading Saudi endocrinologists and policy advisers was convened to discuss and formulate recommendations for the diagnosis and management of hypothyroidism in Saudi Arabia based on their clinical expertise. The final document was shared with leading endocrinologists from the other Gulf  Cooperation Council (GCC) and aconsensus report was generated and summerized in this article. While there is no consensus regarding population screening of hypothyroidism, current recommendations suggest screening patients with risk factors, including those with a history of head or neck irradiation, a family history of thyroid disease or pharmacological treatment that may affect thyroid function. Evidence from a cross-sectional study in Saudi Arabia suggests screening the elderly (> 60 years), at least in the primary care setting. In Saudi Arabia, the incidence of congenital hypothyroidism is approximately 1 in every 3450 newborns. Saudi nationwide population prevalence data are lacking, but a single-centre study estimated that the prevalence of subclinical hypothyroidism in the primary care setting was 10%. Prevalence rates were higher in other cross-sectional studies exclusively in women (13-35%). The recommendations included in this  article aim to streamline the diagnosis and clinical management of hypothyroidism in the GCC, especially in the primary care setting, with the intention of improving treatment outcomes. Further study on the incidence, prevalence and risk factors for, and clinical features of, hypothyroidism in the GCC countries is required.

Background: Osteoporosis is a global public health problem currently affecting millions of people worldwide, and Saudi Arabia is not an exception. Awareness and perceptions of susceptibility and belief in the seriousness of a disease can help in its prevention and control. We aimed to assess knowledge, attitude, and practices for osteoporosis among Saudi general population and to identify its determining factors., Methods: A cross-sectional survey of people aged 18 years or older representing every region in the Kingdom of Saudi Arabia was carried out. A total of 2174 self-administered questionnaires were distributed to identify the levels of knowledge, attitude, and practice., Results: Responses were obtained from 1830 individuals (42% female and 58% male). The majority of the study sample had heard about osteoporosis (78%). There were significant associations between the level of awareness and the following sociodemographics of the participants: age, sex, education, occupation, income, and residence (P<0.01). Regular practice of the main preventive behaviors was correlated with an increase in the level of awareness., Conclusion and Recommendations: The majority of the study cohort had heard about osteoporosis. Female respondents were more knowledgeable. Age was negatively correlated with the level of awareness. Awareness levels and the main sociodemographic determinants were significantly associated. The study recommended that health authorities and physicians should have better involvement in patient education efforts to improve and maintain the information provided on osteoporosis.

Objective: To determine the prevalence, predictors and outcome of dysmenorrhea among female medical students in King Abdulaziz University (KAU), Jeddah, Saudi Arabia., Methods: A cross-sectional study was conducted among 435 medical students at KAU, Jeddah selected through stratified random sample method. A pre-constructed, validated, self-administered questionnaire was used to collect personal and socio-demographic information. Data about menstrual history, stress, smoking were also collected. The severity of dysmenorrhea was scored by the "Visual Analogue Scale (VAS)". Descriptive and analytical statistics were conducted., Results: The prevalence of dysmenorrhea was 60.9%. Logistic regression showed that heavy period was the first predictor of dysmenorrhea (aOR=1.94; 95% CI: 1.29- 2.91), followed by stress (aOR=1.90; 95% C.I.: 1.19-3.07). The prevalence of severe dysmenorrhea among the sufferers was 38.6%. Depressed mood was the commonest (80.8%) symptom accompanying dysmenorrhea. Regarding the outcome of dysmenorrhea, 67.5% of the sufferes reported emotional instability, while 28.3% reported absenteeism from the university., Conclusions: A high prevalence of dysmenorrhea was prevalent among medical students in King Abdulaziz University (KAU), Health promotion, screening programs, and stress management courses are recommended.

Osteoporosis is a growing chronic health problem that could result in mortalities and poor living quality. This study aimed at assessing the awareness of adults in Riyadh about this disease and its associated factors as well as compare KAP levels of men and women. A cross sectional study including 505 participants was conducted in several malls of Riyadh city during March 2012, selected by stratified random sampling technique. Self-administered questionnaire was used for data collection. 86% of the participants had heard of osteoporosis. Media was the main source for Participants' knowledge; the mean knowledge score was 56.6% of the maximum achievable score. There was significant differences in knowledge scores by educational level, employment, income and residence (P = 0.005), (P = 0.008) (P = 0.0122) and (P = 0.009), respectively. Participants had low frequencies of preventive practices, especially females who had a mean total score equivalent to 48.8% of the maximum score, while males' mean score was 54.7% (P = 0.000). Perceived susceptibility was higher among females (83 vs. 74%, P = 0.000), and thus had less perception of the barriers to preventive actions, than men (49.6 vs. 55.5%, P = 0.000). Self-efficacy and perceived benefits had the highest scores (95% of the maximum achievable scores). Considerable number of adult males and females are unaware about osteoporosis. Since there is deficiency in the knowledge, and poor application of the preventive actions. Therefore, Education programs are needed to improve awareness and motivating healthy behaviours.