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Introduction Shisha tobacco use is gaining popularity around the world, especially among young people and college students. Shisha users are exposed to many of the same harmful substances as cigarette smokers but at much higher levels, which could have more serious adverse health impacts. The aims of this study were to: 1) determine the patterns of shisha smoking among university students in the Northern Province of Saudi Arabia; 2) identify the reasons for using shisha tobacco; and 3) ascertain whether usage of shisha smoking differs by their sociodemographic characteristics. Methods A cross-sectional survey was conducted among students of seven different colleges at a public university between October and December 2022. A modified version of the Global Youth Tobacco Survey questionnaire was used to collect information specifically on shisha smoking. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. Results A total of 418 participants were included in the study. Of the studied population, shisha smoking was seen in 73.7% (n=308). Out of 308 shisha smokers, 208 (67.5%) had their first session of shisha smoking within the past two years; 34.4% of participants had used it in the past 30 days (current users), of which 27.4% had smoked shisha from 1 to 7 days during the past 30 days. The majority of respondents (63.6%) reported having friends that smoke. The most popular flavor among respondents (24.6%) was apple. For quitting attempts, 46.4% reported a 24-hour quit attempt in the previous year. Stress (23.0%) was reported as the main reason for beginning shisha use. Shisha smoking was significantly associated with age (Ref. 18–20 years; 24–26 years, AOR=0.08; 95% CI: 0.02–0.33, p

Mohammed S Aldossary,1 Eman H Ismail,2 Mashael M Almutawaa,3 Shahad M Alhajri,1 Afnan M Almuaddi,1 Mervat M El Dalatony1,4 1General Directorate of Research and Studies, Ministry of Health, Riyadh, Saudi Arabia; 2Clinical Dental Science Department, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 3Department of Prosthodontics, College of Dentistry and Nursing, Vision Colleges, Riyadh, Saudi Arabia; 4Public Health & Community Medicine Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Menoufia Governorate, EgyptCorrespondence: Eman H Ismail, Clinical Science Department, College of Dentistry, Princess Nourah bint Abdulrahman University, Airport Road, Riyadh, Saudi Arabia, Email ismail.e.h@hotmail.com; ehismail@pnu.edu.saPurpose: Understanding the factors that influence the level of patient satisfaction with dental services and identifying the strengths and weaknesses in dental clinics will subsequently increase patient satisfaction and contribute to improving dental care quality. This study aims to evaluate the variables that impact patients’ satisfaction with dental services received in specialized dental care centers of the Ministry of Health in Saudi Arabia.Patients and Methods: Secondary data at the national level from a patient experience program were used in this study. Completed Press Ganey® surveys submitted by patients during the first half of 2022 were included. The effect of the different domains (access to dental clinic, moving through dental visit and dentist) on the overall assessment rating of patient satisfaction was assessed using Pearson’s correlation coefficient (r) and multiple linear regression models.Results: A total of 964 surveys were completed and subsequently analyzed. The overall assessment rate of patient satisfaction was 73.4%. All items of the domains showed highly significant correlation levels (P < 0.001). However, the Dentist domain exhibited the highest correlation with the overall assessment rate of ‎patient satisfaction.Conclusion: The dentist acts as the most significant predictor of patient satisfaction.Keywords: patient satisfaction, patient-centered care, quality of health care, Saudi Arabia

Mohammed S Aldossary,1 Mateg A Alahmary,1 Mashael M Almutawaa,2 Shahad M Alhajri,1 Abdulrahman O Almalki,3 Khalid A Alharbi,3 Afnan M Almuaddi,1 Mervat M El Dalatony1,4 1General Directorate of Research and Studies, Ministry of Health, Riyadh, Saudi Arabia; 2Department of Prosthodontics, Vision Colleges, Riyadh, Saudi Arabia; 3General Directorate of Patient Experience Center, Ministry of Health, Riyadh, Saudi Arabia; 4Public Health & Community Medicine Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Menoufia Governorate, EgyptCorrespondence: Mohammed S Aldossary, General Directorate of Research and Studies, Ministry of Health, Tower 2, P.C. 12382, Alnakheel District, Digital City, Riyadh, Saudi Arabia, Tel +966-11-2124000, Email msaldossary@moh.gov.saBackground: Patient satisfaction is crucial for assessing healthcare quality and identifying strengths and weaknesses in healthcare organizations. In Saudi Arabia, the Ministry of Health (MOH) implemented the Patient Experience Measurement Program to enhance patient experience and healthcare quality. This study aimed to identify specific aspects of patient satisfaction with dental visits in Saudi Arabia to improve dental care quality and inform dental services development.Methods: The study used a standardized self-administered questionnaire (Health Links/Press Ganey) and analyzed surveys from patients who visited MOH-specialized dental clinics in Saudi Arabia during the first half of 2022. The dental section comprised 20 questions across five domains, with patients rating their experience on a 5-point Likert scale. Statistical analysis was performed using IBM SPSS Statistics 25.Results: A total of 964 patients were surveyed. The overall patient satisfaction with dental settings was 3.61 out of 5.0 (72.2%). The highest satisfaction score was for personal issues with the dental clinic domain (3.93/5; 78.6%), while the least satisfaction score was for access to the dental clinic domain (3.29/5; 65.8%). Among all items, the cleanliness of the facility showed the highest satisfaction score (4.11/5; 82.2%). The least satisfaction was for the ease of contacting the dental clinic (2.71/5; 54.2%).Conclusion: The study found high levels of satisfaction among Saudi patients with dental services provided through MOH facilities across various component domains. This highlights the crucial role of dentists in ensuring high-quality dental care and serves as an indication of the overall healthcare quality in MOH facilities.Keywords: patient experience, patient-centered care, patient satisfaction, dental care, Saudi Arabia, Press Ganey

This paper investigates the effect of a gene expression time delay on the Brusselator model with reaction and diffusion terms in one dimension. We obtain ODE systems analytically by using the Galerkin method. We determine a condition that assists in showing the existence of theoretical results. Full maps of the Hopf bifurcation regions of the stability analysis are studied numerically and theoretically. The influences of two different sources of diffusion coefficients and gene expression time delay parameters on the bifurcation diagram are examined and plotted. In addition, the effect of delay and diffusion values on all other free parameters in this system is shown. They can significantly affect the stability regions for both control parameter concentrations through the reaction process. As a result, as the gene expression time delay increases, both control concentration values increase, while the Hopf points for both diffusion coefficient parameters decrease. These values can impact solutions in the bifurcation regions, causing the region of instability to grow. In addition, the Hopf bifurcation points for the diffusive and non-diffusive cases as well as delay and non-delay cases are studied for both control parameter concentrations. Finally, various examples and bifurcation diagrams, periodic oscillations, and 2D phase planes are provided. There is close agreement between the theoretical and numerical solutions in all cases.

Telepharmacy is a practical part of telemedicine that refers to providing pharmaceutical services within the scope of the pharmacist's obligations while maintaining a temporal and spatial distance between patients, users of health services, and healthcare professionals. The present study was a cross-sectional study conducted among community pharmacists in Saudi Arabia between March and May 2022 to assess their knowledge, perceptions, and readiness for telepharmacy. The survey was filled out by 404 respondents. The majority of respondents were male (59.90%) and the age of more than half of them was between 30 and 39 years old (54.46%). Most participants worked in urban areas (83.66%), and 42.57% had less than five years of experience in a pharmacy. Most participants agreed that telepharmacy is available in Saudi Arabia (82.67%). Approximately 70% of pharmacists felt that telepharmacy promotes patient medication adherence, and 77.72% agreed that telepharmacy increases patient access to pharmaceuticals in rural areas. More than 72% of pharmacists said they would work on telepharmacy initiatives in rural areas for free, and 74.26% said they would work outside of usual working hours if necessary. In the future, this research could aid in adopting full-fledged telepharmacy pharmaceutical care services in Saudi Arabia. It could also help academic initiatives by allowing telepharmacy practice models to be included as a topic course in the curriculum to prepare future pharmacists to deliver telepharmacy services.

The aim of this study was to investigate the impact of patient satisfaction with a dentist on their loyalty to that dentist in Saudi Ministry of Health dental clinics. Retrospective data were recruited from the patient experience program (Press Ganey Survey) during the first half of 2022. Descriptive statistical analysis, Pearson correlation coefficient ( r ), and multiple linear regression models were used to assess the impact on loyalty to that dentist. Among the 964 respondents who submitted their responses to the survey, the highest mean satisfaction score was for the item concerning the good listening of the dentist to the patient (3.86 of 5; 77.2%). There was a highly significant correlation between each item related to the dentist and the likelihood of the patient to recommend a certain dentist to others “that is, patient loyalty” ( P

Telepharmacy is a technology-based service that provides promoted services such as counseling, medication administration and compounding, drug therapy monitoring, and prescription review. It is unclear whether hospital pharmacists possess the necessary knowledge, attitudes, and willingness to practice telepharmacy. The current study sought to investigate Saudi Arabian hospital pharmacists’ understanding, attitudes, and level of preparedness for telepharmacy services. A total of 411 pharmacists responded to the survey. Only 43.33% of the respondents agreed that telepharmacy is available in Saudi Arabia and 36.67% of the respondents agreed that patients in rural areas can have more medication access and information via telepharmacy. Only 29.33% of pharmacists agreed that telepharmacy improves patient medication adherence, and about 34.00% of the pharmacists agreed that telepharmacy saves patients money and time by eliminating the need for them to travel to healthcare facilities. This research found that hospital pharmacists were unsure of their level of knowledge, their attitude toward telepharmacy, and their willingness to incorporate it into their future pharmacy practices. To ensure that tomorrow’s pharmacists have the skills they need to provide telepharmacy services, telepharmacy practice models must be incorporated into the educational programs that prepare them.

Background/Objectives: Cholesteatoma presents significant management challenges in otolaryngology. This study aimed to delineate the influence of demographic and clinical characteristics, preoperative imaging, and surgical approaches on treatment success in cholesteatoma management. Methods: A cross-sectional analytical study was conducted at the Otolaryngology Department of the University Hospital from January 2021 to December 2022. It included 68 patients diagnosed with cholesteatoma, focusing on three objectives: assessing the impact of demographic and clinical characteristics on treatment outcomes, evaluating the predictive value of preoperative imaging findings, and analyzing the influence of surgical factors. Results: The study population predominantly consisted of male (56%) and Saudi (81%) patients, with an average age of 45 years. Logistic regression revealed that older age (OR: 1.05), male gender (OR: 0.63), and non-Saudi Arab ethnicity (OR: 2.14) significantly impacted treatment outcomes. Clinical characteristics such as severe disease severity (OR: 3.00) and longer symptom duration (OR: 0.96) also influenced treatment success. In preoperative imaging, labyrinthine fistula (Regression Coefficient: 0.63) and epidural extension (Coefficient: 0.55) emerged as key predictors. The surgical factors that significantly affected the outcomes included the extent of surgery (Complete Removal OR: 3.32) and the use of endoscopic approaches (OR: 1.42). Conclusions: This study highlights that patient demographics, clinical profiles, specific preoperative imaging features, and surgical strategies multifactorially determine cholesteatoma treatment success. These findings suggest the necessity for a tailored approach in cholesteatoma management, reinforcing the importance of individualized treatment plans based on comprehensive preoperative assessments. [ABSTRACT FROM AUTHOR]

Introduction: The main criterion of successful aesthetic restoration is to match the colour of the adjacent teeth. Porcelain laminate veneer is widely practiced indirect restoration in the contemporary aesthetic dentistry. The underlying luting cement colour influences the final outcome of the thin, translucent veneer shade. Hence, colour stability of luting cement is important criteria during their selection. Aim: The objective of the study was to assess the colour stability of the different dentin bonding techniques in composite resin luting cements. Materials and Methods: A total of forty intact, non carious teeth were prepared to receive Porcelain Laminate Veneers (PLV). The lithium disilicate PLV were fabricated, and fitting surface was conditioned with 5% hydrofluoric acid and silane application. According to the bonding technique employed for the cementation of the PLV, the teeth samples were randomly divided into the four groups of ten each. The Group I and Group II samples were conditioned with etch and wash; the polymerization of resin was accomplished with the dual cure for Group I and light cure for Group II. The Group III and Group IV samples were conditioned with self-etch and self-adhesive technique correspondingly. The teeth shade was recorded in similar locations with a spectrophotometer before and after subjecting them to the accelerated ageing process. The ageing process included the thermocycling process in water between 5°C and 55°C for 5000 cycles followed by 100 hours xenon light exposure. The data were analysed with SPSS 19.0 by ANOVA and LSD post-hoc comparison. Results: The higher mean colour change was observed in Group I sample (etch washdual cure) with a ∆E value of 2.491. The ∆E value for Group II (etch wash-light cure) and Group III (selfetch) was 1.110 and 2.357 respectively. The lowest mean colour change was observed in Group IV (self-adhesive) with ∆E at 0.614. Statistical analysis showed significant differences between Group IV and Group I; Group IV and Group III with p

Introduction. Caffeine works on elevating the intracellular level of cAMP, which increases synaptic plasticity, accelerating recovery after general anesthesia. A common myth among dental practitioners states that coffee consumers are more likely to feel pain during treatment. This study aims at investigating the effect of caffeine on the onset, duration and efficacy of local anesthesia. Materials and methods. 50 female patients aged between 18-30 years, with sound maxillary central incisors, voluntarily participated in the trial. A chair-side questionnaire was filled in; based on the responses given, subjects were classified as a low caffeine intake group (LCG) or high caffeine intake group (HCG). Baseline sensibility was established using EPT. A single cartridge of 2% Lidocaine with 1:100,000 epinephrine was infiltrated labially to tooth # 11. Patients were monitored for 30 minutes and EPT readings were recorded 2, 5, 10, 20, and 30 minutes after LA injection. Data was then sent for descriptive and statistical analysis. Results and discussion. The failure rate of pulpal anesthesia was 16% (LCG) and 32% (HCG), respectively, with significant differences. The maximum LA onset was at 2 and 5 minute intervals and the duration of pulpal anesthesia was slightly longer in (LCG) compared to (HCG) - 11.5 min and 8 min, respectively. Conclusions. Caffeine effect on the LA was not proven, however, so that another trail with larger sample size is highly recommended. Dental practitioners should not relay the high failure of LA to external reasons without looking deep in the biological responses and variations. [ABSTRACT FROM AUTHOR]

Introduction: The main criterion of successful aesthetic restoration is to match the colour of the adjacent teeth. Porcelain laminate veneer is widely practiced indirect restoration in the contemporary aesthetic dentistry. The underlying luting cement colour influences the final outcome of the thin, translucent veneer shade. Hence, colour stability of luting cement is important criteria during their selection. Aim: The objective of the study was to assess the colour stability of the different dentin bonding techniques in composite resin luting cements. Materials and Methods: A total of forty intact, non carious teeth were prepared to receive Porcelain Laminate Veneers (PLV). The lithium disilicate PLV were fabricated, and fitting surface was conditioned with 5% hydrofluoric acid and silane application. According to the bonding technique employed for the cementation of the PLV, the teeth samples were randomly divided into the four groups of ten each. The Group I and Group II samples were conditioned with etch and wash; the polymerization of resin was accomplished with the dual cure for Group I and light cure for Group II. The Group III and Group IV samples were conditioned with self-etch and self-adhesive technique correspondingly. The teeth shade was recorded in similar locations with a spectrophotometer before and after subjecting them to the accelerated ageing process. The ageing process included the thermocycling process in water between 5°C and 55°C for 5000 cycles followed by 100 hours xenon light exposure. The data were analysed with SPSS 19.0 by ANOVA and LSD post-hoc comparison. Results: The higher mean colour change was observed in Group I sample (etch washdual cure) with a ▵ E value of 2.491. The ▵ E value for Group II (etch wash-light cure) and Group III (selfetch) was 1.110 and 2.357 respectively. The lowest mean colour change was observed in Group IV (self-adhesive) with ▵ E at 0.614. Statistical analysis showed significant differences between Group IV and Group I; Group IV and Group III with p<0.05. Conclusion: The self-adhesive and etch-wash light cure luting cements were found to be less susceptible for colour changes due to accelerated ageing. [ABSTRACT FROM AUTHOR]