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Acute respiratory distress syndrome (ARDS) is one of the major problems in COVID-19 that is not well understood. ARDS is usually complicated by co-infections in hospitals. Although ARDS is inherited by Europeans and Africans, this is not clear for those from the Middle East. There are severe limitations in correlations made between COVID-19, ARDS, co-infectome, and patient demographics. We investigated 298 patients for associations of ARDS, coinfections, and patient demographics on COVID-19 patients' outcomes. Of the 149 patients examined for ARDS during COVID-19, 16 had an incidence with a higher case fatality rate (CFR) of 75.0% compared to those without ARDS (27.0%) ( p value = 0.0001). The co-infectome association showed a CFR of 31.3% in co-infected patients; meanwhile, only 4.8% of those without co-infections ( p value = 0.01) died. The major bacteria were Acinetobacter baumannii and Escherichia coli , either alone or in a mixed infection with Klebsiella pneumoniae . Kaplan-Meier survival analysis of COVID-19 patients with and without ARDS revealed a significant difference in the survival time of patients with ARDS (58.8 +/- 2.7 days) and without ARDS (41.9 +/- 1.8 days) ( p value = 0.0002). These findings prove that increased hospital time was risky for co-infectome-induced SDRS later on. This also explained that while empiric therapy and lethal ventilations delayed the mortality in 75% of patients, they potentially did not help those without co-infection or ARDS who stayed for shorter times. In addition, the age of patients ( n = 298) was significantly associated with ARDS (72.9 +/- 8.9) compared to those without it (56.2 +/- 15.1) and was irrespective of gender. However, there were no significant differences neither in the age of admitted patients before COVID-19 (58.5 +/- 15.3) and during COVID-19 (57.2 +/- 15.5) nor in the gender and COVID-19 fatality ( p value 0.546). Thus, Gram-negative co-infectome potentially induced fatal ARDS, aggravating the COVID-19 outcome. These findings are important for the specific differential diagnosis of patients with and without ARDS and co-infections. Future vertical investigations on mechanisms of Gram-negative-induced ARDS are imperative since hypervirulent strains are rapidly circulating. This study was limited as it was a single-center study confined to Ha'il hospitals; a large-scale investigation in major national hospitals would gain more insights.

Background: Lymphoma is one of the leading cancers in Saudi Arabia. Because there is a paucity of data about the prevalence of lymphomas in Saudi Arabia, numerous extensive investigations are still required. Thus, the present study aimed to assess the common patterns of lymphomas in Northwestern Saudi Arabia., Methods: This is a retrospective study conducted at the Histopathology Departments of King Khalid and King Salman Hospitals in Hail city, Saudi Arabia, between 2008-2020. The present study comprised 134 lymphoma patients, and all data referring to these patients, such as gender, age, lymphoma type, grade, and cancer site, were retrieved., Results: The most common lymphoma type was NHL, followed by HL, constituting 32.8% and 20%, respectively. There was a clear difference between male and female patients of HL type where the male was higher than the female (24% versus 15.3%). The risk of HL associated with male gender, the relative risk (RR) CI (95% Confidence interval) = 2.0077 (0.9447 - 4.2667), p = 0.0700, z statistic = 1.812., Conclusions: Lymphoma is prevalent in the Hail region with an exceptionally everincreasing incidence of HL. Wide-ranging lymphoma varieties have been explored in the Hail region, denoting large groups of unattributable etiologic modifiable risk factors.

Objective: Numerous cancer-causing factors are inversely correlated with health literacy. The current study's objective was to evaluate the Saudi community's knowledge, attitude, and behavior regarding certain carcinogens., Subjects and Methods: To perform this descriptive study, a cross-sectional survey was carried out in Hail City, Northern Saudi Arabia, between September 2020 and November 2020. In the city of Hail, about 450 volunteers have expressed interest in taking part in the study., Results: A total of 165 individuals smoked cigarettes and drank alcohol, respectively (67%) and 42 (9%). Negative attitudes toward cigarette smoking, alcohol consumption, radiation exposure, genetic predisposition, some viruses, some bacterial infection, some parasites, and fungi were 85/450 (19%), 209/450 (46.4%), 206/450 (45.8%), 322/450 (71.6%), 297/450 (66%), 375/450 (83.3%), 403/450 (89.6%), and 405/450 (90%), in that order., Conclusions: Some cancer-causing substances are widely used in the Saudi community. Lack of understanding and a negative attitude toward some carcinogens are widespread, necessitating immediate interventions at the community and health affairs levels.

Objective: The present study aimed at assessing community familiarity with cancer-related lifestyle habits in Northern Saudi Arabia., Subjects and Methods: This descriptive cross-sectional study involved a community-based sample of 442 civilians living in Hail, Northern Saudi Arabia. Data were collected during the period between October and November 2020. Data were randomly collected from different public gathering places regardless of age or sex., Results: Higher nescience percentages were associated with physical inactivity followed by obesity and fast food, representing 328/390 (84%), 311/390 (80%), and 263/390 (67%), respectively., Conclusions: Northern Saudi Arabia has a high negative attitude toward cancer risk factors, necessitating the implementation of community-based health education and cancer awareness programs. Level of education and age have no significant role in the level of cancer awareness.

Background: In recent years, Saudi Arabia has witnessed major tobacco smoking-related disease, such as cardiovascular disease and cancer, particularly among the younger population., Methodology: The present study aimed at evaluating the effect of cigarette smoke on lung epithelial cells., Results: This was a cross-sectional case-control study involving 300 apparently healthy volunteers living in Ha'il, Northern Saudi Arabia. Cigarette smokers (N = 100) were used as cases, and non-smokers (N = 200) were used as controls. A sputum specimen was obtained from each participant, employing all necessary safety precautions and sample adequacy measures., Results: Among 300 study subjects, cytologic atypia was identified in 14/300 (4.7%). Among the 14 cases with atypical cytologic changes, 13/14 (92.9%) were in smokers and 1/14 (7.1%) was in a non-smoker. The risk of lung cytologic atypia associated with cigarette smoking, was OR (95% CI) = 29.73 (3.82-230.87), P = 0.0001. Out of 300 study subjects, metaplasia was identified in 45/300 (15%). Among 45 cases with metaplastic changes, 26/45 (57.8%) were in the smokers and 19/45 (42.2%) were in non-smokers. The risk of lung epithelial metaplasia associated with cigarette smoking was OR (95% CI) = 3.34 (1.74-6.41), P = 0.0003., Conclusion: Cigarette smoking is a significant risk for developing lung epithelial atypia, lung metaplasia, and inflammatory cell infiltrate (especially chronic inflammation). Sputum cytology is a simple, non-invasive method that can be used in screening at-risk populations for early detection of lung proliferative changes associated with tobacco smoking., Competing Interests: None., (IJCEP Copyright © 2021.)