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Mohammad A Jareebi,1 Ahmad Y Alqassim,1 Saja A Almraysi,1 Weaam A Alfaifi,1 Taif A Masri,1 Rana S Alaki,1 Wasan M Qawfashi,1 Khairiah Ibrahim Nehari,1 Sawsan B Hakami,1 Ibrahim M Gosadi,1 Mohammed A Muaddi,1 Abdullah A Alharbi,1 Anwar M Makeen,1 Sarah MA Salih,1 Ali Abdullah Masmali2 1Department of Family and Community Medicine, Jazan University, Jazan, Saudi Arabia; 2Department of Jazan Health Affairs, King Fahd Central Hospital, Jazan, Saudi ArabiaCorrespondence: Mohammad A Jareebi, Department of Family and Community Medicine, Jazan University, Jazan, Saudi Arabia, Email mjareebi@jazanu.edu.saBackground: Despite deep cultural traditions, incense burning significantly impacts respiratory health. Effects of Arabian bakhour remain unknown in Saudi Arabia’s Jazan region with prevalent use. This cross-sectional study addresses this gap by investigating bakhour exposure and respiratory diseases.Methods: This was descriptive cross-sectional study conducted in Jazan area, Saudi Arabia, from October 2023 to March 2024. A total of 1612 participants age more than 18 years, both gender and resident of Jazan Area were included. Those aged less than 18 years were excluded. SPSS v 26 was used for data analysis.Results: The sample (n=1612) had a mean age of 29± 11 years and was 63% female. Bakhour use was nearly universal (98%), especially using coal (73%). Higher bakhour frequency significantly associated with increased cough (p< 0.01) and dyspnea (p< 0.01). Certain bakhour types linked to greater allergic rhinitis prevalence (p< 0.01). Regression analysis revealed cough during bakhour use worsened respiratory health (increased respiratory score) by 3.89 times (95% CI 1.13– 6.64; p=0.006) while dyspnea increased the score by 7.48 times (95% CI 4.70– 10.25; p< 0.001).Conclusion: This study provides valuable insights into the association between Bakhour use and respiratory health in the Jazan region. The findings emphasize the need for further research and public health interventions to mitigate potential respiratory risks associated with Bakhour use.Keywords: bakhour, respiratory health, cough, dyspnea, allergic rhinitis, household air pollution, environmental health

This study evaluated the level of knowledge among parents in Jazan, Saudi Arabia, regarding substances that can harm child development. The Prevention of Toxic Chemicals in the Environment for Children Tool (PRoTECT) was used for this assessment. A cross-sectional survey using a multi-stage cluster random sampling approach was undertaken among 424 parents who were enlisted from eight primary healthcare centers (PHCCs). The PRoTECT score's median value was 72 out of 90, suggesting a generally high level of awareness. The study found that individuals with higher education, particularly those with postgraduate degrees, had greater awareness of protecting their children's health. Interestingly, unemployed individuals and those residing in mountainous areas also demonstrated higher awareness, possibly due to having more time to focus on their children's health and well-being. Most participants (68.2%) acknowledged the correlation between exposure to toxic chemicals during pregnancy and early childhood, and the subsequent development of neurodevelopmental disorders. The study found a solid foundation of knowledge, with 85.1% of participants interested in learning more about reducing children's exposure, but it also stressed the need for specific actions to turn awareness into prevention. These findings would help policymakers develop effective strategies, such as targeted educational campaigns, collaboration with healthcare providers, utilization of media channels, and encouragement of community-led initiatives, to reduce children's exposure to developmental toxicants in line with national and global environmental health initiatives. Future research should focus on longitudinal consciousness and behavior evaluations and regional environmental contaminants.

Background: Lifestyle choices significantly affect health outcomes in Saudi Arabia, but the relationship between health behaviors and satisfaction is unclear. This study aimed to assess lifestyle choices and associated satisfaction levels among residents in the Jazan region of Saudi Arabia., Methods: A cross-sectional study was conducted in Jazan, Saudi Arabia, with 3411 participants. Sociodemographic, lifestyle, and satisfaction data were collected using a questionnaire that was completed during interviews. Logistic regression analyses were implemented to examine the relationships between the study variables and factors related to weight, physical activity, and eating satisfaction., Results: The study found that 38.3% of participants were inactive and 77% rarely ate fruits and vegetables. A total of 47.6% were overweight or obese. Weight (71.12%) and eating (71.59%) satisfaction were high despite these health concerns. The satisfaction-behavior paradox was especially evident in diet. Higher income, physical activity, and healthy eating habits were significantly associated with higher satisfaction (OR = 1.49, 95% CI: 1.15-1.93, p = 0.003 for weight satisfaction, OR = 34.74, 95% CI: 25.42-48.35, p < 0.001 for physical activity satisfaction, and OR = 2.08, 95% CI: 1.67-2.61, p < 0.001 for fruit and vegetable consumption)., Conclusions: Lifestyle behaviors and satisfaction in Jazan, Saudi Arabia, are complex. The satisfaction-behavior paradox, especially in diet, reveals a major gap between perceived and actual health. These findings highlight the need for targeted, culturally sensitive interventions that address behavioral change and perception alignment to improve regional public health.

Objective: Saudi Arabian adults face high rates of depression, stress, and anxiety. Self-stigma complicates the situation, hindering timely treatment and resulting in adverse outcomes. This study examined the prevalence of these mental health conditions and self-stigma among adults and their association with sociodemographic factors in the Jazan region of Saudi Arabia. The findings will inform targeted interventions and support for better mental health understanding in the region., Methods: This cross-sectional study included 1056 participants aged ≥18 years. Convenient sampling was used, and participants completed a self-administered online questionnaire comprising 49 questions. The questionnaire covered demographics, mental illnesses (assessed through the depression, anxiety, and stress scale 21 [DASS-21] questionnaire), and self-stigmatizing attitudes toward the measured mental conditions (measured using the self-stigma of depression scale [SSDS] questionnaire)., Results: The majority of the 1056 participants were Saudi nationals living in the Jazan region, with a mean age of 29 years. The participants' mental health data revealed a high prevalence of depression, anxiety, and stress symptoms (55%, 56%, and 39%, respectively). The DASS-21 questionnaire results revealed varying degrees of depression (normal: 45%, mild: 12%, moderate: 20%, severe: 8%, extremely severe: 15%), anxiety (normal: 44%, mild: 7%, moderate: 18%, severe: 8%, extremely severe: 23%), and stress (normal: 60%, mild: 11%, moderate: 11%, severe: 10%, extremely severe: 7%). The mean self-stigmatization score reported was 52 (Standard Deviation (SD) = 17), with 540 (51%) participants having stigma and 513 (49%) with low levels of stigma. The relationship assessment between stigma and depression, anxiety, and stress revealed that levels of stigma were higher in normal individuals than in those having depression, anxiety, or stress. Regression analysis was performed to investigate the association between mental health variables, self-stigmatization, and other factors. The analysis revealed that urban residence and the severity of depression, anxiety, and stress were associated with lower levels of self-stigmatization., Conclusion: This research highlighted the high prevalence of depression, anxiety, and stress, along with self-stigmatization in Jazan, Saudi Arabia. Recommendations include increasing awareness, improving access to services, promoting early intervention, enhancing community support, combating self-stigma, and conducting further research to confirm generalizability. Targeted interventions and public health strategies are needed to promote mental well-being and address this burden in Jazan., Competing Interests: Declaration of Interests: The authors declare no conflicts of interest., (2024 authors.)

Background and Objective : This study aimed to explore the impact of physical activity on depression, anxiety, and stress among pregnant women in the Jazan region of Saudi Arabia. Materials and Methods : A descriptive cross-sectional study was conducted among pregnant women attending randomly selected prenatal clinics in primary healthcare hospitals in Jazan, Saudi Arabia. The calculated sample size was 350. Data were collected conveniently through a semi-structured questionnaire covering demographic details, pregnancy-related characteristics, physical activity assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), and mental health parameters evaluated by the Depression, Anxiety, and Stress Scale-21 (DASS-21). The statistical analyses included descriptive statistics and Wilcoxon and Kruskal-Wallis rank sum tests, with significance levels set at p < 0.05. Results : The study involved 406 pregnant females. Nearly a third (31%) had a family history of depression, anxiety, or distress. The prevalence of depression, anxiety, and stress was 62.6%, 68.7%, and 38.4%, respectively. The mean sedentary, light, moderate, vigorous, and total energy expenditures were 1.512, 24.35, 22.32, 4.84, and 53.02 metabolic equivalent tasks/day. Anxious females exhibited higher light activity (median 24, p = 0.033), while stressed ones showed higher light (median 25, p = 0.039), moderate (median 20, p < 0.001), and vigorous activity (median 3, p < 0.001). A significant association was observed between total energy expenditure and stress levels ( p < 0.001). Conclusions : This study underscores the importance of physical activity in managing depression, anxiety, and stress among pregnant women in Jazan, Saudi Arabia. The findings suggest a need for tailored interventions to promote physical activity to improve mental well-being during pregnancy.

Background: The COVID-19 pandemic impacted dietary habits and physical activity patterns, with some long-term consequences. This study evaluated the effects of the pandemic on adults' dietary habits and physical activity in Jazan and compared them to pre-pandemic., Methods: An analytical cross-sectional survey was conducted among conveniently selected 559 individuals in Jazan, Saudi Arabia, in February 2022 using a validated online questionnaire. Data was collected to assess changes in eating habits, food intake, and weight before and 21 months after lifting of COVID-19 curfew restrictions in the region. Chi-square and McNemar's tests were used for analysis., Results: The proportion of individuals consuming homemade meals decreased from 50.6% (n=283) before the pandemic to 46.5% (n=260) during the pandemic, while the proportion of participants consuming less than three meals per day increased from 42.2% (n=236) to 45.4% (n=254), and breakfast consumption decreased significantly from 58.1% (n=325) to 53.5% (n=299) (p = 0.033). There was an increase in the consumption of fast food from 10.7% (n=60) to 12.0% (n=67) and dining at restaurants from 18.4% (n=103) to 19.3% (n=108); however, these increases were not statistically significant compared to pre-pandemic rates. During the pre-COVID-19 period, 46.9% (n=262) reported engaging in physical activity one to three times a week, whereas this frequency decreased to 41.3% (n=231) during the pandemic (p = 0.017). In contrast, a significant increase was observed in the duration of computer usage as prior to the pandemic, 20.2% (n=113) reported spending more than five hours per day on the computer, while this proportion increased to 31.8% (n=178) during the pandemic (p < 0.001). Furthermore, a considerable proportion of both males and females, constituting over one-third (n=189) of the total sample, reported an increase in body weight., Conclusion: The findings suggest that the adult population in the Jazan region of Saudi Arabia experienced significant lifestyle changes during the COVID-19 pandemic, including altered dietary patterns and a significant decline in physical activity. To mitigate potential adverse effects on future well-being, it is crucial to implement enduring initiatives promoting healthy lifestyles., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Standing Committee for Scientific Research Ethics-Jazan University issued approval REF# REC-43/05/090, dated 26/12/2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Muaddi et al.)

Vector-borne diseases (VBDs) pose a significant public health challenge in Saudi Arabia, particularly in the Jazan region. This study aimed to assess the knowledge, attitudes, and practices regarding VBDs among the population of Jazan and to identify factors associated with these variables. A cross-sectional survey was conducted among 642 adult residents of Jazan using a convenience random sampling technique. The survey tool consisted of 6 domains: demographics, knowledge of VBDs, preventive practices, care-seeking behavior, knowledge of specific VBDs, and attitudes towards VBDs. Data were analyzed using descriptive statistics, chi-square tests, t tests, ANOVA, and multivariable logistic regression. The majority of participants (60.0%) had high knowledge scores, while (75.5%) and (77.7%) had high attitude and practice scores, respectively. However, knowledge gaps were identified in specific areas, such as the transmission of leishmaniasis and Rift Valley fever. Gender was a significant predictor of both knowledge and practice scores, with males having higher knowledge and females demonstrating higher levels of preventive practices. Age, education, income, and working status were also associated with knowledge scores. The findings highlight the need for targeted interventions and educational campaigns to address the identified gaps in knowledge, attitudes, and practices. Future research should focus on exploring the effectiveness of different intervention strategies and investigating the integration of VBD prevention and control measures into existing healthcare systems. By employing a multi-disciplinary approach, evidence-based strategies can be developed to prevent and control VBDs, ultimately improving public health outcomes in Jazan and other endemic regions worldwide., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

(1) Background: Obesity, a poor diet, and inactivity are major health issues among Saudi youth. However, satisfaction with unhealthy lifestyles could impede change. This study assessed lifestyle factors and related satisfaction among Saudi university students. (2) Methods: In this cross-sectional study, 1957 students at Jazan University completed surveys on demographics, physical activity, dietary habits, and 10-point satisfaction scales for weight, activity, and diet. Chi-squared tests and logistic regression were used to analyze the associations between behaviors and satisfaction. (3) Results: Overweight/obesity prevalence was 25.45%, and only 26.67% of the subjects met activity guidelines. Many of them exhibited poor dietary habits. Despite unhealthy behaviors, some expressed high satisfaction, especially regarding their diets. Subjects with a normal BMI had the highest weight satisfaction. Activity satisfaction increased with higher activity levels. Dietary satisfaction was minimally impacted by healthfulness. Males and higher incomes were correlated with greater satisfaction. (4) Conclusions: A concerning paradox exists between unhealthy lifestyles and satisfaction among Saudi university students, particularly regarding their diets. Multicomponent interventions informed by behavior change theories and employing motivational techniques are urgently needed to address this disconnect and facilitate positive behavior change.

Background Objectives: Despite progress, malaria remains endemic in Jazan, Saudi Arabia necessitating updated epidemiological research to guide elimination strategies. This study analyzed recent surveillance data to elucidate drivers of sustained transmission. A retrospective, epidemiological study was conducted using malaria surveillance data from the Jazan region of Saudi Arabia over a 3-year period from January 2018 to December 2020., Methods: Deidentified records of all confirmed malaria cases reported across Jazan during the study period were obtained from the Jazan Department of Health infectious disease surveillance system. Additional meteorological data was acquired to assess climatic correlates. The final analysis included 5255 confirmed cases meeting completeness criteria for key variables. Descriptive statistics characterized cases across demographic factors and spatial and temporal distributions. Correlations and linear regression modeling identified associations between monthly cases and weather parameters. Mapping visualized geographic patterns., Results: Of 5255 confirmed cases, most were concentrated in Baish sector (50.8-72.0% annually), affected adult male foreigners (93.8-97.0%), peaked inconsistently across seasons, and were imported (85.4-94.9%). Non-Saudi nationality had 6-fold higher incidence versus Saudi citizens in 2020 (677.6 vs 23.1 per 100,000). Monthly cases associated negatively with temperature (p=0.015) and positively with windspeed (p=0.005)., Interpretation Conclusion: Malaria persistence in Jazan involves geographic and demographic hotspots driven by imported infections and climate effects on vectors. Tailored programming aligned with evolving local dynamics will be essential to sustain elimination gains. Surveillance, optimized interventions, and flexible adaptation to high-risk locations/populations and meteorological influences are key priorities., (Copyright © 2024 Copyright: © 2024 Journal of Vector Borne Diseases.)

Background Attention-deficit/hyperactivity disorder (ADHD) in children can adversely impact parental quality of life (QoL). However, limited research exists among families in Saudi Arabia, especially in understudied regions like Jazan. This study was designed to determine the QoL in parents of children with ADHD in Jazan, Saudi Arabia. Methodology This cross-sectional study was conducted in the Jazan region of Saudi Arabia from June 2023 to December 2023. Online questionnaires were used to collect data from parents of children with ADHD residing in the country. A structured questionnaire was developed in consultation with the National Institute for Children's Health Quality (NICHQ) guidelines. The total sample size was 276. The study participants were recruited through convenient non-random snowballing sampling where the promotion of the questionnaire web link aided in reaching the required sample size of the study. Participants aged more than 18 years, residents of the Jazan area, and both genders were included. R software was used for data analysis. Results The study, involving 275 participants, revealed that 45 (16%) children were diagnosed with ADHD by doctors, with a higher prevalence among males 36 (80%). The NICHQ scale identified ADHD in 50 (18%) participants, with the predominant subtypes being inattentive 28 (56%), hyperactive/impulsive 28 (56%), and combined 19 (38%). The median QoL score was 8.6, with good QoL reported by 51.27% of parents and poor QoL by 48.73%. Gender significantly influenced QoL (p < 0.01), with 57% of males and 43% of females reporting good QoL, while 61% of females and 39% of males reported poor QoL. Oppositional defiant symptoms were significantly associated with poorer QoL (p < 0.05). There was a notable alignment between ADHD diagnoses from parental reports and the NICHQ scale. Conclusions This cross-sectional study found that parents of children with ADHD behaviors, especially those exhibiting oppositional defiant symptoms, experienced significantly lower QoL, particularly in personal fulfillment and psychosocial well-being. The findings emphasize the need for culturally tailored psychosocial interventions in Saudi Arabia to improve parental coping and QoL, benefiting overall family well-being and child outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Jazan University issued approval REC-44/07/531. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jareebi et al.)

Background Objectives: Dengue poses a considerable public health threat in Saudi Arabia, with escalating outbreaks in Jazan, where seasonal rains create ideal mosquito breeding conditions. Elucidating local epidemiological dynamics is imperative to strengthen evidence-based prevention policies. This study analyzed the spatiotemporal, demographic, and meteorological patterns of dengue in Jazan from 2015-2020., Methods: This retrospective cross-sectional study utilized surveillance records for 3427 confirmed dengue cases. Descriptive analyses characterized geographic, seasonal, age, gender, and nationality distributions. Forecasting models project expected epidemics through 2025. Regression analysis identified climate factors associated with monthly case counts., Results: Dengue exhibited shifting seasonal peaks, transitioning into year-round transmission by 2019, indicating endemic establishment. Cases clustered in different high-burden sectors annually, requiring localized vector control. The majority of affected individuals were young male adults, with gender gaps narrowing over time. Saudi nationals had an escalating incidence, but non-citizens showed a higher risk, signaling importation threats. Seasonal outbreaks were associated with temperature, wind speed, and direction., Interpretation Conclusion: Enhanced surveillance, outbreak forecasting, targeted control activities, and integrated prevention policies grounded in continuous evidence assessment can effectively address endemic dengue transmission in Jazan. This study provides key insights to optimize data-driven decision-making for dengue control in Saudi Arabia., (Copyright © 2024 Copyright: © 2024 Journal of Vector Borne Diseases.)

Observational studies report inverse associations between educational attainment and depression/anxiety risks, but confounding hinders causal inference. This study aimed to assess potential causal relationships using Mendelian randomization (MR). Two-sample MR analysis was conducted using genetic instruments for education, smoking, body mass index, and physical activity from published genome-wide association studies. Depression and anxiety data came from the UK Biobank ([UKB] 117,782 individuals) and FinnGen (215,644 individuals) cohorts. Inverse variance weighted regression determined associations between exposures and mental health outcomes. Increased educational attainment was causally associated with reduced risks of depression (odds ratio [OR] = 0.99 per year, 95% confidence interval [CI]: 0.990-0.996, P < .001) and anxiety (OR = 0.99, CI: 0.98-0.991, P < .001) in both cohorts. Smoking initiation conferred higher risks of depression (UKB OR = 1.05, CI: 1.03-1.06, P < .001; FinnGen OR = 1.20, CI: 1.10-1.32, P < .001) and anxiety (FinnGen only, OR = 1.10, CI: 1.01-1.21, P < .05). Likewise, maternal smoking history associated with greater depression (UKB OR = 1.15, CI: 1.10-1.35, P = .027) and anxiety susceptibility (FinnGen OR = 3.02, CI: 1.67-5.46, P = .011). Higher body mass index elevated depression risk in both cohorts. Physical activity showed no clear associations. This MR study provides evidence that education may causally reduce mental health disorder risk. Smoking, obesity, and low activity appear detrimentally linked to depression and anxiety. Improving access to education could offer effective strategies for lowering population psychiatric burden., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

(1) Background: The rising prevalence of e-cigarette use among university students necessitates a comprehensive understanding of dependence levels and associated factors. This study investigates e-cigarette dependence among Jazan University students in Saudi Arabia. (2) Methods: With the use of a cross-sectional design, data were collected from 1187 students through an online survey from January to April 2024. Dependence levels were assessed using the Penn State Electronic Cigarette Dependence Index (PS-ECDI), and the Arabic version of the questionnaire was validated through pilot testing. Multivariable logistic regression analysis was employed to identify factors associated with e-cigarette dependence. (3) Results: The results indicated that among current e-cigarette users, 37.4% had low dependence, 34.4% had medium dependence, and 13.8% had high dependence. A significant proportion of current and ever users regarded e-cigarettes to be less harmful (50.6% and 44.4%, respectively) and less addictive (37.9% and 32.3%, respectively) than cigarettes. Significant factors influencing dependence included gender, with males showing higher odds of medium (AOR = 12.8, 95% CI: 3.4-47.6) and low dependence (AOR = 9.7, 95% CI: 2.5-37.3) compared to females. Longer duration of e-cigarette use (>2 years) was strongly associated with high dependence (AOR = 50, 95% CI: 7.7-324). Daily use and multiple quit attempts were also significant predictors of higher dependence levels. (4) Conclusions: These findings highlight the substantial e-cigarette dependence among university students and underscore the need for targeted interventions to address this growing public health concern., Competing Interests: The authors declare no conflicts of interest.

Imposter syndrome (IS) and low self-esteem (SE) are common issues affecting medical students that can impact their well-being and development. This study aimed to assess the prevalence and factors associated with IS and SE among medical students at Jazan University, Saudi Arabia. In this cross-sectional study, 523 medical students in years 2-6 at Jazan University, Saudi Arabia, completed validated questionnaires on IS (Young Imposter Scale) and SE (Rosenberg Self-Esteem Scale). Sociodemographic factors were also collected. Descriptive statistics and logistic regression analyses were used to analyze IS and SE prevalence and correlates. Five hundred twenty-three students with a mean age of 22.09 ± 1.933 participated. The prevalence of low SE and positive IS was 17.6% and 24.3%, respectively. IS and SE had a significant negative correlation (p<0.001). Several sociodemographic factors were associated with increased IS, including 2nd and 4th-year students, forced study choice, and a grade point average (GPA) of 3.0-3.49 (P<0.05). Paternal education beyond high school was associated with lower IS (P<0.05). Logistic regression analyses confirmed that 2nd-year students had a 3.88 times higher odds ratio (OR) (95% confidence interval (CI); 2.19-6.88), and 4th-year students had a 2.37 times higher OR (95% CI; 1.40-4.02) of IS than other years. For SE, advanced academic years, forced study choice, 7+ hours of sleep, and a GPA above 3.5 were associated with higher levels (P<0.05). Negative self-appraisals were associated with lower SE, while positive attitudes were associated with higher SE (P<0.05). Our study reveals that IS and low SE are prevalent among Jazan University, Saudi Arabia, medical students. Therefore, intervention courses that address these issues in medical education at Jazan University, Saudi Arabia, may be necessary to support medical students' well-being and academic success., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 El-Setouhy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Overweight and obesity are excessive fat accumulations linked with many health problems, including heart diseases, type 2 diabetes and cancer. Multiple studies have demonstrated that beliefs about overweight, obesity and self-efficacy play essential roles in the success of interventions for obesity management., Objectives: This study aimed to identify the perceptions of university students of overweight and obesity using the health belief model (HBM) and to analyse their association with the body mass index (BMI) categories of the students., Design: A cross-sectional questionnaire-based study and a multistage sampling technique were used to ensure the recruitment of students from selected colleges of Jazan University-Saudi Arabia., Setting: Six colleges of Jazan University were randomly selected to ensure equal representation of health sciences, sciences and humanities colleges., Participants: A total of 579 students completed an online survey between January and April 2023., Primary and Secondary Outcome Measures: The primary outcome measures were demographic characteristics and HBM constructs. Secondary outcome measures were behavioural intentions relating to obesity management., Results: This study demonstrated that gender and self-reported family history of obesity were significantly correlated with the BMI categories of the students (p <0.001). Students in the underweight category showed the highest mean score for perceived severity (3.62 ±0.08). Perceived self-efficacy in exercise and diet was significantly associated with BMI categories, with adjusted ORs of 2.82 (2.10 to 3.79) and 1.51 (1.09 to 2.09), respectively. Perceived barriers to healthy eating and regular physical activity were significantly related to the behavioural intentions of obesity management. Multivariate logistic regression showed that perceived severity, perceived cues to action, perceived barriers and self-efficacy in dieting and exercise were significant predictors of behavioural intentions for the management of obesity., Conclusion: This study underscores the need for tailored health promotion strategies that consider the perceptions and beliefs of people about the management of obesity., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Vector-borne diseases exert immense health burdens worldwide. Malaria alone causes over 200 million cases and 600,000 deaths annually. Transmission involves complex drivers requiring examination beyond entomological factors. A systematic literature search across databases identified relevant studies on vector-borne disease determinants published in the last two decades, with priority given to rigorous designs like longitudinal analyses, reviews, and meta-analyses from diverse epidemic regions, allowing narrative synthesis of key determinants, relationships, and gaps. This narrative review synthesizes evidence on social, behavioral, and environmental determinants of major vector-borne disease risks over the past decade. Lower education, poverty, unplanned urbanization, gender inequities, inadequate water and waste management, climate variations, and land-use changes stood out as key determinants. However, significant knowledge gaps remain around quantifying precise threshold effects and impacts of tailored interventions across contexts. A social-ecological perspective recognizing interdependencies between determinants should frame integrated control programs. Multicomponent strategies addressing environmental modifications, protective measures, behavioral motivators, and infrastructure alongside governance and community engagement require implementation research and impact evaluation. Overall, this review highlights priority areas for advancing evidence-based vector control through contextualized, determinant-targeted policies and interventions. Further research incorporating modeling, trials, and cost-effectiveness analyses is critical to validate approaches that address influential drivers, leverage motivators, and reduce the global burden., (Copyright © 2024 Copyright: © 2024 Journal of Vector Borne Diseases.)

Background: Accumulating evidence indicates that the incidence of cancer is increasing in the United Arab Emirates (UAE). This analysis aimed to determine the current cancer research output in the UAE to guide future national research., Methods: The Scopus database was searched for cancer-related bibliographic data from the UAE. The number of publications, citation analysis, co-authorship of the author, institution, and country, keyword co-occurrence, and reference co-citations were analyzed using the R-studio bibliometrics package and VOSviewer software., Results: A total of 1678 journal articles were retrieved from 1981 to 2022. Cancer research in the UAE (UCR) is increasing at a rate of 14.64% (R-squared = 0.75; F = 46.477; P<0.001). The UAE had a 0.06% participation rate in terms of the number of original articles. The rate of international co-authorship is 40.23%. The U.S.A., U.K., Egypt, Saudi Arabia, India, and Canada had more than 100 co-authored documents from 156 countries that collaborated with the U.A.E., Conclusions: Compared to other nations, the UAE has fewer publications on cancer, although the number is growing. The current report provides an up-to-date and in-depth summary of the trends in UCR. This project is an excellent place for researchers interested in conducting data-mapping work in this field., Competing Interests: 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., (© 2024 The Authors.)

Background: Khat has a stimulating and addictive effect and can induce consequences on the health and socioeconomic status of khat chewers., Objectives: This study aims to assess knowledge, attitude, and practice of khat chewing among parents in Jazan and its consequential effect on their children., Methods: This cross-sectional investigation was conducted in the Jazan region of Saudi Arabia. Data was collected via a web-based, self-administered questionnaire measuring demographics, knowledge, attitudes, and practices concerning khat chewing. The Chi-square test or Fisher's exact test was used to assess factors associated with khat chewing among parents and its consequential effect on their children., Results: A total of 724 parents were included. The sample had an overall good knowledge about the health hazards of khat chewing and an attitude against khat chewing. Nonetheless, the number of parents who reported that they had ever tried khat chewing was 200 (27.6%) and 106 parents (14.6%) confirmed that their children were khat chewers. Additionally, 98 (13.5%) parents declared that they practiced khat chewing in front of their children. Higher frequencies of parents who reported providing khat to their children were identified among parents with higher attitude levels that favor khat chewing ( P value = 0.04)., Conclusions: Efforts should be made to develop targeted preventive and educational strategies to reduce khat chewing among parents who have favorable attitudes toward khat chewing., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background and objectives Many research studies show that self-stigma related to weight can exacerbate mental health issues. There is also evidence suggesting that depression, anxiety, and stress could be predictors of weight stigma. However, these connections have not been thoroughly investigated among young people in Saudi Arabia, where there is a high prevalence of obesity. This study aimed to explore the relationships between depression, anxiety, stress, and weight self-stigma in Saudi Arabian adolescents and young adults. Materials and methods This cross-sectional study was conducted between January and March 2022 and utilized online surveys, including the Weight Self-Stigma Questionnaire (WSSQ) and Depression, Anxiety, and Stress Scale 21 (DASS-21). We conducted descriptive analysis, independent samples t-tests, analysis of variance (ANOVA), and linear regression for the statistical analysis using SPSS version 25 (IBM Corp., Armonk, NY). Results A total of 1624 participants were enrolled in this survey. Most participants (889, 54.7%) were females. The mean age was 20.73 years (SD: 2.63). Males were more likely to report self-stigma compared to females (p = 0.018). Weight self-stigma demonstrated significant positive associations with body mass index (BMI) (p = 0.0001) and depression, anxiety, and stress (p = 0.0001) scores. Further analysis revealed weight self-stigma was positively correlated with psychological distress levels in the study population (p = 0.0001). The results demonstrated a statistically significant difference between different regions of Saudi Arabia with weight self-stigma being more prevalent in the Al-Baha region and least prevalent in the Al-Madinah region. Conclusions The results of this study indicate robust positive correlations between weight self-stigma scores and depression, anxiety, and stress scale scores among adolescents and young adults in Saudi Arabia. Further epidemiological and clinical studies on the national level are warranted., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ali et al.)

Background and Objectives: Primary headaches are highly prevalent among medical students, negatively impacting their health and academic performance. Excessive electronic device use has been implicated as a risk factor, in contrast to physical activity, which may be a protective factor; however, comprehensive data are lacking, especially for Saudi medical trainees. This study aims to investigate the associations between device use, exercise, and headaches among Saudi medical students. Materials and Methods: In this cross-sectional study, 504 medical students at Jazan University completed an online survey collecting sociodemographic factors, headache characteristics/triggers, electronic device habits, exercise frequency, and headache impacts. Descriptive analyses summarized sample characteristics. Logistic regression identified predictors of 12-month headache prevalence. Results: Overall, 83% reported experiencing headaches in the past year. High headache prevalence was observed among females (86.6%) and third-year students (88.3%). Using electronic devices ≥4 h daily was associated with higher adjusted odds of headaches (OR 13.89, 95% CI 1.96-98.54) compared to ≤1 h daily. Low physical activity (exercising 1 day vs. 7 days a week) also increased headache odds (OR 3.89, 95% CI 1.61-9.42). Headaches impairing productivity (OR 4.39, 95% CI 2.28-8.45) and exacerbated by exercise (OR 10.37, 95% CI 2.02-53.35) were further associated with headache susceptibility. Conclusions : Excessive electronic device use and physical inactivity appear to be modifiable risk factors for frequent headaches in Saudi medical students. Multifaceted interventions incorporating education campaigns, skills training, and support services focused on promoting responsible technology habits, and regular exercise may help mitigate headaches in this population. Robust longitudinal studies and trials are warranted to establish causal mechanisms between lifestyle factors and headaches among medical undergraduates.

Background: Emergency department length of stay is a vital performance indicator for quality and efficiency in healthcare. This research aimed to evaluate the length of stay patterns in emergency departments across Saudi Arabia and to identify predictors for extended stays. The study used secondary data from the Ministry of Health's Ada'a program., Methods: Using a retrospective approach, the study examined data from the Ada'a program on emergency department length of stay from September 2019 to December 2021. These data covered 1,572,296 emergency department visits from all regions of Saudi Arabia. Variables analyzed included quality indicators, year of visit, shift time, hospital type, and data entry method. The analysis was conducted using multiple linear regression., Results: The study found that the median length of stay was 61 min, with significant differences among related predictors. All associations were significant with a value of p of less than 0.001. Compared to 2019, the length of stay was notably shorter by 28.5% in 2020 and by 44.2% in 2021. Evening and night shifts had a shorter length of stay by 5.9 and 7.8%, respectively, compared to the morning shift. Length of stay was lower in winter, summer, and fall compared to spring. Patients in levels I and II of the Canadian Triage and Acuity Scales had longer stays than those in level III, with those in level I reaching an increase of 20.5% in length of stay. Clustered hospitals had a longer length of stay compared to the non-clustered ones. Pediatric hospitals had a 15.3% shorter stay compared to general hospitals. Hospitals with data entered automatically had a 14.0% longer length of stay than those entered manually. Patients admitted to the hospital had a considerably longer length of stay, which was 54.7% longer compared to non-admitted patients. Deceased patients had a 20.5% longer length of stay than patients discharged alive., Conclusion: Data at the national level identified several predictors of prolonged emergency department length of stay in Saudi Arabia, including shift time, season, severity level, and hospital type. These results underline the necessity of continuous monitoring and improvement efforts in emergency departments, in line with policy initiatives aiming to enhance patient outcomes in Saudi Arabia., 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 © 2023 Alharbi, Muhayya, Alkhudairy, Alhussain, Muaddi, Alqassim, AlOmar and Alabdulaali.)

Some changes appeared in women's menstrual cycle after receiving the coronavirus disease 2019 (COVID-19) vaccine, but the information about the pattern and characteristics of these symptoms was unclear. This study was conducted to estimate the prevalence of menstruation change and evaluate the association between COVID-19 vaccination and the occurrence of such disturbance. An online web-based survey was conducted during March-April 2022 that targeted 729 COVID-19 vaccinated women aged between 18 and 45 years in the Jazan region of Kingdom of Saudi Arabia. The tool collected demographic information, psychological data, and COVID-19 post-vaccination side effects. The overall prevalence of menstrual change among the women was 60.9% (95% CI 57.3-64.4). 66.3% and 64.1% of women, respectively, in the age group of 25-34 and 35-45 years were more affected. Most of the detected abnormalities were related to delayed menstruation and changes in pain intensity. Menstrual disturbances that occur after immunization are transient and have no long-term implications. Menstrual disorders are prevalent before vaccination, but there is a considerable increase following vaccination. Because there is no apparent cause for these post-vaccine disturbances, and their effects are difficult to anticipate, it is preferable to warn those concerned and encourage them to learn more about the biological changes causing these problems., Competing Interests: Conflict of interest: Authors state no conflict of interest., (© 2023 the author(s), published by De Gruyter.)

Background: Congenital heart defects (CHDs) are the leading cause of death and morbidity in children under one year around the world. This study explores the prevalence, patterns, and interventions of congenital heart defects in children in the Jazan region, Saudi Arabia., Methods: This was a descriptive cross-sectional study, conducted in the Jazan region, Saudi Arabia. We looked back at all of the CHD patients who went to the two tertiary hospitals in the Jazan region between January 2017 and December 2021 and collected and analyzed their background information and diagnosis., Results: During the study period, 1,275 CHD patients aged under 15 years old were identified. A total of 717 (56.24%) were males, while 558 (43.76%) were females. Acyanotic CHDs were the most common, accounting for 79.21% of all cases, while cyanotic CHDs accounted for only 20.79%. Ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA) were the most common acyanotic CHDs, accounting for 35.69%, 24.31%, and 8% of total cases, respectively. The most common cyanotic CHDs were Tetralogy of Fallot (7.14%) and Total Anomalies of Pulmonary Venous Connection (TAPVC) (1.57%). The most common Cath intervention was patent ductus arteriosus (PDA)., Conclusions: This study's results are similar to those described in previous studies from around the world, except for the unreported Transposition of the Great Arteries (TGA) cases. This kind of information is very important for setting priorities in the Saudi Arabian health sector in light of the National Transformation Program., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

Background and Objectives : Skin problems are a widespread issue that affects people in both developing and wealthy countries, posing significant public health concerns. These disorders can profoundly impact individuals' social and psychological well-being. In this study, we aimed to determine the prevalence of the most common skin diseases in the Jazan region of southwestern Saudi Arabia and investigate their impact on patients' quality of life and psychological and social well-being. Materials and Methods : An observational cross-sectional survey conducted among a random sample of 940 adults ≥ 18 years in the Jazan region, Saudi Arabia. Four standardized questionnaires were used for data collection: Patient Health Questionnaire (PHQ-9), a five-dimension questionnaire (EQ-5D), Rosenberg Self-Esteem Scale, and Loneliness Scale (ULS-8). Results : The most prevalent skin conditions involved hair loss, which was reported by (61.1%) of the study population. These disorders significantly affected a higher percentage of females (71.9%) compared to males (46.3%) ( p < 0.001). Melasma was more common in females (14.1%) than in males (4.3%) p < 0.001. The lowest prevalence was found for urticaria. Those with acne and hair loss reported higher mean scores on the PHQ-9 Scale than the group without these conditions ( p < 0.05 for all). Patients with alopecia, acne, and melasma also reported significantly lower self-esteem scores compared to those without these skin conditions ( p < 0.05 for all). Regarding the activity domain of QoL, participants with skin conditions reported no problems doing usual activities, compared to those without skin problems ( p < 0.001). Conclusions : In conclusion, research revealed that the most prevalent skin condition was hair loss. Further, an association was found between skin diseases and the mental and social well-being of those affected, resulting in a negative impact on their quality of life. The results call for improving the condition of patients with skin diseases, improving their quality of life, and providing appropriate interventions.

Background: COVID-19 (Coronavirus Disease 2019) vaccinations are a critical control measure for the coronavirus pandemic that began in 2019. Several COVID-19 vaccines have been developed, and their effectiveness will almost certainly vary., Objective: This study aimed to assess how effective two doses of the Pfizer and Oxford-AstraZeneca vaccines were in preventing SARS-CoV-2 infection six months after administration., Methods: This is a retrospective cohort study of adult individuals from the Jazan Region of Saudi Arabia who received their second dose of the COVID-19 vaccine [Pfizer and Oxford-AstraZeneca (ASZ)] between April and June 2021. The monitoring and follow-up period continued until the end of January 2022. Data were retrieved from the Health Electronic Surveillance Network and National Vaccination Records. Logistic regression was performed to assess the risk of COVID-19 infection among the vaccinated subjects., Results: This study included randomly enrolled 4458 participants in Jazan who received two doses of the COVID-19 vaccine during the research period. The majority of them received the Pfizer vaccine (3136/4458; 70.3%), while the remaining received the ASZ vaccine (1322/4458; 29.7%). The study participants' mean age was 59.7 years, with a male-to-female ratio of 1.9:1.0 (2920:1538). The results showed that the Pfizer and ASZ vaccines' protection against infection decreased from 93.2% and 90.2%, respectively, during the first three months, to 68.5% and 68.1% after a six-month interval. In the current study population, being Saudi Arabian, younger as well as having longer intervals between vaccines or crossing a 6-month period after the second vaccine dose were factors linked to higher rates of breakthrough infections., Conclusion: Our findings revealed variations in the efficacy of different COVID-19 vaccine types against COVID-19 breakthrough infections. The Pfizer (mRNA-based) vaccine was found to be relatively more effective than the ASZ (DNA-based) vaccine., Competing Interests: Declaration of Competing Interest We have no conflict of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background:  Over the past decades, the global prevalence of obesity has tripled, with the Kingdom of Saudi Arabia experiencing a notably higher rate of increase. While lifestyle modifications remain the first line of treatment, pharmacological interventions are often employed when dietary and exercise interventions prove insufficient. However, safety concerns, misuse, and limited knowledge about weight management medications (WMMs) pose serious challenges., Objectives:  The objectives of this study were to determine the level of knowledge and examine attitudes towards WMMs among the general population, and to explore the factors associated with these knowledge levels and attitude patterns., Methods:  A cross-sectional study was conducted among adults from the general population in Saudi Arabia from January 2023 to May 2023. Participants completed a validated, self-administered electronic questionnaire in Arabic language. The questionnaire captured sociodemographic, lifestyle and health data, knowledge about WMMs, and attitudes toward them. The outcome measures included knowledge and attitudes scores. Factors associated with knowledge and attitudes were analyzed using chi-square tests. Statistical significance was determined at a p-value of <0.05., Results:  Around 716 respondents were included in the final analysis. Most of the participants acknowledged diet 565 (78.9%) and exercise 621 (86.7%) as effective strategies to lose weight. Only 222 (31.0%) participants recognized pharmaceutical medications as a weight management strategy. Knowledge about specific weight loss medications varied, with the highest recognition for semaglutide (Ozempic®, Novo Nordisk, Bagsværd, Denmark) 236 (33.0%) and liraglutide (Saxenda®, Novo Nordisk, Bagsværd, Denmark) 228 (31.8%), while the other WMMs were not commonly known between participants. Regarding attitudes, the majority disagreed with statements that WMMs are more effective than diet/exercise 413 (57.7%), are safe 405 (56.6%), and are more convenient to use 408 (57.0%). Notably, about three-quarters [534 (74.6%)] of participants agreed that these medications require specialist's counseling. No correlation was observed between knowledge score and attitude score (Pearson's correlation coefficient r=0.03; p=0.330). Respondents' knowledge about WMMs was significantly influenced by age, monthly income, educational level, psychiatric history, and previous use of WMMs (p<0.05). Adequate knowledge was more prevalent among participants aged 26-35, earning more than 20K SAR monthly, postgraduates, those with a psychiatric history, and past users of WMMs. Attitudes toward WMMs, however, showed no significant association with sociodemographic or health-related factors (p>0.05). However, prior use of WMMs significantly correlated with attitudes (p=0.007), with past users demonstrating more favorable attitudes., Conclusion:  This study reveals a limited knowledge and cautious attitude regarding WMMs in the Saudi population, despite the high prevalence of obesity. With prior use of WMMs correlating with better knowledge and more favorable attitudes, these findings emphasize the need for targeted interventions to enhance public awareness and safe usage of these medications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Algarni et al.)

Increasing evidence suggests that physical activity (PA) can reduce depression and anxiety in adolescents. At the same time, quality of life (QoL) is sensitive to both mental health and PA, but little is known about the mechanism between these three variables among adolescents. This study aimed to assess the physical activity, mental health, and quality of life of school students when they returned to school after two years of distance learning in the Jazan region. This current investigation represented an observational cross-sectional survey conducted in January 2022 among a random sample of 601 students from intermediate and high schools in the Jazan region, Saudi Arabia. Three standardized questionnaires were used for data collection; the Arabic version of the Pediatric Quality of Life Inventory (PedsQL), Depression Anxiety Stress Scales (DASS21), and the Fels PAQ for children. The analysis revealed a moderate level of physical activity, decreased HRQoL, and symptoms of mental health problems (anxiety, depression, and stress) among the schools' students when they returned to school following COVID-19 lockdown. The overall Pediatric Quality of Life mean score was (81.4 ± 16.4), which differed significantly according to gender, age groups, and grade levels ( p < 0.05 for all). There was a negative correlation between the overall quality of life and mental health domains. Sport was negatively correlated with mental illness symptoms and positively correlated ( p < 0.05) with Pediatric Quality of Life. The regression models revealed that stress was a significant predictor for the quality of life of male and female adolescents ([β = -0.30, (95% CI (-0.59) to (-0.02), p < 0.05)] and [β = -0.40, (95% CI (-0.70) to (-0.01), p < 0.05)], respectively). The analysis revealed a moderate level of physical activity among the schools' students when they returned to school following COVID-19 lockdown. Children's involvement in physical activity was associated with improved quality of life and mental health. The results call for the need to develop appropriate intervention programs to increase school students' physical activity levels.

Background: Adherence to behavioral respiratory hygiene practices is essential in preventing the transmission of COVID-19, especially given the appearance of new variants of the COVID-19 virus. This study estimated the pre- and post-vaccination levels of adherence to COVID-19 preventive behavioral measures among vaccinated people., Methods: This cross-sectional study assessed the sociodemographics and preventive behavioral measures, and pre- and post-vaccination data, via a questionnaire. Paired t-tests and Chi-squared tests were used to assess the variation in adherence levels., Results: Of the 480 participants, 57.9% were male, and 30.4% were aged between 30 and 39 years of age. After vaccination, there was a statistically significant decline in adherence to all the assessed behavioral protective measures ( p < 0.05). Being 50 years old or older, female, a healthcare worker, and a smoker were associated with higher adherence levels compared with other groups in the same categories., Conclusions: A change in the behavior of the community members regarding COVID-19 after receiving the vaccination and a reduction in adherence to respiratory hygiene practices was observed. This indicates the importance of raising awareness about the possibility of reinfection with COVID-19 despite the vaccination, and the importance of behavioral respiratory hygiene for the prevention and control of COVID-19.

This study estimated the prevalence of burnout and its determinants among medical students at Jazan University during the COVID-19 pandemic. A total of 444 medical students completed an online survey containing the Maslach burnout inventory. The prevalence of burnout was 54.5%. Burnout reached its peak during the fourth year whereas it was the lowest in the internship year. Being a resident in mountain areas, being delayed in college-level, being divorced, and having divorced parents were all associated with an increased risk of burnout. During their time at medical school, students generally showed a trend of consistently high scores in the personal accomplishment subscale, a decreasing trend in the emotional exhaustion subscale, and an increasing trend in the depersonalization subscale. The most important predictive factor was having separated parents. Perceived study satisfaction appeared to be a significant protective factor in a dose-response manner. These findings suggest that burnout among medical students during the COVID-19 pandemic is a concern that should be monitored and prevented.

Introduction: Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia., Methods: This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020., Results: This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively., Conclusions: Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2023 Albasheer O. et al.)

Background: Although the eyes represent 0.1% of the total human body, they are exposed to many injuries, some of which may cause blindness. Ocular chemical injury is a true ocular emergency requiring immediate assessment and initiation of treatment. The present study targeted the general population in the Jazan region, Saudi Arabia, to evaluate knowledge of chemical injuries to the eye and the immediate management of the injury., Materials and Methods: A cross-sectional design was employed using a convenience sample of 536 residents of the Jazan region who completed an online, self-administered, anonymous, and pre-validated questionnaire., Results: Most of the respondents were 18-30 years of age (66.0%), and 274 (51.1%) were female. Respondents had an average score of 7.70 (standard deviation: 1.78) out of a total score of 16, indicating an overall lack of knowledge of ocular chemical burns. The majority (95.1%) agreed that ocular complications could result from ocular chemical injury. Regarding the first action in ocular chemical injuries, 317 (59.1%) thought that eye irrigation with a large amount of water, 155 (28.9%) chose to go to the emergency department, 40 (7.5%) chose irrigation of the eye with a small amount of water, 13 (2.4%) chose using eye drops, and 11 (2.1%) chose to cover the eye., Conclusion: The knowledge of ocular chemical burns is lacking in the general population of the Jazan region. There are several knowledge gaps, some of which are serious, necessitating rigorous efforts to correct them through educational programs at the community level., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Background: Stay-home orders and the shutdown of university campuses and fitness centers have greatly influenced health behaviors, resulting in a widespread reduction in physical activity. This study aimed to identify factors associated with maintaining physical activity among Jazan University medical students during the COVID-19 shutdown., Methods: An official Arabic short form of the International Physical Activity Questionnaire was used to assess physical activity before and during the COVID-19 home quarantine. Differences between groups were examined using chi-square analyses and the Mann-Whitney U test. Multinomial logistic regression was used to test whether certain demographic and exercise-related variables were significant predictors of maintaining physical activity levels during the COVID-19 pandemic., Results: More than half of the participants (53%) reported no change or increased physical activity level. Several factors were significantly related to physical activity heterogeneity including income (p = 0.04), fitness center membership ( p < 0.01), usage of fitness tracker devices (p < 0.01), and the purchase of physical activity equipment during the COVID-19 pandemic (p < 0.01). The odds of maintaining physical activity were higher among those who tracked their physical activity (AOR = 6.160; 95% CI = 3.782-10.032, p < 0.001). Similarly, the odds of maintaining physical activity were higher among those who purchased home-exercise equipment during the pandemic (AOR = 2.243; 95% CI = 1.386-3.632, p = 0.001)., Conclusions: Understanding the factors affecting physical activity behaviors is an essential step toward addressing the reduction in physical activity. This could help maintain physical activity levels during a potential future pandemic-related shutdown.

Background : Admission to medical school is competitive, and different countries use various tests in addition to high school grades to minimize selection bias. A few studies have been conducted to evaluate the usefulness of these tests as predictors for students' academic performance. In this article, we aimed to assess factors that influenced students' grades in medical school. Methods : A cross-sectional study included all students who graduated from the Faculty of Medicine at Jazan University between 2018 and 2020. Scores of the included participants were extracted from the registry of Jazan University, and additional questions about study habits were completed by the included students. Descriptive, univariate, and multivariate analyses were performed for the factors that impacted academic performance. Results : There were 331 included candidates, and the majority of them were female (53%). About 60% of the participants were medical residents at the time of the study, and 40% were interns. Univariate and multivariate analyses indicated that grades in high school and the pre-requisite tests were positively associated with students' academic performance. Further, studying more than two hours per day was positively correlated with better grades in medical school. Conclusion : Scores of the admission tests can serve as predictors for student performance in medical school. National studies are deemed essential to evaluate additional admission tests for medical school, an action that would minimize selection bias.

Background: Burnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors., Methods: A cross-sectional survey was conducted among 879 teachers in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory (MBI), during April 2021. Multistage cluster random sampling was used., Results: The mean age of the participants was 41.4 (±6.9) years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms (69.6%). Consequences of burnout were observed, such as using psychotropic medications (4.6%), absenteeism (45.6%), lack of job satisfaction (7.7%), and changing schools (15.8%). Using the MBI scale, most teachers showed medium or high emotional exhaustion (57.6%), low depersonalization (62.2%), and low personal accomplishment (51.4%)., Conclusion: Most teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences., 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 Alqassim, Shami, Ageeli, Ageeli, Doweri, Melaisi, Wafi, Muaddi and El-Setouhy.)

The aim of this study was to measure anxiety levels and many co-factors that might influence the levels of anxiety during the COVID-19 outbreak in southern Saudi Arabia (KSA). A cross-sectional self-reporting survey was conducted to determine the level of generalized anxiety disorder (GAD) symptoms related to COVID-19 and quarantining. We selected a convenience sample of eligible participants who had been invited online through social media apps. The survey instrument was distributed, and 981 participants responded. Of the total sample, almost 90% were under the age of 40, 75% were women, and 77% had an educational level beyond high school. Just over half were single, with nearly all participants Saudi nationals. The overall prevalence of anxiety related to COVID-19 was 27%. Factors most strongly related to reporting anxiety included having a diagnosis of COVID-19, spending 1- ≥ 3 h focused on COVID-19, having a previous mental illness history, being a current or former smoker, being female, having a previous diagnosis of chronic or respiratory illness, being below age 40, having a limited standard of living, and being a student. Our study reveals how critical it is to emphasize preventive mental health care during pandemics and what factors may make some individuals most vulnerable to anxiety. Further research is recommended to examine GAD levels pre, during and post pandemic. Additional research to explore the long-term impact of the pandemic on mental health is also needed. being a student, and a limited standard of living., Competing Interests: The authors declare no conflict of interest., (© 2022 Published by Elsevier Ltd.)

The use of electronic cigarettes (e-cigarettes) has steadily grown over the past few years, rising in popularity amongst young adults, especially. Owing to the perception that e-cigarettes are less harmful than conventional cigarettes, some people have resorted to using them as a means of quitting cigarette smoking. This study aimed to assess the awareness, knowledge, perception and use of e-cigarettes among Jazan University students in Saudi Arabia. An observational cross-sectional study was conducted with 775 students. Using stratified random sampling to recruit study participants, the dataset tabling the use of e-cigarettes, as well as knowledge, perception and awareness was collected using a translated and culturally adapted structured Arabic questionnaire. Our results showed that 21.0% of the participants used e-cigarettes and 35.1% of them used them to quit smoking. E-cigarette use was mostly reported by students from the College of Medical Applied Sciences (31.7%). The overall knowledge score was 3.9, with a standard deviation of 1.3 for the score range from zero to seven. About half of the participants correctly identified e-cigarettes as not less addictive' than cigarettes. However, 70.2% of students failed to identify e-cigarettes as a source of second-hand exposure to nicotine. About two-thirds of the sample believed that e-cigarettes could adversely affect health. The perception of using e-cigarettes for smoking cessation was not significantly associated with e-cigarette use. In conclusion, the prevalence of e-cigarette use was similar to that reported in the literature. However, Jazan University students failed to identify the health risks associated with e-cigarette use. Therefore, a strategy to enhance students' awareness of the benefits and harms of e-cigarettes is needed., (© 2020 John Wiley & Sons Ltd.)

Aim: The study aimed to assess the incidence of needlestick and sharps injuries among healthcare workers (HCWs) in the Jazan region of Saudi Arabia, as well as to determine whether there exists an association between hospital level and needlestick and sharps injuries rate., Design: A cross-sectional survey was conducted among 609 randomly selected HCWs from nine general hospitals., Methods: A self-administered questionnaire, which covered the structure and process of injection safety, was used for data collection., Results: The overall needlestick and sharps injuries incidence rate was 24%. The needlestick and sharps injuries rates were 30% and 14% in secondary and tertiary hospitals, respectively. HCWs working in tertiary hospitals were 61% less likely to have needlestick and sharps injuries than those employed in secondary hospitals. This was mainly the impact of better and continuous training. High safety level maintenance and health education provision are vital in such settings., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background This study aimed to assess regional COVID-19 mortality rates and compare the five proposed business units (BUs).  Methods A cross-sectional study was conducted in the Ministry of Health (MOH) hospitals in the Kingdom of Saudi Arabia (KSA). We included 1743 adults (≥ 18 years of age) with COVID-19 admitted to any of 30 MOH hospitals. Results The inpatients had confirmed mild to severe COVID-19 between March and mid-July 2020. The central BU (Riyadh) was used as the reference. MOH electronic health record data were reviewed and utilized, including variables reflecting hospital course (mortality and discharge status). The primary outcome was COVID-19-related inpatient death. Covariates included patient demographics, pre-existing chronic diseases, and COVID-19-related complications. The data were analysed using univariate and multivariate logistic regression. KSA inpatient mortality was 30%. Univariate and multivariate logistic regression analysis suggested that COVID-19-related mortality was significantly higher in the northern and western BUs and significantly lower in the southern and eastern BUs than in the central BU. On controlling for other variables, adjusted odds ratios (AORs) for essential COVID-19 mortality predictors during admission, using the central BU as a reference, were as 9.90 [95% CI, 4.53-21.61] and 1.55 [95% CI, 1.04-2.13] times higher in the northern and western BUs, respectively, and 0.60 [95% CI, 0.36-0.99] and 0.23 [95% CI, 0.14-0.038] times lower in the southern and eastern BUs, respectively. Conclusion The five BUs differed in COVID-19 mortality rates after adjusting for patient and disease characteristics, with the differences consistent with those in the regions comprising the BUs. These outcome differences apparently relate to differences in healthcare resources and quality., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Alharbi et al.)

Objective: The coronavirus disease 2019 (COVID-19) has impacted the Kingdom of Saudi Arabia (KSA) as it has other nations. However, length of stay (LOS), as a healthcare quality indicator, has not been examined across the healthcare regions in the KSA. Therefore, this study aimed to examine factors associated with LOS to better understand the Saudi Health System's performance in response to the COVID-19 pandemic in the newly suggested five Saudi regional business units (BUs)., Methods: A retrospective study was conducted using Ministry of Health (MOH) data on hospital LOS during the period from March to mid-July 2020. Participants were adult inpatients (18 years or older) with confirmed COVID-19 (n = 1743 patients). The 13 regions of the KSA were united into the defined five regional BUs during the reorganization of the health system. Covariates included demographics such as age and sex, comorbidities, and complications of COVID-19. A multiple linear regression with stepwise forward selection was used to model LOS for other explanatory variables associated with LOS, including demographic, comorbidities, and complications., Results: The mean LOS was 11.85 days which differed significantly across the BUs, ranging from 9.3 days to 13.3 days (p value < 0.001). BUs differed significantly in LOS for transferred patients but not for patients in the intensive care unit (ICU) or those who died in-hospital. The multiple regression analysis revealed that the LOS for inpatients admitted in the Eastern and Southern BUs was significantly shorter than for those in the Central BU. (p value < 0.001). Admission to the ICU was associated with lengthier stays (p value < 0.0001). Factors significantly associated with shorter stays (compared to the reference), were being Saudi, death during admission, and patients referred to another hospital (p value < 0.05)., Conclusion: The LOS for patients with COVID-19 differed across the proposed regional healthcare BUs, suggesting regional differences in quality of care under the reorganization of the national health system. Since patient and disease characteristics did not explain these findings, differences in staffing and other resources need to be examined to develop interventions., Competing Interests: 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., (© 2021 The Author(s).)

Background: Studies on the role of weight self-stigma on the quality of life of young adults are limited. Therefore, the present study aimed to examine the relationship between different forms of weight self-stigma (self-devaluation and fear of enacted stigma) and the quality of life among Saudi youth in the Jazan region., Methods: A cross-sectional study was performed using a sample of 399 participants who were invited through social media platforms. We used Arabic, validated versions of the weight self-stigma questionnaire (WSSQ) and the World Health Organization quality of life questionnaire. Data analysis was performed by independent samples t-test and analysis of variance with Tukey's post hoc test., Results: The study sample consisted of 399 participants aged 21.12 years ± 2.91 years. A total of 264 (66.2%) were female. The overall weight self-stigma score of the study population was 34.81 ± 10.73 on the WSSQ. The analysis showed a significant association between weight self-stigma and quality of life and body mass index (BMI; p < 0.01). In addition, participants who were overweight and obese had more self-devaluation and fear of enacted stigma than did participants with normal weight. Participants with high weight self-stigma had lower quality of life than did those with less weight self-stigma., Conclusions: The results of this study show that weight self-stigma is negatively correlated with the individual's quality of life. Weight self-stigma was positively associated with BMI., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Khodari et al.)

Objective: Saudi Arabia has succeeded in having one of the lowest rates of COVID-19 worldwide due to the government's initiatives in taking swift action to control both the spread and severity of the virus. However, Covid-19 can serve as a test case of the expected response of the new healthcare system under Vision 2030. This study used data from the thirteen present administrative regions of KSA to simulate the variations in ICU admission as a quality indicator in the five business units proposed by a new Model of Care., Methods: We determined the rates of ICU admission for patients with confirmed SARS-CoV-2 (COVID-19) from March to mid-July 2020. The final sample included 1743 inpatients with moderate to severe COVID-19. Patient characteristics, including demographics, pre-existing chronic conditions, and COVID-19 complications, were collected. Business units (BUs) were compared with respect to the relative odds of ICU admission by using multiple logistic regression., Results: After keeping patient and clinical characteristics constant, clear BU differences were observed in the relative odds of ICU admission of COVID-19 patients. Inpatient admission to ICU in our total sample was almost 50%. Compared to the Central BU, the Northern and Western BUs showed significantly higher odds of ICU admission while the Eastern & Southern BUs had significantly lower odds., Conclusion: ICU use for COVID-19 patients differed significantly in KSA healthcare BUs, consistent with variations in care for other non-COVID-19-related conditions. These differences cannot be explained by patient or clinical characteristics, suggesting quality-of-care differences. We believe that privatization and the shift to fewer administrative BUs will help lessen or eliminate altogether the present variations in healthcare service provision., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Polycyclic aromatic hydrocarbons (PAHs) comprise a large family of toxic compounds that come from natural and anthropogenic sources. Chrysene is a PAH with multiple effects, but the toxic potentials of mono-methylchrysenes are less characterized. A comparison of chrysene and six mono-methylchrysenes was performed using assays for cytotoxicity, human aryl hydrocarbon receptor (AhR) reporter gene signaling, and AhR-regulated target gene and protein expression. Sulforhodamine B and trypan blue dye binding assays revealed these chrysenes to be similar in their cytotoxic effects on HepG2 cells. A yeast-based reporter assay detecting human AhR-mediated gene expression identified 4-methylchrysene as being six times more potent and 5-methylchrysene about one-third as potent as chrysene. Other methylchrysenes were more similar to chrysene in the ability to act as AhR ligands. The mono-methylchrysenes all strongly induced CYP1A1 mRNA and protein and moderately induced CYP1B1 expression in HepG2 cells. Levels of CYP1A2 mRNA were induced at higher concentrations of the chrysenes, but protein expression was not significantly altered. The PCR-based gene expression and immunoblotting analyses indicated induced expression differences across the chrysene members were similar to each other. Overall, the effects of methylated chrysenes were comparable to unsubstituted chrysene, suggesting members of this group may be considered approximately equivalent in their effects. © 2019 Wiley Periodicals, Inc., (© 2019 Wiley Periodicals, Inc.)