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Ziad M Bukhari,1,2 Ali S Alsudais,2,3 Abdullatif Ghazi Bshnaq,2,3 Meshari Alshabri,4 Ahmed Ruwaybih Alqurashi,4 Amer M Alghamdi,5 Omar A Alshehri,6,7 Bader Bashrahil,2,3 Saeed Alghamdi1– 3 1Department of Ophthalmology, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia; 2King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 3College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 4Department of Ophthalmology, King Abdullah Medical City, Makkah, Saudi Arabia; 5Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 6Jeddah Eye Hospital, Ministry of Health, Jeddah, Saudi Arabia; 7King Khalid Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Ziad M Bukhari, Email Ziadbukhari19@gmail.comPurpose: The first-line treatment approach of Meibomian gland dysfunction (MGD) comprises conservative management, but antibiotics with anti-inflammatory properties are recommended in severe or persistent cases. Oral doxycycline and oral azithromycin are commonly used antibiotics for managing MGD. However, a systematic review and meta-analysis comparing their efficacy and safety is needed.Patients and Methods: This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included randomized controlled trials (RCTs) focusing on patients with MGD. The primary outcomes assessed were symptom score, sign score, and overall clinical response. Adverse events were also evaluated. Multiple databases were comprehensively searched, and data extraction and quality assessment were performed by two independent authors.Results: Four trials and a quasi-experimental study involving 612 participants/eyes were included. Meta-analysis showed a statistically significantly lower mean sign score in the oral azithromycin group than in the doxycycline group. However, one RCT reported a lower mean symptom score in the doxycycline group. No significant differences were found in the means of total scores between the two groups. Systemic adverse events such as nausea, abdominal cramps, decrease in appetite, and diarrhea were more prevalent in the doxycycline group.Conclusion: The systematic review and meta-analysis suggest that oral azithromycin may be more effective in reducing signs of MGD than oral doxycycline. However, the results regarding symptom scores and total scores were inconclusive. Azithromycin also demonstrated a better safety profile with fewer gastrointestinal adverse events. Further research is needed to determine the optimal antibiotic treatment for MGD.Keywords: Meibomian gland dysfunction, azithromycin, doxycycline

This study applied a subtractive genomics approach to identify a potential drug target in the Porphyromonas gingivalis strain (ATCC BAA-308/W83). The aim was to characterize the whole proteome and hypothetical proteins (HPs) through structural, functional, and pathway predictions. The proteome was systematically reduced to identify essential proteins (EPs), non-homologous proteins (NHPs), and non-paralogous proteins (NPPs) while excluding those that were similar to the human proteome. Out of 1,836 proteins, the cluster database at high identity with tolerance algorithm identified 36 sequences as paralogous, having 80% identity. The resulting 1,827 proteins were compared to the human proteome using BLASTp (e-value 10−3), resulting in 1,427 NHPs. These were then aligned with the DEG database using BLASTp (e-value of 10−5), identifying 396 NHPs essential for pathogen survival. CELLO predicted the sub-cellular localization, and KEGG Automated Annotation Server identified potential metabolic pathways using a BLASTp similarity search of NHPs and EPs against the infrequently updated KEGG database. A total of 79 HPs essential for P. gingivalis were selected, and their molecular weights were determined. HPs were screened for metabolic pathway prediction, and the 3D structures of the proposed HPs were determined using homology modeling, and validation was performed. Only one HP (putative arginine deiminase) was qualified and found to be involved in the arginine and proline metabolic pathway.

Adnan A Mubaraki,1,* Naif M Alotaibi,2,* Ahmed Abdulrahan Alshaer,2,* Mohammed H Alhamayani,2,* Meshal F Althobaiti,2,* Alsharif M Alqurashi,2,* Asrar Alqaedi,3,* Huda Abdullah Aljehafy4,* 1Department of Medicine, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 2Intern Medical Student, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 3Department of Pediatric Nephrology, Taif Children Hospital, Taif, Saudi Arabia; 4Department of Pediatrics, Taif Children Hospital, Taif, Saudi Arabia*These authors contributed equally to this workCorrespondence: Naif M Alotaibi, Email legend.otibah@gmail.comBackground: Diabetes mellitus (DM) has become one of the most prevalent medical conditions worldwide. Despite the fact that DM affects a substantial proportion of the Saudi population over the age of 30, the general level of awareness of diabetic neuropathy has been reported to be poor in Saudi Arabia.Objective: To determine the level of awareness of diabetic neuropathy and its complications among the population of Taif City.Methods: This cross-sectional study evaluated the level of awareness of diabetic neuropathy among the population of Taif City using an online pre-designed self-administered questionnaire.Results: Of 486 participants enrolled in the study, 57.2% were females and 42.8% were males. In addition, 88.1% of the participants were Saudis. Our study showed that awareness of diabetic neuropathy and its complications among the population of Taif was almost non-existent, with 83.9% of the participants having never heard of diabetic neuropathy in their life. The level of awareness of this disorder was scored as 7.65 1.01 out of a total of 18, even though the educational level of the participants was excellent, and 61.3% of them had a university degree and above.Conclusion: This is the first report demonstrating the knowledge of diabetic neuropathy among residents of Taif City. Regardless of educational level, the knowledge of diabetic neuropathy was poor, necessitating greater efforts to increase public awareness using different approaches and campaigns. This will help in the early detection of such complications and impact the response to different treatment modalities.Keywords: diabetes mellitus, diabetic neuropathy, diabetic complications, level of awareness, taif

Hassan Alwafi,1,2 Reham Alwafi,3 Abdallah Y Naser,4 Mohammed Samannodi,1 Dalia Aboraya,5 Emad Salawati,6 Afnan Alqurashi,7 Rakan Ekram,8 Abdullah R Alzahrani,1 Abdulelah M Aldhahir,9 Hamza Assaggaf,10 Mohammed Almatrafi11 1Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al-Abidiyah, P.O.Box 13578, Makkah 21955 Saudi Arabia; 2Al-Noor Specialist Hospital, Makkah, Saudi Arabia; 3Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 4Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan; 5Faculty of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 6Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 7Independent Researcher, Makkah, Saudi Arabia; 8School of Public Health and Health Informatics, Umm Al Qura University, Makkah, Saudi Arabia; 9Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 10Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 11Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Hassan Alwafi, Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al-Abidiyah, P.O. Box 13578, Makkah, 21955, Saudi Arabia, Tel +966 555544319, Email hhwafi@uqu.edu.saBackground: Previous studies investigating the impact of social media influencers on food consumption are limited. Therefore, this study explores the influence of social media on people’s health choices to understand the consequences of food consumption among the Saudi community.Patients and Methods: A cross-sectional study using an online survey was conducted in Saudi Arabia between 24 June and 20 July 2021. A convenience sample of eligible participants was used to recruit the study participants. A 32-items questionnaire was distributed via social media platforms (Facebook, Twitter, Snapchat, and Instagram). In addition, significant predictors of people being affected by social media to change diet and living with obesity were determined using binary logistic regression.Results: A total of 1124 participants were involved in this study. More than half of them (57.8%) were females and aged below 40 years (57.4%). The study participants’ median body mass index (BMI) was 27.4 kg/m2 (IQR: 23.5– 32.5). Around one-third of the study participants (36.6%) reported following influencers on social media. The median attitude score for the study participants was 15.00 (IQR: 1.00– 27.00) out of 72, equal to 20.8%, which highlights that social media influence the diet of around one-fifth of the study participants. Males were less likely to be affected by social media than females (OR: 0.51; (95% CI: 0.40– 0.65). Participants with obesity and participants who had tried a diet to lose weight were more likely to be affected by social media, with odds ratios of 2.14, and 4.83, respectively. Followers of social media influencers were 10-folds more likely to be affected by social media than others.Conclusion: This study showed that social media might influence the food consumption manner in the Saudi population.Keywords: social media, obesity, food consumption, Saudi Arabia, Twitter, Snapchat

Khalid M Alshehri,1 Raghad A Althobaiti,2 Athar I Alqurashi,3 Nada E Algethami,4 Khaled A Alswat5 1Medicine and Endocrinology, AlHada Armed Forced Hospital, Taif, Saudi Arabia; 2Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 3Internal Medicine Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia; 4Medical College, Taif University, Taif, Saudi Arabia; 5Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi ArabiaCorrespondence: Raghad A Althobaiti, Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Al Sulaimaniah, Riyadh, Saudi Arabia, Tel +966 505388455, Email Ralthobaiti@hotmail.comBackground: Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score.Methods: A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥ 19 or scored ≥ 5 on any item or ≥ 4 on three items were considered to have FSD.Results: A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master’s degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929).Conclusion: FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.Keywords: diabetes mellitus, thyroid disorders, female sexual dysfunction, prevalence

Khloud Algothmi,1 Amal Alqurashi,1 Aisha Alrofaidi,1 Mona Alharbi,1 Reem Farsi,1 Najla Alburae,1 Magdah Ganash,1 Sheren Azhari,1 Fatemah Basingab,1 Asma Almuhammadi,1 Amany Alqosaibi,2 Heba Alkhatabi,3,4 Aisha Elaimi,3,4 Mohammed Jan,5 Hesham Aldhalaan,6 Aziza Alrafiah,4 Safiah Alhazmi1 1Biological Sciences Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Biology, College of Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3King Abdulaziz University, Centre of Excellence in Genomic Medicine Research, Jeddah, Saudi Arabia; 4Medical LaboratorySciencesDepartment,Faculty of Applied Medical Sciences, Jeddah, Saudi Arabia; 5College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Center for Autism Research at King Faisal Specialist Hospital & Research Center (KFSH & RC), Riyadh, Saudi ArabiaCorrespondence: Aziza Alrafiah, P.O Box 80200, Jeddah, 21589, Saudi Arabia, Tel +966 126401000 Ext. 23495, Fax +966 126401000 Ext. 21686, Email aalrafiah@kau.edu.saBackground: DNA methylation (DNAm) is one of the main epigenetic mechanisms that affects gene expression without changing the underlying DNA sequence. Aberrant DNAm has an implication in different human diseases such as cancer, schizophrenia, and autism spectrum disorder (ASD). ASD is a neurodevelopmental disorder that affects behavior, learning, and communication skills. Acyl-CoA synthetase family member 3 (ACSF3) encodes malonyl-CoA synthetase that is involved in the synthesis and oxidation of fatty acids. The dysregulation in such gene has been reported in combined malonic and methylmalonic aciduria associated with neurological symptoms such as memory problems, psychiatric diseases, and/or cognitive decline. This research aims to study DNAm in the transcription factor (TF) binding site of ACSF3 in Saudi autistic children. To determine whether the DNAm of the TF-binding site is a cause or a consequence of transcription regulation of ACSF3.Methods: RT-qPCR and DNA methylight qPCR were used to determine the expression and DNAm level in the promoter region of ACSF3, respectively. DNA and RNA were extracted from 19 cases of ASD children and 18 control samples from their healthy siblings.Results: The results showed a significant correlation between the gene expression of ACSF3 and specificity protein 1 (SP1) in 17 samples of ASD patients, where both genes were upregulated in 9 samples and downregulated in 8 samples.Conclusion: Although this study found no DNAm in the binding site of SP1 within the ACSF3 promoter, the indicated correlation highlights a possible role of ACSF3 and SP1 in ASD patients.Keywords: autism, DNA methylation, SP1, ACSF3, Saudi autistic children, DNAm

Algothmi K, Alqurashi A, Alrofaidi A, et al. Pharmgenomics Pers Med. 2022;15:131–142. The authors have advised affiliation 4 on page 131 is incorrect. The correct affiliation should read “Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia”. The authors apologize for this error.

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against >15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history.

This study aims to investigate the beliefs and real practices of four English writing teachers in relation to their written corrective feedback (WCF) and verify whether these beliefs and practices are compatible or not in an ESP context in the preparatory year in Saudi Arabia. The participants in his study were four teachers and fortystudents at the preparatory year in the English Language Center at Umm Al-Qura University. Data were collected via three qualitative instruments, namely classroom observations, semi-structured interviews, and document analysis of 40 student essays. Findings showed that teachers' practices match their beliefs in different areas related to the significance and purpose of their own comments as a primary source of WCF as well as providing comprehensive (unfocused) and varying feedback based on the kind of error and the students' ability levels. Conversely, teachers' practices do not accord with their beliefs with respect to providing direct/indirect, positive/negative feedback. Several contextual factors that influence teachers' behaviors and decisions and shape their WCF practices are identified. The four teachers interviewed have personal values, individual preferences, and behavioral convictions that do not align with the school's policies and regulations. Further, the study concludes that they do not have the essential educational background and work experience to make them professional ESP writing teachers, did not receive any specific on-the-job training related to ESP writing instruction, have a heavy teaching workload, and deal with too many students most of whom are weak and unmotivated. The study recommends that work conditions for teachers should be improved. More importantly, teachers selected to teach ESP writing should be provided with adequate periodic training to help them acquire the necessary pedagogical knowledge and qualify them to build positive beliefs to provide effective feedback.

This study's principal aim revolves around expanding comprehension of the facets affecting people's readiness to use foreign languages. To achieve that, the study investigates the various elements of verbal interaction between undergraduate English as a Foreign Language learners and their instructors in the classroom. Linguistic skills are of particular interest, especially their connection to learners' readiness to speak during classes. The research aims to answer the question 'How does language proficiency affect the willingness to communicate among Saudi EFL students in the classroom?' Qualitative data was gathered through the implementation of a triangulation strategy that incorporated focus-group discussions and individual interviews. Moreover, the research takes inspiration from the work of MacIntyre (1994) and MacIntyre and Charos (1996), who focused on learners' readiness to speak as the conceptual basis for their studies. The study shows that learners exhibit an unwillingness to speak in EFL settings due to perceived linguistic inadequacies, a limited lexicon and concerns that they may make mistakes when attempting to speak English, which would, in turn, prompt further misunderstandings. The study concludes with recommendations for further studies in similar institutions to investigate other factors that may influence students' willingness to communicate.