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Sultan M Alshahrani,1 Amjad Alotaibi,2 Ebtesam Almajed,2 Aisha Alotaibi,2 Kholoud Alotaibi,2 Sara Albisher3 1Department of Neurosciences, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 3College of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Sultan M Alshahrani, Department of Neurosciences, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Airport Road, Riyadh, 11564, Saudi Arabia, Tel +966-112803212, Fax +966-112800000, Email sumalshahrani@kaauh.edu.saIntroduction: Contracting coronavirus disease (COVID-19) during pregnancy has been linked to an increased risk of severe maternal and fetal complications. Mass vaccination is considered a promising solution to successfully combat the COVID-19 pandemic. It includes vaccinating of pregnant and breastfeeding women. The success of a vaccine is determined not only by its efficacy, but also by its acceptability. Therefore, our study aimed to explore the acceptability and reluctance of pregnant and breastfeeding women to receive COVID-19 vaccination in Saudi Arabia.Methods: This cross-sectional study was conducted in Saudi Arabia from March 2022-beginning to June 2022-end. Using an online self-administered questionnaire with a convenience sampling technique, we assessed women for pregnancy, gravidity, parity, high-risk pregnancy, trimester of pregnancy, and current or planned breastfeeding. Furthermore, we assessed patients with preexisting chronic illnesses. The questionnaire comprised sociodemographic data and items drawn from Goncu Ayhan et al, including vaccination history, perception of risk related to the COVID-19 pandemic, impact of the COVID-19 pandemic, and acceptance and attitude toward future COVID-19 vaccination.Results: A total of 854 women (615 pregnant and 192 breastfeeding women) were included. Predictors of COVID-19 vaccination acceptance were found in women with a high level of education, those who lived with an elderly family member, and had close contact with a COVID-19-positive person. The reasons for declining vaccination included COVID-19 diagnosis during pregnancy and concerns about side effects of COVID-19 vaccines. A total of 503 (58.9%) women believed that COVID-19 vaccines had the potential to harm their babies. Only 415 (48.6%) agreed they would take the COVID-19 vaccine if it were recommended for pregnant women.Conclusion: Pregnant and breastfeeding women fear COVID-19 vaccination due to safety concerns for their babies. COVID-19 vaccine acceptance varies among pregnant and breastfeeding women, regardless of whether they receive the COVID-19 vaccine. Our study underlines the importance of public education campaigns to improve the overall quality of information on COVID-19 vaccination, particularly among pregnant and breastfeeding women.Keywords: COVID-19, fears, vaccine, pregnant, breastfeeding, Saudi women

Sultan M Alshahrani,1 Khalid Orayj,1 Ali M Alqahtani,2 Adel Alfatease,3 Atheer Alshahrani,4 Ahmed RN Ibrahim1,5 1Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Pharmacology Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 3Pharmaceutics Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 4Alnahdi Pharmacies, Khamis Mushait, Saudi Arabia; 5Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia, EgyptCorrespondence: Ahmed RN Ibrahim, Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia, Tel +966 554088979, Email aribrahim@kku.edu.saIntroduction: Community pharmacists play a key role as vaccinators for COVID-19. They can reduce the burden of the disease worldwide.Objective: This study used a cross-sectional questionnaire to determine whether the Saudi Arabian public was willing to obtain the COVID-19 vaccine via community pharmacists.Results: The questionnaire focused on the satisfaction, concerns, and opinions towards providing vaccination by community pharmacists. The study featured 415 individuals aged 18 and older (eligible for the COVID-19 vaccine). Of the participants in this study, 58.1% were aged 18– 25, with 55.4% female. Most participants (72.8%) have not been exposed to COVID-19 and are not aware of the approval of COVID-19 vaccination by community pharmacists. Of the 415 complete questionnaires, 45% believed that community pharmacists are not experienced in administering vaccines. However, 63% of participants are satisfied with getting the COVID-19 vaccination by a community pharmacist if no other option is available. More than 68% of the respondents agree that community pharmacies should expand their health care services to include vaccinations, prescriptions, checkups, and other forms of preventative medicine.Discussion: The availability of community pharmacist-administered vaccination in Saudi Arabia could be a significant factor in the success of the country’s vaccination program. This study may serve as a model to expand the role of pharmacists in other countries’ vaccination programs.Keywords: SARS-CoV-2, community pharmacy, immunization, perspective, adherence, patient satisfaction

Adel Alfatease,1 Ali M Alqahtani,2 Khalid Orayj,3 Sultan M Alshahrani3 1Pharmaceutics Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Pharmacology Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 3Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi ArabiaCorrespondence: Sultan M AlshahraniClinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, 61441, Saudi ArabiaTel +966 508747473Email shahrani@kku.edu.saIntroduction: Social media platforms are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination.Purpose: The objective of this study is to understand the influence of social media on the attitudes and willingness of the general public of the Aseer region of Saudi Arabia to receive COVID-19 vaccination.Materials and Methods: A cross-sectional self-administrated online survey was conducted in Saudi Arabia Aseer region, where 613 persons willingly took part in the survey in April and May 2021. Residents of Aseer in Saudi Arabia, who are over the age of 18 (eligible for COVID-19 vaccination) and willing to participate in the survey, were included in the study.Results: Overall, 74.6% agreed that the COVID-19 vaccine was misrepresented via social media. However, 37% of those respondents strongly agreed that social media had increased their willingness to get the COVID-19 vaccine. In addition, employees reported (21.8%) or strongly agreed (28%) that the quantity and quality of information on social media has a detrimental impact on their psychological well-being. Additionally, participants also agreed (21.8%) or strongly agreed (28%) that social media had a negative effect on their psychological condition.Conclusion: The study provides that there was a high degree of awareness indicated among Aseer population regarding misleading information about COVID-19 vaccination via social media. Thus, social media that can share up-to-date scientific information about vaccination must be utilized optimally by the government to assist people in making decisions about accepting vaccinations.Keywords: social media, COVID-19, vaccination, survey, Saudi Arabia

Sultan M Alshahrani College of Pharmacy, King Khalid University, Abha, Saudi ArabiaCorrespondence: Sultan M AlshahraniCollege of Pharmacy, King Khalid University, Abha, Saudi ArabiaTel +966 508747473Email shahrani@kku.edu.saPurpose: This study investigated the knowledge, attitudes, and practice of community pharmacists regarding weight reduction products in Aseer region, Saudi Arabia.Materials and Methods: A questionnaire-based study of community pharmacists in Aseer region, Saudi Arabia, was conducted between March and May 2019.Results: The most commonly prescribed weight reduction agent was green tea followed by oatmeal products and ginseng. The results revealed that almost 85% of the respondents did not know which weight reduction agents are approved as over-the-counter products by the US Food and Drug Administration. Community pharmacists had positive attitudes toward the safety and efficacy of weight reduction products, but 64.91% indicated that they would limit weight reduction agents to obese patients who could not reduce their weight through exercise and diet. More than 80% of the participants agreed that it is very important to counsel patients regarding weight reduction products, and more than 80% also agreed that pharmacists should regularly discuss weight reduction products with other healthcare professionals.Conclusion: Community pharmacists showed positive attitudes and efficient practice towards prescribing weight reducing products. However, there was a deficit regarding the knowledge about which products approved by FDA to manage overweight. That requires to consolidate the role of community pharmacists in weight management in Saudi Arabia with more continuous education and regulation.Keywords: weight, community pharmacists, obesity, survey, Saudi Arabia

Sultan M Alshahrani,1 Sirajudeen Shaik Alavudeen,1 Khaled M Alakhali,1,2 Yaser Mohammed Al-Worafi,3 Ahmed K Bahamdan,1 Easwaran Vigneshwaran1 1Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Clinical Pharmacy Department, College of Pharmacy, USCI University, Kuala Lumpur, Malaysia; 3Clinical Pharmacy Department, College Of Pharmacy, University of Science and Technology of Fujairah, Fujairah, UAECorrespondence: Yaser Mohammed Al-WorafiCollege of Pharmacy, University of Science And Technology of Fujairah, Fujairah, UAETel +971543041178Email yworafi@yahoo.comPurpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia.Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia.Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study.Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended.Keywords: self-medication, students, medical, nonmedical, King Khalid University, Saudi Arabia

Objectives: To measure sleep patterns and quality during summer vacation and weeks 1-4 of the academic year among female university students., Methods: This retrospective prospective cohort study included female students at a university in Riyadh, Saudi Arabia. Participants were recruited with convenience sampling and completed questionnaires online. The questionnaire asked about 5 occasions using the Sleep Quality Scale (SQS) and about their sleep schedule during summer vacation and weeks 1-4 of the academic year., Results: There were 385 participants. The number of students who slept before midnight increased over time from n=127 (32.9%) students during vacation to n=172 (44.6%) students in week 4 ( p <0.001). The average sleep hours decreased from 8.97 (standard deviation (SD)=2.6) hours during summer to 7.01 ( p <0.001, SD=2.7) hours in week 4. Students reported poorer sleep quality during the academic year, particularly in week 1 ( p =0.023), than summer. Students reported higher satisfaction with sleep during summer vacation (n=97; 25.2%) than week 1 (n=38; 9.9%) and week 4 (n=36; 9.4%) ( p <0.001). Students experienced daytime fatigue and tiredness (n=79; 20.5%; p =0.002) and low concentration in week 4 (n=79; 20.5%; p <0.001) compared to summer., Conclusion: In the studied population, multiple sclerosis was the most prevalent cause of ON. Women were more likely to have ON. The prognosis for eyesight was substantially connected with the length of ON., (Copyright: © Neurosciences.)

Background: Non-communicable diseases (NCDs) are a major public health challenge globally, including in Saudi Arabia. However, measuring the true extent of NCD prevalence has been hampered by a paucity of nationally representative epidemiological studies., Objectives: Assess the prevalence of selected NCDs, using population-based electronic health records and applying novel analytical methods to identify cases of NCDs., Design: Retrospective., Settings: A large healthcare network in Saudi Arabia., Patients and Methods: We included all beneficiaries aged 16 years or older (n=650 835[a]) and used the International Classification of Disease (ICD-10) codes, laboratory results, and associated medications to identify individuals with diabetes, obesity, hypertension, dyslipidemia, mental disorders, and injuries. For diabetes and hypertension, we used natural language processing (NLP) on clinical notes in the electronic health records. The prevalence of multimorbidity across age groups was also tabulated, and logistic regression was used to examine its association with glycemic control., Main Outcome Measures: The primary outcomes measured were the prevalence of diabetes, hypertension, and multimorbidity, and their association with glycemic control., Sample Size: 650 835 individuals aged 16 years or older., Results: The study population was relatively young, with 41.2% aged between 26 and 45 years, and around two-thirds were married. The prevalence of diabetes and hypertension was 18.5% (95% CI: 18.5-18.7) and 13.0% (95% CI: 12.9-13.1), respectively. Approximately 26.7% (95% CI: 26.7-26.8) of the population had multimorbidity, with levels increasing to 62.9% for those aged 65 or older. Multimorbidity was associated with a four-fold increase in the likelihood of poor glycemic control. NLP analysis suggested that the prevalence of diabetes or hypertension may be underestimated by no more than 1.5%., Conclusions: The study suggests a higher prevalence of NCDs than earlier national estimates. Electronic health records with regular analysis provide an opportunity to estimate changes in the prevalence of NCDs in Saudi Arabia. Health policies and interventions are needed to address the high levels of multimorbidity, which adversely impact glycemic control., Limitations: Retrospective design and reliance on electronic health records, which may not capture all cases of NCDs.

Background: The World Health Organization reports that depression affects more than 280 million people globally. Women are approximately 50% more likely to experience depression compared to men. Depression during pregnancy leads to deterioration of the mother's and the fetus's health. We aim to explore women's perceptions and attitudes toward using antidepressants and to identify the factors that influence decision-making regarding antidepressant use., Method: A cross-sectional survey, employing a convenience sampling method, was conducted on a university campus in Riyadh, Saudi Arabia. The survey was developed by the investigators and validated by health practitioners. Answers were reported using a 5-point Likert scale. The responses were summed up to give a total score for each respondent. Respondents who scored above or equal 75% of the total score was considered positive perception or favorable attitude. Binary logistic regression analysis was used to identify factors influencing participants' perception and attitude toward taking antidepressants., Results: A total of 991 subjects were surveyed. The majority of women had negative perceptions and favorable attitudes towards using antidepressants during pregnancy reaching 64%. While women with positive perceptions and favorable attitudes represented about 20% of the study subjects. Participants reported that social stigma, religious beliefs, and fear of addiction significantly influenced their attitudes toward antidepressant use., Conclusions: This study explores women's perceptions of depression and antidepressant use, revealing that a significant proportion of Saudi women have a negative perception. The research emphasizes the need for tailored awareness programs to promote informed decision-making regarding antidepressant usage among Saudi women., (© 2024. The Author(s).)

This paper presents a thorough examination for drug release from a polymeric matrix to improve understanding of drug release behavior for tissue regeneration. A comprehensive model was developed utilizing mass transfer and machine learning (ML). In the machine learning section, three distinct regression models, namely, Decision Tree Regression (DTR), Passive Aggressive Regression (PAR), and Quadratic Polynomial Regression (QPR) applied to a comprehensive dataset of drug release. The dataset includes r (m) and z (m) inputs, with corresponding concentration of solute in the matrix (C) as response. The primary objective is to assess and compare the predictive performance of these models in finding the correlation between input parameters and chemical concentrations. The hyper-parameter optimization process is executed using Sequential Model-Based Optimization (SMBO), ensuring the robustness of the models in handling the complexity of the controlled drug release. The Decision Tree Regression model exhibits outstanding predictive accuracy, with an R 2 score of 0.99887, RMSE of 9.0092E-06, MAE of 3.51486E-06, and a Max Error of 6.87000E-05. This exceptional performance underscores the model's capability to discern intricate patterns within the drug release dataset. The Passive Aggressive Regression model, while displaying a slightly lower R 2 score of 0.94652, demonstrates commendable predictive capabilities with an RMSE of 6.0438E-05, MAE of 4.82782E-05, and a Max Error of 2.36600E-04. The model's effectiveness in capturing non-linear relationships within the dataset is evident. The Quadratic Polynomial Regression model, designed to accommodate quadratic relationships, yields a noteworthy R 2 score of 0.95382, along with an RMSE of 5.6655E-05, MAE of 4.49198E-05, and a Max Error of 1.86375E-04. These results affirm the model's proficiency in capturing the inherent complexities of the drug release system., 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 © 2024 Alshahrani, Alotaibi and Alqarni.)

The availability of drugs across the country is a direct measure for fairer public health. Several issues have been reported drastically related to various organizations that fail to provide quality medicines on time. There has been a consistent increase in cases where the treatment, as well as exempted drugs, were supplied due to the unavailability of proper traceability of the supply chain. Several parties are involved in the supply and have similar interests that may defer the adequate shareability of the drugs. The existing system for managing the drug supply chain suffers from several backlogs. The loss of information, unavailability of resources to track the proper medicinal storage, transparency of information sharing between various stakeholders and sequential access. The applicability of the decentralized model emerging from the blockchain can apply to one of the perfect solutions in this case. The drug traceability chain can be deployed to a Ledger-based blockchain that may result in decentralized information. Continuous supply from the Internet of Things (IoT) based devices might be handy as the middleware for providing a trustworthy, safe, and proper transaction-oriented system. The data integrity, along with the provenance resulting from the IoT-connected devices, is an effective solution towards managing the supply chain and drug traceability. This study presents a model that can provide a token-based blockchain that will help provide a cost-efficient and secure system for a reliable drug supply chain., Competing Interests: The authors declare that they have no competing interests., (© 2024 Alshahrani.)

The primary aim of this study was to estimate the incidence of posterior fossa anomalies (PFA) and assess the associated outcomes in King Abdulaziz Medical City (KAMC), Riyadh. All fetuses diagnosed by prenatal ultrasound with PFA from 2017 to 2021 in KAMC were analyzed retrospectively. PFA included Dandy-Walker malformation (DWM), mega cisterna magna (MCM), Blake's pouch cyst (BPC), and isolated vermian hypoplasia (VH). The 65 cases of PFA were 41.5% DWM, 46.2% MCM, 10.8% VH, and 1.5% BPC. The annual incidence rates were 2.48, 2.64, 4.41, 8.75, and 1.71 per 1000 anatomy scans for 2017, 2018, 2019, 2020, and 2021, respectively. Infants with DWM appeared to have a higher proportion of associated central nervous system (CNS) abnormalities (70.4% vs. 39.5%; p-value = 0.014) and seizures than others (45% vs. 17.9%; p-value = 0.041). Ten patients with abnormal genetic testing showed a single gene mutation causing CNS abnormalities, including a pathogenic variant in MPL, C5orf42, ISPD, PDHA1, PNPLA8, JAM3, COL18A1, and a variant of uncertain significance in the PNPLA8 gene. Our result showed that the most common PFA is DWM and MCM. The autosomal recessive pathogenic mutation is the major cause of genetic disease in Saudi patients diagnosed with PFA., (© 2024. The Author(s).)

Background and objective Bimatoprost ophthalmic solution (0.03%) is used for the treatment of ocular hypertension. However, one of the side effects of this prescription is that it causes overgrowth of eyelashes, causing hypertrichosis. Therefore, the Bimatoprost ophthalmic solution was rebranded to be used for cosmetic purposes. This study aims to assess the awareness and practices of female university students regarding the use of Careprost (Bimatoprost, Latisse, Allergan, Inc., Irvine, CA) for cosmetic purposes. Methodology A descriptive cross-sectional study was conducted among female students at Bisha University, including those from medical and non-medical colleges, spanning from November 2022 to February 2023. All participants who completed the study questionnaire were considered for analysis, but those who had missing answers were excluded from the study. The total number of participants was 305, representing an 81.2% response rate out of the 376 surveys distributed. Results A total of 305 students completed the survey, with approximately 132 (54.5%) from the medical college and 173 (65.3%) from the non-medical college. Approximately 32 (24.2%) of participants from the medical college and 51 (29.4%) from the non-medical college understood that Bimatoprost drops can be used for the elongation of eyelashes. More than half of the participants were not aware of the side effects of Careprost (0.03%), including 65 (49.2%) medical students and 108 (62.7%) non-medical students. In total, 42 (13.77%) of the participants believed that Careprost (0.03%) could be administered without a prescription. Among the participants, 75 (24.59%) reported that they had previously used Careprost (0.03%) eye drops. Additionally, more than one-fourth of the participants (83, 27.2%) thought that Careprost (0.03%) could be used for eyelash elongation. Conclusions This study revealed that female university students had a poor level of awareness and practices about the cosmetic uses of Careprost (0.03%) eye drops for eyelashes. A better awareness level was noted regarding the side effects of Careprost drops, which may have contributed to a low utilization rate among female students., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alshahrani et al.)

Electricity theft presents a substantial threat to distributed power networks, leading to non-technical losses (NTLs) that can significantly disrupt grid functionality. As power grids supply centralized electricity to connected consumers, any unauthorized consumption can harm the grids and jeopardize overall power supply quality. Detecting such fraudulent behavior becomes challenging when dealing with extensive data volumes. Smart grids provide a solution by enabling two-way electricity flow, thereby facilitating the detection, analysis, and implementation of new measures to address data flow issues. The key objective is to provide a deep learning-based amalgamated model to detect electricity theft and secure the smart grid. This research introduces an innovative approach to overcome the limitations of current electricity theft detection systems, which predominantly rely on analyzing one-dimensional (1-D) electric data. These approaches often exhibit insufficient accuracy when identifying instances of theft. To address this challenge, the article proposes an ensemble model known as the RNN-BiLSTM-CRF model. This model amalgamates the strengths of recurrent neural network (RNN) and bidirectional long short-term memory (BiLSTM) architectures. Notably, the proposed model harnesses both one-dimensional (1-D) and two-dimensional (2-D) electricity consumption data, thereby enhancing the effectiveness of the theft detection process. The experimental results showcase an impressive accuracy rate of 93.05% in detecting electricity theft, surpassing the performance of existing models in this domain., Competing Interests: The authors declare that they have no competing interests., (© 2024 Khalid et al.)

Recently, the use of the Internet of Medical Things (IoMT) has gained popularity across various sections of the health sector. The historical security risks of IoMT devices themselves and the data flowing from them are major concerns. Deploying many devices, sensors, services, and networks that connect the IoMT systems is gaining popularity. This study focuses on identifying the use of blockchain in innovative healthcare units empowered by federated learning. A collective use of blockchain with intrusion detection management (IDM) is beneficial to detect and prevent malicious activity across the storage nodes. Data accumulated at a centralized storage node is analyzed with the help of machine learning algorithms to diagnose disease and allow appropriate medication to be prescribed by a medical healthcare professional. The model proposed in this study focuses on the effective use of such models for healthcare monitoring. The amalgamation of federated learning and the proposed model makes it possible to reach 93.89 percent accuracy for disease analysis and addiction. Further, intrusion detection ensures a success rate of 97.13 percent in this study., Competing Interests: The authors declare there are no competing interests., (©2024 Almalki et al.)

Purpose: Saudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions., Methods: It is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly., Results: A total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant ( p  = 0.026). Similarly, the total practice scores across the settings were statistically significant ( p  = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists ( p  = 0.016 & 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists., Conclusion: It is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists., 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., (© 2023 The Authors.)

In this study, we investigated both meat-derived and methicillin-resistant Staphylococcus aureus (MRSA), exploring their genetic relatedness to patient-derived MRSA isolates in Saudi Arabia. We collected 250 meat samples and identified 53 S. aureus isolates, with 79% being methicillin-sensitive Staphylococcus aureus (MSSA) and 21% being MRSA. Moreover, we included 80 clinically confirmed patient-derived MRSA isolates. We identified the most common S. aureus clone in both patients and retail meat. In meat, ST6 and ST97 were the most common clones in 55% of the MRSA isolates, and ST1153 and ST672 were the most common in 21% and 17% of the MSSA isolates. In patients, ST5 and ST6 were the predominant clones in 46% of the S. aureus isolates. CC5/ST5-SCCmecVc-t311 and CC361/ST672-SCCmecV-t3841 were common MRSA clones in both meat and patients. CC97 and CC361 clones were the second most prevalent S. aureus clones in meat and were relatively common in patients. Furthermore, we sequenced and characterized novel S. aureus strains ST8109, ST8110, and ST8111. The genomic similarities between meat- and patient-derived S. aureus isolates suggest that retail meat might be a reservoir for S.aureus and MRSA transmission. Therefore, a structured One Health approach is recommended for S. aureus dissemination, genetic characterization, antibiotic resistance, and impact on human health.

Background: Understanding antibiotic consumption patterns over time is essential to optimize prescribing practices and minimizing antimicrobial resistance. This study aimed to determine whether the antibiotics restriction policy launched by the Saudi Ministry of Health in April 2018 has impacted antibiotic use by assessing changes and seasonal variations following policy enforcement. Methods: Quarterly sales data of J01 antibacterial for systemic use in standard units were obtained from the IQVIA-MIDAS database, spanning from the first quarter of 2016 to the last quarter of 2020. Antibiotics consumption was measured in defined daily doses per 1,000 inhabitant per day- in a quarter (DDDdq). A comparative analysis of antibiotic consumption pre- and post-policy periods introduction was conducted by computing the average consumption values for each period. Statistical comparison of the mean differences between the two periods were then made using independent samples t-test, Mann-Whitney U Test where needed. Time series analysis was employed to estimate the projected antibiotic consumption in the post-policy period if the restriction policy had not been implemented, which was then compared to actual consumption values to evaluate the effectiveness of the restriction policy. Results: During the pre-policy, there were seasonal trends of the total and oral antibiotic consumption through quarters, with higher consumption observed in the first and fourth quarters. In contrast, parenteral antibiotic consumption did not appear to follow a clear seasonal pattern. Following the restriction policy, there was a significant reduction in total and oral antibiotic use, with mean reductions of -96.9 DDDdq ( p -value = 0.002) and -98 DDDdq ( p -value = 0.002), respectively. Conversely, a significant increase in parenteral antibiotic consumption was observed with a mean increase of +1.4 DDDdq ( p -value < 0.0001). The comparison between the forecasted and actual models showed that the actual antibiotics consumption for total, oral, and parenteral were lower than the corresponding forecasted values by 30%, 31%, and 34%, respectively. Conclusion: Overall, our analysis of antibiotics consumption from 2016 to 2020 displays great success for the policy implemented by the Saudi Ministry of Health in significantly reducing the total and oral use of antibiotics. However, future studies are needed to explore the increased consumption of the parenteral antibiotics as well as the persistent high consumption patterns during the fall and winter months even after the implementation of the restriction policy., 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 Alzahrani, Alshahrani and Alajel.)

Background and aim Parasomnias are a group of sleep-related movements or emotions like sleepwalking, sleep talking, teeth grinding (Bruxism), nocturnal enuresis (sleep enuresis), sleep terrors (night terrors), sleep-related eating disorder (SRED), nightmare disorder, REM Sleep Behavior Disorder (RBD), and confusional arousals. Parasomnias are more common in children than in adults. This study aimed to estimate the prevalence of different parasomnias among university students in Saudi Arabia. Additionally, it aimed to study the relationship between different parasomnias and gender-associated sleep disorders, mental disorders, and other medical diseases, stress, substance use, and medications. Methods This study is a descriptive cross-sectional survey-based study. The target population for this study is university students from different regions of Saudi Arabia. Parasomnia was defined as having at least one of the 11 disorders (over the past six months). Data was collected through an online survey. The survey was distributed on different online platforms to collect data from other regions of Saudi Arabia. The study took place between August and November 2022. Results Among 1,296 participants, 934 (72.1%) were female, and 1,071 (82.6%) were aged 19-24 years. A total of 1054 (81, 3%) participants reported having at least one parasomnia disorder. The most prevalent parasomnias were sleep talking 656 (50.6%), nightmares 650 (50.2%), and confusional arousals 524 (40.4%). The least prevalent parasomnia was sleep-related eating disorder 98 (7.6%). Among participants, 580 (44.8%) had a family history of parasomnia, 439 (33.9%) were diagnosed with sleep disorders, 296 (22.8%) were diagnosed with mental illnesses, and 92 (7.1%) had other medical diseases. Conclusion Parasomnias are prevalent among university students in Saudi Arabia. Parasomnias were higher in female students and in students with a family history of parasomnia. Parasomnias in adults might be a chronic or recurrent disorder. Parasomnias are significantly associated with psychological stress, depression, and anxiety disorders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alshahrani et al.)

Despite the availability of human papillomavirus (HPV) vaccines and screening facilities at various health centers in Saudi Arabia, the annual death rate due to cervical cancer is high. Therefore, knowledge and awareness are essential for self-care and educating others, particularly among healthcare students. The present descriptive, cross-sectional study explored female pharmacy students' knowledge, attitudes, and practices related to cervical cancer. A total of 140 students participated in the survey. The survey was conducted for the period between April 2022 to September 2023. We observed a good knowledge score and positive attitudes among 8.5% and 93.5% of participants, respectively. A total of 10% of the study participants reported good practice scores. Most participants had never been screened for cervical cancer (94.3%). Among the non-screened subjects, feeling healthy and lacking information were the participants' significant reasons for not screening for cervical cancer. A positive history of cancer related to smoking significantly impacted the knowledge score ( p = 0.050). The current study reveals that healthcare awareness programs for cervical cancer and HPV vaccination are necessary at the level of educational institutions to improve public health.

Telepharmacy is a practical part of telemedicine that refers to providing pharmaceutical services within the scope of the pharmacist's obligations while maintaining a temporal and spatial distance between patients, users of health services, and healthcare professionals. The present study was a cross-sectional study conducted among community pharmacists in Saudi Arabia between March and May 2022 to assess their knowledge, perceptions, and readiness for telepharmacy. The survey was filled out by 404 respondents. The majority of respondents were male (59.90%) and the age of more than half of them was between 30 and 39 years old (54.46%). Most participants worked in urban areas (83.66%), and 42.57% had less than five years of experience in a pharmacy. Most participants agreed that telepharmacy is available in Saudi Arabia (82.67%). Approximately 70% of pharmacists felt that telepharmacy promotes patient medication adherence, and 77.72% agreed that telepharmacy increases patient access to pharmaceuticals in rural areas. More than 72% of pharmacists said they would work on telepharmacy initiatives in rural areas for free, and 74.26% said they would work outside of usual working hours if necessary. In the future, this research could aid in adopting full-fledged telepharmacy pharmaceutical care services in Saudi Arabia. It could also help academic initiatives by allowing telepharmacy practice models to be included as a topic course in the curriculum to prepare future pharmacists to deliver telepharmacy services., 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., (© 2023 The Authors. Published by Elsevier B.V. on behalf of King Saud University.)

Background: Suicide is defined as the deliberate ending of one's own life or a deadly self-injurious act with evidence of the intention to die. Suicide among youths is a significant public mental health issue. Young individuals, particularly adolescents, are naturally susceptible to mental health problems., Methods: The present study has the cross-sectional study design based on simple random sampling technique. Initially, the questionnaire was self -administered to 4353 respondents. Questionnaire with incomplete responses was discarded, and finally, a sample of 4278 was used for the analysis. The study is based in the Kingdom of Saudi Arabia, and the data was collected between the months of January 2022 and April 2022. The survey instrument used in the present study comprised of two sections., Results: In our study, 79.5% of the respondents agreed to the statement "the ruling of suicide is the biggest factor to the low incidences of suicide in our community." Further, 66.6% of the respondents agreed that suicide is an idea or an act that a person can repel by religious practices such as prayer., Conclusion: A focus on suicidal behavior is a critical public health priority because although suicide is a prominent cause of mortality among teenagers; many more youths are at risk for suicide as a result of having suicidal ideation, creating suicide plans, and making an attempt. Trends in teenage suicide attempts increased overall and among numerous demographic categories., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

Quercetin (QtN) displays low systemic bioavailability caused by poor water solubility and instability. Consequently, it exerts limited anticancer action in vivo. One solution to increase the anticancer efficacy of QtN is the use of appropriate functionalized nanocarriers that preferentially target and deliver the drug to the tumor location. Herein, a direct advanced method was designed to develop water-soluble hyaluronic acid (HA)-QtN-conjugated silver nanoparticles (AgNPs). HA-QtN reduced silver nitrate (AgNO 3 ) while acting as a stabilizing agent to produce AgNPs. Further, HA-QtN#AgNPs served as an anchor for folate/folic acid (FA) conjugated with polyethylene glycol (PEG). The resulting PEG-FA-HA-QtN#AgNPs (further abbreviated as PF/HA-QtN#AgNPs) were characterized both in vitro and ex vivo. Physical characterizations included UV-visible (UV-Vis) spectroscopy, Fourier transform infrared (FTIR) spectroscopy, transmission electron microscopy (TEM), particle size (PS) and zeta potential (ZP) measurements, and biopharmaceutical evaluations. The biopharmaceutical evaluations included analyses of the cytotoxic effects on the HeLa and Caco-2 cancer cell lines using the MTT assay; cellular drug intake into cancer cells using flow cytometry and confocal microscopy; and blood compatibility using an automatic hematology analyzer, a diode array spectrophotometer, and an enzyme-linked immunosorbent assay (ELISA). The prepared hybrid delivery nanosystem was hemocompatible and more oncocytotoxic than the free, pure QtN. Therefore, PF/HA-QtN#AgNPs represent a smart nano-based drug delivery system (NDDS) and could be a promising oncotherapeutic option if the data are validated in vivo.

Measuring patient safety culture in the community pharmacy can help with identifying areas for development. The current study is a descriptive, cross-sectional, electronic survey conducted among pharmacists working in community pharmacies located in the southern region of Saudi Arabia. The community pharmacy version of the "Pharmacy Survey on Patient Safety Culture" (PSOPSC) was used to collect data. The positive response rate (PRR) was calculated as per the guidance provided by the Agency for Healthcare Research and Quality (AHRQ). Based on the PRR, two least-achieved items (<25%) were taken for further analysis to identify the possible predictors. A sum of 195 pharmacists were included in this study and most of them were working in chain pharmacies. The highest PRRs were observed with teamwork (94.99), and patient counseling (94.13), followed by physical space and environment (93.07). The lowest PRRs were observed with staffing, work pressure, and pace (47.70), followed by communication openness (72.60). Specific characteristics, such as experience and the number of working hours, are significantly related to a poor PRR. The current study results indicate that the scope for improving patient safety exists in various areas of community pharmacies. However, it is necessary to prioritize the need based on a positive response rate.

Objective: The aim of this study was to investigate the relationship between organizational characteristics and diabetes care from the perspective of health care professionals (HCPs) in Abha, Kingdom of Saudi Arabia., Subjects and Methods: A cross-sectional, self-reported survey of healthcare professionals was done. The study comprised a total of 106 HCPs from various departments involved with diabetes patient clinics or service providers. The electronic data collecting form was used to gather the data., Results: The study revealed a stronger association between the availability of bed facilities and better glycemic control. Moreover, the majority of HCPs believes that urbanization and sedentary lifestyles are the main contributors to the rise of diabetes mellitus in Saudi Arabia. Depending on organizational features, the regulations that are available for monitoring defaulter patients and running continuous medical education (CME) programs are vastly different. The main cause of the reported lack of medications for managing diabetic care was described as being a problem with the central medical supply store's drug supply, which was influenced by the type of health sector., Conclusions: Facilitating change at all levels, including patient education, HCPs education, and organizational development, can improve the quality of treatment. The current study can provide insight into the focus of interventional strategies to deliver diabetes patients with high-quality patient care.

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

The first conductive polymers (CPs) were developed during the 1970s as a unique class of organic substances with properties that are electrically and optically comparable to those of inorganic semiconductors and metals while also exhibiting the desirable traits of conventional polymers. CPs have become a subject of intensive research due to their exceptional qualities, such as high mechanical and optical properties, tunable electrical characteristics, ease of synthesis and fabrication, and higher environmental stability than traditional inorganic materials. Although conducting polymers have several limitations in their pure state, coupling with other materials helps overcome these drawbacks. Owing to the fact that various types of tissues are responsive to stimuli and electrical fields has made these smart biomaterials attractive for a range of medical and biological applications. For various applications, including the delivery of drugs, biosensors, biomedical implants, and tissue engineering, electrical CPs and composites have attracted significant interest in both research and industry. These bimodalities can be programmed to respond to both internal and external stimuli. Additionally, these smart biomaterials have the ability to deliver drugs in various concentrations and at an extensive range. This review briefly discusses the commonly used CPs, composites, and their synthesis processes. Further highlights the importance of these materials in drug delivery along with their applicability in various delivery systems., Competing Interests: The authors declare no conflict of interest.

One of humanity's most devastating health crises was COVID-19. Billions of people suffered during this pandemic. In comparison with previous global pandemics that have been faced by the world before, societies were more accurate with the technical support system during this natural disaster. The intersection of data from healthcare units and the analysis of this data into various sophisticated systems were critical factors. Different healthcare units have taken special consideration to advance technical inputs to fight against such situations. The field of natural language processing (NLP) has dramatically supported this. Despite the primitive methods for monitoring the bio-metric factors of a person, the use of cognitive science has emerged as one of the most critical features during this pandemic era. One of the essential features is the potential to understand the data based on various texts and user inputs. The deployment of various NLP systems is one of the most challenging factors in handling the bulk amount of data flowing from multiple sources. This study focused on developing a powerful application to advise patients suffering from ailments related to COVID-19. The use of NLP refers to facilitating a user to identify the present critical situation and make necessary decisions while getting infected. This article also summarises the challenges associated with NLP and its usage for future NLP-based applications focusing on healthcare units. There are a couple of applications that reside for android-based systems as well as web-based chat-bot systems. In terms of security and safety, application development for iOS is more advanced. This study also explains the block meant of an application for advising COVID-19 infection. A natural language processing powered application for an iOS operating system is indeed one of its kind, which will help people who need to advise proper guidance. The article also portrays NLP-based application development for healthcare problems associated with personal reporting systems., Competing Interests: The authors declare there are no competing interests., (©2023 Alshahrani and Khan.)

Objective: The aim of this study was to understand the impact of demographic characteristics and to describe the gender differences in knowledge, beliefs, and attitudes towards bipolar disorders among common residents in the Southern region of Saudi Arabia., Subjects and Methods: This cross-sectional survey was conducted between January 2021 and March 2021. The survey was conducted among the common residents in the southern region of the Kingdom of Saudi Arabia. The data were collected by using a structured, self-administered, validated questionnaire comprised of a dichotomous type of questions along with Likert scale., Results: There is a significant difference in the distribution of knowledge scores between male and female study participants (p=0.000). No significant gender differences have been identified in beliefs and attitudes toward bipolar disorder (p=0.229) and in overall score (p=0.159). The traumatic event was reported as the major cause of bipolar disorder. The age group and employment status were found to be the major predictor of knowledge, beliefs, and attitudes about bipolar disorder., Conclusions: Although the knowledge awareness rate on bipolar disorder is high among public in the Southern region, there is a vast scope for improving it. Education should be disseminated to promote mental health awareness and improve attitudes and beliefs on bipolar disorders and reduce stigma and discrimination against patients with bipolar disorders.

This study aimed to evaluate Saudi Arabian public perceptions toward influenza and COVID-19 immunization during the flu season. A cross-sectional self-administered, structured, and closed-questionnaire online survey was conducted on the general public. A total of 422 people willingly participated in the survey using several social media platforms from 15 May to 15 July 2021. Residents of Saudi Arabia aged 18 or older (eligible for COVID-19 vaccination) were included in the study and willing to answer questionnaires. The 422 participants who agreed to participate in the study completed the questionnaire. Thirty-seven percent of the participants were youth (18-25 years). More than 80% of the participants in the study agreed or strongly agreed that flu and COVID-19 vaccines must be mandatory for all populations. At the same time, 42.4% considered that the COVID-19 vaccine might positively impact the public and the economy in the future. Participants confirmed to have had COVID-19 or the flu since the beginning of the outbreak totaled 21.3%. Of the participants, 54% had sufficient knowledge about vaccine types and safety. Most of our participants (54.9%) agreed that preventive measures were still required, even with the existence of vaccines. Our study provides an overview of COVID-19's influence on Saudi Arabia during the flu season. The Saudi Arabian government should consider preventive efforts to strengthen confidence in the health advantages offered by prospective immunization to prevent a twindemic of influenza and COVID-19.

Wilson's disease causes copper accumulation in the liver and extrahepatic organs. The available therapies aim to lower copper levels by various means. However, a potent drug that can repair the damaged liver and brain tissue is needed. Silymarin has hepatoprotective, antioxidant, and cytoprotective properties. However, poor oral bioavailability reduces its efficacy. In this study, a "thin film hydration method" was used for synthesizing silymarin-encapsulated liposome nanoparticles (SLNPs) and evaluated them against copper toxicity, associated liver dysfunction and neurobehavioral abnormalities in Wistar rats. After copper toxicity induction, serological and behavioral assays were conducted to evaluate treatment approaches. Histological examination of the diseased rats revealed severe hepatocyte necrosis and neuronal vacuolation. These cellular degenerations were mild in rats treated with SLNPs and a combination of zinc and SLNPs (ZSLNPs). SLNPs also decreased liver enzymes and enhanced rats' spatial memory significantly ( p = 0.006) in the diseased rats. During forced swim tests, SLNPs treated rats exhibited a 60-s reduction in the immobility period, indicating reduced depression. ZSLNPs were significantly more effective than traditional zinc therapy in decreasing the immobility period ( p = 0.0008) and reducing liver enzymes, but not in improving spatial memory. Overall, SLNPs enhanced oral silymarin administration and managed copper toxicity symptoms.

In the fall of 2022, the number of influenza-like illnesses (ILIs) and severe acute respiratory infections (SARIs) in Saudi Arabia had significantly increased compared with the corresponding period in previous years. Concerns regarding the population's seasonal influenza vaccine (SIV) uptake rates have emerged. In particular, the SIV uptake rates may have dropped post the COVID-19 pandemic compared with rates prior to the COVID-19 era. In this study, we aimed to estimate the prevalence and predictors of SIV uptake in Saudi Arabia post the COVID-19 pandemic. We conducted a cross-sectional study utilizing an online survey platform. We mainly collected sociodemographic information and determined whether the respondent was a healthcare professional or had a chronic disease. The overall SIV uptake prevalence was 31.8%. A lower SIV uptake was observed among those aged 55 years or older, females, residents of the central region, non-health practitioners, and those without chronic diseases. Several factors were associated with SIV uptake. Those aged 35-44 were over three-fold more likely to receive an SIV than those aged 55 years or older (OR: 3.66; 95% CI: 1.33-10.05). In addition, males had 73% higher odds of SIV uptake than females (OR: 1.73; 95% CI: 1.18-2.55). Health practitioners were more likely to receive an SIV than non-health practitioners (OR: 2.11; 95% CI: 1.45-3.06). Similarly, those with chronic diseases had 86% higher odds of SIV uptake than those without chronic diseases (OR: 1.86; 95% CI: 1.18-2.95). These findings can provide insights into the low prevalence and predictors of SIV uptake in Saudi Arabia. Future studies should be conducted to further explore the potential factors associated with such a low prevalence of SIV uptake post COVID-19 in Saudi Arabia.

Particle size, shape and morphology can be considered as the most significant functional parameters, their effects on increasing the performance of oral solid dosage formulation are indisputable. Supercritical Carbon dioxide fluid (SCCO 2 ) technology is an effective approach to control the above-mentioned parameters in oral solid dosage formulation. In this study, drug solubility measuring is investigated based on artificial intelligence model using carbon dioxide as a common supercritical solvent, at different pressure and temperature, 120-400 bar, 308-338 K. The results indicate that pressure has a strong effect on drug solubility. In this investigation, Decision Tree (DT), Adaptive Boosted Decision Trees (ADA-DT), and Nu-SVR regression models are used for the first time as a novel model on the available data, which have two inputs, including pressure, X1 = P(bar) and temperature, X2 = T(K). Also, output is Y = solubility. With an R-squared score, DT, ADA-DT, and Nu-SVR showed results of 0.836, 0.921, and 0.813. Also, in terms of MAE, they showed error rates of 4.30E-06, 1.95E-06, and 3.45E-06. Another metric is RMSE, in which DT, ADA-DT, and Nu-SVR showed error rates of 4.96E-06, 2.34E-06, and 5.26E-06, respectively. Due to the analysis outputs, ADA-DT selected as the best and novel model and the find optimal outputs can be shown via vector: (x1 = 309, x2 = 317.39, Y1 = 7.03e-05)., (© 2023. The Author(s).)

Curcumin is the main active constituent in turmeric, and it is one of the biopolyphenolic compounds. A cumulative body of research supports the use of curcumin in the treatment of wounds, yet poor water solubility and lack of therapeutic dose determination hamper its use for this therapeutic purpose. This work aimed at preparing novel curcumin wafer dressings to provide a favorable environment for wound healing. Hybrid synthetic (PVA, PVP, HPMC, and CMC) and biodegradable (sodium alginate and dextran) polymers were employed to prepare wafer dressings loaded with incremental three doses (2, 10, and 20 mg) of curcumin per a wafer dressing. The solvent casting method was used to prepare the dressings. Dimension, surface pH, mechanical properties, DSC, FTIR, XRD, erosion time, and in vitro release were studied. Skin wound healing assay was studied in Wistar albino rats. Six curcumin-loaded wafers were successfully prepared with good mechanical properties. Curcumin was dispersed in an amorphous/molecular form, as evidenced by thermal (DSC) and spectral (FTIR and XRD) analyses. Prolonged curcumin release (>24 h) was recorded for F6 (10 mg curcumin) and F7 (20 mg curcumin). Wound healing rate constants and time for 50% wound closure (T1/2) were estimated from a semi-log wound diameter versus time curve. A superior healing rate (up to 3-fold faster) was recorded for curcumin-loaded wafer dressings containing 10 mg (F6) with T1/2 of 7 days compared to 20 days for the placebo-treated group. These results warrant using the selected curcumin-loaded wafer dressing for safer and faster wound closure.

Antibacterial restorative materials against caries-causing bacteria are highly preferred among high-risk patients, such as the elderly, and patients with metabolic diseases such as diabetes. This study aimed to enhance the antibacterial potential of resin composite with Magnesium-doped Zinc oxide (Mg-doped ZnO) nanoparticles (NPs) and to look for their effectiveness in the alloxan-induced diabetic model. Hexagonal Mg-doped ZnO NPs (22.3 nm diameter) were synthesized by co-precipitation method and characterized through ultraviolet-visible (UV-Vis), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS) analysis. The Mg-doped ZnO NPs (1, 2.5 and 5% w/w) were then evaluated for antibacterial activity using a closed system in vitro biofilm model. Significant enhancement in the antibacterial properties was observed in composites with 1% Mg-doped ZnO compared to composites with bare ZnO reinforced NPs (Streptococcus mutans, p = 0.0005; Enterococcus faecalis, p = 0.0074, Saliva microcosm, p < 0.0001; Diabetic Saliva microcosm, p < 0.0001). At 1−2.5% Mg-doped ZnO NPs concentration, compressive strength and biocompatibility of composites were not affected. The pH buffering effect was also achieved at these concentrations, hence not allowing optimal conditions for the anaerobic bacteria to grow. Furthermore, composites with Mg-doped ZnO prevented secondary caries formation in the secondary caries model of alloxan-induced diabetes. Therefore, Mg-doped ZnO NPs are highly recommended as an antibacterial agent for resin composites to avoid biofilm and subsequent secondary caries formation in high-risk patients.

Rizatriptan (RZT) is an efficient anti-migraine drug which belongs to the class of selective 5 HT (1B/1D) serotonin receptor agonists. Nevertheless, RZT elicits several adverse effects and RZT nasal sprays have a limited half-life, requiring repeated doses that could cause patient noncompliance or harm to the nasopharynx and cilia. The current research aimed to develop orally disintegrating films (ODFs) of RZT employing maltodextrin (MTX) and pullulan (PUL) as film-forming polymers, as well as propylene glycol (PG) as a plasticizer. The ODFs were prepared by solvent casting method (SCM). The technique was optimized using Box-Behnken design (BBD), contemplating the ratios of PUL: MTX and different levels of PG (%) as factor variables. The influence of these factors was systematically analyzed on the selected dependent variables, including film thickness, disintegration time (D-time), folding endurance (FE), tensile strength (TS), percent elongation (%E), moisture content (%), and water uptake (%). In addition, the surface morphology, solid state analysis, drug content uniformity (%), drug release (%), and pH of the RZT-ODFs were also studied. The results demonstrated a satisfactory stable RZT-ODFs formulation that exhibited surface homogeneity and amorphous RZT in films with no discernible interactions between the model drug and polymeric materials. The optimized film showed a rapid D-time of 16 s and remarkable mechanical features. The in vitro dissolution kinetics showed that 100% RZT was released from optimized film compared to 61% RZT released from conventional RZT formulation in the initial 5 min. An animal pharmacokinetic (PK) investigation revealed that RZT-ODFs had a shorter time to achieve peak plasma concentration (T max ), a higher maximum plasma concentration (C max ), and area under the curve (AUC 0-t ) than traditional oral mini capsules. These findings proposed a progressive approach for developing anti-migraine drugs that could be useful in reducing the complications of dysphagia in geriatric and pediatric sufferers.

Computational analysis of drug solubility was carried out using machine learning approach. The solubility of Decitabine as model drug in supercritical CO 2 was studied as function of pressure and temperature to assess the feasibility of that for production of nanomedicine to enhance the solubility. The data was collected for solubility optimization of Decitabine at the temperature 308-338 K, and pressure 120-400 bar used as the inputs to the machine learning models. A dataset of 32 data points and two inputs (P and T) have been applied to optimize the solubility. The only output is Y = solubility, which is Decitabine mole fraction solubility in the solvent. The developed models are three models including Kernel Ridge Regression (KRR), Decision tree Regression (DTR), and Gaussian process (GPR), which are used for the first time as a novel model. These models are optimized using their hyper-parameters tuning and then assessed using standard metrics, which shows R 2 -score, KRR, DTR, and GPR equal to 0.806, 0.891, and 0.998. Also, the MAE metric shows 1.08E-04, 7.40E-05, and 9.73E-06 error rates in the same order. The other metric is MAPE, in which the KRR error rate is 4.64E-01, DTR shows an error rate equal to 1.63E-01, and GPR as the best mode illustrates 5.06E-02. Finally, analysis using the best model (GPR) reveals that increasing both inputs results in an increase in the solubility of Decitabine. The optimal values are (P = 400, T = 3.38E + 02, Y = 1.07E-03)., (© 2022. The Author(s).)

Cardiovascular diseases (CVD) are the leading causes of death worldwide. Dyslipidemia is a cardiometabolic risk factor of CVD, yet it can be modifiable. Walnuts have been suggested as a dietary intervention to improve the lipid profile. Therefore, we reviewed the literature to assess the evidence linking walnut intake to the improvement of blood lipids, including total cholesterol (TC), low-density lipoprotein (LDL-C) cholesterol, high-density lipoprotein (HDL-C) cholesterol, and triglycerides (TG). PubMed and Embase databases were searched from 2010 up to March 2022. We limited our search to randomized controlled trials conducted on humans and published in English during the specified period. Cochrane's risk of bias tool for interventional studies was used. A random-effects model was used for the meta-analysis, and weighted mean differences were obtained (WMD) Thirteen trials from the U.S., Europe, and Asia were included. Walnut intake was associated with significant reductions in TC (WMD: -8.58 mg/dL), LDL-C (WMD: -5.68 mg/dL), and TG (WMD: -10.94 mg/dL). Walnut consumption was not associated with HDL-C. Subgroup analysis showed that overweight/obese and those with comorbidities had more lipid improvement. A longer trial duration did result in further improvements. However, our results may be prone to bias due to extraneous confounding factors. Additionally, levels of heterogeneity were considerable for some outcomes of interest. Results from this meta-analysis provide evidence for the health benefits of walnuts on blood lipids. Walnuts possibly reduce the risk of CVD; thus, they can be successfully added to a dietary pattern to enhance health benefits.

New universities and educational organizations are increasing in Saudi Arabia with the increase in the need for high-quality education. This increased the need for a fast transformation to digitise the educational system in Saudi Arabia, which is one of the important pillars of the Saudi Vision 2030. The students who study in these organizations suffer the verification of academic records and other educational documents. Students who want to study at universities abroad also face the challenge of academic records and certificates verification. A secure, fast, and transparent model is required in the education sector in order to verify academic certificates issued by various educational organizations. Blockchain technology can be used with high data security to empower the educational sector of Saudi Arabia in the digital transformation and to help the educational organizations in verifying academic documents. In order to avoid any document fraud and forgery, along with the ease of verification of academic records and educational documents for the students. This research focuses on developing a model which will be helpful in achieving digital transformation in academic document verification by blockchain technology., Competing Interests: The authors declare there are no competing interests., (©2022 Alangari et al.)

Over the last years, extensive motivation has emerged towards the application of supercritical carbon dioxide (SCCO 2 ) for particle engineering. SCCO 2 has great potential for application as a green and eco-friendly technique to reach small crystalline particles with narrow particle size distribution. In this paper, an artificial intelligence (AI) method has been used as an efficient and versatile tool to predict and consequently optimize the solubility of oxaprozin in SCCO 2 systems. Three learning methods, including multi-layer perceptron (MLP), Kriging or Gaussian process regression (GPR), and k-nearest neighbors (KNN) are selected to make models on the tiny dataset. The dataset includes 32 data points with two input parameters (temperature and pressure) and one output (solubility). The optimized models were tested with standard metrics. MLP, GPR, and KNN have error rates of 2.079 × 10 -8 , 2.173 × 10 -9 , and 1.372 × 10 -8 , respectively, using MSE metrics. Additionally, in terms of R-squared, they have scores of 0.868, 0.997, and 0.999, respectively. The optimal inputs are the same as the maximum possible values and are paired with a solubility of 1.26 × 10 -3 as an output.

Introduction:  The recent multi-nation outbreaks of human monkeypox in non-endemic areas have created an emerging public health issue. Medical students who will become future healthcare providers are directly associated with community people and can easily sensitize the general population, so it is crucial to assess their degree of knowledge and attitudes regarding recently emerging infections or pathogens. However, studies on medical students' perception of the monkeypox virus are scarce in Saudi Arabia. Therefore, the objective of this study was to assess the monkeypox virus-related knowledge and attitudes among medical students in the country., Methods: A cross-sectional study was conducted from May to July 2022 among undergraduate medical students at King Khalid University, Abha, Saudi Arabia. A systematic random sampling technique was applied to select the study participants. A self-administered questionnaire was used to gather data on sociodemographic characteristics, knowledge and attitudes toward the monkeypox virus. Descriptive statistics and Chi-square tests were performed., Results: A total of 314 medical students were recruited for this study. The findings from this study showed that the vast majority of medical students (72%) had poor knowledge about the monkeypox virus. Respondents' age, grade point average (GPA), fathers' education level, and training received about the monkeypox virus were significantly associated with the level of knowledge about the monkeypox virus (p < 0.05). Nearly half of the respondents (45.9%) agreed that the monkeypox virus could be transmitted to Saudi Arabia. Overall, this study showed that the awareness levels regarding the monkeypox virus were significantly higher among seniors as compared to junior students., Conclusion: The study found poor knowledge of the monkeypox virus among currently enrolled medical students in the country's highest-ranked medical school. This finding emphasizes the urgent need to increase their knowledge because controlling outbreaks requires significant cooperation from knowledgeable and skilled healthcare providers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alshahrani et al.)

Amphotericin B (AMB) is commonly used to treat life-threatening systemic fungal infections. AMB formulations that are more efficient and less nephrotoxic are currently unmet needs. In the current study, new ZnO-PEGylated AMB (ZnO-AMB-PEG) nanoparticles (NPs) were synthesized and their antifungal effects on the Candida spp. were investigated. The size and zeta potential values of AMB-PEG and ZnO-AMB-PEG NPs were 216.2 ± 26.9 to 662.3 ± 24.7 nm and -11.8 ± 2.02 to -14.2 ± 0.94 mV, respectively. The FTIR, XRD, and EDX spectra indicated that the PEG-enclosed AMB was capped by ZnO, and SEM images revealed the ZnO distribution on the surface NPs. In comparison to ZnO-AMB NPs and free AMB against C.albicans and C.neoformans , ZnO-AMB-PEG NPs significantly reduced the MIC and MFC. After a week of single and multiple dosage, the toxicity was investigated utilizing in vitro blood hemolysis, in vivo nephrotoxicity, and hepatic functions. ZnO-AMB-PEG significantly lowered WBC count and hematocrit concentrations when compared to AMB and ZnO-AMB. RBC count and hemoglobulin content, on the other hand, were unaltered. ZnO-AMB-PEG considerably lowered creatinine and blood urea nitrogen (BUN) levels when compared to AMB and ZnO-AMB. The difference in liver function indicators was determined to be minor by all formulae. These findings imply that ZnO-AMB-PEG could be utilized in the clinic with little nephrotoxicity, although more research is needed to determine the formulation's in vivo efficacy.

Objectives: Because the epidemiology of road traffic injuries (RTIs) can differ in time due to differences in traffic dynamics or behaviors, this paper aims to examine whether RTIs are more likely to occur at sunset in Ramadan than in other months in KSA., Methods: A nationwide cross-sectional study of all RTIs recorded in the Saudi Red Crescent Authority database. Cases were those who sought emergency care following any RTI in 2021. Differences in counts of RTIs between Ramadan and other months were compared using Chi-2 tests. A logistic regression model was constructed to evaluate the association between Ramadan and the likelihood of sunset RTIs., Results: The total number of RTIs was 112,188, of which 9922 (8.8%) occurred in Ramadan. Higher percentages of RTIs during Ramadan as compared to other months were observed among males (82.2% vs. 79.6%; P < .01) and non-Saudis (42.7% vs. 38.9%; P < .01). Interaction effects between Ramadan and region were significant in the regression model (P < .01). RTIs in Ramadan were almost two times more likely to occur at sunset than in other months in the Northern Borders (OR = 2.14; 95% CI:1.44-3.17), while a negative association was found in Bahah region (OR = 0.67; 95% CI: 0.44-0.99)., Conclusion: RTI burden is higher in Ramadan than in other months, and that varies by region. Further investment in prevention strategies, such as increased enforcement and awareness programs, is warranted in regions with a higher RTIs burden to improve traffic safety and population health., (© 2022 Taibah University. Production and hosting by Elsevier Ltd.)

Due to the COVID-19 pandemic, all Saudi universities have adopted e-learning systems to ensure that educational activities continue. Shaqra University adopted a platform called the Shaqra University e-learning platform. This study aimed to identify the factors contributing to the success of that platform in Shaqra University, based on students' responses. This research has proposed an extension of well-known DeLone and McLean's Information Systems Success (D&M ISS) model to check and validate the success factors of the Shaqra University platform. The questionnaire was adopted in this study to collect data from students currently enrolled at Shaqra University. One thousand online links to the questionnaire were randomly distributed among current students enrolled in Shaqra University. The results revealed that the instrument adopted in this study was valid and reliable. Also, the results showed that the model was a good fit for the Saudi context. The proposed factors of instructor's quality, learner quality, and perceived usefulness positively impacted the e-learning platform. On the other hand, the factors information quality, system quality and service quality had no positive impact on the use of the e-learning platform., Competing Interests: The authors declare that they have no competing interests., (© 2022 Alotaibi and Alshahrani.)

Ethanopharmacological Importance: Alpinia galanga (L.) Willd (AG), belonging to Zingiberaceae family is used as a spice and condiment in various culinary preparations of Indonesia, Thailand and Malaysia. It has been also used as a key ingredient in various traditional systems of medicine for the treatment of throat infection, asthma, urinary ailments, inflammation and rheumatism amongst other conditions. AG is widely used as a functional food and included in various preparations to obtain its nutraceutical and pharmacological benefits of its phytoconstituents such as phenyl propanoids, flavonoids and terpenoids. Over the past decades, several researchers have carried out systematic investigation on various parts of AG. Numerous studies on AG rhizomes have shown positive pharmacological effects such as anti-inflammatory, anticancer, antipsoriasis, antiallergic, neuroprotective and thermogenesis. Till date, no comprehensive review summarizing the exploitation of AG into nanomedicine has been published., Aim of the Review: This comprehensive review aims to briefly discuss cultivation methods, propagation techniques, extraction processes for AG. The ethnopharmacological uses and pharmacological activities of AG extracts and its isolates are discussed in detail which may contribute well in further development of novel drug delivery system (NDDS) i.e. future nanomedicine., Materials and Methods: Information about AG was collected using search engine tools such as Google, Google Scholar, PubMed, Google Patent, Web of Science and bibliographic databases of previously published peer-reviewed review articles and research works were explored. The obtained data sets were sequentially arranged for better understanding of AG's potential., Results: More advanced genetic engineering techniques have been utilized in cultivation and propagation of AG for obtaining better yield. Extraction, isolation and characterization techniques have reported numerous phytoconstituents which are chemically phenolic compounds (phenyl propanoids, flavonoids, chalcones, lignans) and terpenes. Ethnopharmacological uses and pharmacological activity of AG are explored in numerous ailments, their mechanism of action and its further potential to explore into novel drug delivery system are also highlighted., Conclusions: The review highlights the importance of plant tissue culture in increasing the production of AG plantlets and rhizomes. It was understood from the review that AG and its phytoconstituents possess numerous pharmacological activities and have been explored for the treatment of cancer, microbial infection, gastrointestinal disorders, neuroprotective effects, obesity and skin disorders. However, the use of AG as alternative medicine is limited owing to poor solubility of its bioactive components and their instability. To overcome these challenges, novel drug delivery systems (NDDS) have been utilized and found good success in overcoming its aforementioned challenges. Furthermore, efforts are required towards development of scalable, non-toxic and stable NDDS of AG and/or its bioactives., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Rutin-loaded nanoemulsion (NE-RU) formulation is the core research work in this report. Labrafil ® M 1944 CS was used as the oil phase, Tween 80 as the surfactant, and Transcutol P as the co-surfactant in the preparation of nanoemulsion. By utilizing a three-level central composite design (CCD), the composition was optimized. The optimized formulation showed a droplet size of 98.53 ± 3.22 nm, zeta potential -46.70 ± 4.78 mV, and drug loading 92.34 ± 3.87%. The results of dissolution, permeability, and oral bioavailability showed about 25.55 folds, 1.98 folds, and 33.68 folds, respectively, in the case of NE-RU as compared to its naïve form. The response of fresh and aged NE was non-significantly different in terms of particle size, zeta potential, and drug loading, indicating that the formulation was stable. The successful development of NE-RU with an improved bioavailability profile suggested that this formulation might be used to examine the pharmacodynamics of oxidative stress-related metabolic disorders.

A document's keywords provide high-level descriptions of the content that summarize the document's central themes, concepts, ideas, or arguments. These descriptive phrases make it easier for algorithms to find relevant information quickly and efficiently. It plays a vital role in document processing, such as indexing, classification, clustering, and summarization. Traditional keyword extraction approaches rely on statistical distributions of key terms in a document for the most part. According to contemporary technological breakthroughs, contextual information is critical in deciding the semantics of the work at hand. Similarly, context-based features may be beneficial in the job of keyword extraction. For example, simply indicating the previous or next word of the phrase of interest might be used to describe the context of a phrase. This research presents several experiments to validate that context-based key extraction is significant compared to traditional methods. Additionally, the KeyBERT proposed methodology also results in improved results. The proposed work relies on identifying a group of important words or phrases from the document's content that can reflect the authors' main ideas, concepts, or arguments. It also uses contextual word embedding to extract keywords. Finally, the findings are compared to those obtained using older approaches such as Text Rank, Rake, Gensim, Yake, and TF-IDF. The Journals of Universal Computer (JUCS) dataset was employed in our research. Only data from abstracts were used to produce keywords for the research article, and the KeyBERT model outperformed traditional approaches in producing similar keywords to the authors' provided keywords. The average similarity of our approach with author-assigned keywords is 51%., Competing Interests: The authors declare there are no competing interests., (©2022 Khan et al.)