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Ismail Ibrahim Abuallut,1 Abeer Rihan Alomaish,2 Alshaymaa Mohammad Arishy,2 Mariam Asiri Mashragi,2 Kholod Hadi Alfaifi,2 Noura Ali Alnamazi,2 Aisha Mansour Moafa,2 Mohamed S Mahfouz,3 Majid A Moafa,4 Sultan A Jafaari,5 Abdulaziz A Alagsam,6 Hani Basher Albalawi,7 Mohammad A Jareebi3 1Department of Surgery, Ophthalmology Division, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 3Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 4Optometric Department, Faculty of Medicine, Qassim University, Qassim, Saudi Arabia; 5Department of Dermatology, King Fahd Central Hospital, Jazan, Saudi Arabia; 6Department of Ophthalmology, Mohammed Bin Nasser Hospital, Jazan, Saudi Arabia; 7Ophthalmology Division, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi ArabiaCorrespondence: Ismail Ibrahim Abuallut, Ophthalmology Consultant & Assistant Professor of Ophthalmology, Department of Surgery, Ophthalmology Division, Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia, Email iabuallut@jazanu.edu.sa; iabuallut@qmed.caBackground: In cases of atopy, IgE antibodies are formed in reaction to certain environmental factors like house dust mites, pollen, or even food allergens. Some studies have shown an association between atopic diseases and keratoconus. This study aims to determine the prevalence of atopy and its associated factors among keratoconus patients.Materials and Methods: A cross-sectional study was conducted among the Jazan population attending ophthalmology clinics regardless of their sex. Data collection started in August 2020 and finished in mid-June 2021. The sample was selected using the convenience sampling technique, and the total sample size was 83 participants. Data were collected via a questionnaire-based interview that contained 46 questions in the Arabic language. The data collected were analyzed using SPSS software.Results: Family history is the leading predisposing factor for keratoconus (P < 0.001). Also, eye rubbing was a significant (P < 0.015) trigger for keratoconus. However, other factors, including demographic factors such as gender and atopic conditions, did not have any significant association.Conclusion: A combination of genetic and environmental factors is the leading cause of the development of keratoconus; however, family history is the most influential factor, followed by eye rubbing.Keywords: atopic disease, keratoconus, prevalence, risk factor, Jazan, Saudi Arabia

Abuallut II, Alomaish AR, Arishy AM, et al. Int J Gen Med. 2023 Oct 27:16:4873-4881. Our authors have advised that affiliation 4 for Majid A Moafa on page 4873 “4Optometric Department, Faculty of Medicine, Qassim University, Qassim, Saudi Arabia” should be “4Department of Optometry, College of Applied Medical Sciences, Qassim University, Qassim, Saudi Arabia”. The authors apologise for this oversight.

Mohamed Moukhyer,1,2 Mohamed Salih Mahfouz,3 Mahmoud M Habibullah,4 Nouf Hussain Abuhadi,5 Nizar A Khamjan,4 Aymen M Madkhali,4 Ali O Hakamy,6 Hassan A Hamali,4 Mazharul Hoque,1 Mohtashim Lohani,1 Aziza Mukhayer7,8 1Emergency Medical Services, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 2Public Health Programs, School of Medicine, University of Limerick, Limerick, Ireland; 3Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 4Medical Laboratory Technology Department, Jazan University, Jazan, Saudi Arabia; 5Diagnostic Radiology Technology Department, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 6Department of Respiratory Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 7Faculty of Medicine, Ahfad University for Women, Omdurman, Sudan; 8Department of Health Promotion, University of Maastricht, Maastricht, The NetherlandCorrespondence: Mohamed Moukhyer, Tel +966-568878291, Email mmoukhyer@jazanu.edu.saBackground: The emergence of COVID-19 posed a threat to millions of lives worldwide. The pandemic impacts extended to affect people’s psychological well-being, resulting in significant behavioural change. This study was designed to assess the knowledge regarding COVID-19 precautions among the College of Applied Medical Science students at Jazan University and to evaluate the general, psychosocial, and behavioral changes due to COVID-19.Methods: This is an observational study targeting 630 undergraduate students randomly selected during January 2020, using stratified random sampling. Data were collected using an online questionnaire. Linear regression models were used to evaluate the predictors of three outcome measures: knowledge, attitudes, and practice scores.Results: Knowledge of COVID-19 revealed that the students with correct answers ranged from 48.9 to 95%. Furthermore, significant gender differences are found regarding shortness of breath, fatigue, persistent chest discomfort, headache, and malaise (p < 0.05). Knowledge scores differed significantly across gender and academic level (p < 0.05) and so does attitude scores (p < 0.05). No significant difference was observed between practice scores according to socio-demographic background (p > 0.05). The linear regression model showed that females had significantly higher knowledge, attitudes, and practice scores (p < 0.05) as well as those within the 21– 23 age group and above (p < 0.05). Students residing in urban and semi-urban places had significantly higher scores for knowledge, attitudes, and practice (p < 0.05).Conclusion: The results demonstrated moderate knowledge about COVID-19 among study participants, with significant differences between the responses of males and females and among the urban and rural populations. Outcomes suggest the need for interventions to bridge students’ knowledge about COVID-19 and practice gaps. Students were concerned about basic life amenities and the inability to provide for their dear ones regarding behavioral changes.Keywords: COVID-19, health and safety, public health

Abeer Rihan Alomaish,1 Lamyaa Ahmed Mohamed El Hassan,2 Mohamed Salih Mahfouz,3 Wejdan Nasser Haidar,1 Husam-eldin Omer M Omer2 1Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2Department of Pathology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 3Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Mohamed Salih Mahfouz, Department of Family and Community Medicine, Jazan University Faculty of Medicine, Jazan, Saudi Arabia, Email mm.mahfouz@gmail.com; mmahfouz@jazanu.edu.saPurpose: The selection of a specific medical specialty is crucial to medical students and is increasingly associated with future job satisfaction and success in the medical field. We aim to evaluate the perception of medical students at Jazan University towards choosing pathology as a future career and the factors influencing their decisions in order to better the employability of graduates and provide information to both the labor force and curriculum designers.Methods: An observational cross-sectional study was conducted among a random sample of (391) students at the faculty of medicine, Jazan University, from the 2nd to 6th year who registered as a formal student in the academic year 2021/2022. Data was collected via (web-based) a self-administered questionnaire because of COVID-19 pandemic. Chi-squared tests and regression analysis were performed.Results: In this investigation, 92.9% of participants responded. Only 16.2% of undergraduates selected pathology as a future career choice. Among the participants who desired to choose pathology as a career, 28.6% preferred hematopathology as a future sub-specialty. Around 16% considered the most crucial reason for not choosing pathology is the preference for direct patient contact. The differences in age groups, academic level, GPA, and educational level of father between respondents who having a desire to choose pathology as a future career were found to be significantly different.Conclusion: Among the respondents involved in this study, only 16.2% were interested in pathology, while 3.1% chose the field as their first future career choice. Our findings can be applied to help undergraduate better prepare for the future and encourage them to apply to the pathology program to address the shortage of pathologists in the area. Qualitative research is a need to explore the perceptions of current pathology residents and the reasons that can encourage them to choose this important specialization as a future career.Keywords: undergraduate, career choice, pathology, digital pathology, medical curriculum, Jazan, Saudi Arabia

Alshaymaa M Arishy,1 Mohammed Salih Mahfouz,2 Husameldin E Khalafalla,2 Mostafa ME Atteya,3 Yahya H Khormi4 1Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 3Department of Surgery, King Fahad Central Hospital, Jazan, Saudi Arabia; 4Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi ArabiaCorrespondence: Alshaymaa M Arishy, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia, Tel +966548339496, Email Alshaymaa_arishy1@hotmail.comBackground: Low back pain (LBP) is one of the most common health problems. Red flags (RFs) of LBP are risk factors that are reported during clinical assessment to determine serious illness. This study aimed to assess primary health-care physicians’ knowledge of and practices for RFs of LBP and identify variables associated with a high level of knowledge and awareness about it.Methods: An observational cross-sectional survey was conducted in 2021 among a random sample of 261 primary health care (PHC) physicians in the Jazan Region in southwest Saudi Arabia. A web-based questionnaire was used to collect data on LBP red flags awareness and practices. Descriptive (frequency and percentage) and inferential statistics were used for data analysis.Results: The overall mean score of RFs knowledge among physicians was 82.33 ± 36.3, with 95% confidence interval (CI); (77.7– 86.9). Regarding the Physician’s practices, more than 95% of the participants would refer patients to higher levels in the presence of symptoms or signs of RFs. General practitioners and residents were significantly more likely to ask for an Xray, even with symptoms that had persisted for less than 2 weeks without RF signs (p = 0.006). The overall percentage of patients with nonspecific LBP referrals was as high as 57.8%. The number of patients with LBP seen per month (fewer than 15) and female physician were associated with an increased level of knowledge (OR = 2.2, 95%, P < 0.05) and (OR = 2.2, 95%, P < 0.05) respectively.Conclusion: Overall, awareness of RFs for LBP and referring critical patients who present with LBP is good among PHC physicians in the Jazan Region. Junior physicians have a low threshold to request images. The referral rate for nonspecific LBP is still high, which could overwhelm spinal clinics. Further educational programs for back pain management are recommended.Keywords: cauda equina syndrome, low back pain, spinal fractures, red flags, spinal infection, spinal tumor

Mohammed Badedi,1 Hussain Darraj,1 Awaji Qasem Alnami,1 Ali Makrami,1 Mohamed Salih Mahfouz,2 Khalid Alhazmi,2 Nahid Mahmoud,1 Halimh Mosa1 1General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia; 2Jazan University, Jazan, Jazan Region, Saudi ArabiaCorrespondence: Mohammed Badedi Email dr.badedi@gmail.comObjective: Fatalities due to coronavirus disease 2019 (COVID-19) continue to increase, and information on the epidemiological and clinical characteristics of deceased patients who were hospitalized with COVID-19 is limited in the Arab region. The current study aimed to address this gap.Methods: Three hundred and four Saudi patients in Jazan Region, Saudi Arabia, who died after being hospitalized with COVID-19 between July 1, 2020, and December 31, 2020, were analyzed in this retrospective cohort study.Results: A greater proportion of male patients (59%), compared to female patients (41%), died due to COVID-19. Just over half (55%) of the deaths due to COVID-19 affected patients aged ≥ 65 years. More than two-thirds of the deceased COVID-19 patients had diabetes (70%) and hypertension (69%); other comorbidities were obesity (30%), heart disease (30%), and chronic kidney disease (14%). Dyspnea (91%), cough (80%), and fever (70%) were the most frequently reported clinical symptoms. Eighty-five per cent of COVID-19 deaths occurred in patients admitted to the intensive care unit (ICU), and 90% of the patients required mechanical ventilation. Typically, lymphopenia, and neutrophilia were observed on admission and 24 hours prior to death. Creatinine and serum ferritin levels and erythrocyte sedimentation rate and D-dimer plasma levels increased significantly following infection with COVID-19. Lung infiltrates and pulmonary opacity (83%) were the most common findings on chest X-ray. Respiratory failure (70%) and acute respiratory distress syndrome (52%) were the leading complications to death. Logistic and Cox regression revealed that a higher age, smoking, high creatinine and aspartate transaminase levels, and respiratory failure were significantly associated with the risk of mortality during the early stay in hospitals.Conclusion: The proportion of comorbidities was high in deceased patients who were hospitalized with COVID-19 in Jazan region, Saudi Arabia. A higher age, smoking, and respiratory failure were significant predictors of mortality during the early stay in hospitals.Keywords: COVID-19, SARS-CoV-2, deaths, mortality

Mohamed Salih Mahfouz,1 Suhaila Abdalkarim Ali,1 Alanoud Yahya Bahari,2,* Reham Eissa Ajeebi,2,* Hadeel Jaber Sabei,2,* Sara Yahya Somaily,2,* Yusra Ahmed Madkhali,2,* Reem Hady Hrooby,2,* Roa’a Nasser Shook2,* 1Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia; 2Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia*These authors contributed equally to this workCorrespondence: Mohamed Salih Mahfouz Email mm.mahfouz@gmail.comBackground: Many studies have documented a strong association between poor sleep quality and physical inactivity. This study evaluates the association between poor sleep quality and physical inactivity among Jazan University students in Saudi Arabia.Methods: An observational cross-sectional study was conducted among undergraduate students at Jazan University. Cluster random sampling was used to select 440 students. The Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), and Depression Anxiety Stress Scales (DASS) were utilized for data collection.Results: According to the PSQI results, the majority of respondents (63.9%; n = 281) reported having poor sleep quality. The majority of students (62.7%; n = 276) were also physically inactive. Based on DASS-21 criteria, the majority of students (53.4%) were stressed. Sleep quality differed significantly according to participants’ physical activity status (p = 0.0090). Among physically active participants, 43.9% reported having good sleep quality. Sleep duration, daytime dysfunctions, and global PSQI differed significantly according to levels of physical activity (p < 0.05 for all). Univariate analysis revealed that being physically active was significantly associated with good sleep quality (OR = 1.70, 95% CI 1.14– 2.54, p < 0.001). Multivariate logistic regression models also demonstrated a significant association between physical activity and good sleep quality (OR = 1.72, 95% CI 1.15– 2.56, p = 0.008).Conclusion: The majority of Jazan University students had poor sleep quality and were physically inactive. Evidence-based prevention and therapeutic strategies are needed to promote physical activity among university students.Keywords: sleep quality, PSQI, physical inactivity, Jazan

Badreldin Abdelrhman Mohamed,1 Mohamed Salih Mahfouz,2 Mohamed Farouk Badr1 1Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; 2Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi ArabiaCorrespondence: Mohamed Salih MahfouzDepartment of Family and Community Medicine, Faculty of Medicine, PO Box 2531, Jazan, Saudi ArabiaEmail mm.mahfouz@gmail.comBackground: University students might experience numerous sources of stress in their daily lives. Previous research has found that stress affects food selection patterns, but the effect might vary by country and sex. No previous study conducted in Saudi Arabia has assessed the association between stress and dietary habits among university students. Thus, this study aimed to examine the association between perceived stress and food selection patterns among undergraduate students by sex at King Saud University (KSU).Methods: A cross-sectional study of 400 students attending the College of Applied Medical Sciences in Riyadh, Saudi Arabia, was conducted. The self-administered questionnaire that was used consisted of three sections: sociodemographic, food frequency questionnaire, and Cohen’s Perceived Stress Scale.Results: Approximately (59.0%) of the participants reported suffering from some level of stress, with more females (64.5%) experiencing stress than males (54.0%). The univariate analysis showed that under stress, more females (68.0%) reported eating more than usual than males (49.0%), while the percentage of respondents that reported eating less than usual was higher for females (23.0%) than that for males (31.0%). The McNemar test indicated that under stress, there was an increased preference for salty flavors, which was not associated with sex. Significantly more females (82.0%) than males (64.5%) reported preferring sweets under stress. More males reported preferring bitter and savory flavors than females. Under stress, females preferred homemade food, while males preferred takeout foods. More females (68.0%) reported losing control and overeating than males (49.0%). A logistic regression showed that for female students, perceived stress was associated with frequent consumption of sweets, cake/cookies, snacks and beverages and less frequent consumption of fruits and vegetables. For males, the consumption of fast food and meat was significantly positively associated with perceived stress.Conclusion: Perceived stress led to unhealthy changes in eating patterns in both sexes, as evidenced by reports of an increased preference for sweets, snacks and cake/cookies among females and an increased preference for fast food and meat among males. These results may be potentially important targets for interventions for stress-related food consumption.Keywords: stress, food intake, undergraduate students, sex, Riyadh

Tariq Al Bahhawi,1 Osama B Albasheer,1 Anwar M Makeen,1 Abdulelah Mohammed Arishi,2 Othman Mohammed Hakami,2 Sultan Mohsen Maashi,2 Hamood Khairat Al-Khairat,2 Omar Madiny Alganmy,2 Yasir Adnan Sahal,2 Abdulaziz Aaref Sharif,2 Mohamed Salih Mahfouz1 1Department of Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia; 2Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia Background: Depression, anxiety, and stress levels are considered important indicators for mental health. Khat chewing habit is prevalent among all segments of Jazan population in Saudi Arabia. Few studies have been conducted to evaluate depression, anxiety, and stress among Jazan University students, and information about the correlation between khat use and these disorders is scarce. Thus, this study aims to evaluate the prevalence of depression, anxiety, and stress and their correlation with khat chewing and other risk factors among Jazan University students. Methods: A cross-sectional study was conducted on 642 students from Jazan University. Multistage sampling was used, with probability proportional to size-sampling technique. The Depression, Anxiety, and Stress Scale 21 questionnaire was used to collect the data, which were analyzed using SPSS Version 20.0 software. Results: Moderate depression was prevalent among 53.6% of the sample, anxiety was found among 65.7%, while 34.3% of the students suffered from stress. Female gender was strongly associated with higher mean scores for symptoms of depression, anxiety, and stress, with P-values

Abdulaziz Darraj,1 Mohamed Salih Mahfouz,2 Abdullah Alsabaani,3 Mubarack Sani,2 Anwar Alameer1 1Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Jazan University, Jazan, Saudi Arabia; 3Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia Background: Poor sleep quality is common among patients with diabetes. It is associated with negative physical, psychological, and functional consequences. However, the implicated risk factors of poor sleep quality remain uncertain.Objectives: This study aimed to determine the prevalence of poor sleep quality among patients with diabetes and to investigate the factors associated with the poor sleep quality.Patients and methods: An analytical cross-sectional study of 307 diabetic patients in Jazan, Saudi Arabia was conducted in 2018. A multistage cluster random sampling was used to select the study participants. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data on patient’s characteristics were gathered via patients’ interviews, and medical data were collected based on the patients’ files. Logistic regression analysis was used to identify the predictors of poor sleep quality.Results: The mean score of PSQI was 5.29±2.73. The prevalence of poor sleep quality was 55.4% (95% CI 49.7–60.8). Sociodemographic and clinical factors were significantly associated with poor sleep quality, such as being elderly, female, illiterate, smoker, complications of diabetes, comorbidity, or psychological symptoms. However, female gender was the strongest predictor of reporting poor quality of sleep, OR= 3.69, 95% CI 1.65–8.28 (P

Ali I Swaid,1 Abdelkhalig H Elhilu,2 Mohamed S Mahfouz3 1Department of ENT, Faculty of Medicine, Jazan University, 2Department of Surgery, Faculty of Medicine, Jazan University, 3Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia Background: Internship training offers an important opportunity for personal development and career planning. However, there are many factors affecting the efficiency of training, and the views of interns are rarely considered. The main objective of this study was to explore the views of interns enrolled in Jazan University internship program during the year 2015. Subjects and methods: A web-based cross-sectional study was conducted in the Jazan region, Kingdom of Saudi Arabia, during the academic year 2015. To achieve the study goals, an online questionnaire was distributed to all interns (n=85) enrolled in the Jazan University internship program. Results: Results revealed that satisfaction with training was more evident in general surgery and pediatrics (76.1%, n=54 and 77.5%, n=55, respectively). Satisfaction was lowest for obstetrics and gynecology programs (45.1%, n=32), while in internal medicine it was 54.9% (n=39). Training in general surgery and pediatrics was rated as excellent by most of the interns (45.8% and 43.1%, respectively). The picture is reversed in obstetrics and gynecology, as 43.1% rated it as average. More than half of the study sample felt that they were well prepared to start the next step in their career at the end of internship (50.7%), while 25.4% felt that they were moderately prepared. Conclusion: It is clear that training quality in views of interns is variable across the major specialties, and there are some problems in obstetrics and gynecology training. More studies are needed to explore in-depth dimensions of internship training program in the Kingdom of Saudi Arabia. Keywords: Jazan University, internship program, gynecology and pediatrics

Iodine Deficiency Disorders (IDD) Control Programme in Sudan adopted salt iodization as the long-term strategy in 1994. In 2000, it was found that less than 1% of households were using adequately-iodized salt. The objectives of this study were to: (i) study the coverage and variation of different geographical regions of Sudan regarding access to and use of iodized salt, (ii) explore the possible factors which influence the use of iodized salt, (iii) develop recommendations to help in the implementation of the Universal Salt Iodization (USI) strategy in Sudan. This paper is based on the Sudan Household Health Survey (SHHS) dataset. A total sample of 24,507 households was surveyed, and 18,786 cooking salt samples were tested for iodine levels with rapid salt-testing kits. Nationally, the percentage of households using adequately-iodized salt increased from less than 1% in 2000 to 14.4%, with wide variations between states. Access to iodized salt ranged from 96.9% in Central Equatoria to 0.4% in Gezira state. Population coverage with iodized salt in Sudan remains very low. The awareness and political support for USI programme is very weak. National legislation banning the sale of non-iodized salt does not exist. Utilization of the already-existing laws, like the National Standardization and Metrology Law (2008), to develop a compulsory national salt specification, will accelerate the USI in Sudan. [ABSTRACT FROM AUTHOR]

Background: Children's eye disorders are a major cause of irreversible vision loss. Delays in diagnosing eye problems in children are recurring problems that require quick attention. This study assesses parents' knowledge, attitudes, and practices regarding the early ophthalmological screening of preschool-aged children in Jazan, KSA., Methods: An observational cross-sectional study was conducted among 522 parents of preschool-aged children in the Jazan region. A self-administered web-based questionnaire was randomly distributed to the parents via WhatsApp. The survey tool consisted of four main sections: socio-demographic data, knowledge about eye care, attitudes toward eye screening, and eye care practices., Results: Parents' level of knowledge regarding children's eye care was distributed as follows: low (21.5%), medium (40.2%), and high (38.4%). Parent gender, age, occupation, level of income, and nationality showed no statistically significant association with the knowledge level ( p > 0.05 for all). However, parent education played a significant role ( p = 0.013). Further, parents expressed a positive attitude toward the early screening of eye problems, as more than 90% agreed that early eye examinations for children reduce complications from visual problems and that the increased use of electronic devices requires early eye examinations. Almost 47.0% of the parents had examined their children's eyes when they were between 1 and 5 years of age, compared with only 10.3% of parents of children less than 1 year of age. The multiple linear regression model for factors that predict knowledge level among the study participants showed that having a child undergo early screening is positively associated with an increased knowledge score ( p < 0.05)., Conclusions: Jazan parents showed a positive attitude toward the early screening of eye problems, and one-third had a high level of knowledge regarding children's eye care. However, the proportion of those who practiced early eye screening was low. More health education is necessary to increase parents' awareness regarding early eye care practices.

Background: Prostate cancer (PCa) is the second most prevalent malignancy among males and ranks as the fifth primary cause of mortality worldwide, underscoring its substantial impact on public health. Notably, there is a lack of research focused on PCa within the context of Saudi Arabia. Consequently, this study endeavours to elucidate the knowledge, attitudes, and screening practices related to PCa among males in Jazan, Saudi Arabia. Methodology: A cross-sectional survey was carried out on males over 40 years old in the Jazan region of Saudi Arabia between December 2022 and March 2023. The survey used a web-based questionnaire containing questions about sociodemographic characteristics, PCa knowledge, and attitudes toward screening practices. Descriptive and inferential statistical analysis evaluated the participants' knowledge and attitudes toward PCa screening. Results: Out of the 468 male participants aged over 40 years, approximately 44% demonstrated limited awareness about PCa. Intriguingly, 60.3% of participants showed a positive attitude toward PCa screening. Moreover, 35.7% reported consulting a urologist for screening purposes. Furthermore, 25.6% had undergone a prostate-specific antigen (PSA) test, with the predominant rationale (25.8%) being medical advice. Multivariate analysis revealed that being married (adjusted odds ratio (AOR) = 4.5, p = 0.011) and having a family history of PCa (AOR = 4.6, p = 0.001) were significant predictors of heightened PCa awareness. Concurrently, a history of PCa (AOR = 6.8, p = 0.001) and holding a postgraduate qualification (AOR = 5.5, p = 0.024) emerged as significant determinants of proactive practices toward PCa. Conclusion: The results revealed a significant lack of knowledge regarding PCa and the screening practices associated with it among the study participants. These results emphasize the urgent need to provide men with comprehensive information about the benefits and limitations of PCa screening in order to enable them to make more informed decisions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Anas Elyas et al.)

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

Background and Objectives : Endoscopic biliary plastic stenting is a safe and effective temporary therapeutic modality used in various benign biliary disorders. Long-term indwelling stents for more than one year without retrieval are termed "forgotten biliary stents". In clinical practice, the forgotten stents are underestimated and the majority of data were obtained from case reports. The aim of this study was to determine the forgotten-biliary-plastic-stent-related complications, their management, and the patients' clinical outcomes. Materials and Methods : This retrospective study was performed at three hospitals during the period from January 2021 to December 2023. In total, 577 patients with biliary plastic stents-inserted for a variety of benign biliary conditions-were included. They were divided into two groups, as follows: group 1 included 527 patients who had biliary stents removed within 3 months, and group 2 included 50 patients with biliary stents retrieved after one year of their deployment. The stent-related complications (e.g., acute cholangitis, stent clogging, distal stent migration, new common bile duct (CBD) stone formation, and proximal stent migration) and the endoscopic management success rate were evaluated. Results : Irretrievable CBD stones were the main indication for biliary plastic stenting in both groups. The stent-related complications, number of endoscopic sessions, and hospital admissions were significantly higher in the patients with forgotten biliary stents than those with stent removal within 3 months. All the study patients were successfully managed endoscopically with uneventful outcomes. Conclusions : Based on this retrospective study, non-adherence to the endoscopists' instructions is the main reason for retained biliary stents for more than one year. The patients with forgotten stents had significantly higher complication rates, a higher number of endoscopic sessions, and a higher number of hospital admissions than those with stents that were retrieved in the scheduled time. All patients were managed endoscopically with a technical success rate of 100%, and with no complication-related mortality.

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

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

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

Introduction: Previous studies have identified several risk factors for acute coronary syndrome (ACS). This study was intended to examine the potential risk of ACS associated with khat and tobacco use., Methods: A case-control study of 344 people (172 cases and 172 controls) was conducted at Prince Mohammed Bin Nasser Hospital in Jazan, Saudi Arabia, from April to September 2019. The cases and controls were matched for age (±5 years) and gender. Data were analyzed using descriptive, inferential, and modeling analyses. We utilized the adjusted odds ratio (AOR) to express the results., Results: The prevalence of ever khat chewing among all study participants was 29.1%, significantly higher for the cases with ACS than for the control group (43.6% vs 14.5%, p<0.001). Cigarette smokers accounted for 33.4% of the study participants, and 22.1% were ACS cases, which is a significantly higher percentage than the control group. The prevalence of smokeless tobacco was 20.3% among ACS cases and 14.5% among controls, with no statistically significant differences (p>0.05). In the final model, tobacco use was more likely to be reported among cases with myocardial infarction (MI) (AOR=4.58; 95% CI: 1.01-4.73, p<0.05) as was khat chewing (AOR=3.4; 95% CI: 1.55-7.46, p<0.05), after controlling for other traditional risk factors., Conclusions: Khat chewing was reported more by those who reported ACS. ACS cases were more likely to be frequent khat users with chewing sessions of five or more days per week. Regular tobacco use was also reported in those who reported ACS, and this increases with the amount of tobacco used. Implementing early intervention strategies can help mitigate the impact of khat chewing and smoking on the development of ACS., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2024 Alsanosy R. et al.)

Background and Objectives : Functional gastric stenosis, a consequence of sleeve gastrectomy, is defined as a rotation of the gastric tube along its longitudinal axis. It is brought on by gastric twisting without the anatomical constriction of the gastric lumen. During endoscopic examination, the staple line is deviated with a clockwise rotation, and the stenosis requires additional endoscopic manipulations for its transposition. Upper gastrointestinal series show the gastric twist with an upstream dilatation of the gastric tube in some patients. Data on its management have remained scarce. The objective was to assess the efficacy and safety of endoscopic balloon dilatation in the management of functional post-sleeve gastrectomy stenosis. Patients and Methods : Twenty-two patients with functional post-primary-sleeve-gastrectomy stenosis who had an endoscopic balloon dilatation between 2017 and 2023 were included in this retrospective study. Patients with alternative treatment plans and those undergoing endoscopic dilatation for other forms of gastric stenosis were excluded. The clinical outcomes were used to evaluate the efficacy and safety of balloon dilatation in the management of functional gastric stenosis. Results : A total of 45 dilatations were performed with a 30 mm balloon in 22 patients (100%), a 35 mm balloon in 18 patients (81.82%), and a 40 mm balloon in 5 patients (22.73%). The patients' clinical responses after the first balloon dilatation were a complete clinical response (4 patients, 18.18%), a partial clinical response (12 patients, 54.55%), and a non-response (6 patients, 27.27%). Nineteen patients (86.36%) had achieved clinical success at six months. Three patients (13.64%) who remained symptomatic even after achieving the maximal balloon dilation of 40 mm were considered failure of endoscopic dilatation, and they were referred for surgical intervention. No significant adverse events were found during or following the balloon dilatation. Conclusions : Endoscopic balloon dilatation is an effective and safe minimally invasive procedure in the management of functional post-sleeve-gastrectomy stenosis.

Background: The concept of recovery in mental health has been extensively documented in the Western context. Yet, little is known about this concept in the Arab context, particularly in Jordan., Aim: The aim of this study was to explore the conceptuality of recovery in mental health from the perspectives of both Jordanian service users and their families., Methods: A qualitative descriptive design was used, and semi structured interviews were conducted with 16 service users and 16 family members, selected from three different mental health sectors in Jordan: Government, Military and University Sectors. The data were transcribed verbatim, translated into English, and then analyzed using an inductive thematic analysis approach., Results: Three main themes were identified as a result of the qualitative data analysis: (1) the definition of recovery implies functional recovery, (2) the definition of recovery implies symptomatic recovery, and (3) the definition of recovery from a religious perspective., Conclusions: The findings of the present study shed light on how recovery in mental health is perceived by service users and their families in the Jordanian context, and they generate insight into what to consider when targeting the development and implementation of recovery-supporting care within the mental health services (MHSs) in Jordan.

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

Background: Identification of Autism Spectrum Disorder (ASD) especially at early stages is highly important to improve the quality of life and help to decrease the disease burden. This study was performed to assess the school teachers' level of knowledge and perception regarding Autism., Materials and Methods: An observational cross-sectional study was carried out in the Jazan region among a random sample of school teachers (males and females) who are working at the governmental primary Schools, throughout the scholastic year 2019-2020. A structured validated self-administered questionnaire was used for data collection. It includes three sections: sociodemographic information of the participants, the Autism Knowledge Questionnaire (AKQ), and statements exploring the teachers' attitudes toward children with autism., Results: The study included 403 primary school teachers. The age of 47.1% of them ranged between 35 and 44 years. Slightly more than half (50.9%) were males. Overall, the total autism knowledge score ranged between 2 and 26, out of a possible 30 with a median (interquartile range "IQR") of 15 (12-18). Teachers who ever encountered a child with autism had higher significant knowledge scores about autism compared to their counterparts (mean ranks were 263.95 and 179.32, respectively), P < 0.001. Female compared to male teachers more significantly agreed that teachers not trained in special education should not be expected to deal with a child with autism, P = 0.018. Teachers aged between 35 and 44 years are more willing to have an autistic child in their class in compare to those ages ≥55 years that they would not want children with autism in their class, P = 0.036 and more interested in attending training in the area of childhood developmental and behavioral disorders, P = 0.010. Postgraduate teachers were more agreed than Bachelor holders that teachers not trained in special education should not be expected to deal with a child with autism, P = 0.001. Diploma-holder teachers were more agreed than postgraduates that children with autism are too impaired to benefit from activities of a general school, P = 0.019 and students with Autism should be given every opportunity to function in the regular education classroom whenever possible, P = 0.028., Conclusion: The knowledge about autism among primary school teachers is average in general, however, they expressed mostly positive attitudes towards autistic children., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

Background and Objectives : Neonates can show subtle signs of illness that could be overlooked by their mothers and caregivers. Therefore, basic knowledge regarding neonatal health and early detection of neonatal diseases can help improve survival. We assessed nursing students' knowledge and attitudes toward the danger signs of neonatal illnesses. Materials and Methods : We performed a descriptive cross-sectional study using a structured online questionnaire based on danger signs categorized by the World Health Organization to assess knowledge of neonatal illness danger signs among nursing students. Results : We assessed 342 students, of which 67.0% (95% CI: 61.8-71.7) had good knowledge regarding neonatal illness danger signs, and 71.6% received information about neonatal care. About 33% of the participants had a basic knowledge of neonatal care, such as breastfeeding, immunization, routine postnatal care, and eye care. Students who received information on neonatal care were three times (AOR = 2.95, 95% CI: 11.59-5.47, p = 0.001) more likely to have good knowledge than those who did not. The students also showed a positive attitude towards the importance of knowledge regarding neonatal illness danger signs, teaching this subject in their college, participating in studies involving the practice and knowledge of mothers regarding neonatal illness danger signs, and the importance of knowledge in reducing neonatal mortality in the region. Conclusions : More training programs on neonatal care should be implemented to enhance knowledge and raise nursing students' awareness of the dangerous signs of neonatal illnesses.

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

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

Objectives: The main objective of this research was to investigate the Work-life balance (WLB), mental health, and quality of life and their associated factors among Healthcare Professionals (HCPs) in Sudan during the peak of the COVID-19 pandemic during 2021. Methods: An observational cross-sectional web-based survey was conducted during August-December 2021 among a sample of 430 HCPs working in the hospitals of four Sudanese states. The study used the WHOQoLBREF scale, Work-Life Balance Scale, and General Anxiety Disorder (GAD-7). Results: HCPs reporting a poor quality of life made up 33.5% (95% CI 29.1-38.0), while those reporting worse WLB made up 52.6% (95% CI 47.8-57.2). HCPs reporting moderate to severe anxiety symptoms accounted for 35.8% (95% CI 31.4-40.5). The Multiple Regression model indicated that an increase in the anxiety scores is associated with a decrease in Health-related Quality of Life (HRQoL) ( β = 0.831, p < 0.05). Female HCPs exhibited 4.53-fold lower HRQoL scores than their male colleagues ( p < 0.05). Conclusion: Approximately one-third of the HCPs in Sudan reported low HRQoL and suffered from moderate to severe anxiety, while a large portion of them had an unequal work-life balance during COVID-19. Health policies addressing these factors are needed to improve the quality of health of HCPs., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Mahfouz, Osman, Mohamed, Saeed, Ismaeil, Elkhider and Orsud.)

Background and Objective: Concerns about the incidence of eating disorders (EDs) among university students are spreading throughout the world. In Saudi Arabia, little is known about the prevalence and associated factors of EDs among female university students. Thus, this study investigated the prevalence, common types, and potential associated factors of EDs among female students of Jazan University.  Methods: A cross-sectional survey was conducted between August 31, 2020, and November 2, 2020. The snowball technique was used to recruit female students via an electronic survey distributed in Arabic. The survey collected information about demographic characteristics, and SCOFF (Sick, Control, One, Fat, Food) and Eating Attitudes Test (EAT-26 ) scales. Cronbach's alpha for the SCOFF and EAT-26 scales was calculated to be 0.78 and 0.58, respectively, in this study., Results: A total of 566 female students participated in the survey, with a mean age of 22.12 ± 2.93 years. The results showed that 47.9% of participants were at risk for EDs based on SCOFF scores, while 26.5% were at risk based on EAT-26 scores. The most common types of EDs were bulimia nervosa and binge eating disorder. Furthermore, the study identified several sociodemographic characteristics, including year of study (p = 0.042), college type (p = 0.004), body weight (p = 0.001), and BMI (p = 0.001), that are significantly associated with EDs. However, no significant relationships were observed between marital status (p = 0.103), age (p = 0.147), and height (p = 0.509) with SCOFF scores. Some students reported frequent binge eating, purging, or laxative/diet pill misuse., Conclusions: The study revealed a moderate to high prevalence of risk for EDs among female university students in Jazan, Saudi Arabia, associated with higher study years, college majors, and body weight and BMI. Dangerous ED behaviors reported by some students signal an urgent need for resources to identify and support those suffering from these disorders. Targeted interventions and services may help address this critical issue on campuses and support vulnerable students in need. Continued research and public health action are needed to curb the spread of these disorders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ali et al.)

Background The use of artificial intelligence (AI) in healthcare continues to spark interest and has been the subject of extensive discussion in recent years as well as its potential effects on future medical specialties, including radiology. In this study, we aimed to study the impact of AI on the preference of medical students at Jazan University in choosing radiology as a future specialty. Methodology An observational cross-sectional study was conducted using a pre-tested self-administered online questionnaire among medical students at Jazan University. Data were cleaned, coded, entered, and analyzed using SPSS (SPSS Inc., USA) version 25. Statistical significance was defined as a P-value of less than 0.05. We examined the respondents' preference for radiology rankings with the presence and absence of AI. Radiology's ranking as a preferred specialty with or without AI integration was statistically analyzed for associations with baseline characteristics, personal opinions, and previous exposures among those who had radiology as one of their top three options. Results Approximately 27.4% of males and 28.3% of females ranked radiology among their top three preferred choices. Almost 65.2% were exposed to radiology topics through pre-clinical lectures. The main sources of information about AI for the studied group were medical students (41%) and the Internet (27.5%). The preference of students for radiology was significantly affected when it is assessed by AI (P < 0.05). Around (16.1%) of those who chose radiology as one of their top three choices strongly agree that AI will decrease the job opportunities for radiologists. Logistic regression analysis showed that being a female is significantly associated with an increased chance to replace radiology with other specialty when it is integrated with AI (Crude odds ratio (COR) = 1.91). Conclusion Our results demonstrated that the students' choices were significantly affected by the presence of AI. Thereover, to raise medical students' knowledge and awareness of the potential positive effects of AI, it is necessary to organize an educational campaign, webinars, and conferences., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Hakami et al.)

The purpose of this study was to undertake a randomized control trial examining the effects of a 12-week home-based physical activity program on Saudi Arabian adults with type 2 diabetes. Sixty-four patients with type 2 diabetes mellitus were recruited from the Jazan Diabetes and Endocrinology Center, located in the Jazan region of southwestern Saudi Arabia. Patients were randomly assigned to either control, i.e., usual care (males = 46.9% and females = 53.1%, age  =  45.88 ± 8.51 years, mass  =  76.30 ± 15.16 kg, stature  =  160.59 ± 8.94 cm, body mass index (BMI)  =  29.73 ± 6.24 kg/m 2 , years since diagnosis  =  8.12 ± 6.22 years) or a home-based physical activity (males = 50% and females = 50%, age  =  42.07 ± 9.72 years, mass  =  74.58 ± 13.67 kg, stature  =  158.94 ± 9.38 cm, BMI  =  29.44 ± 4.38 kg/m 2 , years since diagnosis  =  12.17 ± 8.38 years) trial arms. The home-based physical activity group was required to undertake aerobic training by increasing their habitual step count by 2000 steps per day and performing resistance training 3 times per week for 12 weeks. The primary outcome was hemoglobin A1c (HbA1c), and secondary measures of anthropometrics, blood biomarkers, physical fitness, and patient-reported quality of life outcomes pertinent to type 2 diabetes were measured at timepoints, i.e., baseline, 12 weeks, and 24 weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (control: baseline = 8.71%, 12-weeks = 8.35%, and follow-up = 8.72%; home-based physical activity: baseline = 8.32%, 12-weeks = 8.06%, and follow-up = 8.39%) between trial arms. However, improvements in psychological wellbeing at follow-up measured using the Patient Health Questionnaire-9 were significantly greater in the home-based physical activity group (baseline = 6.84, 12-weeks = 5.96, and follow-up = 5.00) compared to the control (baseline = 6.81, 12-weeks = 5.73, and follow-up = 8.53). No other statistically significant observations were observed. Home-based physical activity is not effective in mediating improvements in HbA1c levels or secondary hematological, blood pressure, anthropometric, or fitness indices. However, given the link between psychological wellbeing and the etiology/progression of disease activity in type 2 diabetes, home-based physical activity may be effective for tertiary disease management. Future trials should examine the efficacy of relative exercise intensities greater than those in the current study.

Background: Hypertension (HTN) is a major global public health problem. Knowledge of the risk factors and repercussions of HTN is crucial to preventing the disease. Rural populations have lower levels of knowledge of the disease than urban populations. However, no studies have assessed the levels of awareness of HTN and their determinants in rural regions of Saudi Arabia., Objectives: This study aimed to assess the awareness of HTN and its determinants among a rural population of Jazan region, Saudi Arabia., Methodology: We conducted a cross-sectional analytical study among six primary healthcare centers selected randomly from the rural areas of Jazan region. We targeted all Saudi adults visiting these centers. Information was gathered using interview questionnaires completed by 607 people. SPSS was utilized to analyze the collected data., Results: In all population groups, the prevalence of diagnosed HTN increased with age, particularly gradually increasing in those aged younger than 40 years and then rapidly and sharply increasing in those aged 40 years and over. The women (43.3%) had a higher prevalence of HTN than the men (34.6%), which is comparable with findings in other areas in Saudi Arabia and the Middle East. Approximately 65.6% of the participants without HTN and 34.4% of the participants with HTN did not know their normal blood pressure. Approximately 61.7% of the participants without HTN and 59.0% of the participants with HTN felt that pharmaceuticals are insufficient in curing HTN, while 60.7% and 64.7% believed that HTN can be cured., Conclusions: The global prevalence of HTN is increasing annually owing to rapid changes in lifestyle and dietary habits. Furthermore, because adherence to antihypertensives is poor in rural Jazan, the Ministry of Health and researchers advocate implementing a program to increase awareness and assess patient adherence to prescribed medication for the control of HTN.

Introduction: infant feeding practices are important determinants of growth and development not only in infancy but also in later life. The main objective of this study is to describe infant feeding practices and the factors affecting complementary feeding (CF) among mothers in Jazan City., Methods: an observational cross-sectional study was conducted among 400 mothers having children less than 24 months old, attending the well-baby clinics in Primary Health Care Centers (PHCCs) in Jazan City, Saudi Arabia. A structured questionnaire was used to collect data in a face-to-face interview., Results: on the mother's level of knowledge regarding proper infant feeding, 49% scored high, 41% scored medium, and 9.75% scored low. The mother's educational level, working status, family income, and knowledge source played a significant role in the knowledge scores (p < 0.05 for all). Overall, 15.8% of the mothers never breastfed (BF) their children, 39.8% BF less than six months, 17.5% BF 6-12 months, and 27% BF over 12 months. Breastfeeding feeding (BF) duration is significantly associated with maternal literacy and family income (p = 0.006 for both). Overall, approximately one-third of the women (36.2%) started CF at six months or later, while 63.8% started CF at 4-6 months., Conclusion: Jazan women use some positive infant feeding practices, including breastfeeding. One-third of the women started CF at six months or later, which is considered the optimal time for the CF introduction. More nutrition education is necessary to raise maternal awareness regarding appropriate infant feeding and weaning practices., Competing Interests: The authors declare no competing interests., (Copyright: Aisha Awaf et al.)

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

Postpartum depression (PPD) is a serious public health problem in many Middle Eastern countries. Mothers with PPD experience various extreme symptoms that affect their daily lives. This study aims to discover how common PPD is in the Jazan region, the most significant risk factors, and how likely depressed women are to seek help. An observational cross-sectional survey targeting a sample of 444 mothers in their first year after delivery using a pre-tested and validated EDPS standard tool to evaluate the prevalence of postpartum depression amongst them has been conducted. The data was collected and then analyzed using SPSS. Descriptive statistics and inferential statistics were used for data analysis. Multivariate logistic regression was used to assess the risk factors associated with PPD. The results indicate an extremely high prevalence of PPD in Jazan (75.7%). The prevalence of mothers having suicidal ideation was 6.3% quite often, 5.0% sometimes, and 7.9% hardly. Regarding the duration of depression symptoms, 34.78% were less than a month, 20.72% were less than six months, and 13.06% were less than one year. The study shows that the development of depression symptoms occurred within less than a week for 30.4% of the women. The most significant association with PPD was a lack of family support, which significantly increased the risk of PPD (OR = 5.9; p -value < 0.001). The mothers who had unexpected pregnancies had a risk of PPD (OR = 2.5; p -value < 0.001). Current research has revealed a high prevalence of postpartum depression among mothers in the Jazan region and that it is associated with different risk factors that increase the probability of PPD development. Pregnant women need to raise their awareness about PPD and learn how to avoid or deal with it.

Background Patient satisfaction has become an influential corner in the health services process. Web-based appointment scheduling has been expanded for its benefits and has become a popular research topic. This study's objectives were to assess patients' satisfaction and perception with the new Web-Based Medical Appointment System "Mawid" program and determine the associated factors at the Primary Health Care Centers level in Jazan Southwest Saudi Arabia. Methods An observational cross-sectional survey was implemented among 424 adults aged 18 years and above, attending a randomly selected 12 primary health care centers in the Jizan region, Southwest Saudi Arabia. The study instrument included socio-demographic background information, perception, and level of satisfaction with the new appointment system. Responses were analyzed using the SPSS program by applying descriptive and inferential statistical techniques. Results The overall level of satisfaction was very high at 94.3% with 95% C.I. (91.7-96.1). A large proportion of study participants were highly satisfied with the new Web-Based Medical appointment System "Mawid" as nine satisfaction items scored a level of satisfaction of 90% and above. Regarding the perception, 89.1% of the participants agreed that the appointment booking system regulates the number of patients, while 87.7% of participants considered that the appointment system reduces clinic crowding. More than half of respondents (61.8%) agreed that the community culture might limit the scheduling system's use. Univariate and multivariate logistic regression analysis suggested that male patients were more likely to have a higher level of satisfaction as compared with female (COR= 2.95, 95% C.I.:1.15-7.60,  p = 0.025) and (AOR= 3.12, 95% C.I:1.14-8.52, p = 0.026), respectively. Conclusions In conclusion, this study revealed a high level of satisfaction among study the participants with the new Web-Based Medical Appointment System "Mawid." The system effectively improved patients' satisfaction with registration and reduced waiting times. Patients' satisfaction can be assessed regularly and used systematically as a quality and benchmarking instrument in primary health care., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mahfouz et al.)

The contraceptive use profile is poorly understood in some Gulf Arabian countries, including Saudi Arabia. The present study aimed to assess the knowledge, attitude, and practices related to contraceptive use among women of childbearing age in Jazan city, Saudi Arabia. An observational, analytical cross-sectional study was conducted among a random sample of 450 women in Jazan city. The data were obtained through personal interviews using a questionnaire that included questions on women's level of knowledge about contraception methods, their attitudes towards contraception methods, and their practices. Data were analyzed using descriptive and inferential statistics techniques using the SPSS program. The prevalence of ever having used contraceptives was significantly different according to age group, job status, children ever born, and the number of pregnancies ( p < 0.05 for all). On the other hand, the prevalence of desire to use the contraceptives in the future was high, at 70.9%, with a 95% CI [66.5-74.9]. It differed significantly according to age group and job status ( p < 0.05 for both). The most familiar and usable types of contraceptives were pills (36.3%) and intrauterine devices (24.4%). When asked their reasons for using contraceptives, 53.8% of participants cited child spacing and 21.8% improving child health. Logistic regression revealed that the use of contraception among women was more associated with the 20-34 age group [COR = 7.7, 95% CI = 4.4-13.5, p < 0.001] than the 15-24 age group. Having more than one pregnancy and having more than one child were also associated with increased use of contraceptive methods ( p < 0.001 for both). These results indicate there is a high level of awareness about contraceptives, a positive attitude toward them, and good practices for the use of them among Saudi women in Jazan. More efforts are needed to improve women's awareness for better utilization of the available services.

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

Background: Vitiligo is a common acquired hypopigmentation skin condition defined by an idiopathic, gradual, and restricted loss of melanin pigment from otherwise healthy-looking skin. The present study aims to evaluate the knowledge and perceptions of and attitudes toward vitiligo among the general population of Jazan Province, Saudi Arabia. Methods: An observational cross-sectional survey targeting adults of the Jazan region was conducted in 2022. The data were collected using an electronic questionnaire distributed through social media in the region. Statistical analysis was performed using the SPSS computer program. Knowledge and attitude scores were computed. Results: Most of the respondents (83.7%) had an adequate knowledge level of vitiligo, and almost half of the respondents (46.8%) had a positive attitude toward the disease. The majority of the respondents (84.5%) knew that vitiligo is not contagious. However, the majority of the participants (78.6%) did not know that vitiligo is an autoimmune disease. Most of the respondents (93.1%) do not avoid shaking hands with a vitiligo patient to prevent infection, accept food prepared by a vitiligo patient (69.4%), accept sharing a plate with a vitiligo patient (73.6%), and accept to be helped by a vitiligo patient (86.7%). However, about half of the participants (50.4%) refused to marry a person diagnosed with vitiligo. The knowledge of vitiligo in the study population was not correlated with any of the demographic characters, such as age, gender, education, or occupation (p > 0.05). The most important factors associated with good attitudes were male gender (COR = 1.92; 95% CI: 1.92−2.84; p = 0.001) and being aged over 50 years (COR = 3.06; 95% CI: 1.53−6.13; p = 0.002). Conclusions: The population in Jazan had a good level of knowledge of vitiligo and a positive attitude toward patients with vitiligo. Social media is the source of information for vitiligo for the majority of the study population. The good attitude toward patients with vitiligo was more prevalent in males and older people. More efforts are needed to improve the knowledge of and attitudes toward vitiligo.

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

Background and objectives : The prevalence of type 2 diabetes in Saudi Arabia is high and rising steeply. However, the management of type 2 diabetic patients has largely employed a medical approach and ignored the self-care management approach. This observation has even been obscured further by the COVID-19 pandemic, which has affected the psychological health of these patients. This study aimed to understand the effects of psychological health and DSM on type 2 diabetic patients in the Jazan region during COVID-19. Materials and methods : An analytical cross-sectional study was employed in this study. Participants were type 2 diabetic patients from the diabetic center at Jazan, Saudi Arabia. The Arabic-translated version of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to collect data. Data were analyzed using SPSS software. Results : Depression and anxiety were higher in females compared to males and were more reported by participants from urban compared to rural settings. Smoking and Khat chewing were inappropriate diabetic self-care management practices while exercising was appropriate. A negative correlation was observed between depression vs. health care utilization, and depression vs. diabetic self-care management. Anxiety results also showed similar findings to that of depression. Additionally, depression and anxiety were easily predicted by urban residence, and diabetic self-care management was predicted by exercise. Conclusions : Adequate self-care behavior in patients with type 2 diabetes is needed. Medical professionals should ensure improved efforts to accurately ascertain how an individual can implement the recommended lifestyle changes and facilitate self-care education.

The Kingdom of Saudi Arabia is renowned for its high incidence of type-2 diabetes mellitus, with a prevalence rate of around 33%, which is expected to increase to 45.8% by 2030. Engagement in regular physical activity has been shown to significantly attenuate non-communicable diseases including type-2 diabetes. However, the overall rate of physical inactivity among Saudi Arabian adults is currently 80.5%, owing to time pressures, high-density traffic, poor air quality, lack of suitable exercise places/sports facilities, lack of social/friends support, gender, cultural barriers, low self-confidence, lack of time and environmental factors. Previous analyses have shown that home-based activity interventions can be effective. Therefore, given the aforementioned barriers to physical activity in Saudi Arabia; a home-based physical activity may be an ideal solution in type-2 diabetic patients. This manuscript describes the study protocol for a randomized control trial, examining the effects of a home-based physical activity intervention in Saudi Arabian adults with type-2 diabetes. The study will recruit 62 individuals with type-2 diabetes from the Jazan region of the Kingdom of Saudi Arabia, who will be individually randomized to either a physical activity or control group. This 24-week investigation will involve 12-weeks of physical activity in the physical activity group and feature three examination points i.e., baseline, 12-weeks and 24-weeks (follow-up). The primary study outcome is the between-group difference in blood HbA1c levels relative to controls. Secondary outcomes measures will be between-group differences in anthropometric, blood lipid, physical fitness, and patient-reported quality of life outcomes pertinent to type-2 diabetes. Statistical analysis will be conducted on an intention-to-treat basis. The trial has been granted ethical approval by Jazan University, Health Research Ethics Committee (REF: 2177) and formally registered as a trial (NCT04937296). We expect dissemination of the study findings from this investigation to be through publication in a leading peer-reviewed journal.

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine acceptance among Jazan University students and identify its predictors. In this cross-sectional study, an online questionnaire based on the health belief model (HBM) was sent through social media "WhatsApp" to two strata of students selected by convenient sampling. The overall desire to get vaccinated was noted in 83.6% of participants, and 16.4% reported no desire to be vaccinated. The constructs of the HBM were shown to significantly predict vaccine acceptance with the exception of "perceived susceptibility". In conclusion, the level of acceptance of the COVID-19 vaccine among Jazan University students was relatively high. The HBM constructs are important predictors of the vaccination behavior with the exception of the construct "perceived susceptibility".

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

Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from patients with chronic gastritis and minimal or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H-E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR). The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H-E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The sensitivity of IHC staining (87.50%) was higher than that of H-E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H-E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H-E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive. In contrast to routine H-E and modified Giemsa staining, IHC allows for the accurate H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.

Visceral leishmaniasis (VL) is the most severe clinical form of the disease and has been reported in the Jazan region of southwest Saudi Arabia. This study aimed to diagnose VL by real-time polymerase chain reaction (PCR) and the direct agglutination test (DAT) and to identify the causative Leishmania species. A total of 80 participants, including 30 suspected VL patients, 30 healthy endemic control individuals, and 20 malaria disease controls, were enrolled in this study. Blood samples were collected and tested for Leishmania DNA by real-time PCR and for antibody by the DAT. Sequencing of some amplified PCR products was used to identify the causative Leishmania species. The diagnosis of VL was successfully achieved by both real-time PCR and by DAT with 100% sensitivity. Leishmania donovani and Leishmania infantum species were detected by sequencing both by the kDNA and ITS1 target genes, followed a BLASTn search. The detection of VL antibody by the DAT followed by the confirmatory detection of Leishmania DNA in patient blood by PCR could promote the adoption of the much less invasive and more sensitive methods for the routine diagnosis of VL. Further study with high sample volume to evaluate the PCR and the DAT are needed, to generate more robust evidence. Based on the sequencing results, emerging studies on VL should focus on the causative Leishmania species, reservoirs, and vectors that are important in the study area.

Context: Blood transfusion is an essential medical procedure conducted with various purposes to provide patients with blood needed. The procedure saves patients' lives, as blood cannot be manufactured artificially and can only be obtained from human blood sources., Aims: To assess the awareness of, perceptions of, motivations regarding, and barriers to blood donation among a sample of Jazan University students in the Kingdom of Saudi Arabia (KSA)., Settings and Design: An observational cross-sectional study was conducted among the undergraduate students of Jazan University., Materials and Methods: Stratified random sampling was used to collect information from 440 students, and a predesigned, structured questionnaire was used to collect data on the study variables., Statistical Analysis: Involved descriptive statistics and inferential statistics. SPSS was used for data analysis., Results: The prevalence of blood donation was 29.0% (95% CI, 25.0-33.3), significantly higher for males at 44.3% (95% CI, 38.3-50.4) than for females at 10.5% (95% CI, 7.3-16.0; P < 0.001), and with odds ratio (OR) = 6.8; [95% CI, 4.1-11.2] than females. Students' level of knowledge regarding blood donation was low. The main barriers to blood donation were identified as being unqualified for blood donation (57.5%) and risk of contracting infectious disease (48.7%) and the desire to donate in the future to a close friend (38.6%). The main motivations for donating blood were identified as religious reasons (77.5%), altruism (77.5%), and to serve the homeland and meet the call of need (77.5%)., Conclusions: The prevalence of blood donation was found to be low, and students' knowledge regarding blood donation appeared to be lacking. The development of awareness programs among the university's students will address students' misconceptions about blood donation and encourage them to join donation campaigns., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Avicenna Journal of Medicine.)

Purpose: Refractive errors (REs) are common and continue to increase globally, particularly myopia. Uncorrected REs are the second leading cause of preventable blindness and the most common cause of visual impairment. The main objective of this study is to assess the prevalence of REs and to investigate its associated risk factors among medical students of the Jazan region, Saudi Arabia., Methods: An observational analytical cross-sectional study was conducted among a random sample of 447 medical students at Jazan University. Eye examination was conducted using an autorefractor test (Huvitz HRK-8000A Autorefractor Keratometer) to measure spherical refraction (emmetropia, myopia, and hyperopia) and cylindrical refraction (astigmatism). Factors associated with myopia and hyperopia were evaluated using logistic regression models., Results: The overall prevalence of REs was 48.8% (95% confidence interval [CI] [44.2, 53.4]). The prevalence of REs among female medical students was 55.1% (95% CI [48.6, 61.5]), which was significantly higher than that among males (42.3%, 95% CI [36.0, 48.9]), with a P = 0.007. Of the 447 medical students examined, approximately one-third (33.8%) had myopia, 10.5% had astigmatism, and only 10.5% had hyperopia. The results of logistic regression indicated that females were 52% more myopic than males (odds ratios [OR] = 1.52, 95% CI [1.04, 2.22]), while participants with both parents having a history of REs were twofold more myopic than students with no family history of REs (OR = 2.01, 95% CI [1.2, 3.4]). A history of blurred vision also increases the risk of myopia by seven times (OR = 7.2, 95% CI [6.4, 11.3])., Conclusion: RE among medical students is a problem. Thus, it needs to be assessed carefully before students choose a specialty that may need very good near and far vision for postgraduate study., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Middle East African Journal of Ophthalmology.)

Purpose: The purpose of this study is to assess the prevalence of burnout syndrome and its associated factors among medical students at Jazan University, Jazan, Kingdom of Saudi Arabia., Design/methodology/approach: A cross-sectional survey was conducted among 440 randomly selected medical students at Jazan University. The questionnaire used for this study was based on the Copenhagen Burnout Inventory., Findings: The overall prevalence of burnout was estimated at 60.2% (95% CI 55.6-64.8). The prevalence was higher for females (64.1%) than for males (56.2%) but without statistically significant differences ( p  > 0.05). On average, the students scored the highest averages in the personal burnout category, followed by the study-related and client-related burnout categories. In the multivariate analysis, a lower age (beta = -3.17, p = 0.026), female (beta = -0.896, p = 0.016), and having better burnout knowledge (beta = 0.710, p = 0.025) predict significantly higher personal burnout., Practical Implications: It is necessary to implement strategies to reduce the incidence of burnout among medical students for the sake of a better quality of life for future doctors., Originality/value: There is a high prevalence of burnout among Jazan's medical students., Competing Interests: Author Contributions: All authors contributed equally to this research. Funding: This research received no external funding. The authors would like to thank the study participants for their time. The authors would also like to thank the Faculty of Medicine, Jazan University, for the general assistance while conducting this study. Conflicts of Interest: The authors declare no conflict of interest., (© Mohamed Saih Mahfouz, Suhaila Abdalkarim Ali, Haya Ahmed Alqahtani, Amani Ahmad Kubaisi, Najla Mohammed Ashiri, Eshrag Hassan Daghriri, Shaima Ali Alzahrani, Azhar Ahmed Sowaidi, Afnan Mousa Maashi and Doa’a Albarag Alhazmi.)

Despite the benefits of physical activity (PA) for the management of type 2 diabetes Mellitus (T2DM), the topic of PA is poorly addressed in Saudi Arabia (SA), especially in females with T2DM. The present study examined PA and its associated factors in females with T2DM in Riyadh, Saudi Arabia. This observational cross-sectional study was performed in a random sample of 372 women with T2DM. A face-to-face interview that covered PA, health and environmental correlates of PA was performed. Discriminant analysis was used to determine which barriers had the greatest impact on PA in these women. The results showed that approximately 26.3% of the study participants met PA recommendations. Multivariate linear regression revealed lower levels of PA were associated with women who had more than three children (β = -0.17) compared to women with no children, older age (β = -0.18), women with a duration of diabetes ≥ 6 years (β = -0.16), women who were obese (β = -0.23), women with no family support (β = -0.20), no friend support (β = -0.13) and no healthcare provider support (β = -0.14). Discriminant analysis indicated that culture and tradition, lack of skills and knowledge, safety, fatigue, lack of time, weather conditions, and lack of facilities were the barriers that differentiated between the women who met and those who did not meet the PA recommendations. The present study suggests that the prevalence of PA is low and number of children, age, duration of diabetes, Obesity, family support, friend support and healthcare provider support are identified correlates of PA. These findings are valuable and should be used to design and implement future PA interventions, especially for women with T2DM. Healthcare providers may improve exercise levels and identify the specific barriers to reaching the recommended level of PA to improve health outcomes for each patient., Competing Interests: No authors have competing interests.