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In the fourth quarter of the year 2019, the planet became overwhelmed by the pandemic caused by the coronavirus disease (COVID-19). This virus imperiled human life and have affected a considerable percentage of the world population much before its early stage detection mechanisms were discovered and made available at the grassroots level. As there is no specific drug available to treat this infection, the vaccine was intended to serve as the ultimate weapon in the war against this species of coronavirus, but like other viruses, being an RNA virus, this virus also mutates continuously while it passes from one human to the other, making the development of highly potent vaccines even more challenging. This work is being sketched at the juncture when a huge percentage of the human population is already affected by this virus globally. In this work, we are proposing an idea to develop an app to detect coronavirus (COVID-19) symptoms at an early stage by self-diagnosis at home or at the clinical level. An experimental study has been performed on a dummy dataset with 11000 entries of various breadth patterns based on the spirometry analysis, lung volume analysis, and lung capacity analysis of normal male subjects and detailed breath patterns of infected male patients. A logistic regression model is trained after using SMOTE oversampling to balance the data and the predictive accuracy levels of 80%, 78%, and 90%. The results accomplished through this study and experiments may not only aid the clinicians in their medical practice but may also bestow a blue chip to the masterminds engaged in the biomedical research for inventing more evolved, sophisticated, user-friendly, miniaturized, portable, and economical medical app/devices in the future.

Reem Al Dossary,1 Amani Alnimr,1 Reem Aljindan,1 Khaled R Alkharsah,1 Ahmed K Al-Qurayn,1 Obeid Eltreifi,1 Feras A Alkuwaiti,2 Abdullah B Almashouf,2 Ahmed M Alsahlawi,2 Amal Alshammari,3 Dhoha Hudhaiah,3 Mohammed S Alshahrani,4 Huda Bukhari2 1Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia; 2Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia; 3Department of Medical Laboratory, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia; 4Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi ArabiaCorrespondence: Reem Al Dossary P.O Box: 1982, Dammam, 34221 Tel +966 333 0000 ext 35155Email raaldossary@iau.edu.saPurpose: Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19), with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness.Patients and Methods: This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity.Results: The median age was 45 years. Males were twice as likely to be infected than females (p < 0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (> 65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness.Conclusion: Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.Keywords: factors, ethnicity, Ct value, Arabs, virus shedding

Reem A Al Dossary,1 Awatif N Alnafie,2 Salma Ali Aljaroodi,1 Jawad Ur Rahman,1 Basavaraj C Hunasemarada,1 Khaled R Alkharsah1 1Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia; 2Department of Pathology, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Khaled R AlkharsahDepartment of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi ArabiaTel +966-13 3331053Email kalkharsah@iau.edu.saPurpose: Hepatitis E virus (HEV) causes acute hepatitis in humans and constitutes a major problem for immunocompromised patients, patients with hematological diseases, and pregnant women. It is transmitted mainly through fecal oral route; however, transmission through blood and blood products is reported globally and becoming a health concern. We sought to determine the prevalence of HEV among blood donors in the Eastern Province of Saudi Arabia using molecular as well as serological assays to assess the safety of blood transfusion and the need for HEV screening among blood donors.Patients and Methods: A total of 806 whole blood samples were collected from blood donors between May and November 2020 and tested for anti-HEV IgG and IgM antibodies by ELISA and for HEV RNA by RT-PCR.Results: The overall seroprevalence of HEV IgG antibodies was 3.2% with no statistically significant difference between the non-Saudis (3.28%) and Saudis (3.17%) (p value 0.929) or between males (3.14%) and females (4.88%) (p value 0.527). None of the IgG positive individuals had IgM antibodies. HEV RNA was not detected in any of the blood donors.Conclusion: HEV seroprevalence is low among blood donors in the Eastern Province of Saudi Arabia and may constitute minimal risk for transfusion associated infections.Keywords: HEV, IgG, IgM, seroprevalence, ELISA, RT-PCR

Introduction: High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests’ results, which are still not well known in the Eastern Province of Saudi Arabia. Methods: Over 7 years (2013–2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. Results: Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value Discussion/Conclusion: HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.

The epidemiology of herpes simplex virus (HSV) infections varies among populations depending on their demographic characteristics and exposure. This study describes the prevalence of HSV 1/2 IgG and IgM antibodies among individuals over a period of 5 years. A retrospective study was conducted to collect data on cases tested for HSV-1 and HSV-2 IgG and IgM antibodies for different medical conditions over five years between January 2014 and December 2018. 620 samples were tested for HSV 1/2 IgG and IgM during the study period. The total HSV seropositivity in the study population was 68% (422/620). The total seropositivity excluding children below 6 months of age was 65.3% (313/479). HSV-IgG seropositivity was significantly higher in married individuals (p

ObjectiveHigh-risk HPV (human papillomavirus) is found to be responsible for 4.5% of all cancer, especially cervical cancer. The prevalence of high-risk HPV associated with cervical lesions is not well- known in Saudi Arabia. This study aims to highlight the genotypes of high-risk HPV associated with pre- malignant cervical lesions.MethodsOver 6 years (2013 - 2018), 5091 Pap (Papanicolaou) smears results and 170 high-risk HPV test results were collected from the Information System at King Fahd University Hospital. Statistical analysis was performed using the software SPSS (Statistical Package for Social Sciences).ResultsOut of 5091 Pap smears, only 1.89% (n=96) were abnormal; 0.18% (n=9) were malignant (7 Squamous cell carcinomas and 2 adenocarcinomas), while 1.7% (n=87) showed pre-cancerous lesions, 44 ASCUS (Atypical Squamous Cells of Undetermined Significance), 17 LSIL (Low-grade Squamous Intraepithelial Lesions), 12 HSIL (High-grade Squamous Intraepithelial Lesions), and 14 AGC (Atypical Glandular Cells). Out of 170 patients co-tested for high-risk HPV, only 13.5% (n=23/170) had positive results (5 cases were positive for HPV16, 1 case was positive for both HPV16 and 18, while the remaining 17 cases were positive for high-risk HPV other than 16 or 18), among them, 6.47% (n=11/170) had normal Pap smear, while 7.06% (n=12/170) patients had abnormal Pap smear; 4 ASCUS, 6 LSIL and 2 HSIL. Statistical analysis showed a significant correlation between HPV findings and the Pap smear results (P- value 0.000), however, no significant correlation was found with the patients’ age and/or nationality.DiscussionOur study showed a unique distribution of high-risk HPV genotypes which reflects different geographical infection patterns. Furthermore, the high association of high-risk HPV with normal Pap smears highlights the need, for all women at risk, to be co-investigated for high-risk HPV. These findings could help in customizing regional vaccine-combinations and screening programs.

(1) Introduction: The objective of this study was to evaluate the patient experience with the Mawid application during the COVID-19 pandemic in Al Hassa, Saudi Arabia. (2) Methodology: A quantitative cross-sectional survey was designed to evaluate the patient experience with the Mawid app during the COVID-19 pandemic in Al Hassa, Saudi Arabia. A total of 146 respondents completed the questionnaire. (3) Results: More than half of the participants (65.8%) opined that application was easy to use. Furthermore, 65.1% of the participants considered it to be very easy and easy to search for the required information; and 63.7% of the respondents reflected that it was easy to book an appointment. There was a statistically significant difference between the ease of searching for the required information (p-value = 0.006); the ease of undoing an unwanted move and gender (p-value = 0.049); the ease of searching for the required information and educational level (p-value = 0.048); the ease of booking an appointment and educational level (p = 0.049); and the ease of searching for the required information and the labor sector of the respondents (p value= 0.049) among the genders. No significant differences were identified among the age groups. (4) Conclusions: Overall, most participants suggested that the Mawid app was easy to use and had a potentially useful set of features to help mitigate and manage the COVID-19 pandemic in Al Hassa, Saudi Arabia.

The absence of scope of practice guidelines may lead to role ambiguity and legal consequences in nursing practice. This study measures the scope of practice of nurses in Saudi Arabia. The study utilized a descriptive cross-sectional design using an electronic version of the Arabic Actual Scope of Nursing Practice (A-ASCOP) questionnaire among 928 nurses. Descriptive analysis was followed by a t-test and an analysis of variance (ANOVA). Significance was assured through the Bonferroni test; the effect size was measured through partial η2 when appropriate. The A-ASCOP mean score of each dimension ranged from 4.29 to 4.72 (overall mean = 4.59). Significant overall ASCOP score variations were evident, with higher ASCOP among expatriate nurses, females, Hospital Operation Program (HOP) nurses, and nurses with postgraduate qualifications. Partial η2 showed a small effect of

Background Breast cancer is considered the most common cancer in women worldwide and is the leading cause of cancer mortality. Sequences similar to Mouse Mammary Tumor Virus (MMTV) were detected in human breast cancer in several studies from different geographical areas. However, the role played by this virus in breast cancer tumorigenesis is not completely understood. These MMTV-like sequences were found to be associated with breast cancer of more malignant types. The aim of this study is to determine the prevalence of MMTV-like envelope gene (env) positivity in breast cancer and non-cancerous breast tissue from Saudi Arabia. Methods Detection of MMTV-like env proviral sequences was done using newly designed primers for conventional polymerase chain reaction (PCR). One hundred nighty four samples were collected from 103 females with breast cancer in addition to 51 control breast tissue obtained from individuals without cancer. We additionally investigated the association of proviral positivity with age of the patients, grade of breast cancer and presence of lymph node metastasis. The results were confirmed by sequencing. Results The prevalence of MMTV-like env proviral positivity was 8.7% (9/103). MMTV env proviral sequences were detected in 5.9% (6/101) of breast cancer tissues and 9.7% (9/93) of non-cancerous adjacent tissues obtained from the same patients. None of the 51 control sample showed positive result for the MMTV env gene. No significant association was found between detection of the virus and the age of the patient, grade of the cancer or presence of metastasis. Conclusion We document the presence of low frequency of MMTV env provirus sequence among breast cancer patients from Saudi Arabia. Further studies are needed to explore the role of the MMTV in breast cancer.

Background Similarly to what shown for exogenous tumorigenic retroviruses, endogenous retrovitus (ERVs) have been implicated in the pathogenesis of cancer. ERVs may participate in the process of malignant transformation or promote tumor growth, e.g. through insertional mutagenesis or via counteracting tumor immunosurveillance. Growing evidences show that the activation of endogenous retroviral sequences might be involved in transformation of melanocytes as well as in the increased ability of melanoma cells to escape immune surveillance.