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Abstract Background Nosocomial infections are a global problem in hospitals all around the world. It is considered a major health problem, especially in developing countries. The increase in the patient’s stay in hospitals has increased the mortality rate, and consequently, the costs drastically increase. The main purpose of using disinfectants in the hospital environment is to reduce the risk of nosocomial infections. Ethylene diamine tetra acetic acid (EDTA) causes lysis and increases susceptibility to antimicrobial agents in the planktonic form of bacteria. This substance affects the permeability of the outer membrane of bacteria. It also prevents the formation of biofilms by bacteria. Materials and methods In the current study, 120 isolates of Acinetobacter baumannii (A. baumannii) were confirmed by phenotypic and genotypic methods. Antibiogram was performed and then the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of isolates against 5% sodium hypochlorite, ethanol %70, sayasept-HP 2%, chlorhexidine 2%, dettol 4/8% were evaluated. In addition, the disinfectant effect was re-evaluated with the mixture of EDTA solution. All isolates were examined for biofilm presence by crystal violet staining method in triplicates and repeated three times for each strain. Also for all isolates detection of efflux pump genes (Qac-E, qacE-Δ1, SUG-E) by PCR technique was done. Results Antibiogram results of A. baumannii showed that 6.7% were Multi-drug-resistant (MDR), and 89.2% were Extensively drug-resistant (XDR) isolates. The highest effect of disinfectants was related to 5% sodium hypochlorite, and the least effect was 70% ethanol. EDTA increases the efficacy of selected disinfectants significantly. The highest prevalence of the efflux pump genes was related to SUG-E (95%) and Qac-E (91.7%), and, the qacE-Δ1 gene with 12.5%. The biofilm production rate was 91.3% among all isolates. Conclusion The best and safest way to disinfect hospital floors and surfaces is to choose the right disinfectants, and learn how to use them properly. In this study, a mixture of disinfectants and EDTA had a significant effect on bactericidal activity. it was found that improper use of disinfectants, especially the use of sub-inhibitory dilutions, increases the resistance of bacteria to disinfectants.

Introduction: Identifying factors that influence the patient experience are critical to implementing strategies that support patient engagement and ultimately achieve better health outcomes. The present study was conducted with the aim of presenting a model of empowerment of hospitalized patients. Methods: The current research was a qualitative-quantitative study that was cross-sectional by stratified sampling method with proper allocation in hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran, on 230 heads, managers, matrons, supervisors, heads of clinical and paraclinical departments and hospital headquarters units, nurses and doctors were done. The data were collected using the demographic information tool and the questionnaire made by the researcher to design a model of empowering patients admitted to the hospital. Determining the ability of the designed model by fitting the data was done with the confirmatory factor analysis method. Data were analyzed by SPSS version 16 software and Amos.v 24 software. Results: Questionnaire for designing a model of empowering patients in the hospital has 8 areas and 61 items or components. In the present study, the Chi-square ratio to the degree of freedom was significant (p

BackgroundStress is a biological process in which exposure to stressors is associated with bad health effects, decreased ability of disease management, and a higher likelihood for disease-related complications and comorbidities. Stress has been considered the main factor in the etiology of many diseases such as diabetes mellitus, cardiac diseases, and body aches for centuries. Students meet many stressful situations such as the need for success, academic demands, homesickness, and lack of social support. Coping with stress can be a leading cause in preventing psychological distress and a serious illness.MethodsA correlational cross-sectional approach was applied to the current research. The research targeted all secondary school male students in Abha city. A multistage cluster sample was applied by selecting schools and students from the Directorate of Education in Abha. Self-administered questionnaire sheets were distributed to students in their classes. The questionnaire covered students’ sociodemographic data such as age, grades, parents’ education and work, living conditions, and comorbidities. Stressors to which the students were exposed were also enumerated with the degree of stress for each. Stress was assessed using the Holmes–Rahe Stress Inventory for youth. Coping skills were measured using the abbreviated version of the COPE Inventory.ResultsThe study included 324 students whose ages ranged from 15 to 20 years old with a mean age of 17 ± 0.9 years old. Approximately 33% of the students were in first grade; 44.4% of the students had no or minimal level of stress while major stress was recorded among 26.5% of the students. In total, 77.8% of the students had moderate coping and none had high coping ability.ConclusionThe study revealed that more than half of the students had significant levels of stress and one out of each four had major stress. The most common stressors were due to the school environment and future planning. Young age, low socioeconomic status, parents’ separation, and having chronic health problems were the most important determinants of stress among the students.

IntroductionMeasuring and monitoring physical growth is a key element in assessing children's health. The physical and mental development of a growing child are indicators of good health and nutrition. This study aimed to explore the patterns of growth parameters among children under 5 years old attending primary health care centres (PHCCs) in rural northern Abha. Feeding habits during the first 2 years of life were also assessed.MethodThis study was conducted on 1-5 April 2022 in all (PHCCs) in Billasamr and Ballahmar, two neighbourhoods of northern Abha. The investigator designed a form for collecting each child's age (months), weight (kilograms), gender, birth order, number of family members, type of feeding (exclusive breastfeeding, exclusive bottle feeding, or mixed feeding), and duration of exclusive breastfeeding.ResultsGender affected the body weight of Saudi infants, as boys weighed significantly more than age-matched girls. Birth order also affected body weight. During the first and third years of life, Saudi children's body weight was not significantly affected by feeding type. During the second and fifth years of life, formula-fed children weighed more than breastfed or combination-fed children. However, during the fourth year of life, body weight was highest in combination-fed children.ConclusionGrowth patterns over time, established from multiple data points, must be used in conjunction with other medical and family history to evaluate appropriate growth. Recording and tracking body size, especially recumbent length and weight, as part of well-baby care is critical for any assessment of child wellbeing and health status.

Abstract Background Stenotrophomonas maltophilia is able to cause infections in immunocompromised patients, and the treatment of this opportunistic pathogen is complicated due to its virulence factors, antibiotic resistance, and the ability of the bacteria to produce biofilm. The main goals of this study were to assess the susceptibility of extensively drug-resistant (XDR) isolates to ethanol and EDTA, and evaluating the synergistic effect of these disinfectants, and also survey the effect of exposure to sub-inhibitory concentrations of ethanol and EDTA on the expression of biofilm-producing smf-1, rpfF genes. Results The results showed that EDTA significantly increased the effectiveness of the ethanol and have a synergistic effect. All of the 10 XDR isolates included in the current study harbored smf-1 and rpfF genes and produced biofilm. After exposure to MIC, sub-MIC, synergism, and sub-synergism of ethanol and EDTA, the expression of smf-1 and rpfF genes was repressed significantly. Conclusion In the current study, it was indicated that the expression of biofilm-producing genes was repressed when bacteria are exposed to different concentrations of ethanol and EDTA. Future studies should include more complex microbial communities residing in the hospitals, and more disinfectants use in hospitals. Expression of other virulence genes in different conditions is suggested.

Introduction: Multiple Sclerosis is a chronic, inflammatory disorder of the central nervous system, which leads to demyelination of nerves. Treatment with interferon beta is one of the best approaches to reduce recurrence and progression of the disease. The aim of this study is to search for the relationship between 4 polymorphisms FokIrs10735810, TaqIrs731236, ApaIrs797532 and BsmIrs1544410 located in the vitamin D receptor in MS patients responsive and non-responsive to interferon beta treatment and pave the way for the correct and fast administration of the appropriate drug, as well as reducing time, cost and lack of success in treatment. Methods: The type of study is observational and the study method is case-control. Blood samples were taken from 200 MS patients who were treated with interferon (100 responders and 100 non-responders). Using PCR-RFLP technique, the samples were subjected to enzymatic digestion with restriction enzymes ApaI, FokI, TaqI and BsmI. The data were evaluated using SPSS version 16, SNP Analyzer and Prism software, and K-tests and logistic regression. Results: A significant difference in the genotypic and allelic frequencies of ApaI (p=0.68), BsmI (p=0.65), FokI (p=0.57) and TaqI (p=0.50) polymorphisms in the patients between the two responsive and non-responsive groups to treatment was not observed. Conclusion According to our findings, there was no significant correlation between ApaI, FokI, TaqI and BsmI polymorphisms located in vitamin D receptor gene and response to treatment.

Abstract Background Chikungunya is an arboviral infection caused by the Chikungunya virus (CHIKV) transmitted to humans by mosquitoes of Aedes spp. CHIKV has been confined to African countries and South-East Asia up to 2004, but since then, the pathogen has become more global, and its high morbidity rate has become more visible. Saudi Arabia is not an endemic region of CHIKV, and the virus’s origin is not yet fully understood. This study aimed to characterize the genome of CHIKV from samples detected in Jeddah in 2018. Method Twenty-two sets of primers were designed to amplify near-full length genome of CHIKV. RT-PCR was conducted from clinical samples. Two samples were used for studying near complete genome sequence while the remaining samples were used to study the E1 gene. Different bioinformatics tools were utilized. Results Phylogenetic analysis showed that the CHIKV strains clustered with strains isolated from Kenya during 2017–2018 and belonged to ECSA genotype. E1: L136F, K211E and I317V mutations were identified in our strains. Also, E2: M74I, A76T, and V264A mutations were documented. Additionally, the capsid N79S substitution was also detected. Conclusion The genome of CHIKV was analyzed for the first time in Saudi Arabia to better understand the origin of the CHIKV and its genetic diversity, which showed high similarity with IE—a subclade of CHIKV strains detected in Mombasa (Kenya) indicating its possible origin.

Background and Objectives: Healthy eating is a crucial approach to improving overall health, encompassing a well-balanced diet of natural and fresh foods, plenty of fruits and vegetables, and foods rich in minerals and vitamins. This study aimed to assess the prevalence of obesity and associated dietary habits among medical students at King Khalid University, Aseer, Saudi Arabia. Materials and Methods: This observational cross-sectional study was conducted through face-to-face interviews. A structured predesigned questionnaire was used to collect data. Results: A total of 540 medical students were included; 43.3% of participants were aged 20–22 years, 24.8% were in the 3rd year, and 82.0% had an average income level. Of them, 21.9% were overweight and 14.6% were obese. There was a significant association between obesity and grade (p = 0.004). Significant differences were observed between males and females in adding sugar to beverages, the frequency of eating out, cooking meat, and drinking water (p < 0.05). The predictors of obesity were being male (OR = 3.5, 95% CI [1.6–7.8], p = 0.002), age (OR = 1.8, 95% CI [1.1–3.0, p = 0.019], being at grade 2 (OR = 38.8, 95% CI [4.0–375.8], p = 0.002), having grilled meat (OR = 0.42, 95% CI, [0.20–0.99], p = 0.048), using artificial sweeteners [OR = 0.24, 95% CI [0.08–0.73], p = 0.012], and drinking sparkling bottled water (OR 8.6, 95% CI [1.2 333–63.8], p = 0.034). Conclusions: The study revealed a high prevalence of obesity and overweight among medical students of both sexes. It recommends education on healthy eating habits, balanced nutrition, and regular physical activity, as well as gender-specific health initiatives, nutritional counseling, and the inclusion of physical activity.

Several samples coming from the recently discovered (February 2019) Late Bronze Age/Early Iron Age Chovdar necropolis in Azerbaijan were analysed using the X-ray fluorescence (XRF) technique. The analysis allowed a preliminary classification of the samples in eight groups based on their composition, obtained from the XRF spectra using the fundamental parameter method. A more detailed classification was then obtained using the graph clustering method.

Abstract Background The overuse of biocides in healthcare-facilities poses risk for emergence and spread of antibiotic resistance among nosocomial pathogens. Hospital-acquired infections due to S. maltophilia have been increased in the recent years and with its various resistance mechanisms contribute to patient morbidity and mortality in hospitals. The current study aimed to evaluate the susceptibility of biofilm-producing and non-producing S. maltophilia clinical isolates to five commonly used hospital biocides, alone and in combination with EDTA to examine the synergistic effect of combining EDTA on the bactericidal activity of them by microbroth dilution method. As well as the frequency of efflux genes encoding resistance to biocides among isolates. This study also intended to assess the effect of exposure of S. maltophilia isolates to sub-inhibitory concentrations of sodium hypochlorite upon the antimicrobial susceptibility patterns. Results Based on minimum inhibitory and bactericidal concentrations of biocides sodium hypochlorite 5% (w/v) and ethyl alcohol 70% (v/v) were the strongest and weakest biocides against S. maltophilia isolates, respectively. The combination of EDTA with biocides significantly increased the effectiveness of the studied biocides. Exposure to sub-inhibitory concentration of sodium hypochlorite showed a significant change in the susceptibility of isolates towards ceftazidime (p = 0.019), ticarcillin/clavulanate (p = 0.009), and chloramphenicol (p = 0.028). As well as among the isolates examined, 94 (95%) were able to produce biofilm. The frequency of sugE1 resistance genes was found in 90.7% of our clinical S. maltophilia isolates. None of the isolates carried qacE and qacEΔ1 gene. Conclusions The current study recommended that using the mixture of biocides with EDTA can be effective in reducing nosocomial infections. Also, this study demonstrated that exposure to sub-inhibitory concentrations of sodium hypochlorite leads to reduced antibiotic susceptibility and development of multidrug-resistant S. maltophilia strains.

Abstract Background Pseudomonas aeruginosa is a common pathogen in Hospitalized patients, and its various resistance mechanisms contribute to patient morbidity and mortality. The main aims of the present study were to assess the susceptibility of biofilm-producing and non-producing P. aeruginosa isolates to the five commonly used Hospital disinfectants, to evaluate the synergistic effect of selected disinfectants and Ethylene-diamine-tetra acetic acid (EDTA), and the effect of exposure to sub-inhibitory concentrations of Sodium hypochlorite on antimicrobial susceptibility test. Results The results showed that sodium hypochlorite 5% and Ethanol 70% were the most and least effective disinfectants against P. aeruginosa, respectively. The addition of EDTA significantly increased the effectiveness of the selected disinfectants. The changes in the antibiotic-resistance profiles after exposure to sub-inhibitory concentrations of disinfectants were observed for different classes of antibiotics (Carbapenems, Aminoglycosides, Cephalosporins, Fluoroquinolones). As well as near the all isolates harbored efflux pump genes and 117 (97.5%) of isolates produced biofilm. Conclusion In the current study, the mixture of disinfectant and EDTA were the most suitable selection to disinfect Hospital surfaces and instruments. Also, it was clear that exposure to sub-inhibitory concentrations of Sodium hypochlorite results in resistance to some antibiotics in P. aeruginosa species. Strong and intermediate biofilm formers belonged to MDR/XDR strains. Future studies should include more complex microbial communities residing in the Hospitals, and more disinfectants use in Hospitals.

The measurement of pharmaceutical compounds in biological fluids is considered an effective way to evaluate their effectiveness. On the other hand, lorazepam is a drug with good efficiency in treatment and some side effects, which measurement is very important. In this study, the ZnO nanoparticle was synthesized as an electrocatalyst by chemical precipitation method. In continuous a simple modification on paste electrode (PE) by ZnO nanoparticle (ZnO-NPs) and 1-hexyl-3-methylimidazolium chloride (HMImCl) was made and new sensor was used for sensing of lorazepam. The HMImCl/ZnO-NPs/PE showed catalytic behavior on oxidation signal of lorazepam and improved its signal about 2.17 times compared to unmodified PE. On the other hand, oxidation signal of lorazepam was reduced about 110 mV at surface of HMImCl/ZnO-NPs/PE compare to unmodified PE that confirm accelerating the electron exchange process after modification of sensor by HMImCl and ZnO-NPs as powerful catalysts. The HMImCl/ZnO-NPs/PE was used for monitoring of lorazepam in water and injection samples and results showed recovery data 98.5 to 103.5 % that are acceptable for a new sensor.

Background: Diabetic emergencies are serious acute life-threatening complications of diabetes mellitus (DM). The Hajj season requires the health system in Saudi Arabia to prepare efficiently for the healthcare of millions of pilgrims, particularly for diabetic emergencies. Thus, diabetic emergencies need rapid recognition, diagnosis and treatment. This study aimed to explore the frequency and associated factors of diabetic emergencies among the pilgrim's patients with DM during Hajj, Mecca 2019. Methods: This is a prospective study which was conducted on 153 patients with DM. They were selected from three major healthcare-providing facilities during Hajj, which are Arafat, Muzdelefah and Muna healthcare centres. The study was conducted from Aug 5 to 12, 2019. All the patients who presented with any of the hypoglycaemic or hyperglycaemic emergencies had their demographic and clinical characteristics recorded to estimate the prevalence of each emergency and identify its significant associated factors. Result: More than 90% of the study participants were patients with type 2 diabetes mellitus (T2DM), while around 7% had type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia were presented in (n = 11, 7.2%), (n = 19, 12.4%) and (n = 28, 18%), respectively, of the participants. Moreover, the study found that “younger age” (odds = 30.4, P = 0.0115) and “type of medication” are significantly associated with DKA. Furthermore, “older age”, “type of medication”, “having Cardiovascular Disease (CVD)” and “diabetes duration” were found to have a significant association with HHS. Moreover, hypoglycaemia was associated with neuropathy complication (odds = 3.54948, P = 0.0187). Conclusions: Among the pilgrims with diabetes participating in Hajj, a considerable proportion with a range of diabetic emergencies present to the onsite medical facilities. Preparation is required in terms of logistics and health education about diabetic emergencies to meet the needs of pilgrims with DM, especially those who use insulin and have longstanding diabetes. Further research on DM and the creation of guidelines for health providers and patients with DM during Hajj are important focuses for the future.

Background The COVID-19 pandemic has disrupted the daily life and academic trajectory of many students. The objectives of this study were to evaluate the effect of the pandemic on perceived stress levels among medical students. Methods Comparative pre-pandemic and pandemic surveys were conducted among samples of undergraduate medical students. Students responded to a questionnaire including personal and academic data, and Cohen’s Perceived Stress Scale (PSS). Results Overall, the prevalence of high perceived stress during the pandemic (20.6%) was significantly higher (p = 0.001) than pre-pandemic (11.6%). A multivariable analysis revealed that the independent factors associated with high perceived stress were: participation in the study during the pandemic (aOR = 1.79, 95% CI: 1.22–2.63), female sex (aOR = 1.74, 95% CI: 1.23–2.47), younger age (aOR = 1.62, 95% CI: 1.04–2.55) and lower family income (aOR = 1.50, 95% CI: 1.12–2.03). PSS score was negatively correlated with increasing age, family income, and academic level. PSS score was positively correlated with: worries about the possible disruption of education or exams, excessive news exposure, worries about the possibility of COVID-19 infection, and the effects of mandatory isolation and social distancing. Conclusion The COVID-19 pandemic increased the level of stress among medical students. Female students, younger students, and those in lower academic grades are the most at risk of having high stress. Worries about possible academic disruptions due to the pandemic are significant stressors. The implementation of online stress management programs is recommended.

IntroductionThrombotic complications of coronavirus disease 2019 (COVID-19) have received considerable attention. Although numerous conflicting findings have compared escalated thromboprophylaxis doses with a standard dose to prevent thrombosis, there is a paucity of literature comparing clinical outcomes in three different anticoagulation dosing regimens. Thus, we investigated the effectiveness and safety profiles of standard, intermediate, and high-anti-coagulation dosing strategies in COVID-19 critically ill patients.MethodologyThis retrospective multicenter cohort study of intensive care unit (ICU) patients from the period of April 2020 to August 2021 in four Saudi Arabian centers. Inclusion criteria were age ≥ 18 years, diagnosis with severe or critical COVID-19 infection, and receiving prophylactic anticoagulant dose within 24–48 h of ICU admission. The primary endpoint was a composite of thrombotic events, with mortality rate and minor or major bleeding serving as secondary endpoints. We applied survival analyses with a matching weights procedure to control for confounding variables in the three arms.ResultsA total of 811 patient records were reviewed, with 551 (standard-dose = 192, intermediate-dose = 180, and high-dose = 179) included in the analysis. After using weights matching, we found that the standard-dose group was not associated with an increase in the composite thrombotic events endpoint when compared to the intermediate-dose group {19.8 vs. 25%; adjusted hazard ratio (aHR) =1.46, [95% confidence of interval (CI), 0.94–2.26]} or when compared to high-dose group [19.8 vs. 24%; aHR = 1.22 (95% CI, 0.88–1.72)]. Also, there were no statistically significant differences in overall in-hospital mortality between the standard-dose and the intermediate-dose group [51 vs. 53.4%; aHR = 1.4 (95% CI, 0.88–2.33)] or standard-dose and high-dose group [51 vs. 61.1%; aHR = 1.3 (95% CI, 0.83–2.20)]. Moreover, the risk of major bleeding was comparable in all three groups [standard vs. intermediate: 4.8 vs. 2.8%; aHR = 0.8 (95% CI, 0.23–2.74); standard vs. high: 4.8 vs. 9%; aHR = 2.1 (95% CI, 0.79–5.80)]. However, intermediate-dose and high-dose were both associated with an increase in minor bleeding incidence with aHR = 2.9 (95% CI, 1.26–6.80) and aHR = 3.9 (95% CI, 1.73–8.76), respectively.ConclusionAmong COVID-19 patients admitted to the ICU, the three dosing regimens did not significantly affect the composite of thrombotic events and mortality. Compared with the standard-dose regimen, intermediate and high-dosing thromboprophylaxis were associated with a higher risk of minor but not major bleeding. Thus, these data recommend a standard dose as the preferred regimen.

Background and Aims: Peripheral neuropathy is a common diabetic complication. It is linked to poor glycaemic control and longer duration of diabetes. We explored the association between HbA1c and neuropathy risk considering the duration of diabetes in a sample of Saudi diabetic patients. Method: We conducted a monofilament test on 343 diabetic patients referred to our specialist diabetology centre in Saudi Arabia. We utilized a multiple generalized logistic regression model with a binary outcome related to neuropathy complications. Results: We found that over four out of every five patients have peripheral neuropathy. The interaction between HbA1c and duration was significant (estimate = −0.02802, P = 0.00534), a positive association between neuropathy and both HbA1c (increased risk by 46.2%, P = 0.03222) and DM duration (increased risk by 19.6%, P = 0.04497). Conclusions: The shorter the duration of diabetes, the more positive the relationship between HbA1c and peripheral neuropathy. In patients living for over 40 years with diabetes, HbA1c was higher among those who did not have peripheral neuropathy. It could be argued that this is an artefact of survival as poorer glycaemic control will likely result in higher mortality in earlier years of the diabetes career.

Objectives: The burden of postpartum depression (PPD) is significant because it remains unrecognized, and it not only affects the mother adversely but also has a negative consequence on the family life and the development of the infant. The aim of the study was to measure the prevalence of PPD and identify the risk factors of PPD among mothers attending the well-baby clinic of six Primary Health Care centers in Abha city, Southwest Saudi Arabia. Materials and Methods: A total of 228 Saudi women having a child aged between two weeks to one year were recruited in the study by using a consecutive sampling technique. The Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) was used as a screening tool to measure the prevalence of PPD. The mothers were also inquired about their socio-demographic characteristics and risk factors. Results: The prevalence rate of postpartum depression was 43.4%. Family conflict, and lack of support by spouse and family during pregnancy were found to be the strongest predictors of developing PPD. Women who had reported family conflict were at six times higher risk for developing PPD compared to those who did not have a family conflict (aOR = 6.5, 95% CI = 2.3–18.4). Women who reported a lack of spousal support during pregnancy encountered 2.3 fold increased risk for PPD (aOR = 2.3, 95% CI = 1.0–4.8) and women who had not received family support during pregnancy period were more than three times (aOR = 3.5, 95 % CI 1.6–7.7) likely to experience PPD. Conclusion: The risk of PPD among Saudi postnatal women was high. PPD screening should be an integral part of postnatal care. Awareness of women, spouses and families about potential risk factors can be a preventive strategy. The early identification of high-risk women during the antenatal and post-natal period could help to prevent this condition.

Background: Gastroesophageal reflux disease (GERD) is an abnormal reflux of the gastric content into the esophagus. In Saudi Arabia the GERD prevalence is not recently well studied. Objective: To investigate the prevalence of gastroesophageal reflux disease and associated factors among attendants of primary health care centers (PHCCs) at Abha city, Saudi Arabia. Method: A descriptive cross- sectional study was performed using GerdQ as diagnostic tool for the GERD. The GerdQ consisted of six questions. Four questions were about the positive GERD predictors. The other two questions were about the negative GERD predictors. The scoring of GerdQ relies on the frequency of GERD symptoms during the last seven days. Using stratified random sample technique a representative sample was slected from the study PHCCs taking into conmsideration the relative catchment population in each center among adult males and females attending the selected PHCCs for any reason. Results: The present study included 320 persons. The study showed a prevalence of GERD of 67.8%. The prevalence of GERD with high impact on daily life (HIDL) was found to be 50%. By multiple logistic regression (enter method) only four significant independent factors associated with GERD were identified; being unmarried (aOR = 1.85, 95% CI:1.02–3.23); smoking (aOR = 2.11, 95% CI: 1.41–5.98), fast food intake (OR = 1.28, 95% CI:1.01–1.71), and subjective perception of stress (OR = 3.0, 95% CI:1.68–5.26). Conclusions: GERD is a public health problem among adults in the region. Community level awareness programs are recommended. Healthcare providers must be aware of community perceptions and practices.

Background and Objectives: Prostatitis affects about 16% of men in their lifetime and sometimes leading to prostate cancer. Bacterial infections are the most common causes of prostatitis. Diagnosis of the causative agents of bacterial prostate infections plays an essential role in timely treating and preventing secondary complications. This study isolated bacterial infectious agents in patients’ surgical prostate and evaluated them by routine and molecular microbiological methods. Materials and Methods: In this cross-sectional study, 72 prostate biopsy specimens were collected from the Orology Departmen of hospitals of Qazvin University of Medical Sciences. All samples were cultured in aerobic and anaerobic conditions. Antibiotic susceptibility test by Kirby-Bauer standard method was performed for all isolated bacteria. In addition, all isolated bacteria were identified using 16S rDNA PCR and sanger sequencing methods. Also, TaqMan real-time PCR was applied to detect Ureaplasm aurealyticum, Mycoplasma hominins, and Mycoplasma genitalium. Results: In conventional culture method, out of 18 positive samples, 15 samples (83.3%) were Gram-negative bacteria and 3 samples (16.6%) were Gram-positive bacteria, containing Escherichia coli (55.5%), Klebsiella pneumoniae (11.1%), Enterobacter cloacae (5.5%), Pseudomonas aeruginosa (11.1%), Staphylococcus aureus (11.1%), and Enterococcus faecalis (5.5%). The results of molecular identification methods were the same as conventional culture results. Also, four patients were Ureaplasm aurealyticum, and three patients were positive for Mycoplasma hominis. Conclusion: Most bacteria isolated from prostate specimens belonged to the Enterobacteriaceae family, especially Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae. Staphylococcus aureus and Enterococcus faecalis were cocci isolated in the specimens too. Also, Ureaplasma urealyticum, and Mycoplasma hominis were identified in prostatitis.

Background: Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. Objective: To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. Methods: Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. Results: The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12−1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31−2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04−2.89) and these were not statistically different from seroprevalence in the Makkah region. Conclusions: At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling.

Background: Worldwide, mental health is a big problem and Saudi Arabia is not far behind in observing this. It seems that progress in the field of mental health is slow. Interventions in mental health education have resulted in positive results. Participation by family members, sensitization to care and social integration include some of methods believed to target understanding and counter stigma surrounding mental illness. Aim: To assess mental health literacy among female students of secondary schools in Abha city, Kingdom of Saudi Arabia. Methodology: A descriptive cross-sectional study from May 2019 to 2020 was conducted at the female governmental secondary schools in Abha sector. A total sample of 350 female students from a total of 5000 students were included. Sampled students were selected from secondary schools using probability proportionate to size using two stage cluster sample technique. Data were collected from students directly using pre-structured questionnaire. The researchers created the study questionnaire after extensive literature review and expert consultation. Results: Almost half (48.9%) study participants had good awareness of the signs and indications of anxiety and depression. Loss of confidence and poor self-esteem were identified as signs of depression by 81%, sleep disturbance by 77% and disturbed appetite by 76.2% participants. Parent's education level and occupation, participant's educational performance and family living arrangement were significantly related with their awareness in univariate analysis. Father's education level (ORA = 1.45), maternal engagement with occupation (ORA = 4.18) and participant living with parents (ORA = 5.4) were identified as predictors of mental health awareness. Social media was reported as the most common source of awareness. The approach towards individuals with mental illness were helpful. Conclusions and recommendations: In conclusion, the study revealed that secondary school students had satisfactory awareness level regarding mental health and its impact. They exhibited positive attitude towards friendship with person having mental illness.

Background: Burnout is a workplace phenomenon and is high among healthcare workers, particularly physicians. It brings in significant negative impact on patient care and physicians. Considerable number of studies have highlighted burnout issues on residents of other specialties; however, scarcity of data exist on burnout among family medicine residents. Objectives: This study aimed to measure the prevalence of burnout, and its predictors amongst family medicine residents in Aseer region, Saudi Arabia. Methodology: This cross-sectional study was conducted among 133 family medicine residents using a custom-designed and validated Self administered questionnaire. The Maslach Burnout Inventory Human Services Survey (MBI-HSS) was used to measure the three dimensions of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Results: The overall prevalence of burnout was 84.2%. In terms of three dimensions of burnout, 29.3% of respondents scored high for EE burnout, 19.5% for DP and 79.7% for PA. High burnout in all three dimensions was found to be strongly associated with a number of variables under study. Male gender (aOR = 3.41, 95% CI 1.1-11.10; P = 0.042), married residents (aOR = 3.32, 95% CI 1.1-10.48) and use of anti-anxiety drugs (aOR = 3.75,95% CI = 2.0-21.26) were identified as predictors of high emotional exhaustion. A work schedule of more than 8 hours per day (aOR = 3.79, 95% CI 1.12-10.87) and young age (aOR = 2.6, 95% CI 1.12-10.87) were identified predictors for high depersonalisation and low personal accomplishment, respectively. Conclusions: Prevalence of burnout in this study exhibits that it is a common problem in family medicine residents. There is a need for a nationwide longitudinal study targeting the family medicine residents to study the effects of burnout on physician well-being and patient care.

Objectives: This study aims to explore knowledge, attitude and practices of physicians working at primary health care (PHC) in Abha, KSA, regarding assessment and management of acute bronchial asthma. Subjects and Methods: This is a cross-sectional study that was conducted among PHC physicians in Abha, Khamis Mushayt and Ahad Rufeida cities, Aseer region KSA in 2018. A questionnaire that was constructed by the investigators was used to assess the knowledge, attitude and practices of PHC physicians regarding the diagnosis and management of patients with acute asthma. The questionnaire was distributed under the supervision of the first investigator. Data management was carried out using SPSS version 23. Results: A total of 200 PHC physicians participated in this study. About two-thirds of them (63.5%) had good grade of knowledge regarding acute asthma management, whereas 44% had positive attitude toward acute asthma management. The main knowledge gaps were doses of drugs used in the management of acute severe asthma attack (36%), and diagnosis of acute severe asthma attack (51.5%). Physicians' main source of knowledge on asthma included textbooks (26%) and guidelines (61.5%). Physicians' practice grades were significantly higher among those with less experience in PHC (p = 0.011). Almost all PHC centers (PHCC) (98%) had oxygen and nebulizers, 72.5% had steroids, 71.5% had salbutamol, 50.5% had ipratropium and 41% had peak flow meter, whereas 73.5% had the Saudi Initiative for Asthma (SINA) guidelines. Conclusion: This study revealed that knowledge of PHC physicians regarding the management of bronchial asthma was suboptimal, their attitude is not completely positive, and their adherence to asthma management guidelines is quite low. Some PHCCs were lacking important drugs and equipment for management acute asthma that should be provided. Well-structured training of PHCC doctors on SINA is mandatory to upgrade their knowledge, promote their attitude and improve their skills.

In this study, cyclic peptide (CP) with cyclooctaglycine model and gold nanoparticles (AuNP) with Au6 cluster model were used to examin the function of penicillamine (PCA) drug on ten different configurations of cyclic peptide-gold nanoparticles (CPAuNP). Binding energies, quantum molecular descriptors such as electrophilicity power (ω), global hardness (η), and solubility energies were studied in aqueous solution and gas phase at the M06-2X density functional level. The binding energy analysis was performed on (CPAuNP/PCA1-10) structures to determine the most stable structure. The obtained values for solvation energies indicate that CPAuNPs can have an effective performance when used along with PCA drug, which is a major factor in drug delivery. The quantum molecular descriptors reveal that the reactivity of cyclic peptide (CP) and PCA drug increases in (CPAuNP/PCA1-10) structures. AIM calculations for all structures show that intermolecular hydrogen bonding and Au-L (L = H, O, S, C, N) interactions play an important role for this drug delivery system. When the PCA drug is parallel to the CPAuNP carrier, interacting simultaneously with CP and AuNP, the structure is more stable than the structures in which the drug has interactions only with the CP or AuNP. DOI: http://dx.doi.org/10.17807/orbital.v12i3.1519

Background: Heart failure is a complex clinical syndrome of cardiovascular disease. Heart failure occurs when the heart muscle is weakened and cannot pump enough blood to meet the body's needs for blood and oxygen. It is characterised by several attacks of dyspnoea, chest pain, orthopnea and pulmonary or systemic congestion. The heart inability to fulfill the demands of the body further failure of heart to pump the blood with normal efficiency. Lack of patients' adherence to their treatment may affect their clinical compensation. Aim: To assess the extent of assessing the level and predictors of medication adherence among patients with heart failure in the Aseer region. Methodology: A descriptive cross-sectional approach was used for targeting all registered heart failure patients attending the cardio clinic and chronic diseases clinic in Aseer region hospitals. Data were collected using a direct interview questionnaire that was developed by the researchers with the help of experts. Questionnaire included the patients' sociodemographic data, co-morbidities, disease-related data and drugs. Results: The study included 151 patients diagnosed with heart failure. About 66% of the patients were above the age of 60 years and 62.3% were males. Exact of 47% of the cases had the disease for less than 3 years and 43.7% of the patients had the treatment for more than 3 years. About 49% of the patients forget to have their medication at least once while 34.4% had problems remembering to take your medication. Totally, more than half of the patients had poor medication adherence and only 7.3% had a high adherence rate. Conclusions and Recommendations: In conclusion, the adherence rate for the patients' medication was poor due to forgetting to have the medications. Poor adherence was related more with single patients who are not working with poor income.

Background: Phobia is an extreme form of anxiety or fear which is triggered by a given situation or object or even danger associated with a situation or object for more than 6 months. There are three main forms of phobia: social phobia (social anxiety disorder), specific phobia, or agoraphobia. Agoraphobia is a form of anxiety disorder where one fears and avoids situations or places that might cause them to panic. The main purpose of this study is to investigate phobia among residents in broad training programs in Abha city and compare phobia between residents in broad training programs and general practitioners in Abha city. Methods: It is a cross-sectional study. The study was conducted in Abha city of Saudi Arabia from December 2019 to March 2020. It included a representative sample of medical doctors under broad training programs and general practitioners (none trained) in all the health-care centers. A link for the survey questionnaires was created and shared with the respondents. The questionnaire included sociodemographics of the participants, the Kutcher Generalized Social Anxiety Disorder Scale, and the Psychometric Properties and Clinical Utility of the Specific Phobia Questionnaire in an Anxiety Disorders Sample for specific phobia. Results: The study included 300 physicians. Majority of them (81%) were in the age group between 25 and 30 years. Males represent 54% of them. There was no statistically significant difference between resident physicians and general practitioners regarding the avoidance of different social situations. Conclusion: Overall, the residents in board training programs in Abha city expressed lower levels of discomfort, anxiety, distress, avoidance, fear, and life interference of some social and specific situations compared to general practitioners.

Abstract Background Middle East Respiratory Syndrome Coronavirus (MERS-COV) is the main cause of lung and kidney infections in developing countries such as Saudi Arabia and South Korea. This infectious single-stranded, positive (+) sense RNA virus enters the host by binding to dipeptidyl-peptide receptors. Since no vaccine is yet available for MERS-COV, rapid case identification, isolation, and infection prevention strategies must be used to combat the spreading of MERS-COV infection. Additionally, there is a desperate need for vaccines and antiviral strategies. Methods The present study used immuno-informatics and computational approaches to identify conserved B- and T cell epitopes for the MERS-COV spike (S) protein that may perform a significant role in eliciting the resistance response to MERS-COV infection. Results Many conserved cytotoxic T-lymphocyte epitopes and discontinuous and linear B-cell epitopes were predicted for the MERS-COV S protein, and their antigenicity and interactions with the human leukocyte antigen (HLA) B7 allele were estimated. Among B-cell epitopes, QLQMGFGITVQYGT displayed the highest antigenicity-score, and was immensely immunogenic. Among T-cell epitopes, MHC class-I peptide YKLQPLTFL and MHC class-II peptide YCILEPRSG were identified as highly antigenic. Furthermore, docking analyses revealed that the predicted peptides engaged in strong bonding with the HLA-B7 allele. Conclusion The present study identified several MERS-COV S protein epitopes that are conserved among various isolates from different countries. The putative antigenic epitopes may prove effective as novel vaccines for eradication and combating of MERS-COV infection.

Background: Medical research is a systematic method to obtain new knowledge, reduce diagnosis problems, discover the latest or best treatment for a disease, and also used for disease prevention.Objective: The study aims to assess the challenges and barriers to conduct medical research among medical and dentistry students and determine the reasons that hinder the conduct of the study.Methods: In this cross-sectional study, the research population consisted of medical and dental students affiliated with King Khalid University in Saudi Arabia in 2020. The study followed a descriptive approach based on quantitative analysis. The Statistical Package of the Social Sciences (SPSS) program (V. 16.0, SPSS Inc., Chicago, IL, USA) was used for data analysis.Results: A total of 327 students participated in this study, and the response rate was 100%. Among them, 61.5% were females. In this study majority (63.3%) had a moderate attitude toward conducting medical research and the average was 56.17. The majority (53.8%) had a reasonable behavior toward conducting medical research, and the average was 29.06. Lack of time, skills, funding, facilities, and limited access to medical journals and related databases were the significant barriers found. Most of the students had positive attitudes, except that they are not awarded on their research, do not attend the sessions, and do not speak their thoughts. A significant relationship between demographic characteristics (age, level, and Grade Percentage Average), attitudes & perceived barriers toward research was found (

Background: Studies regarding cleansing the area with antiseptic solutions prior to catheterization in premature infants are limited. Therefore, the present study aimed to evaluate and compare the effects of chlorhexidine 2% and iodopovidone-alcohol solutions on bacterial colonization associated with the peripheral venous catheterization in premature infants. Methods: This quasi-experimental study was conducted in 2016-2017 at a neonatal intensive care unit in Qazvin, Iran. Premature infants (N=106) were assigned to the two groups of “A” treated with chlorhexidine 2% or “B” cleaned with iodopovidone-alcohol 10%. Quantitative culture of the catheters was performed 48 hours after insertion. Results: Our findings showed that the frequency of positive catheter tips culture was 6.6% among all the samples (N=7). Out of the seven positive cultures, five (43.9%) belonged to the iodopovidone-alcohol group and two (3.7%) were from the chlorhexidine 2% group. Although a number of the positive cultures in the iodopovidone-alcohol group was higher than the chlorhexidine 2% group, this difference was not statistically significant (P=0.21). Conclusion: Results of this study demonstrated that bacterial colony growth may be decreased when using preparatory chlorhexidine 2%, compared with iodopovidone-alcohol at no added risk to infants. We recommend further study in this regard.

In this study, the noncovalent interactions and four mechanisms of covalent functionalization of hydroxyurea have been examined using the density functional theory. Quantum molecular descriptors were also studied in noncovalent interactions. Hydroxyurea is an anticancer drug that, when loaded onto the γ-Fe2O3 nanoparticles, will have additional properties and efficacy in the medical applications. The Lumo-Homo energy gap of hydroxyurea is greater than that of noncovalent configurations, indicating the high reactivity of hydroxyurea. Hydroxyurea can bond to the γ-Fe2O3 nanoparticles through various functional groups such as the CO (k1 mechanism), the NH2 (k2 mechanism), the OH (k3 mechanism) and the NH (k4 mechanism). These reactions were considered to calculate the activation energies, the activation enthalpies and the activation Gibbs free energies. Using these calculations, the product of k4 mechanism was found to be a thermodynamic and kinetic product. These results can be applied to other similar medications. DOI: http://dx.doi.org/10.17807/orbital.v11i3.1367

Backgrounds: Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver. Child abuse may include any act or failure to act by a parent or other caregiver that results in actual or potential harm to a child, and can occur in a child's home or in the organizations, schools, or communities the child interacts with. This study was conducted to assess the primary health care (PHC) centers' physicians' knowledge and attitude toward child abuse including its types, and child neglect with their behavior regarding reporting of abuse cases. Methods: A cross-sectional study was conducted in Abha which is the capital of Aseer Province, including all PHC physicians (about 475) working in PHC centers. Data regarding physicians' demographic characteristics, perception, and awareness regarding child abuse and neglect were collected by self-administrative questionnaire in the PHC center during their time between patients' consultation. Results: The study included 300 PHC physicians whose ages ranged from 25 to 50 years old with mean age of 28 years. About 65% of the physicians were males and 69% of them were married with about 73% having at least one child. Overall, 96.3% of the physicians recorded good awareness level regarding types of child abuse and 97.3% recorded good awareness level regarding child neglect patterns. Underreporting of child abuse cases was recorded by about 64% of physicians. Conclusion: Regarding child abuse and neglect, PHC physicians have good knowledge, optimal attitude, and positive perception. There was also the problem of underreporting of suspected child abuse cases among PHC physicians in Saudi Arabia, with many barriers to report, such as community traditions; unclear reporting strategy was identified.

Background: Human coronaviruses (hCoV) usually cause mild to moderate upper respiratory tract illnesses. The novel coronavirus (nCoV), or Middle East respiratory syndrome coronavirus (MERS-CoV), is a particular strain different from any other known hCoV with the possibility of human and also zoonotic transmissions. The aim of the study to assess primary health care (PHC) physicians' knowledge and adherence regarding Saudi Ministry of Health guidelines regarding MERS-CoV. Materials and Methods: A cross-sectional study design was followed to include 85 PHC physicians in Abha city. An interview questionnaire has been designed by the researcher that was used to assess knowledge and practices of PHC physicians regarding diagnosis and management of MERS-CoV. It includes personal characteristics, the MERS-CoV knowledge assessment questionnaire, and practices related to adherence toward guidelines regarding MERS-CoV. Results: PHC physicians' knowledge gaps regarding MERS-CoV included protected exposure (32.9%), highest seasonal incidence of MERS-CoV in Saudi Arabia (60%), relation between incidence of MERS-CoV and overcrowding (62.4%), case fatality of MERS-CoV cases (63.5%), and collecting specimens from MERS-CoV patients (64.7%). The knowledge of PHC physicians about MERS-CoV was poor among 5.9%, good among 63.5%, and excellent among 30.6%. Personal protective equipment to be used when seeing suspected cases of MERS-CoV infection were mainly the mask (94.1%), gloves (78.8%), the gown (60%), goggles (31.8%), and the cap (22.4%). All participants stated that the most important standard precaution that should be applied when seeing a case of MERS-CoV infection is hand washing, whereas 97.6% stated that the most important respiratory precaution to prevent transmission of respiratory infections in PHC setting when seeing a case of MERS-CoV infection is masking and separation of suspected MERS-CoV patients, and 81.2% stated that upon exit from the room of a MERS-CoV patient, the physician should remove and discard personal protective equipment. PHC physicians' knowledge about MERS-CoV differed significantly according to their nationality (P = 0.038), with non-Saudi physicians expressing higher percent of excellent knowledge than Saudi physicians (40% and 20%, respectively). Those who attended continuing medical education (CME) activities had significantly higher percent of excellent knowledge than those who did not attend a CME activity (55.6% and 23.9%, respectively, P = 0.011). PHC physicians' knowledge did not differ significantly according to their age, gender, qualification, experience in PHC, and practice-related adherence to guidelines. PHC physicians' practice-related adherence to guidelines about MERS-CoV differed significantly according to their position (P = 0.035), with specialists having the highest percent of excellent practice (13%). Conclusions: There are knowledge gaps among PHC physicians in Abha city, and their practice is suboptimal regarding MERS-CoV infection. Less than one-fourth of PHC physicians attend CME activities about MERS-CoV infection. However, significantly less practice-related adherence to guidelines are associated with Saudi PHC physicians, those who did not attend a related CME activity, and MBBS qualified physicians' general practitioners. To increase awareness, more CME activities related to MERS-CoV infection management needs to be organized.

Some new Schiff-base compounds based on pyrrole were synthesized by the reaction of 2-amino-1-methyl-4,5-diphenyl-1H-pyrrole-3-carbonitrile (1)with aromatic aldehydes (2a-2e) in ethanol/acetic acid at room temperature. The structures of the Schiff bases were characterized by full spectral data. The fluorescence emission intensity of the Schiff bases has been measured in different polar solvents (protic and aprotic) at different temperatures and also pHs. Among the products of this reaction, 2-[(2-hydroxy-benzylidene)-amino]-1-methyl-4,5-diphenyl-1H-3-carbonitrile(3a) exhibited good results. The molecular docking studies on all Schiff bases revealed that the compound 3a forms a stable complex with polo-like kinase1 as a target and gives a binding affinity value of -8.9 kcal/mol. According to the obtained results, the DFT calculations carried out on 3a by using B3LYP/6-31+G(d,p) level of theory which the theoretical data were in good agreement with the experimental data. Furthermore, the NBO analysis showed the electron transfers correctly.

Objectives Our study aims at comparing the efficacy and safety of IFN-based therapy (lopinavir/ritonavir, ribavirin, and interferon β-1b) vs. favipiravir (FPV) in a cohort of hospitalized patients with non-critical COVID-19. Methods Single center observational study comparing IFN-based therapy (interferon β-1b, ribavirin, and lopinavir/ritonavir) vs. FPV in non-critical hospitalized COVID-19 patients. Allocation to either treatment group was non-random but based on changes to national treatment protocols rather than physicians’ selection (quasi-experimental). We examined the association between IFN-based therapy and 28-day mortality using Cox regression model with treatment as a time-dependent covariate. Results The study cohort included 222 patients, of whom 68 (28%) received IFN-based therapy. Antiviral therapy was started at a median of 5 days (3–6 days) from symptoms onset in the IFN group vs. 6 days (4–7 days) for the FPV group, P Conclusion Early IFN-based triple therapy was associated with lower 28-days mortality as compared to FPV.

The dual-specificity tyrosine phosphorylation-regulated kinase 1A (DYRK1A) is a novel, promising and emerging biological target for therapeutic intervention in neurodegenerative diseases, especially in Alzheimer’s disease (AD). The molMall database, comprising rare, diverse and unique compounds, was explored for molecular docking-based virtual screening against the DYRK1A protein, in order to find out potential inhibitors. Ligands exhibiting hydrogen bond interactions with key amino acid residues such as Ile165, Lys188 (catalytic), Glu239 (gk+1), Leu241 (gk+3), Ser242, Asn244, and Asp307, of the target protein, were considered potential ligands. Hydrogen bond interactions with Leu241 (gk+3) were considered key determinants for the selection. High scoring structures were also docked by Glide XP docking in the active sites of twelve DYRK1A related protein kinases, viz. DYRK1B, DYRK2, CDK5/p25, CK1, CLK1, CLK3, GSK3β, MAPK2, MAPK10, PIM1, PKA, and PKCα, in order to find selective DYRK1A inhibitors. MM/GBSA binding free energies of selected ligand–protein complexes were also calculated in order to remove false positive hits. Physicochemical and pharmacokinetic properties of the selected six hit ligands were also computed and related with the proposed limits for orally active CNS drugs. The computational toxicity webserver ProTox-II was used to predict the toxicity profile of selected six hits (molmall IDs 9539, 11352, 15938, 19037, 21830 and 21878). The selected six docked ligand–protein systems were exposed to 100 ns molecular dynamics (MD) simulations to validate their mechanism of interactions and stability in the ATP pocket of human DYRK1A kinase. All six ligands were found to be stable in the ATP binding pocket of DYRK1A kinase.

Background: Free-living amoeba (FLA) are widely distributed in different environmental sources. The most genera of the amoeba are Acanthamoeba, Naegleria and Vermamoeba. The most common consequences of the infections in immune-deficient and immunocompetent persons are amoebic encephalitis and keratitis. The aim of this study was to investigate the presence of Acanthamoeba spp. and Naegleria spp., isolated from the main agricultural water canal in Qazvin. Methods: Totally, 120 water specimens were collected and later the specimens were cultured and cloned to identify positive samples. PCR amplification and sequencing were carried out to identify the isolated species as well as the genotypes of amoeba. Results: According to morphological surveys, 41.7% (50/120) of water specimens were positive for FLA. Molecular analysis revealed that 68.6% and 31.4% of Acanthamoeba specimens were identified as T3 and T4 genotypes, respectively. Also, two species of Naegleria named as N. lovaniensis (57.1%) and Naegleria spp. (42.8%) were identified. The results of pathogenicity assays demonstrated that 38.5% of T3 and 61.5% of T4 genotypes of Acanthamoeba were highly pathogenic parasites. Conclusion: The water flowing in the agricultural canal of the area is contaminated with potential pathogenic FLA, therefore, it is recommended that more attention to be paid towards proper treatment of water sources to prevent possible risk of the disease.

Background: We aimed to investigate the genotypes of Giardia intestinalis among the food handlers in Qazvin, Iran. Methods: Overall, 1530 stool specimens were collected from the food handlers who visited Shahid Bolandian Health Center, Qazvin, Iran during 2016. Specimens were evaluated by microscopic and concentration methods. Twenty specimens with appropriate number of giardia cysts were selected followed by DNA extraction. Determination of giardia genotypes was achieved through PCR and sequencing the glutamate dehydrogenase gene. The phylogenetic tree was drawn using the MEGA7 software. Finally, the data were analyzed statistically with a P-value

Background: Workplace violence in healthcare settings is a common, but an underreported problem that has been largely ignored. Violence against healthcare workers can have an adverse effect on their performance outcomes and thus influence patients' health and satisfaction. The aim of this study was to determine the frequency and types of violence against healthcare workers in a Saudi Arabian city. It was also to identify the risk factors of violence against healthcare workers and to investigate the possible consequences of such behavior. Materials and Methods: In Abha city, there are two government hospitals and ten primary healthcare centers. All healthcare workers in these healthcare institutions including physicians, nurses, dentists, pharmacists, laboratory technicians or specialists, radiologists, social workers, and psychologists were eligible to participate in this cross-sectional study. Data were collected using a structured self-administered questionnaire. Results: A total of 738 healthcare workers responded (92% response rate). The mean age was 31 ± 7.7 years (range 21–60) and the majority (64.9%) were females and 69.4% were Saudis. More than half (57.5%) had experienced some workplace violence at least once. Verbal assaults and slaps were the most common form of workplace-related violence (58%). Conclusions: Violence against healthcare workers in Abha city is more common, especially against nurses. The reasons need to be explored in order to set and develop policies, regulations and interventions to prevent violence against workers.

Bullying is a type of behavior that involves frequent, hostile activities expected to harm another person physically, mentally, or emotionally. Bullying behavior uses force, pressure, or threats to maltreat, forcefully dominate, or terrify another individual. The aim of this study was to assess the bullying prevalence and related features among secondary school pupils in Khamis Mushait city, southwestern Saudi Arabia. A cross-sectional investigation was performed among governmental and private secondary schools in Khamis Mushait city. Data were gathered from the study pupils using a pre-structured questionnaire. Bullying was assessed using the school climate bullying survey. The study included 300 secondary school students (163 females and 137 males). The overall rate of bullying was 64.7% (95% CI 59.1–69.9). The most prevalent type of bullying was verbal (41.7%, 95% CI 36.0–47.5) followed by physical (17.0%, 95% CI 12.9–21.7), and social (6.0%, 95% CI 3.6–9.3). Males had more than two times greater probability of having been bullied than females (aOR = 2.522, 95% CI 1.408–4.518). Similarly, students in first-level grade classes had more than three times greater probability of being bullied victims than those in the higher classes, i.e., second- and third-level grade classes (aOR = 3.417, 95% CI 1.159–10.07). More than half of the students tell teachers when other students are being bullied (53.7%) and tell a teacher or staff member at the school if they are being harassed (53.6%); teachers are doing anything they can to help if they are told that a student is being bothered (58.7%), and teachers are making clear to students that bullying is not tolerated (52.3%). In conclusion, in the present study, we reported a high prevalence rate of bullying among secondary school pupils in Khamis Mushait city, southwestern Saudi Arabia. Concerted efforts among teachers and health care providers in the region should be mandatory to deal with the problem.

Dietary supplements are commercially available manufactured products used as an addition to the normal diet and involve vitamins, minerals, herbs (botanicals), amino acids, and various other products. With the use of a cross-sectional survey, the present paper intended to analyze dietary supplement usage and its health and sociodemographic determinants among attendants of primary health care centers in Abha City, southwestern Saudi Arabia. The sample was selected randomly using the two-stage cluster sampling technique. The study included 438 participants (115 males and 323 females). Their ages ranged from 18 to 59 years, with an average of 36.2 ± 11.7 years. The study showed that 330 people used dietary supplementation, giving a prevalence of 75.3% (95% CI: 71.1–79.2%). The most commonly used supplements were multivitamins (215, 65.2%), specific vitamins (60, 18.2%), and mineral pills (38, 11.5%). Advice from health care workers was the most frequent reason for using dietary supplements (49.4%). The majority (71.2%) reported feeling a better quality of life after using dietary supplements. The most frequent disadvantages of using dietary supplements were constipation and headache (30%) and the most frequent advantage was increasing appetite (59.8%). The people who most frequently recommended the use of supplements were health care workers (190, 57.6%), followed by friends or family members (62, 18.8%), and people on social media (43, 13%). Females had a significantly higher probability of using dietary supplements than males did (Cor = 2.0, 95% CI = 1.21–3.27), and those with a chronic disease had a considerably higher likelihood of using dietary supplements (cOR = 3.48, 95% CI = 2.04–6.06). Age, educational level, and marital status were not significantly related with dietary supplement usage. In conclusion, health care workers should focus on females and persons with chronic diseases in their practice. They should provide them with evidence-based advice regarding the use of dietary supplements. Continued medical education training programs tailored to the needs of health care staff addressing this issue should be provided. New guidelines should be developed to help health professionals to provide their patients with comprehensive care at the primary health care level.

Herein, it has been shown that the bismuth ferrite magnetic nanoparticles (BFO-MNPs) are new, efficient and recyclable catalysts for the synthesis of polyhydroquinoline derivatives by the Hantzsch reaction. The one-pot four-component cyclocondensation reaction of dimedone, aromatic aldehydes, ethyl acetoacetate and ammonium acetate was carried out under solvent-free conditions. The desired products were obtained in very short reaction times with high yields. The magnetic nanocatalyst was characterized by the X-Ray Diffraction (XRD) and FT-IR analysis. For the first time, the bismuth ferrite magnetic nanoparticles were used as a catalyst in the Hantzsch reaction. The catalyst was found to be reusable, which showed considerable catalytic activity after the third run.

In the present study, some new bis-imidazole derivatives have been prepared through four-components condensation of 2,6-bis (4-aminophenyl)-4-p-tolylpyridine, benzaldehyde derivatives, benzil and ammonium acetate in presence of acetic acid. The present methodology offers several advantages such as good yields, simple procedure, milder conditions and the possibility of introducing a variety of substituents at different positions of the imidazole and pyridine rings. These new compounds were confirmed by spectral methods 1H NMR, 13C NMR, FT-IR, and elemental. Also, optimized geometries and chemical shifts have been calculated for the ‎synthesized compounds using Density Functional Theory (DFT) method. Their optimized ‎geometries are not planar.‎

Objectives. To explore the magnitude and determinants of burnout among emergency physicians and nurses working at emergency departments of hospitals in Abha and Khamis Mushait cities. Subjects and Methods. A cross-sectional hospital-based study was conducted in emergency departments of hospitals in Abha and Khamis Mushait cities belonging to Ministry of Health. All physicians (n=95) and nurses (n=187) currently working at these sites were invited to participate in the study by filling a validated self-administered questionnaire including two main sections: personal and professional characteristics of physicians and nurses as well as Maslach burnout inventory (MBI) to assess the three components of the burnout syndrome: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results. The study included 282 physicians and nurses. The age of more than half of them (54.3%) ranged between 31 and 35 years. Most of them (70.9%) were females. About two-thirds of the respondents (66.3%) were nurses while the remaining 33.7% were physicians. Majority of the emergency healthcare professionals (88.7%) had high emotional exhaustion. The prevalence of high depersonalization (cynicism) was 20.6% whereas that of low personal accomplishment was 41.1% among emergency healthcare professionals. The overall prevalence of burnout among healthcare professionals was 16.3%. Multivariate logistic regression analysis revealed that male healthcare professionals were at almost higher three-folded risk for developing burnout compared to females (aOR=2.76; 95% confidence interval (CI): 1.21-6.28, p=0.017)). Smokers were at higher significant risk for burnout compared to nonsmokers (aOR=15.37; 95% CI: 7.06-33.45, p

Smoking is well known to be correlated with cardiovascular abnormalities, in particular atherosclerosis and heart diseases. This article investigates the effect and relationship of smoking tobacco on the thickness of the intima–media (IMT) belonging to the common carotid arteries (CCAs), and also blood concentration of the lipid profile (LP), mainly the total cholesterol, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL) and also triglycerides. Nineteen male tobacco smokers and thirty-five healthy male non-smoking Saudi participants were involved in this study after obtaining their informed consent. An ultrasound and a spectrophotometer were used to determine the IMTs and lipid parameters, respectively. The thicknesses of the smokers’ right (RCA) and left carotid (LCA) arteries (0.72 and 0.7 mm, respectively) were significantly greater than the thicknesses of the arteries of the non-smokers (0.58 and 0.62 mm, respectively) (p-value = 0.005 and 0.04). Insignificant differences between the means of the other parameters in the two groups were studied. Smoking is a risk factor for stroke, because it significantly increases the IMTs of both the right and left carotid arteries.