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Nine Penicillium digitatum isolates were isolated from citrus fruits and tested for their pathogenicity on Navel orange fruit (Citrus sinensis L.). In this regard, the isolates exhibited three different levels of virulence. The isolates were identified morphologically using malt extract agar (MEA) and Czapek yeast extract agar (CYA) for colony characteristics, and MEA for microscopic features. Each one of the isolates has the unique features of P. digitatum, especially the largest conidia (6.1-11.9 µm long X 3.2-8 µm width), and phialides (10.1-21.4 µm long X 4-5.1 µm width). In addition, the isolates were identified on a molecular basis using ITS1 and ITS4 primers to confirm morphological identification. Phylogenetic analysis revealed that there was high variance among the isolates, and there were different relations between some of our isolates and other P. digitatum registered strains originating from different countries all over the world. The sequences were submitted to respective GenBank nucleotide databases with accession No. OR198852, OR198853, OR198854, OR198855, OR198856, OR198857, OR198858, OR198859 and OR198860. We also isolated a new P. digitatum (OB15: OR198859) strain with high virulence and rapid sporulation

Background: COVID-19 pandemic has sent serious waves of medical emergency all over the world. Healthcare workers (HCWs) are vulnerable to the infection through various patient care processes. As the pandemic advances, it becomes necessary to screen the asymptomatic HCWs for COVID-19 as they constitute potential sources for the disease transmission. Objectives: To screen for the incidence of COVID-19 among asymptomatic HCWs in the tertiary care centers in the Southern regions of Saudi Arabia using both RT-PCR and serology. Methods: A cross-sectional, hospital-based study was conducted to determine the incidence of COVID-19 among the asymptomatic HCWs using RT-PCR and serological assays among 186 consented participants. Results: The total number of COVID-19 cases among the participants using all tests was 34 (18.3%). Out of the total participants, 4.8%, 3.2%, 7%, 10.2%, and 11.8% positive COVID-19 cases were detected using RT-PCR, rapid ICT for IgG, rapid ICT for IgM, ELISA for IgG and ELISA for IgM respectively. Significantly higher cases were observed among HCWs in the ICU of Aseer Central Hospital. 100% of the medical students and administrative staff, 40% of respiratory therapists, 31.8% of laboratory specialists, 22.7% of cleaners, 13.5% of physicians, 12.2% of nurses participated were positive to COVID-19. Participants of 18-24 years old showed the highest level of cases. However, considering the total number of positive COVID-19, nurses showed the highest number of cases. Conclusions: Considerable number of COVID-19 cases were detected among HCWs in the Southern region of KSA. Screening of HCWs should have the priority in the preventive interventions. [ABSTRACT FROM AUTHOR]

Purpose: Complete blood count (CBC) is a commonly used blood test for health checks. This study was conducted to compare CBC from two different altitudes and from sea-level populations in order to suggest correction factor for altitude-related increment on the hemoglobin and red blood cell indices. Patients and Methods: In this retrospective lab records study, large datasets of CBCs over 5-year period were screened from three different regions of Saudi Arabia, Jeddah (a coastal city), Taif City located at 1879 m above sea level, and Abha City at located 2270 m above sea level. Descriptive analysis and significance testing of the CBC variables at different altitude were compared. Results: A total of 57,059 participants were included for final analysis. Mean hemoglobin (Hb) concentration (g/dL) was 14.81 for men and 13.77 for women at sea level, whereas Hb concentrations were 15.35 and 14.19 for men and women residing at Taif City, respectively, and 15.40 and 14.71 for men and women at Abha City, respectively. Hemoglobin and other red cell indices were significantly different among men and women across different altitude, except for mean corpuscular volume (MCV). The MCV 95th percentile range was lower at sea level and both altitudes as compared to current reference range (76– 91 fL vs 81– 98 fL). Conclusion: Although altitude-associated increment in Hb concentration was evident in both men and women, it was lower than as suggested by World Health Organization and Centers for Disease and Control. Results of this study can also be used to derive new CBC reference intervals for Saudi residents living at high altitude. A correction factor (ΔHb) of 0.30 g/dL per 1000 m altitude is suggested to be used in adult population living at high altitudes in Saudi Arabia which should help better define anemia and polycythemia at altitude. [ABSTRACT FROM AUTHOR]

Background: Well-baby clinic (WBC) service is implemented in all primary health care centers and is provided based on international standards to all children under 5 years in Saudi Arabia. It is a comprehensive package of health promotion and curative care to improve and maintain the health status and well-being of this age group. Aim: The main aim is to assess parents' awareness and perception regarding WBC in primary health care centers in Abha sector, Kingdom of Saudi Arabia (KSA). Methodology: A descriptive cross-sectional approach was used in the current study. The study targeted all babies' caregivers attending WBCs in primary health care centers in Abha city. The children's parents were included using three stages cluster sample technique. The questionnaire included participants' demographic data such as age, gender, relation to the baby, educational level, work, and monthly income. Awareness regarding the WBC was assessed using two main items covering hearing about the clinic provided services. Results: The study included 1593 participants whose ages ranged from 19 to 55 years old with a mean age of 34.6 ± 11.8 years. About 64% of the respondents knew about the WBC, which was significantly higher among the females than males (P =.003). Also, 71.2% of respondents aged 25–34 years knew about well-baby clinic (WBC) compared to 35% of parents aged less than 25 years (P =.001). Exact 57.1% of the respondents went to the nearest governmental health office at vaccination times. About 46% of the respondents reported that the clinic nurse was the main person who dealt with them. Regarding services provided by a nurse at the vaccination clinic, registering child vaccination was the most reported (66.2%), followed by helping the mother make the child calm (56.8%). Conclusions: In conclusion, the study revealed that proper care is vital for a child's survival as well as optimal physical and mental development. Adequately cared child has proper well-being and happiness. Mothers and children caregivers had adequate awareness and acceptable attitude towards WBCs and provided services. Some barriers were declared including lack of available WBCs within the residence range, not all WBCs usually working, and more information should be provided about WBCs. [ABSTRACT FROM AUTHOR]

Objective: The goal of the study is to appraise the diagnostic validity of carotid Doppler ultrasound in stroke patients. Design: Retrospective Setting: Aseer central Hospital, Abha, Saudi Arabia Methods: A total of 77 stroke patients, admitted to Asir Central Hospital (ACH), Saudi Arabia, from January 2017 to December 2018 were enrolled. The degree of carotid artery stenosis was assessed by CT-angiography and carotid Doppler ultrasonography. The degree of stenosis was classified as: <70% or >70% and <50% or >50%. Considering CT-angiography the gold standard reference test, the diagnostic validity of carotid Doppler ultrasonography was calculated. Results: The location of stenosis was in the internal carotid artery among 69% of patients, while in 19%, it involved both the common carotid and the internal carotid arteries. Doppler ultrasonography had a sensitivity of 100%, a specificity of 87.5%, a positive predictive value of 94.6%, a negative predictive value of 87.5%, and an overall accuracy of 96.1%, when considering cut-off point of 50% stenosis. Conclusion: Carotid Doppler ultrasound offers high diagnostic validity among stroke patients. It is highly recommended for screening cases with symptoms of transient ischemic attacks or for differential diagnosis of stroke. However, since it is operator-dependent, continued training of radiographers and the use of enhanced technology are essential to improve its diagnostic validity. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of iron deficiency, latent and symptomatic, is heterogeneous worldwide. In this study, we aim to explore the prevalence of iron deficiency, with and without anemia, among medical college females at the high Altitude Aseer region of Southwestern Saudi Arabia. Methodology: 200 female medical students were randomly sampled, between the ages of 19 and 27 years. Blood samples were collected for complete blood count (CBC) values and serum ferritin determination. Questionnaires were completed in order to collect demographics, medical history, and socioeconomic information of the participants. Results: Prevalence of overall iron deficiency was high (63%, serum ferritin <20 μg/L, 52.5%, ferritin <15 μg/L). Anemia, adjusted for high altitude (defined as less than 13 g/dL was present in 41 participants (20.5%) and 12 (6.5%) have Hb <12 g/dL. Iron-deficiency anemia (Hb <13 g/dL and serum ferritin <15 μg/L) was present in 35 (17.5%). Personal and family history of anemia and poor animal product containing meals were positively correlated with the presence of iron deficiency state. Neither symptoms of anemia, nor the presence of menorrhagia correlate with the presence of iron deficiency anemia. Conclusion: Iron deficiency with and without anemia is a very common and condition in young females' population at high altitude. Implementing a lab method to screen for anemia on vulnerable populations is needed. Frequently asymptomatic, the primary care providers should maintain a high degree of suspicion in order to initiate screening for iron status. [ABSTRACT FROM AUTHOR]

Background: Little is recognized about factors affecting poor sleep hygiene and relations of sleep problems with the quality of life among adults. Aims: To evaluate sleep hygiene, explore its associated factors, assess the prevalence of excessive daytime sleepiness (EDS) and insomnia, and their relations with sleep hygiene. Besides, correlate sleep problems with life quality. Methods: A representative sample of primary healthcare population was surveyed using questionnaires comprising sociodemographic characters, personal lifestyles, validated Arabic versions of Epworth sleepiness scales, Athens insomnia scale, short-form health survey questionnaire (SF-12), and developed Arabic sleep hygiene index (SHI). Results: A total of 401 adults participated in the study. The average SHI score was 17.25 ± 7.33. Poorer sleep hygiene was significantly detected in younger age, unmarried, unemployed, smokers, and energy drinks consumers (P < 0.05). Positive significant correlations were correlated with cellphone and video-gaming duration. About 56.61% and 39.90% of participants suffered insomnia symptoms and EDS, respectively. Significant poorer SHI was detected among insomnia and EDS sufferers. Negative significant correlations were observed between scores of both components of SF-12 and EDS, insomnia, and SHI. Conclusion: Significant negative associations were detected between SHI, EDS, insomnia, and both components of life quality. The role of sleep hygiene education programs in the promotion of sleep and quality of life need to be considered. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and risk factors of brucellosis in human and animal's communities in southern Saudi Arabia. Methods: A cross-sectional sero-epidemiological study was conducted in Aseer and Jazan, Saudi Arabia (October 2017-October 2018). Human serum samples (n=339) were initially screened for Brucella antibodies and positive samples were further titrated for Brucella antibodies by immunocapture assay (titer of ⩾1:320 as positive). Animal samples (n=828) were screened using the Rose Bengal test. Relationship status was dichotomized to measure and predict independent contributions to variations in human using univariate and multivariate stepwise binary logistic regression model. Results: The rate of brucellosis among the 339 human samples in the two regions was 33.9%, and the rate of acute brucellosis was 12.4%. The rate of brucellosis in animals was 4.7%. Human brucellosis among the target groups was higher in northwestern Aseer (53.3%) compared to Southeastern Aseer (25.9%) and Jazan region (20.6%). The disease was more prevalent among non-Saudi nationals (35.2%) compared to Saudis (30.5%). The rate of brucellosis among butchers and shepherds was 37.5% and 37.2%, respectively. The rate of brucellosis was 37.8% in people over 30 years of age. Our univariate analysis showed that residing in Aseer region (OR: 2.60, 95% CI: 1.50-4.40), especially residing in northwestern Aseer region (OR: 4.40, 95% CI: 2.40-7.90), frequent consumption of raw meat (OR: 2.90, 95% CI: 1.50-5.50), shepherds (OR: 2.10, 95% CI: 0.80-5.30), owning sheep (OR: 2.20, 95% CI: 1.10-4.40), daily contact with animals (OR: 2.10, 95% CI: 0.75-5.80), and those > 30-year-old (OR: 1.50, 95% CI: 1.00-2.40) were significantly associated with increased risks of brucellosis. Our multivariate analysis further showed that residing in northwestern Aseer (OR: 9.16, 95% CI: 3.39-24.76) and having sheep (OR: 1.16, 95% CI: 1.00-1.35) were significant and independent risks of brucellosis while residing in agricultural region (OR: 0.28, 95% CI: 0.10-0.78) was a significant and independent protector against brucellosis. Conclusions: The study concluded that residing in northwestern Aseer area and having animals (sheep) are associated with significantly increased risks of brucellosis. [ABSTRACT FROM AUTHOR]