The Assessment of Diabetic Ketoacidosis Awareness Among Diabetic Patients and Their Caregivers in Makkah, Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM). It occurs due to a decrease in the level of insulin and an increase in the level of glucose in the blood, which makes cells unable to use glucose as an energy source and begin to break fat into ketones; an overload of ketones levels in the blood can lead to DKA. The aim of the study is to assess awareness of DKA among diabetic patients and their caregivers in Makkah City, Saudi Arabia. METHODS: This study is a cross-sectional study collected through an online questionnaire of diabetic patients and their caregivers in Makkah City. A self-reported questionnaire designed in Arabic and English through the use of Google Forms, it distributed electronically via social media to the target population with the objectives of the survey. RESULTS: A total of 400 participants were included, 73% of them were males, while 27% were females. A 9% of the participants have been diagnosed with DKA. A high awareness level about DKA was found in 32.5% of participants, while 67.5% had a poor awareness level. Factors associated with a high level of awareness towards DKA are young age, being single, students and having a previous DKA diagnosis. CONCLUSION: Regarding our participants who have poor awareness of DKA, further education for diabetic patients and their caregivers about DKA is crucial to prevent life-threatening complications, and improve quality of life for these patients.

Real-world treatment patterns and clinical outcomes in patients with prostate cancer.: A single institution experience in Saudi Arabia.

OBJECTIVES: To describe the current real-world treatment landscape, sequence of therapies, and outcomes in patients with prostate cancer (PC). METHODS: A retrospective cohort study for PC patients diagnosed at King Abdullah Medical City Cancer Center in Makkah, Saudi Arabia, between January 2011 and December 2021. Data extracted from electronic medical records. RESULTS: A total of 282 patients with PC, with a mean age of 70 years and body mass index of 27. Among them, 274 (99%) had no family history of cancer, while 164 (58%) had hypertension and 125 (44%) had diabetes mellitus. Adenocarcinoma was the most common histology, found in 275 (97%) patients, with 99 (35%) having a Gleason score of 9. Notably, 184 (65%) patients presented with metastatic disease, and 147 (52%) with bone metastasis. While 198 (70%) patients underwent surgery, 184 (65%) did not receive radiotherapy. The most common first-line metastatic therapy was abiraterone in 23 (8%) patients, followed by enzalutamide in 7 (2.5%). During the study period, 167 (59%) patients survived, with an average treatment duration of 2.5 years. CONCLUSION: This study provides insights into real-world treatment patterns and clinical outcomes in patients with PC. The findings of this study highlight the importance of adhering to treatment standards and making informed clinical decisions.

Complementary and Alternative Medicine Use Among Patients with Dry Eye Syndrome in Saudi Arabia: A Survey Study.

Introduction: Complementary and alternative medicine (CAM) includes all healthcare practices that are not part of conventional medicine. One of the most common eye disorders for visiting an ophthalmology clinic is dry eye disease (DED), and due to the increasing number of CAM used for eye conditions, 1 in 5 patients has been reported in previous studies to use CAM for eye treatment. This study aimed to estimate the prevalence of CAM use among patients with (DED). Methods: A web-based survey was used to collect the data, the first part of the questionnaire was about demographic data, and the second part included a validated Arabic version of the ocular surface disease index (OSDI). The third part was about practices that alleviate DED other than conventional medicine. Results: The total sample was 282, 61 were males, and 221 were females. Most participants (48.5%) were between 25 and 44 years old, 90% were Saudi, and only 10% were non-Saudi. Of the participant, 70% reported having attained a university or higher education level. The prevalence of the use of CAM among patients with dry eye was around 85%. The most frequently reported type of CAM used among the participants was faith healing (Ruqyah) (41%). This was followed by warm compressors (37%). There was no significant correlation between the severity of OSDI and using CAM, as the p-value was 0.909. Conclusion: In conclusion, our study shows that CAM is a popular choice among patients with dry eye syndrome. Faith healing and warm compressors are the most used types of CAM. However, the lack of correlation between OSDI severity and CAM use indicates that patients may use CAM for reasons other than symptom severity. Further research is needed to explore the reasons behind CAM use and its effectiveness in managing dry eye syndrome.

Multi-Chaos-Based Lightweight Image Encryption-Compression for Secure Occupancy Monitoring.

With the advancement of camera and wireless technologies, surveillance camera-based occupancy has received ample attention from the research community. However, camera-based occupancy monitoring and wireless channels, especially Wi-Fi hotspot, pose serious privacy concerns and cybersecurity threats. Eavesdroppers can easily access confidential multimedia information and the privacy of individuals can be compromised. As a solution, novel encryption techniques for the multimedia data concealing have been proposed by the cryptographers. Due to the bandwidth limitations and computational complexity, traditional encryption methods are not applicable to multimedia data. In traditional encryption methods such as Advanced Encryption Standard (AES) and Data Encryption Standard (DES), once multimedia data are compressed during encryption, correct decryption is a challenging task. In order to utilize the available bandwidth in an efficient way, a novel secure video occupancy monitoring method in conjunction with encryption-compression has been developed and reported in this paper. The interesting properties of Chebyshev map, intertwining map, logistic map, and orthogonal matrix are exploited during block permutation, substitution, and diffusion processes, respectively. Real-time simulation and performance results of the proposed system show that the proposed scheme is highly sensitive to the initial seed parameters. In comparison to other traditional schemes, the proposed encryption system is secure, efficient, and robust for data encryption. Security parameters such as correlation coefficient, entropy, contrast, energy, and higher key space prove the robustness and efficiency of the proposed solution.

Cyber Threat Intelligence-Based Malicious URL Detection Model Using Ensemble Learning.

Web applications have become ubiquitous for many business sectors due to their platform independence and low operation cost. Billions of users are visiting these applications to accomplish their daily tasks. However, many of these applications are either vulnerable to web defacement attacks or created and managed by hackers such as fraudulent and phishing websites. Detecting malicious websites is essential to prevent the spreading of malware and protect end-users from being victims. However, most existing solutions rely on extracting features from the website's content which can be harmful to the detection machines themselves and subject to obfuscations. Detecting malicious Uniform Resource Locators (URLs) is safer and more efficient than content analysis. However, the detection of malicious URLs is still not well addressed due to insufficient features and inaccurate classification. This study aims at improving the detection accuracy of malicious URL detection by designing and developing a cyber threat intelligence-based malicious URL detection model using two-stage ensemble learning. The cyber threat intelligence-based features are extracted from web searches to improve detection accuracy. Cybersecurity analysts and users reports around the globe can provide important information regarding malicious websites. Therefore, cyber threat intelligence-based (CTI) features extracted from Google searches and Whois websites are used to improve detection performance. The study also proposed a two-stage ensemble learning model that combines the random forest (RF) algorithm for preclassification with multilayer perceptron (MLP) for final decision making. The trained MLP classifier has replaced the majority voting scheme of the three trained random forest classifiers for decision making. The probabilistic output of the weak classifiers of the random forest was aggregated and used as input for the MLP classifier for adequate classification. Results show that the extracted CTI-based features with the two-stage classification outperform other studies' detection models. The proposed CTI-based detection model achieved a 7.8% accuracy improvement and 6.7% reduction in false-positive rates compared with the traditional URL-based model.

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia. A cross-sectional study.

OBJECTIVES: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with pre-hospital delay. METHODS: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, and multivariate analysis were used to examine factors associated with pre-hospital delay. RESULTS: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). CONCLUSION: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the bene ts of availing an ambulance service.

Analysis of Hepatitis B virus (HBV) mutations in patients from Western Saudi Arabia with chronic disease.

INTRODUCTION: Extensive research has provided a link between HBV variants and the clinical complications of liver diseases. This study was performed to further investigate the relationship between HBV variants in preS, S and BCP/PC regions and disease progression in chronic hepatitis B (CHB) cases in Jeddah, Saudi Arabia. METHODOLOGY: 182 CHB patients were recruited for this study. HBV DNA was amplified by PCR in the PreS, S, and BCP/PC regions. Sequences were generated from 31 and 26 treated cases in PreS and S regions respectively and from 72 cases in the BCP/PC region. RESULTS: The majority of cases (86.7%) were genotype D. Mutations at preS1-A2922C, X-A1624C and PC-G1887A were detected only in cases with either a high fibrosis score or hepatocellular carcinoma (HCC), while mutations at positions PC-C1982A, PC-G1951T, X-C1628T and X-A1630G were detected more frequently in HCC cases, without reaching statistical significance. Seven deletions were detected in the PreS-region. No deletions were detected in the CCAAT box. The accumulation of mutations per sample in the preS1-2 and S regions were associated with elevated ALT (p < 0.001, 0.001 and 0.001; respectively) and increased fibrosis (p = 0.018, 0.02 and 0.013; respectively). The accumulation of mutations per sample in the BCP/PC region is associated with high viral load. Occult hepatitis B infection (OBI) was identified in 5 samples. CONCLUSION: Our results add to the knowledge about HBV genotype-D variants. The accumulation of mutations per sample and OBI seem to play a role in the progression of HBV infection. G1896A was associated with the HBeAg negativity. The preS deletions did not play a role in liver disease progression.