Brief tele-mindfulness-based intervention: A multicenter randomized controlled trial.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has proven to be detrimental to the psychological well-being of healthcare providers (HCP). This study was a psychological intervention during the COVID-19 pandemic to check extent to which brief mindfulness-based interventions (MBIs) and progressive muscle relaxation (PMR) affect psychological well-being, resilience, and anxiety of HCPs. MATERIALS AND METHODS: A randomized trial study conducted from July to August 2020. One hundred and forty-seven COVID-19 frontline HCPs were randomized to a 2-week virtual intervention with a brief MBI or a PMR. Pre- and postintervention assessments were done using the State-Trait Anxiety-20-Item Scale, the Connor-Davidson Resilience Scale-10, and WHO-5 Well-Being Index. RESULTS: The final sample included 125 HCPs (64 in BMI group and 61 in PMR group) who completed pre- and post-intervention assessment. The results showed a significant improvement in the psychological well-being and reduction of the state anxiety of the two groups, but not in the trait anxiety or resiliency. Improvement was more in the group's brief MBI (81.3%) than in the group's PMR (51.8%) (P = 0.0001), concerning psychological well-being. CONCLUSION: Both the brief MBI and PMR improved the psychological well-being and reduced the anxiety of frontline healthcare providers during the COVID-19 pandemic with a slightly better improvement in the brief MBI.

Development and Validation of the Sinonasal Outcome Test-12.

OBJECTIVES: Quality of life (QoL) questionnaires are widely used in clinical interviews to assess the impact of medical interventions or measure the outcomes of healthcare services. The main aim of such questionnaires is the subjective assessment of health status and its impact on QoL. This study aimed to develop an efficient, short sinonasal disease assessment instrument, the sinonasal outcomes test-12 (SNOT-12), and to compare it with the preexisting SNOT-22. METHODS: This was a two-phase cross-sectional study. The study was performed between June 2019 and February 2020 using the electronic files of the ORL department outpatient clinics at King Fahd University Hospital, affiliated with Imam Abdulrahman Bin Faisal University. The study was performed in 2 phases: an item reduction phase, which resulted in an initial SNOT-12 scale, and a validation phase, using a comparative analysis of the initial SNOT-12 and the SNOT-22. RESULTS: The developed short-form SNOT-12 maintained the 4 latent factors extracted in EFA (nasal, Sleep/extra nasal, psychological, ear/facial). It strongly correlated with SNOT-22 (r = 0.973). It had good construct reliability (0.705-0.901) and validity and a higher discrimination power than the SNOT-22. CONCLUSIONS: The SNOT-12 is a short, valid, and reliable instrument that may prove useful for the initial screening and monitoring of patients with chronic rhinosinusitis.

Psychological Resilience, Anxiety, and Well-Being of Health Care Providers During the COVID-19 Pandemic.

Background: On the frontlines of the pandemic, healthcare providers (HCPs) are overworked, anxious, and fearful. Yet, despite all the fear and anxiety, the facilitation of protective resilience and psychological well-being has become crucial to ensure that minimal intangible psychological losses are incurred due to the pandemic. Aim: The present study aimed to examine the psychological resiliency, state anxiety, trait anxiety, and psychological well-being of frontline HCPs during the COVID-19 and to determine the association among resiliency, state-trait anxiety, and psychological well-being and their links with demographic and workplace factors. Design and Settings: A cross-sectional study concerning frontline HCPs was conducted at two of the largest hospitals in the eastern province of Saudi Arabia. Results: A significant inverse correlation was determined between resilience and state anxiety (r=-0.417, p<0.05) and between resilience and trait anxiety (r=-0.536, p<0.05). Likewise, a positive intermediate correlation between resilience and the age of the individual (r=0.263, p<0.05) and a weak positive correlation with years of experience (r=0.211, p<0.05) were established. Also, the resilience score of volunteer workers (50.9) was lower than that of regular staff (66.8) (p=0.028). Conclusion: Resilience is a crucial factor affecting the training of individuals, which will further promote their work output and mental health capacity, thus improving their overall concept of survival in adversity.

Patient Trust in Primary Care Physicians: A Mixed Methods Study of Persons with Diabetes at University- Based Clinics in the Eastern Province of Saudi Arabia.

Background: The establishment of patient trust in physicians is becoming increasingly valuable. Trust can be fundamental to successful patient care, favorable patient outcomes and improved financial savings for healthcare organizations. This study aims to explore patients' perceptions of trust in physicians, determine factors that play a role in this relationship, and to identify ways to improve patient trust. Methods: The study was conducted via a mixed-method design using semi-structured in-depth interviews until data saturation was reached (n=24), followed by a cross sectional survey of consecutive sampling until the number of participants (n=256) exceeded the required sample size. Adult patients with diabetes, aged 18-65, attending internal medicine (IM) or family medicine (FM) clinics of King Fahd Hospital of the University, Saudi Arabia were included in the interviews and surveys. Patients' interview transcripts were analyzed into trust dimensions resulting in a 51-item scale. Quality function deployment (QFD) was used to define the highest priority patient requirements. Overall satisfaction was calculated as a satisfaction percent, and factors related to satisfaction were tested using independent samples t-test and ANOVA. Results: Significant domains for establishing patient trust in physicians were the perceived physician's competency level, comprehensiveness of care, morals, personal traits, and establishing continuity of care. The trust score ranged from 42.0% to 100% with an average of 90.4%. There was no difference between the FM and IM setting, nor between the sociodemographic factors and the patients' satisfaction level. No statistically significant results were found between diabetes type, years of diagnoses, achieving the target HbA1c with patients' satisfaction level and trust. Patients reporting hypo or hyperglycemic symptoms had lower levels of satisfaction than those who did not. Conclusion: Persons with diabetes were more trustful of primary care physicians if they displayed satisfactory communication skills, experience, and a caring attitude.

Breaking Bad News of a Cancer Diagnosis: A Mixed-Methods Study of Patients' Perspectives.

Purpose: A cancer diagnosis is an overwhelming process for both patients and doctors. Many studies have addressed doctors' opinions and knowledge regarding breaking bad news (BBN). However, scarce knowledge exists regarding patients' perspectives for communicating bad news. Therefore, the current study aims to assess cancer patient preferences and satisfaction about BBN. Patients and Methods: This is a mixed methods study consisting of two phases; an in-depth interview and cross-sectional quantitative analysis. Thematic analysis was used for the qualitative data to explore patients' satisfaction and preferences about BBN. For quantitative analyses, the overall satisfaction was calculated as satisfaction percent. Bivariate analyses were performed, and statistical significance was set as p < 0.05. Quality function deployment was used to effectively define patient requirements of highest priority. Results: Thematic analysis revealed two main themes. Theme 1; patients' requirements for BBN and theme 2; patients' reaction at the time of diagnosis with their categories. For the quantitative part, a total of 222 patients responded to the survey, females made up 70% of the sample. Satisfaction score percent ranged from 25.5 to 100%, with a mean of 82.7±11.9%. The most preferred items were mainly concerned with the doctor being honest and encouraging, good listener and interacting giving simple smooth explanations without using medical terms, and empathetic (average score 4.8/5). Also, providing the diagnosis in a calm and private environment (4.7/5). Analysis also found that the requirements for improvement included providing a written summary after receiving the diagnosis and patient perception assessed by the doctor before telling the diagnosis. Conclusion: Communicating bad news effectively is crucial in the management of cancer patients. The process of BBN should be patient-centered, focusing on patients' needs. Thus, the current study has demonstrated the patients' preferences and the requirements, which should be incorporated into BBN protocols.

Characteristics of Pediatric Primary Healthcare Visits in a University-Based Primary Healthcare Center in Saudi Arabia.

This study aimed to identify the characteristics of pediatric primary health care (PHC) visits and evaluate the outcomes of patients presenting with complaints along with their referral and consultation capabilities. This was a retrospective medical record-based study. The study population included any pediatric patient (≤14 years old), including females and males, Saudis, and non-Saudis. Research data were gathered for visits from 2016-2021. Sampling was performed using a stratified random sample based on age groups, followed by simple random sampling with proportional allocation to different age groups. The number of pediatric visits included was 1439 (males, 52.2%). The most common age group was toddlers, and 60% of the total sample was from Saudi Arabia. The most common cause of visits was vaccination (32%), followed by general checkups and/or a well-baby visit (25.4%), and fever (11.2%). Approximately 10% of visits needed referral to other subspecialties. Approximately 50% of visits with complaints concerning ophthalmology, cardiology, and surgical intervention were referred to a specialized department. More awareness needs to be raised about the important role of PHC services in the pediatric age group, as it was capable of handling approximately 90% of their cases.

Clinical, Laboratory, and Ultrasound Related Diagnoses of Thyroid Disorders: Using a Family Medicine Center Data to Assess Thyroiditis and Thyroid Nodules in the Eastern Province of Saudi Arabia.

INTRODUCTION/OBJECTIVES: The prevalence of thyroid disorders is high in Saudi Arabia. Among the disorders, goiter and thyroiditis are the most common and have unique ultrasound (US) features, underscoring the need for US screening for thyroid pathologies. This study aimed to determine the prevalence of thyroiditis and thyroid nodules in patients attending the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University. METHODS: This registry-based cross-sectional study analyzed laboratory and US data from 240 patients who attended the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University from January 2020 to December 2021. Abnormalities of the thyroid gland were categorized according to laboratory and US data. Associations between different types of thyroid pathology and clinical and laboratory findings were assessed using appropriate statistical methods. RESULTS: The majority of participants were Saudi women. The prevalence of thyroiditis in the study population was 43%. Approximately 25% of these patients had more than 1 nodule, and fine-needle aspiration biopsy showed that most nodules were benign. Most nodules were found in clinically euthyroid patients. Thyroiditis might be associated with abnormal thyroid function. CONCLUSIONS: Thyroiditis and thyroid nodules were common in our cohort. Vitamin D deficiency, other autoimmune diseases, and a family history of thyroid disorders were associated with thyroiditis and thyroid nodules. US is useful for identifying the type of thyroid disease.

Quality of Life and the Perceived Impact of Epilepsy in Children and Adolescents in the Eastern Province of the Kingdom of Saudi Arabia.

Objectives This cross-sectional study aimed to assess the perceived impact of epilepsy on children and adolescents and analyze its aspects. Materials and methods The study included patients with epilepsy aged between and two and 19 years old in three major hospitals in the Eastern Province of Saudi Arabia. Data were collected through an online survey. Results The mean score percentage of the quality of life (QOL) assessment was 65.6. This study showed better mean score QOL percentages in males (67), adolescents (65), patients with higher family income and socioeconomic status (64), and those living in Al Jubail (71). QOL was negatively associated with seizure frequency, the number of fears, problems, and concerns, and longer treatment duration. The most common concerns in children and adolescents with epilepsy are having/starting a relationship with others and what people at school will think if they have a seizure. The most common problems were lack of concentration and feeling short-tempered or grumpy. Continuing with education was the most common fear for the future. The most common concern of parents/caregivers was their ability to keep up with schoolwork. The QOL of participants who preferred to keep their epilepsy a secret (69) and those who used magazines and books (71) as one of the sources of information was better than that of those who did not. Conclusion Better QOL was found in males, adolescents, patients with higher family income, those living in Al Jubail, who preferred to keep their epilepsy a secret, and those who used magazines and books as sources of information. However, the QOL was negatively associated with seizure frequency, the number of fears, problems, and concerns that the patients/caregivers had, and longer treatment duration.

Association between glycemic control and shift working among healthcare workers with diabetes, Dammam, Saudi Arabia: Five years' experience.

OBJECTIVES: To delineate the relation between shift work and glycemic control among the healthcare workers (HCWs) with diabetes mellitus (DM) in the hospitals of Dammam, Saudi Arabia. METHODS: A cross-sectional study was conducted among HCWs with DM working in 3 hospitals in Dammam, Saudi Arabia, from November 2018 to January 2019. The study participants answered a self-administered questionnaire related to sociodemographic data, work-related questions, diabetes-related questions, the latest hemoglobin A1C test outcome, and self-management activities. The Chi-square and t-test were used to determine the association between the risk factor of glycemic control and shift work. RESULTS: The HCW's ages ranged from 24-60 years. The mean age of the employees in the day shift was 42.4±7.7 years and night shift was 42.1±7.3 years. The significant difference between daytime workers and shift workers was observed in terms of occupation, and obesity. Day shift employees reported being significantly more physically active than shift workers. The daily day shift led the employee to miss their routine clinic visits for DM. Shift workers had more weight gain due to unhealthy food intake, sleep deprivation, and improper physical activity when compared with daytime employees. Anti-clockwise shift rotation significantly demonstrated that 92.9% of employees developed uncontrolled DM. CONCLUSION: Glycemic control was worsened among the shift worker with DM compared to daytime workers.

Epidemiology of tuberculosis among different occupational groups in Makkah region, Saudi Arabia.

Each year in Saudi Arabia, the Hajj season represents one of the world's most significant annual mass gatherings, attracting high proportion of immigrants from different parts of the world in small crowded areas, posing a risk for Tuberculosis (TB) transmission. There is a high potential for TB contact and infection in the workplace as it is transmitted through the air. Most of the studies in Saudi Arabia assessed the TB infection among health care workers. However, the TB incidence rate among other variant occupational groups was not yet determined. This study was conducted to assess the incidence rate of tuberculosis, and determine the risk factors of TB infection among different occupational groups in the Makkah region, Saudi Arabia 2016. A cross-sectional study was carried out based on the secondary data of the patients registered in the Saudi national tuberculosis control and prevention program in 2016. Data were then organized and analyzed for age, gender, nationality, educational level, average monthly wage, average weekly working hours, and occupation of the patients. Occupations were reclassified according to the Saudi Standard Classification of Occupation (SSCO). A total of 1270 cases were included in this study, 300 (23.6%) of them were workers. The incidence rate of TB among workers in the Makkah region was 9 per 100,000 workers compared to 31 per 100,000 persons among the general population in 2016. The TB incidence rate was the highest among occupation of supporting basic engineering with 13 per 100,000 workers in 2016. The highest incidence rate of TB among occupations of supporting basic engineering could be attributed to close contact with the general population in closed spaces for long periods of time, and low socioeconomic status.

Workplace violence among health-care workers in emergency departments of public hospitals in Dammam, Saudi Arabia.

BACKGROUND: Workplace violence is a serious occupational health problem. Emergency health-care workers have a high risk of exposure to violence with negative personal consequences. AIMS: To estimate the prevalence and possible associated factors of workplace violence among health-care workers in emergency departments of public hospitals in Dammam, Saudi Arabia. METHODS: A cross-sectional study was conducted during August to October 2018 at 4 emergency departments of public hospitals belonging to the Saudi Ministry of Health. Data were collected using a self-administered questionnaire. RESULTS: Of 380 questionnaires distributed, 324 were returned (85% response rate). Almost two thirds of the participants were women (66.4%) and more than half (54%) were nurses. A total of 155 health-care workers (47.8%) had experienced at least 1 type of violent incident in the preceding 12 months. Of the total violence incidents, 52% were verbal abuse, 19% were physical violence, and sexual harassment (3%) was the least common. Lack of encouragement to report incidents and Saudi nationality were the only significant variables associated with workplace violence. CONCLUSIONS: Workplace violence was prevalent, and verbal abuse was the commonest type among health-care workers in emergency departments of Saudi hospitals. Encouragement to report violent incidents and raising awareness among health-care workers about violence reporting systems are important strategies to improve workplace safety.

Perceived Effect of Calorie Count Display on Customers' Eating Behaviors in Food Facilities of Eastern Province, Saudi Arabia: A Mixed Method Study.

BACKGROUND: As the Saudi Food and Drug Authority (SFDA) has recently requested all food facilities to display the calorie count on their menus, this study aimed to identify the perceived changes in costumers' eating behaviours in response to the calorie count display (CCD) policy in the Eastern Province. METHODS: This was a mixed methods study. The first being quantitative, using a cross-sectional questionnaire which included 400 customers of both genders, aged 10 years and older, and was collected at food facilities from three cities in the Eastern Province. Customers completed a self-administered questionnaire and handed their registered receipts. Collected receipts were used to calculate the total calories ordered per customer. The second method is a qualitative in-depth interview with food facility managers. RESULTS: Customers who reported checking the CCD were 30.5% of the total sample, and 58.2% of them changed their order accordingly. The mean calories ordered were 36 kcal less in customers checking the CCD than those who do not (P=0.674). Customers who exhibit healthy lifestyle habits calculate their daily consumed calories, knowledgeable of the recommended daily caloric intake (RDCI), dining in a dine-in restaurant, and have an educational level of above high school were more likely to check the CCD. This study found that customers who cared to check the CCD were more likely to change their eating behavior. It has been found that only a small percentage (12% to 18%) of customers were knowledgeable regarding the RDCI. After the implementation of the policy, restaurant managers reported a positive change in customers eating behavior, which was more profound in females and athletes. CONCLUSION: There is a significant association between checking the CCD and positive behavioral changes in customers' eating behaviors. The results of this study suggest that further enforcement and awareness raising are crucial to increase the number of customers checking and using the CCD.

Burnout Prevalence and Associated Stressors in Medical Students of Traditional and Problem-Based Learning Curricula in a Saudi University.

BACKGROUND: Medical students are prone to burnout, and several stressors have been associated with it. From the literature, it is yet unclear if type of curricula in medical schools plays a role in burnout among students. AIMS: To assess the prevalence of burnout and its associated stressors in medical students in problem-based learning and traditional curricula at Imam Abdulrahman Bin Faisal University. SUBJECTS AND METHODS: The analytical, cross-sectional study was conducted between February and May 2017 and included all third- to sixth-year medical students of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. In the 2016-2017 academic year, third- and fourth-year students were in problem-based learning, whereas fifth- and sixth-year students were in traditional learning. All eligible students were verbally invited to complete a 56-item questionnaire comprising three sections eliciting sociodemographic information, level of burnout (using a modified Copenhagen Burnout Inventory with personal, medical school- and faculty-related subsections) and stressors associated with burnout. Burnout was measured using a Likert-type scale, and scores of >50 were considered as high burnout. Chi-square and logistic regression analysis were used for statistical analysis. RESULTS: Of 947 eligible students, 593 (62.6%) completed the questionnaire: 317 (53.5%) were in problem-based learning and 276 (46.5%) in traditional learning. Of these, 329 (55.5%) had high burnout, with no difference between type of curricula (problem-based learning = 178 [56.2%]; traditional = 151 [54.7%]; P = 0.73). All measured stressors were significantly associated with high burnout, including lack of sleep (odds ratio [OR] = 2.139, P = 0.005) and perceiving teaching staff as inflexible and unsupportive (OR = 2.995, P < 0.001). CONCLUSIONS: This study found high prevalence of burnout among medical students in a university from Saudi Arabia, but no significant difference between students in problem-based learning and traditional curricula. A longitudinal study is recommended to better understand the long-term effect of type of curricula on burnout.

Knowledge and attitudes regarding elder abuse in the community, Eastern Province Saudi Arabia.

BACKGROUND: The population of old people is increasing world-wide. Along with the increase in their population, an increase in the cases of elder abuse is expected. This study identifies the knowledge of elder abuse and attitudes towards it among the adult attendees of Al Qatif primary health care centers (PHCCs) in Saudi Arabia. METHODS: In this cross-sectional study, 430 participants at PHCCs, in Al Qatif, in the kingdom of Saudi Arabia completed a questionnaire concerning their knowledge of elder abuse and their attitudes toward the subjects of such abuse. RESULTS: A total of 430 subjects participated in the study. The mean age of the respondents was 35.6 years. Participants included both caregivers (n = 93) and non-caregivers (n = 337). The overwhelming majority of respondents 97% stated that it is their individual responsibility to report elder abuse and neglect if they witness any. Similarly, (91.8%) of the participants agreed that elder abuse and neglect is a criminal act and they have the responsibility to prevent such abuse and neglect. Also, (90.7%) were aware of financial abuse, and (93.5%) believed that using swear words can be considered abuse, as it is not part of their culture. The majority of them (90.5%) agreed that occasional manhandling of the older people is violence/abuse. CONCLUSION: Most of the participants regarded abuse and neglect of the older people as a serious problem and considered it their responsibility to intervene when they encountered it. Further efforts are required to explore the factors associated with elder abuse to utilize that knowledge in the development of effective interventions to prevent such abuse.

Consumption of vitamin and mineral supplements and its correlates among medical students in Eastern Province, Saudi Arabia.

BACKGROUND: Although vitamin and mineral supplements are popular in many countries, few studies have documented their use among college students. Moreover, there is not much national data on the use of supplements by Saudi medical students. The aim of this study was to determine the prevalence of the use of vitamin and mineral supplements by female medical students at Imam Abdulrahman Bin Faisal University (IAU) in Dammam, Saudi Arabia, and to identify characteristics associated with the use of supplements in this population. MATERIALS AND METHODS: For this cross-sectional study, all female medical students at IAU in Dammam, Saudi Arabia, were approached during September to November 2016. Results were presented as frequency distribution. Chi-square test and logistic regression analysis were performed to determine factors associated with supplement use; P < 0.05 was considered statistically significant. RESULTS: Completed questionnaires were returned by 474 students (response rate of 77%). The prevalence of the use of vitamin and mineral supplements was 44.6%; Vitamin D was the most commonly used supplement. Association of supplement use with a higher family income and the habit of regular exercise was statistically significant. However, this use of supplements was not significantly associated with smoking or marital status. CONCLUSION: The use of supplements, particularly Vitamin D, by female medical students was 44.6%. The highest percentage of users belonged to families with higher incomes and had the habit of exercising regularly.

Eating disorders and associated risk factors among Imam Abdulrahman bin Faisal university preparatory year female students in Kingdom of Saudi Arabia.

OBJECTIVES: To estimate the prevalence of eating disorders among Imam Abdulrahman bin Faisal University (IAU) in Dammam, Kingdom of Saudi Arabia, female students and to investigate the associated factors. Methods: A cross-sectional study was conducted at IAU, Dammam, Kingdom of Saudi Arabia, in 2016 with 670 participants. Data was collected by self-administered questionnaires, including the Eating attitude test 26 (EAT-26) and the sociocultural attitudes toward appearance questionnaire (SATAQ-4). Eating behavior questions were asked to determine whether the respondents should seek evaluation for an eating disorder (ED) from a professional. RESULTS: Eating attitude test 26 results showed that 29.4% of participants were categorized at a high level of concern for an ED, and 45.5% were categorized as at risk of having problematic feeding behaviors. Of the participants who scored above 20 on the EAT-26, 60.7% demonstrated high-risk feeding behavior attitudes, and approximately 11.5% who scored a body mass index (BMI) classified as underweight or very underweight required referral to a psychologist. A significant relationship was found between family stress to lose weight and EAT-26 scores above 20. The media was also found to represent external influence to lose weight. CONCLUSION: This study concluded that early detection of EDs or problematic feeding behaviors and attitude is vital to minimize the risks to physical health and well-being of the sufferers' experiences.

Prevalence of type 2 diabetes mellitus in a sample of the adult population of Alexandria, Egypt.

AIMS: To determine the prevalence of type 2 diabetes mellitus in a sample of the adult population of Alexandria, Egypt, and to delineate the epidemiologic profile of the disease in this community. METHODS: This cross-sectional study was conducted on a representative sample of the population. Participants provided demographic data, their medical history, and blood samples for measurement of plasma glucose (fasting and after oral glucose load) and underwent a detailed physical examination. RESULTS: Of 10,640 eligible subjects, 9657 (90.8%) aged 18-90 years agreed to participate (3795 men, 5862 women). We found an age-adjusted prevalence of diabetes of 16.8% (men, 12.7%; women 19.1%); of prediabetes, 14.6% (men, 13.5%; women, 15.2%), and of newly diagnosed diabetes, 5.5% (men, 3.3%; women, 6.6%). Diabetes was most common in people older than 50 years; prediabetes was most common in 30-39-year-old men and in women younger than 20. In logistic regression analysis, factors independently associated with prediabetes were a history of dyslipidaemia, urban residence, and widowhood. Independent associated factors for diabetes were a high waist-to-hip ratio, family history of diabetes, being divorced, history of dyslipidaemia, peripheral arterial disease or hypertension, low education level, and being not working. CONCLUSIONS: We found a high prevalence of diabetes and prediabetes in Alexandria, particularly in the middle-aged population. Given globally increasing life expectancies, the number of individuals with diabetes could become particularly challenging to the Egyptian healthcare system. Comprehensive national preventive measures are urgently needed.

Misconceptions of Parents about Antibiotic use in Upper Respiratory Tract Infections: A survey in Primary Schools of the Eastern Province, KSA.

BACKGROUND: Misuse of antibiotics has become a global public health issue for several reasons, one of which is the rapid development of antibiotic resistance that leads to high morbidity and mortality. OBJECTIVES: The objective of this study was to study the misconceptions of parents of primary school children in Dammam, Khobar, and Dhahran about the use of antibiotics for upper respiratory tract (URT) symptoms; and also study perceptions, attitudes, and behavior toward antibiotic use and identify the factors affecting this. MATERIALS AND METHODS: Analytic cross-sectional study of parents in three large cities: Dammam, Khobar, and Dhahran in Saudi Arabia. Study population was parents of children studying in these schools, and were selected multistgae sampling and proportional to population size (PPS). RESULTS: The questionnaire was distributed to 1306 parents. The response rate was 78.9%, 56.6% respondents were mothers with a mean age of 40 ± 7. Sixty-seven percent of the parents admitted to self-prescription once or more, and the most common reason for self-prescribing, was because they thought the child was not ill enough to be taken to hospital (41.8%). This was followed by 37.7% who used "leftovers". Regarding the attitude toward antibiotic prescription, 62.5% agreed that children should not be given an antibiotic when they have a fever and nasal congestion. In addition, 63.5% agreed that they should give their child antibiotic for ear or throat pain. Around two-thirds agreed that upper respiratory tract infection (URTI) was caused by a virus. Those who obtained their information from primary health-care centers and general practitioners had the lowest median of total knowledge score, and the highest knowledge was for those who obtained information from websites and the social media. Multiple linear regressions revealed that parents whose incomes were high, had high education, had children in private schools were more likely to have good knowledge and highly favorable attitudes and practices toward antibiotic use. CONCLUSION: Thirteen percent had an excellent knowledge, and 52.7% had an intermediate level of knowledge. Of those with excellent knowledge, 58.6% still expected to get antibiotic prescription from a physician for URTI.

Knee problems and its associated factors among active cyclists in Eastern Province, Saudi Arabia.

INTRODUCTION: Bicycling is one of the most enjoyable aerobic exercises recommended for the promotion of an individual's health. The Eastern Province of Saudi Arabia has seen a huge increase in the number of people who cycle. People have different goals for bicycling, but the injuries they sustain are common. Most of them relate to overuse, particularly of lower body joints. This study was conducted to determine the prevalence of knee problems and factors associated with knee pain in cyclists. MATERIALS AND METHODS: A cross-sectional study was conducted in October 2015, using an online self-administered questionnaire. The questionnaire was based on pertinent literature, was piloted, and validated. A web link was sent to 513 cyclists (professional and amateur) using E-mail, WhatsApp application, or SMS. Three hundred and eleven responses were received, 283 of which were included in the analysis. RESULTS: The overall prevalence of knee pain was 25.8%; 27.6% for amateur cyclists and 15.9% for professional cyclists. Only 17.2% knee pain was attributed to cycling, whereas in 32.8% it happened spontaneously and in 25% of cases it occurred while running. Majority of the cyclists reported pain as mild (61.6%) or moderate (28.7%); anterior knee pain accounted for 58.1% knee pain. Different goals of cycling and different bicycle types had statistically significant difference on the rate of knee pain. Of underweight cyclists, 62.2% reported knee pain. Cyclists who run more or participated in football had a higher rate of pain. CONCLUSION: Knee injuries are common with cyclists. Factors such as the type of the bicycle, the goal of bicycling, club type, body mass index, and participation in other sports play a significant role in the rate of knee pain.

Hepatitis C infection awareness among fourth year medical students at University of Dammam.

OBJECTIVES: To determine awareness about hepatitis C among 4th -year medical students at Dammam University, on hepatitis C and possible associated factors. MATERIALS AND METHODS: A cross-sectional study was conducted using a self-administered questionnaire comprising questions on awareness of hepatitis C virus (HCV) transmission, screening of the population, symptoms, complications, prevention, and treatment. RESULTS: A total of 201 students participated, with a response rate of 79.8%. About 75% of students had a poor grasp of HCV transmission while the awareness of <25% of students was fair. More than half of students had fair knowledge about screening, prevention, and treatment of HCV. The majority of students were familiar with the clinical presentation and complications of HCV. The overall awareness of the 4th -year medical students on HCV infection was fair, with no significant difference between males and females. CONCLUSIONS: Overall grasp of hepatitis C by the studied group was fair. However, there were serious gaps in their knowledge, which need to be filled or modified, especially knowledge about transmission which was poor.