Prevalence, factors associated and management of needle phobia among the general population in Saudi Arabia and Egypt.

OBJECTIVE: This study aims to assess the prevalence of needle phobia among Saudi and Egyptian adult populations. In addition, underlying causes and strategies that can be utilized to address needle fear were investigated. METHODS: A cross-sectional online survey study was conducted in Saudi Arabia and Egypt between 1 May and 30 June 2023. Participants aged 18 years and above and living in Saudi Arabia and Egypt were eligible to complete the survey. Participants were invited to participate in this study through social media platforms (Facebook, X, Snapchat, and Instagram). A convenience sampling technique was used to recruit the study participants. A 21-item questionnaire consisting of four sections including a Likert scale score was used to answer the research objectives. Numeric data were presented as mean ± SD. For categorical variables, percentages were used. Comparison between groups were made by Student's t-test or Mann Whitney test according to data distribution. Chi squared tests for categorical values were conducted. A binary logistic regression analysis was conducted to investigate factors associated with needle phobia. RESULTS: A total of 4065 participants were involved in this study (Saudi Arabia: 2628 and Egypt: 1437). Around one-third of the study participants (36.5%) confirmed that they have needle phobia. Most of the study participants (81.1%) reported that they have had needle phobia since they were under 18 years of age. Pain, general anxiety, and fear of making a mistake during the procedure were the most commonly reported contributors for fear of needles during or before a medical procedure. Around 15.8% of the study participants reported that they have tried to get rid of phobia from needles. Non-surgical alternatives (such as oral medications and patches) and using smaller/thinner needles were the most commonly reported interventions that reduced fear of needles. Binary logistic regression analysis identified that females, those who are aged (41-50 years), widowed, those with bachelor's degrees and higher education, and those unemployed were more likely to have needle phobia compared to others. CONCLUSION: Our study highlighted the high prevalence of needle fear within an adult population in Egypt and Saudi Arabia. Females, those who are aged (41-50 years), those widowed, those with higher education degrees, those unemployed, those working in the health sector and people with low income were more likely to have needle phobia compared to others.

Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey.

INTRODUCTION: Health warnings on cigarette sticks are emerging as a tool to control tobacco consumption; hence, understanding how they are perceived is valuable in determining their effectiveness. Our study aimed to evaluate the perception of health-related messages and warnings on individual cigarette sticks. It also aimed to evaluate the perceptions of the effectiveness of cigarette packaging warnings and the acceptance level for the inclusion of health warnings on cigarette sticks. METHODS: This cross-sectional survey was conducted on 285 individuals in Al-Madinah, Saudi Arabia. The survey was distributed online using a non-probability convenience sampling technique. The chi-squared test and logistic regression analysis were used to determine the association of sociodemographic characteristics and smoking-related variables with participants' perceptions of health warnings on cigarette sticks and packaging. The responses were also assessed qualitatively using conceptual content analysis. RESULTS: In all, 18.6% of participants perceived that the package warnings were either 'quite effective' or 'very effective' in prompting smokers to quit. For health warnings on cigarette sticks, 28.1% of participants perceived that the theme of statistics on mortality was either 'quite effective' or 'very effective' in prompting smokers to quit, compared to 35.0 % for the theme of social and financial consequences. Respondents who had secondary education and lower were almost two times more likely to support the inclusion of health warnings than those who had a university education and higher (OR=1.9; 95% CI: 1.02-3.7, p=0.042). Most of the comments were positive for the inclusion of health warnings on cigarette sticks. CONCLUSIONS: Most participants perceived that package warnings were ineffective, but warnings on cigarette sticks were effective methods of dissuasion of cigarette use. Smokers were almost twice as likely to perceive as effective supportive messages to quit than non-smokers. The majority of participants 'agreed' or 'strongly agreed' to the inclusion of health warnings on cigarette sticks.

A Rare Case of Progressive Familial Intrahepatic Cholestasis Type 4: A Case Report and Literature Review.

Progressive familial intrahepatic cholestasis (PFIC) is a group of genetic disorders characterized by progressive intrahepatic cholestasis. Different mutations in hepatocellular transport genes result in distinct PFIC subtypes with unique clinical manifestations, laboratory findings, and histopathological characteristics. Three PFIC genotypes have been commonly described (PFIC 1, 2, and 3), but in recent years, PFIC 4, 5, and 6 genetic mutations have been identified. Here, we report the first PFIC 4 case in the Middle East in a 46-day-old male infant who was successfully treated with a liver transplant. A 46-day-old, male, full-term infant presented with persistent jaundice and obstructive liver pathology suggested by liver profile and biopsy. Whole exome sequencing confirmed the diagnosis of PFIC 4. Medical treatment failed to improve the patient's symptoms. Therefore, the patient underwent hepatectomy and an unrelated liver transplant. He is currently exhibiting significant clinical improvements and is free of active complaints. PFIC is a rare disease that poses diagnostic and therapeutic challenges for clinicians. Infants presenting with unexplained cholestasis should have PFIC 4 as a differential diagnosis. Early recognition and treatment of PFIC 4 with liver transplantation may result in a more favorable prognosis.

Neonatal Septic Arthritis of the Hip: A Case Report.

Neonatal septic arthritis is a bacterial infection that, if not identified and treated right away, can affect human joints and result in osteonecrosis, joint destruction, and permanent abnormalities. Around 0.3 out of every 1,000 live births are impacted by septic arthritis worldwide. Although there is very little available data on the newborn population, we present a novel case of neonatal hip septic arthritis that was presented to our hospital and was successfully treated with surgical irrigation and debridement through arthrotomy with the Smith-Petersen approach in addition to antibiotics, despite its early vague presentation and lack of complications. Thus, it is crucial to clinically and radiologically evaluate neonates presenting with obscure symptoms and signs to prevent future disabilities and complications resulting from septic arthritis.

Retrospective Observational Assessment of the Impact of Cefepime Prophylaxis in Neutropenic Pediatric Patients With Acute Myelogenous Leukemia.

BACKGROUND: The potential for cefepime prophylaxis to reduce bloodstream infections (BSIs) in pediatric patients with acute myelogenous leukemia (AML) has been incompletely characterized. METHODS: A retrospective quasi-experimental study of patients under 21 years of age admitted with AML from 2010 through 2018 at two affiliated pediatric tertiary-care hospitals before and after the adoption of routine cefepime prophylaxis for afebrile AML patients during profound neutropenia. RESULTS: The rate of BSIs per 1000 neutropenia days was significantly lower in the prophylaxis group than the baseline group (2.6 vs 15.5, incidence rate ratio [IRR] 0.17, 95% CI 0.09-0.32). Interrupted time-series analysis showed that a sharp reduction in BSIs coincided with the implementation of prophylaxis. Bacteremia with viridans group streptococci was frequent in the baseline group but not observed after adopting prophylaxis. Despite the increased use of cefepime, the rate of cefepime-nonsusceptible BSIs per 1000 neutropenia days decreased (1.6 vs 4.1, IRR 0.40, 95% CI 0.16-0.99). The median number of febrile neutropenia episodes per patient also decreased in the prophylaxis group, as did the proportion of patients admitted to the intensive care unit (ICU) (22/51 (43.1%) vs 26/38 (68.4%); risk difference -25.3%, 95% CI -44.4 to -2.8). A trend was observed toward an increased proportion of patients with Clostridioides difficile infection in the prophylaxis group (10/51 (19.6%) vs 3/38 (7.9%); risk difference 11.7%, 95% CI -3.4 to 29.0). CONCLUSIONS: Cefepime prophylaxis was associated with a significant reduction in BSIs, febrile neutropenia, and ICU admission among pediatric AML patients.

Attitudes and Practices of the Public Toward Precautionary Measures Post-COVID-19 Pandemic in Saudi Arabia.

Objective: This study aimed to assess the practices and attitudes of the general population towards coronavirus disease-2019 (COVID)-19 after the removal of precautionary and preventive measures in Saudi Arabia. Methods: A cross-sectional study was conducted among the general population in all regions of the Kingdom of Saudi Arabia, from September 2022 to October, 2022 via a virtual survey to evaluate the practices, and attitudes of the general population towards COVID-19. A stratified random sampling technique was applied to collect the sample with inclusion criteria for all individuals who are Arabic language speakers using social media platforms. The individuals selected for this study were 18 years and older. Results: A total of 2406 responses were received for the study questionnaire. Most of participants (66.3%) were females aged 18 to 29 years (61.8%). Half of the participants reported a positive history of COVID-19 infection. Nearly 90% of participants still wear masks, 80% attended a crowded event, and 60% often wash their hands even though the Saudi government has erased the precautions. Females, young (30-39 years) and elderly (60 years and over) individuals, singles, those with a postgraduate degree, those who are employed, and healthcare workers were more likely to adhere to COVID-19 precautionary measures (p<0.05). Conclusion: The study's findings indicate that most of the population discontinued practicing precautionary measures after lifting the measures in Saudi Arabia. More public health initiatives should raise the scores of sanitary best practices to prevent the spread of viral illnesses.

Physician's Knowledge and Attitudes on Antibiotic Prescribing and Resistance: A Cross-Sectional Study from Hail Region of Saudi Arabia.

BACKGROUND: Antibiotic (AB) resistance is caused partly by overuse, varies by region, and is influenced by prescriber perspectives. This study sought to determine physicians' knowledge and attitudes toward AB prescribing, particularly in the Hail region of Saudi Arabia. METHODS: An interdisciplinary team created and validated an electronic questionnaire via the test-retest method that measured reliability and consistency. The 19 questions covered the following subjects: demographic information (7), experience with AB resistance in daily work (3), AB prescribing behavior (2), communication with patients regarding AB resistance (3), and prescribing practices (4). The revised questionnaire was prepared and distributed to physicians in the Hail region via multiple electronic communication channels. Inferences were drawn based on descriptive statistics and multivariate regression analysis. RESULTS: The questionnaire responses of 202 participants were eligible for analysis. A total of 70 (34.80%) participants were general practitioners, 78 (38.12%) were engaged in daily work that was only mildly related to AB resistance, and 25 (12.37%) performed work that was substantially related to AB resistance. A total of 88 (43.56%) physicians believed that prescribing behavior contributed to the emergence of AB resistance, whereas 68 (33.66%) did not. Regarding exposure, 51 (25.24%) physicians reported encountering instances of AB resistance monthly, whereas 104 (51.48%) reported seeing cases of AB resistance very rarely. In terms of prescribing practices, 99 (49.0%) physicians prescribed ABs to patients daily and 73 (36.13%) weekly. Regarding AB-resistance-related communication with patients, 73 (36.13%) physicians frequently discussed AB resistance with patients suffering from infections, whereas 13 (6.4%) never discussed it with patients. CONCLUSION: General practitioners in the Hail region exhibited comprehensive awareness of the elements that contribute to AB resistance but only rarely communicated about the issue with their patients, presuming the latter to be oblivious to the science behind AB resistance. Our findings suggest that the features underlying practitioners' AB prescribing behavior could be a powerful strategy for lowering AB resistance.

Predictors of Parental Recall of Newborn Hearing Screening Program in Saudi Arabia.

Hearing impairment is a prevalent disabling condition among children; all newborns should undergo a universal newborn hearing screening (UNHS). Unfortunately, many newborns who fail the screening test are lost to follow-up. Our study aims to evaluate parents' perceptions of UNHS and to identify predictors for newborn hearing screening recall in Saudi Arabia. A cross-sectional study involving Saudi parents with 0-to-18-year-old children born in Saudi Arabia was conducted. Descriptive statistics and binary logistic regression were used to describe the participants' characteristics and to identify UNHS recall predictors. A total of 1533 parents were surveyed. Overall, 29.9% of them recalled a hearing screening at birth, while 22.2% reported no hearing screening, and 47.8% were unable to remember. Only (6.9%) participants reported a failed hearing screening, of which 75.9% recalled a follow-up recommendation. Females, parents aged 30-34 years, consanguineous parents, and parents of newborns who were treated with antibiotics were more likely to recall hearing screening compared to others. This study highlights inadequate awareness of UNHS among parents. Our findings support the need to improve the reporting system of UNHS results and implement educational programs to increase parents' recall of hearing test results and ensure early follow-ups for neonates with failed test results.

The Prevalence, Clinical Picture, and Triggers of Allergic Rhinitis in Saudi Population: A Systematic Review and Meta-Analysis.

Objective: To summarize the current evidence regarding the prevalence of Allergic rhinitis (AR) and its symptoms, triggers, and impact on the quality of life of the Saudi population. Methods: A Computerized Search in MEDLINE via PubMed, MEDLINE Core database, Scopus, and Web of Science was conducted using relevant keywords. A two-stage screening process, data extraction, and quality assessment were conducted by four independent reviewers. Comprehensive Meta-analysis was used for all statistical analyses (CMA; USA: version 3.3.070). Results: Sixteen articles (n= 31,990 patients) were included. The overall estimated prevalence of AR was 21.2%, 95% CI (12.8-33.1%). Males had a higher prevalence of AR than females (31.7% vs 27.1%), although the difference was not significant (OR=1.24, 95% CI: 0.78-1.953; p=0.356). Children and adolescents exhibited a lower prevalence of AR than adults (13.7% vs 31.1%). Urban AR prevalence was much greater than rural (38.4% vs 13.0%). Asthma, atopic dermatitis, and eczema are all associated with AR. The most common signs and symptoms of AR were headache 33.9%, watery discharge 28.6%, sneezing 24.6%, itchy nose, runny nose 22.2%, nasal obstruction or congestion 22.0%, loss of smell 21.9%, and wheezing 17.2%. The most prevalent triggers of AR were perfume 36.8%, dust 27.3%, air conditioning 23.4%, weather or temperature changes 17.8%, air pollution 14.5%, drugs or chemicals 13.8%, tobacco 10.8%, atopy 10.3%, and insects 10.2%. Conclusion: The overall prevalence of AR in Saudi Arabia is 21.2%. The prevalence of AR was comparable in both males and females. However, it was higher in adults than in children and adolescents, and in urban areas than rural areas. Asthma, atopic dermatitis, and eczema co-occurrence with AR are common. AR has a negative impact on the quality of life of the patients in the form of interference with daily activities, sleep problems, difficulty of breath, and school absenteeism.

Disseminated Tuberculosis Post COVID-19 Infection: A Case Report.

Diagnosis of tuberculosis was affected during the coronavirus disease 2019 (COVID-19) pandemic. Several studies have shown an association between tuberculosis reactivation and COVID-19, but disseminated tuberculosis was rare. We present a case of a 17-year-old male hospitalized due to a fever of unknown origin for two weeks. The patient recovered from COVID-19 five weeks ago, and his nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was negative on current hospitalization. After investigations, diagnosis of disseminated tuberculosis was made by lymph node biopsy and radiological features. The patient was treated with four anti-tuberculosis medications and had a favorable outcome.

A Rare Case of a Child Diagnosed With Multisystem Inflammatory Syndrome After COVID-19 Presenting With Renal Infarctions and Transient Blast Cells: A Case Report and Literature Review.

Multisystem inflammatory syndrome in children (MIS-C) can develop weeks after the Coronavirus disease 2019 (COVID-19). The disease's clinical spectrum includes persistent febrile illness, features resembling Kawasaki disease, and cytokine storm symptoms. In severe cases, multisystem organ failure and death may result if not treated promptly. This report discusses a rare case of a 13-year-old girl presenting with fever and acute kidney injury (AKI) eight weeks after recovering from COVID-19 who was diagnosed with MIS-C. A 13-year-old female presented with a fever and abdominal pain following a recent COVID-19. A physical examination revealed a febrile, ill-looking child with abdominal tenderness. Pancytopenia, transaminitis, AKI, and a hyperinflammatory state were noted in the initial laboratory workup. Furthermore, blast cells were seen on the peripheral blood smear. Despite appropriate empiric antibiotic therapy for sepsis, she did not show signs of clinical improvement. An abdominal computed tomography (CT) scan revealed multiple focal areas of hypoattenuating lesions involving both kidneys, suggestive of bilateral renal infarction. Since she met the criteria of the Centers for Disease Control and Prevention (CDC) for MIS-C diagnosis, a high dose of intravenous immunoglobulin (IVIG) led to a dramatic improvement in the patient's condition and complete recovery from her illness. This case report describes a rare clinical presentation of MIS-C in a child who presented with AKI due to presumably thrombotic events and transient blast cells in blood film secondary to a severe inflammatory process. Further studies are needed to determine the prevalence of thrombotic AKI associated with MIS-C.

Perception and Acceptance of Using Different Generic Types of COVID-19 Vaccine, the "Mix-and-Match" Strategy, in Saudi Arabia: Cross-Sectional Web-Based Survey.

Background: Soon after the COVID-19 pandemic was declared, a pharmaceutical company expressed rapid interest in developing a safe and effective vaccine candidate to contain the spread of SARS-CoV-2 infections. The FDA approved the Pfizer-BioNTech, AstraZeneca, Moderna, and Janssen vaccines. Here, we investigated the attitude and acceptance of using different generic types of COVID-19 vaccines in Saudi Arabia. Methods: This study is a cross-sectional study using an online survey conducted in Saudi Arabia from the 19th of October to the 6th of December 2021. The questionnaire was distributed using social media platforms such as Twitter, WhatsApp, and Facebook. The inclusion criteria to participate in this study were adults who live in Saudi Arabia (Saudis or non-Saudis) and had two doses of COVID-19 vaccinations. Result: 3486 participants were included in this study, and 67.5% of the participants had side effects after the first dose. Similarly, 66.7% of the study participants had side effects after administering the second dose. Our data showed that most participants were unsure if the heterologous COVID-19 vaccination could cause severe side effects. In addition, 47.6% of the participants refused to receive a different generic type of COVID-19 vaccine due to fear of health problems. However, most participants obtained information regarding COVID-19 vaccination from the Saudi Ministry of Health. Conclusions: We found a low level of acceptance for receiving different generic types of vaccines if the participants had a choice. Therefore, plans should focus on increasing the acceptance level among the Saudi population through official platforms such as the Saudi Ministry of Health and private clinics.

De Novo Heterozygous Mutation in FGFR2 Causing Type II Pfeiffer Syndrome.

Pfeiffer syndrome (PS) is an autosomal dominant disorder with three subtypes stemming from heterozygous mutations in the fibroblast growth factors FGFR1 and FGFR2. The subtypes overlap with heterogeneous clinical manifestations and variable prognosis dependent on neurological and respiratory compromise that impact short- and long-term outcomes and survival. We present a male, term infant with type II PS that was diagnostically suspected antenatally based on three-dimensional ultrasonographic findings that were confirmed postnatally by craniofacial tomography and magnetic resonance imaging. A new generation sequencing panel identified a unique de novo FGFR2, c.335 A > G p. Tyr112Cys variant, the first of its kind, and features that closely aligned with subtype II PS. Initial molecular results categorized the mutation as nonpathogenic, but it was later reclassified as pathogenic. Antenatal, multidisciplinary parental counseling about the tentative diagnosis and prognosis facilitated postnatal decisions that culminated in an informed choice for palliative care and early demise.

The Influence of COVID-19 Pandemic on Influenza Immunization in Saudi Arabia: Cross-Sectional Study.

Introduction: Influenza vaccination is the primary control measure for severe complications caused by influenza viruses. Moreover, in the face of the COVID-19 pandemic, Saudi Arabia recommends vaccinating people at risk against influenza to minimise co-infection risk with SARS-CoV2. Therefore, this study aims to assess the Saudi population's knowledge, attitude, and practice toward influenza vaccination during the COVID-19 pandemic. Moreover, we evaluate the impact of the COVID-19 pandemic on seasonal influenza vaccination. Methods: This cross-sectional study was conducted using an online survey in Saudi Arabia between July to August 2021. Participants were invited to complete the questionnaire through a survey link sent to social media platforms. Results: A total of 2410 participants were included in this study. Our data demonstrate a lack of practice, attitude, and knowledge, especially on the influenza virus's symptoms, viral transmission, and vaccine efficacy. Moreover, this study showed that the COVID-19 pandemic significantly impacted seasonal influenza vaccination in the Saudi population by 1.5-times compared to the previous years. Conclusion: COVID-19 pandemic has increased the hesitancy of Saudi participants in influenza vaccination due to the lack of knowledge. As the pandemic of COVID-19 is fading, awareness campaigns are needed to encourage the public about the importance of receiving the influenza vaccine, especially for those at high risk each year.

Determinants of Post-COVID-19 Conditions among SARS-CoV-2-Infected Patients in Saudi Arabia: A Web-Based Cross-Sectional Study.

Background: Large numbers of people infected with COVID-19 developed acute symptoms. Post-COVID-19 conditions have been reported after recovery or discharge from the hospital. However, little is known about the prevalence and possible risk factors of post-COVID-19 conditions in the Saudi community. Here, we describe the incidence of post-COVID-19 conditions among the general population of Saudi Arabia. Methods: We conducted a cross-sectional, nationwide study using an online survey in Saudi Arabia from 1 September 2021 to 28 February 2022. The survey was distributed using social media platforms, such as Twitter, WhatsApp, and Facebook. Patients with SARS-CoV-2 infection were included in the questionnaire adapted from published studies. Result: The study enrolled 7520 individuals who were previously infected with SARS-CoV-2. Most patients in our study were symptomatic and their acute symptoms may persist for more than six days. On the other hand, long-term complications may develop and continue for an extended period (post-COVID-19 conditions). Most of these complications are respiratory, neurological, psychological, or skin related. The proportion of long-term complications reported in this study is 36% among SARS-CoV-2-infected individuals. In addition, being female, old age, number of chronic complications, long-term medication, length of stay in hospital and intensive care unit, and duration of acute symptoms may be significant predictors of post-COVID-19 symptoms. Conclusion: In conclusion, the incidence of post-COVID-19 conditions among the Saudi population was high, which urges further investigation into the risk factors associated with post-COVID-19 symptoms.

Parental Knowledge and Awareness of Childhood Urinary Tract Infections: A Cross Sectional Survey.

Background: Parent's misconceptions or lack of knowledge about childhood urinary tract infections (UTIs) can negatively impact their children's health. Therefore, the present study aimed to determine the childhood urinary tract infections awareness and understanding among parents in Saudi Arabia. Patients and Methods: An online validated cross-sectional survey of parents in Saudi Arabia was conducted from August to September 2021. Study participants who met the inclusion criteria were selected using a convenience sampling technique. A questionnaire with two domains was used to assess parental awareness of childhood urinary tract infection symptoms, complications, treatment, prevention, epidemiology, and diagnosis. The total childhood urinary tract infections awareness scores were classified into three categories: low awareness, moderate awareness, and high awareness. Descriptive statistics were used to determine the data distribution. A chi-square test was used to evaluate the relationship between parental awareness about urinary tract infections in children and other variables. Statistical significance was established at 0.05. Results: Of the 1688 parents who completed the survey, 1289 (76.4%) were female, 1581 (93.7%) were married, and 1161 (68.8) had a university degree. Parent's total awareness scores were high; however, individual domain scores indicate a moderate level of knowledge. Statistically significant relationship were observed between total awareness and gender, occupation, and level of educational level ((P=0.004, P=0.001, P=0.007, respectively). Another statistically significant relationship was noted between the history of urinary tract infections and awareness of disease prevention (P=0.009). Conclusion: In Saudi Arabia, parental knowledge about childhood urinary tract infections is moderate to high. However, future studies are needed to investigate gender, educational, and occupational variations in childhood UTI knowledge among parents in Saudi Arabia.

Assessment of Nurses' Knowledge and Confidence Regarding Tracheostomy Care in a Pediatric Long Term Care Hospital in Saudi Arabia.

Background: The incidence of tracheostomy insertion in pediatric patients has increased over the last few decades. Tracheostomized pediatric patients need daily, meticulous care by qualified nurses to minimize severe, avoidable complications. Adequately trained nurses facilitate patients' stability, accelerate weaning from the ventilator, and reduce potential tracheostomy dislodgement. Methods: A cross-sectional, retrospective cohort survey was conducted in September 2021, using an electronic version of a self-questionnaire, to assess nurses' knowledge and comfort level regarding tracheostomy care of pediatric patients at the International Extended Care Center in Jeddah, Saudi Arabia. Statistical analysis of the accrued data was performed using the SPSS 21.0 software package and a P-value <0.05 calculated by t-Test, was considered significant. Results: Among 43 nurses included in the study, 14 (32.6%) were very comfortable taking care of tracheostomized patients, 13 (30.2%) were comfortable, and 16 (37.2%) were uncomfortable. Regarding knowledge, three main aspects of tracheostomy care were correctly answered (%) by all the nurses: knowledge of routine tracheal care (55%), tracheal care skills (11.6%), and tracheal emergency care (2.3%). The study showed a significant positive correlation between nurses' comfort level with tracheal care and academic degree, duration of pediatric experience, completion of more than one life support course, and attendance at the annual local tracheostomy care competency learning program (TCCLP; all P <0.05). Conclusion: Deficits exist in nurses' knowledge of tracheostomy care. Improved knowledge garnered through repetitive participation in tracheostomy competency programs and life support courses correlate with greater comfort and more than 5 years of pediatric experience. Nurses' deficits in emergency care knowledge and skills should be addressed through a structured educational program and a simulation, hands-on based TCCLP course, irrespective of comfort level with tracheostomy care.

Evaluation of Medical Students' Knowledge on Palliative Care: A Single Institution Cross-sectional Study.

Background: Palliative care is the branch of medicine which has a target of setting focus on the improvement of the quality of life of patients, particularly toward their end of life, such as cases of terminal diseases with low prognosis. Despite growing recognition of the importance of palliative care, a gap remains in medical education. Our study aims to evaluate the current level of knowledge of medical students in regard to palliative care. Methods: A cross-sectional descriptive study was conducted in Batterjee Medical College, Jeddah, Saudi Arabia, through a period of three months from December 2021 to March 2022. Results: A total of 254 students participated in our study. Psychosocial and spiritual needs of the patient alongside definition of palliative care were perceived the most important by the students with a mean score of 3.9 each. Conclusion: Our study concludes that there is an overall lack of confidence among medical students in providing palliative care. We recommend further enhancement and implementation of palliative care as part of undergraduate mandatory courses.

Prevalence and predictors of nomophobia among the general population in two middle eastern countries.

BACKGROUND: Nomophobia is a psychological condition caused by a fear of disconnecting from others through mobile phones. AIM: This study aims to determine the prevalence of and predictors of nomophobia and anxiety symptoms among the general population in Saudi Arabia and Jordan. METHODS: This study was an observational cross-sectional study using a web-based online survey distributed in two middle eastern countries (Saudi Arabia and Jordan) between Jun 24 and Jul 20, 2021. A convenience sample was used to recruit the study participants. Categorical variables were identified as frequencies and percentages. In addition, a binary logistic regression analysis was used to determine the factors associated with nomophobia symptoms. The Statistical Package for Social Science (SPSS) software, version 27 (IBM Corp, Armonk, NY, USA), analyzed the data. RESULTS: A total of 5,191 responded to the online survey. Around (26.5%) reported that they suffer from an anxiety problem or use a treatment for anxiety. The median daily time spent using a mobile phone (IQR) (minutes) was around 210 min per day. About half of the study sample (51.2%) are diagnosed with dependence syndrome. The binary logistic regression analysis revealed that those within the age group of 30-49 years and 50 years and above) are less likely to have mobile phone dependence compared to those less than 30 years old. Females were 16% at lower risk of developing mobile phone dependence compared to males Married participants were less likely to have mobile phone dependence compared to single participants (OR: 0.62 (95% CI 0.56-0.70)), while divorced participants were at a 46% higher risk of developing mobile phone dependence. CONCLUSION: Nomophobia prevalence among Saudi Arabia and Jordon's population is 51.2%. Several factors may predict mobile phone dependence including age, gender, marital status, and previous history of anxiety.

Impact of COVID-19 Pandemic on Medical Education: A Cross-Sectional Study in the Western Region of Saudi Arabia.

Background: As the Coronavirus Disease 2019 (COVID-19) outbreak has made a tremendous impact on medical education and healthcare institutions, we aimed to measure effects of online classes on medical students' comprehension in comparison with attending campus classes during the COVID-19 pandemic. Methods: A cross-sectional survey has been conducted between September 2020 and June 2021 in the western region of Saudi Arabia. The Convenience sampling technique was conducted to collect the data from medical students in their basic and clinical years, using a questionnaire that involved 45 multiple-choice and multiple-answer questions. Results: Out of 3700 questionnaires, 922 completed the questionnaires from 11 different medical schools. Umm AL-Qura University had the highest response rate with 232 responses (25.2%), followed by King Abdulaziz University with 186 responses (20.2%). The majority of institutions preferred Blackboard and Zoom as platforms for e-learning. A total of 355 (38.5%) believed that it resulted in higher academic achievement, whereas 555 (60.2%) of students believed the limitation of clinical access was one of the biggest disadvantages of e-learning. Overall, 518 (56.2%) of students did not want to continue using e-learning on its own in the future. Whereas 668 (72.5%) wished to keep using e-learning in combination with traditional learning. Conclusion: According to our findings, advantages of e-learning vary among students. Most of the students thought e-learning to be an interactive system that provides a learning opportunity. In contrast, many of the students believed that there were many disadvantages regarding online teaching methods.