Dental decay in children and the link to weight status: A cross-sectional analysis of national school health data.

Recent national reports have indicated an increasing trend of dental decay among school-aged children. National school-based data are required to guide decision-making to ensure effective public health efforts to manage dental decay. This study aimed to assess the prevalence of dental decay among school-age children in Saudi Arabia and explore the possible link between dental decay and weight status. This was a cross-sectional analysis of a national sample including 1,134,317 Saudi children in the 1st, 4th, 7th, and 10th grades who participated in a national school screening program. Data for weight, height, body mass index (BMI), dental decay prevalence, and decayed, missing, and filled teeth (DMFT) index were analysed. An independent t-test, one-way analysis of variance, and chi-square test were used to compare the means, while Pearson's r correlation and multiple linear regression were used to examine the relationships between the study variables. The prevalence of dental decay was 24.20%, and dental decay was the highest among female students (26.5%), students in primary school (25.9%), students living in the eastern region (35.2%), in the administrative capital (27.6%), and in rural areas (23.4%). Dental decay was the highest among students who were underweight. Female sex and living in rural areas significantly predicted higher DMFT while being overweight/obese significantly predicted lower DMFT. Dental decay is highly prevalent among underweight students, female students, and students living in rural areas and the eastern regions of Saudi Arabia. To reduce the prevalence of dental decay and related health disparities, dental health screening programs should be designed to detect dental decay early among children at high risk due to abnormal BMIs and sociodemographic factors. In addition, dental health screening and management programs should utilize standardized dental decay assessment methods and ethnically representative growth charts.

Comparative effectiveness and cost evaluation of Risankizumab and Adalimumab in the management of psoriasis: a real-world study in Saudi Arabia.

BACKGROUND: Psoriasis, an immune-mediated chronic inflammatory disease primarily affecting skin and joints, has varying prevalence rates globally. It manifests in five types, with chronic plaque psoriasis being the most common. Treatment, which has no definitive cure, aims for complete resolution of skin symptoms and depends on disease extent, severity, and impact on patients' lives. Biologics are an emerging treatment for psoriasis, targeting specific inflammatory pathways for potentially safer, more effective outcomes. However, these come with significant costs, necessitating more research to ensure value for money. This study aimed to compare the effectiveness of Risankizumab versus Adalimumab, the most commonly utilized biologic for managing psoriasis in Saudi Arabia. METHODS: This study retrospectively compared the effectiveness and direct medical cost of Risankizumab and Adalimumab in treating chronic plaque psoriasis in adults from two Saudi Arabian healthcare centers. The Psoriasis Area and Severity Index (PASI) and body surface area (BSA) were used to assess treatment effectiveness, with patient data sourced from electronic medical records. Multiple regression analysis was performed to examine various factors affecting treatment outcomes. An economic evaluation was conducted to examine the cost-effectiveness of the two drugs, considering four scenarios with varying dosage patterns and costs. Analysis was performed from the perspective of public healthcare payers and considered all utilized health services. RESULTS: The data for 70 patients were analyzed, with comparable baseline characteristics between groups. While Risankizumab led to a greater reduction in PASI scores and BSA affected, these results were not statistically significant. The annual treatment cost for Risankizumab was higher than Adalimumab. Various scenarios were studied, considering real acquisition costs, double dosing for Adalimumab, and the use of biosimilars. A scenario assuming double dosing for Adalimumab and a 40% discount for Risankizumab demonstrated both cost and efficacy advantages in 71.25% of cases. CONCLUSIONS: This study compared the effectiveness and cost of Risankizumab and Adalimumab for treating chronic plaque psoriasis in Saudi Arabian hospitals. Although Risankizumab showed a greater reduction in symptoms, the difference was not statistically significant. However, under certain scenarios, Risankizumab demonstrated cost and efficacy advantages. These findings may influence treatment decisions for psoriasis, but further research is needed.

The shifting patterns of childhood obesity: Insights from national school screening data.

Background: Recent reports indicated an increasing prevalence of obesity among children and adolescents in Saudi Arabia, making it an impending national epidemic. However, obesity prevalence data in children and adolescents in Saudi Arabia are largely inconsistent. Objectives: This study analyzed and compared the prevalence of obesity among a national sample of children and adolescents across sexes, school grades, regions, and city types in Saudi Arabia using the Growth Charts for Saudi Children and Adolescents. Methods: Weight, height, and body mass index (BMI) data from 1 134 317 children in first, fourth, seventh, and tenth school grades who participated in the national school screening program were analyzed cross-sectionally. BMI values were classified using the Growth Charts for Saudi Children and Adolescents. Results: Nearly 10.4% of students were overweight, 10.7 % were obese, and 4.50% were severely obese. Male students had a higher prevalence of overweight and obesity than their female counterparts. The prevalence of overweight and obesity was the highest among students in intermediate school, the Central region, and administrative capitals. Conclusion: Managing childhood obesity is challenging due to its multifaceted nature Therefore, utilizing clinical and community-based participatory approaches is essential to develop nationwide obesity prevention and management program that is effective and sustainable. This program must utilize dynamic BMI surveillance systems using ethnically representative growth references, conduct national pediatric obesity research with careful consideration for demographic and regional differences, lead targeted pediatric obesity awareness campaigns, provide obesity management interventions in a pediatric multi-disciplinary clinic, and evaluate the program outcomes periodically.

Inhibiting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants: Targeting the Spike and Envelope Proteins Using Nanomaterial Like Peptides.

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused significant death, economic crisis, and the world to almost completely shut down. This present study focused on targeting the novel SARS-CoV-2 envelope protein, which has not been frequently mutating, and the S protein with a much larger peptide capable of inhibiting virus-mammalian cell attraction. In doing so, molecular dynamics software was used here to model six peptides including: NapFFTLUFLTUTE, NapFFSLAFLTATE, NapFFSLUFLSUTE, NapFFTLAFLTATE, NapFFSLUFLSUSE, and NapFFMLUFLMUME. Results showed that two of these completely hydrophobic peptides (NapFFTLUFLTUTE and NapFFMLUFLMUME) had a strong ability to bind to the virus, preventing its binding to a mammalian cell membrane, entering the cell, and replicating by covering many cell attachment sites on SARS-CoV-2. Further cell modeling results demonstrated the low toxicity and suitable pharmacokinetic properties of both peptides making them ideal for additional in vitro and in vivo investigation. In this manner, these two peptides should be further explored for a wide range of present and future COVID-19 therapeutic and prophylactic applications.

Community Pharmacists' Views of the Enforced Antibiotics Dispensing Law and Its Impact on Oral Antibiotics Sales in Saudi Arabia.

OBJECTIVES: The aim of this study was to explore community pharmacists' views toward the antibiotics dispensing law that was enforced in May 2018 and bans the sale of antibiotics without a prescription in community pharmacy settings in Saudi Arabia. Moreover, the potential impact of the law enforcement on the sales of oral antibiotics in Saudi Arabia was also explored. METHODS: A questionnaire-based cross-sectional study was conducted between September 2019 and March 2020 in Riyadh, Saudi Arabia. A multistage sampling technique was used to recruit community pharmacists from different districts. Pharmacists who consented to participate and reported practicing prior to the law enforcement were interviewed about their views of the law using a 14-item newly developed questionnaire. The annual sales of oral antibiotics for the years of 2017, 2018, and 2019 were retrieved from the Saudi Food and Drug Authority (SFDA) database. RESULTS: Two hundred and eighty six pharmacists consented to participate and met the inclusion criteria. After the law enforcement, approximately 51% of the participants reported that the percentage of patients seeking antibiotics without a prescription is less than 25%. Moreover, the majority (87.41%) reported a drop in the sales of antibiotics. Additionally, about 90% of the participants believed that the rate of inappropriate use of antibiotics will decrease as a result of the law enforcement. About 41% of the participants reported that the law has negatively impacted their pharmacies' profits. The sales of oral antibiotics have seen a 16.6% drop in the year of 2019 as compared to 2017. CONCLUSION: The antibiotics dispensing law is favorably perceived among community pharmacists in Saudi Arabia despite some concerns about its impact on their sales. Exploring different business models that delink the profits from the volume of antibiotics sales is necessary for this vital industry to thrive.

Increased serum sclerostin and decreased serum IGF-1 are associated with vertebral fractures among postmenopausal women with type-2 diabetes.

Insulin-like growth factor 1 (IGF-1) is a determinant of bone mass and is inversely associated with vertebral fractures (VFs). Sclerostin regulates bone formation by inhibiting Wnt/ß-catenin signaling. Currently, there is little information on circulating sclerostin levels among postmenopausal women with type-2 diabetes mellitus (T2DM) with VFs in relation to serum IGF-1 (s-IGF-1). We investigated the relationships between serum sclerostin, s-IGF-1, and VFs in postmenopausal women with T2DM. We assessed cross-sectionally 482 postmenopausal women with T2DM and 482 age-matched postmenopausal women without T2DM who were recruited at diabetic clinics and primary health care centers for inclusion in a bone health survey. The main outcome measures were serum sclerostin, s-IGF-1, bone mineral density (BMD), and bone turnover markers. Lateral X-rays of the thoracic and lumbar spine were taken to diagnose VFs. Serum sclerostin levels were increased, whereas s-IGF-1 levels were decreased when T2DM women were stratified by the number of VFs (P<0.0001). Multiple logistic regression analysis showed that serum sclerostin levels were positively associated with 1 VF (odds ratio [OR]=1.27, (95% CI:1.01-2.03), P=0.016), 2 VFs (OR=1.41, (95% CI:1.03-2.36), P=0.006), and ≥3 VFs (OR=1.54, (95% CI:1.12-2.44) P=0.005). s-IGF-1 levels were inversely associated with 1 VF (OR=0.58, (95% CI:0.39-0.88), P=0.041), 2 VFs (OR=0.42, (95% CI:0.21-0.90), P=0.012), and ≥3 VFs (OR=0.19, (95% CI: 0.14-0.27), P<0.001). Increased serum sclerostin and decreased s-IGF-1 were associated with VFs among postmenopausal women with T2DM, suggesting that sclerostin and/or IGF-1 may be involved in increased bone fragility in T2DM and could be potential markers of VF severity.