Prevalence and Determinants Influencing the Use of Electronic Cigarette Smoking in Male Students of Taif University.

BACKGROUND AND AIM: Electronic cigarette (e-cigarette) smoking is a significant public health problem in Saudi Arabia, particularly among youth who use it as an alternative to traditional cigarettes. This study aimed to evaluate the prevalence and beliefs towards e-cigarette use among Taif University students in Saudi Arabia. METHODS: A cross-sectional study was conducted among male Taif University students using a self-administered questionnaire. A sample of 319 students was selected through stratified sampling. The questionnaire included questions about socio-demographic characteristics, smoking history, awareness of e-cigarettes, prevalence of e-cigarette use, beliefs towards e-cigarettes, and reasons for e-cigarette use. RESULTS: The study revealed a high prevalence of e-cigarette use among Taif University students, with 40.1% of participants having used e-cigarettes at least once during their lifetime and 43.7% believing that e-cigarettes are less dangerous than traditional cigarettes. Participants studying sciences had 0.76 times the odds of believing that e-cigarettes help smokers to quit compared to participants studying literature. Compared to smokers, ex-smokers had an OR of 34.1 (p<0.001) and non-smokers had an OR of 35.9 (p<0.001) for experimentation of e-cigarettes. Smokers who had friends that tried e-cigarettes had an OR of 6.6 (p<0.001) for trying e-cigarettes, compared to smokers who did not have such friends. CONCLUSION: The study found that 40.1% of participants have used e-cigarettes at least once during their lifetime with a significant proportion of participants unaware of the potential health hazards of e-cigarettes, and many believed that e-cigarettes are less dangerous than traditional cigarettes. These findings emphasize the need for targeted educational interventions to address misconceptions and promote awareness among university students.

Lifestyle Assessment of Primary Healthcare Physicians in Taif, Saudi Arabia in the Year 2022.

Objective This study aims to evaluate primary healthcare physicians' lifestyles to promote their well-being and improve care quality for the general population. Methods This cross-sectional quantitative study was conducted on primary healthcare physicians in Taif, Kingdom of Saudi Arabia (KSA), using self-administered questionnaires. Results We included 206 participants aged 26-66. Most participants were 35 years old or younger (67%), male (62.1%), and residents (52.4%). Of all participants, 49.5% held a Bachelor's degree, 40.8% had completed their board certificate or Ph.D., and 69.9% had at least 10 years of experience. Of all participants, 16.5% and less than 9% reported having hypercholesterolemia and other comorbidities, respectively. More than 50% were physically inactive, 26.2% were moderately inactive, and 17.4% were moderately active or active individuals. Physical activity was significantly associated with job titles (p < 0.018). The qualification was associated with dietary score (p = 0.034), and 42.7% of participants were in need of diet change. About a quarter (25.2%) were smokers, and 92.3% of them smoked daily. Male participants were associated with a greater likelihood of smoking (p < 0.001). Overall, 41.7% were overweight, and 25.7% were obese. Increased BMI was associated with older age and male gender (p < 0.001 and p < 0.002, respectively), as well as the title of the physician and years of experience (p < 0.001 and p < 0.002, respectively). Conclusion Participants' unhealthy lifestyles indicate the need to establish measures to promote healthy lifestyles among physicians.

The Influence of Prenatal Exposure to Methamphetamine on the Development of Dopaminergic Neurons in the Ventral Midbrain.

Methamphetamine, a highly addictive central nervous system (CNS) stimulant, is used worldwide as an anorexiant and attention enhancer. Methamphetamine use during pregnancy, even at therapeutic doses, may harm fetal development. Here, we examined whether exposure to methamphetamine affects the morphogenesis and diversity of ventral midbrain dopaminergic neurons (VMDNs). The effects of methamphetamine on morphogenesis, viability, the release of mediator chemicals (such as ATP), and the expression of genes involved in neurogenesis were evaluated using VMDNs isolated from the embryos of timed-mated mice on embryonic day 12.5. We demonstrated that methamphetamine (10 µM; equivalent to its therapeutic dose) did not affect the viability and morphogenesis of VMDNs, but it reduced the ATP release negligibly. It significantly downregulated Lmx1a, En1, Pitx3, Th, Chl1, Dat, and Drd1 but did not affect Nurr1 or Bdnf expression. Our results illustrate that methamphetamine could impair VMDN differentiation by altering the expression of important neurogenesis-related genes. Overall, this study suggests that methamphetamine use may impair VMDNs in the fetus if taken during pregnancy. Therefore, it is essential to exercise strict caution for its use in expectant mothers.

Increasing the Efficacy of Seproxetine as an Antidepressant Using Charge-Transfer Complexes.

The charge transfer interactions between the seproxetine (SRX) donor and π-electron acceptors [picric acid (PA), dinitrobenzene (DNB), p-nitrobenzoic acid (p-NBA), 2,6-dichloroquinone-4-chloroimide (DCQ), 2,6-dibromoquinone-4-chloroimide (DBQ), and 7,7',8,8'-tetracyanoquinodi methane (TCNQ)] were studied in a liquid medium, and the solid form was isolated and characterized. The spectrophotometric analysis confirmed that the charge-transfer interactions between the electrons of the donor and acceptors were 1:1 (SRX: π-acceptor). To study the comparative interactions between SRX and the other π-electron acceptors, molecular docking calculations were performed between SRX and the charge transfer (CT) complexes against three receptors (serotonin, dopamine, and TrkB kinase receptor). According to molecular docking, the CT complex [(SRX)(TCNQ)] binds with all three receptors more efficiently than SRX alone, and [(SRX)(TCNQ)]-dopamine (CTcD) has the highest binding energy value. The results of AutoDock Vina revealed that the molecular dynamics simulation of the 100 ns run revealed that both the SRX-dopamine and CTcD complexes had a stable conformation; however, the CTcD complex was more stable. The optimized structure of the CT complexes was obtained using density functional theory (B-3LYP/6-311G++) and was compared.

Enhancement of Haloperidol Binding Affinity to Dopamine Receptor via Forming a Charge-Transfer Complex with Picric Acid and 7,7,8,8-Tetracyanoquinodimethane for Improvement of the Antipsychotic Efficacy.

Haloperidol (HPL) is a typical antipsychotic drug used to treat acute psychotic conditions, delirium, and schizophrenia. Solid charge transfer (CT) products of HPL with 7,7,8,8-tetracyanoquinodimethane (TCNQ) and picric acid (PA) have not been reported till date. Therefore, we conducted this study to investigate the donor-acceptor CT interactions between HPL (donor) and TCNQ and PA (π-acceptors) in liquid and solid states. The complete spectroscopic and analytical analyses deduced that the stoichiometry of these synthesized complexes was 1:1 molar ratio. Molecular docking calculations were performed for HPL as a donor and the resulting CT complexes with TCNQ and PA as acceptors with two protein receptors, serotonin and dopamine, to study the comparative interactions among them, as they are important neurotransmitters that play a large role in mental health. A molecular dynamics simulation was ran for 100 ns with the output from AutoDock Vina to refine docking results and better examine the molecular processes of receptor-ligand interactions. When compared to the reactant donor, the CT complex [(HPL)(TCNQ)] interacted with serotonin and dopamine more efficiently than HPL only. CT complex [(HPL)(TCNQ)] with dopamine (CTtD) showed the greatest binding energy value among all. Additionally, CTtD complex established more a stable interaction with dopamine than HPL-dopamine.

The Patterns of Acquired Upper and Lower Extremity Amputation at a Tertiary Centre in Saudi Arabia.

INTRODUCTION: Upper and lower extremity amputations are associated with variable degrees of physical disability. In Saudi Arabia, disability still represents a major challenge for healthcare systems. There are insufficient data to describe the incidence and prevalence of impairment and disability. This study attempts to identify the patterns of limb amputations at a tertiary centre. METHODS: A retrospective chart review of the data of patients who received integrated tertiary healthcare in an amputation rehabilitation program (ARP) from 2013 to 2018 at King Fahad Medical City, Riyadh, Saudi Arabia was conducted. Data were collected using the demographic data and clinical history of amputees. RESULTS: A total of 412 patients were included in the study. Transtibial amputation (70%) and partial hand amputation (48%) were the most common levels for lower and upper limb amputations, respectively. There was a significantly higher rate of lower limb amputations secondary to vascular causes than that of upper limb amputations, which were more related to traumatic causes. Most patients, 213 (52%), were enrolled in an amputation rehabilitation program over a year after their amputation. CONCLUSION: Vascular amputation is the most common cause of amputation. Most patients entered the rehabilitation program over a year after amputation. National guidelines for the prevention and management of the risk factors for vascular amputations should be developed.

Causes, timing, and modes of death in a tertiary pediatric intensive care unit: Five years' experience.

OBJECTIVES: To identify the causes, modes, and timing of death in a tertiary pediatric intensive care unit (PICU). METHODS: This is a retrospective data analysis of patients older than 48 hours and younger than 15 years who died in the PICU over a 5-year period from January 2012 until December 2016 at a tertiary hospital in Riyadh, Saudi Arabia. RESULTS: There were 101 deaths out of 2295 admissions, representing average crude mortality rate of 4.4%. Sepsis was the most common cause of death in 31 patients (30.7%), followed by lower respiratory tract infections in 19 (18.8%), and cardiac diseases in 12 (11.9%). Failed cardiopulmonary resuscitation was the most common mode of death in 51 patients (50.5%), followed by withholding life-sustaining treatment in 43 (42.6%), and brain death in 7 (6.9%). Although more deaths occurred during after hours (n=70; 69.3%), there was no significant correlation between mode of death and working hours vs. after hours (p>0.05). Among the cohort, 63 patients (62.4%) had an infection-attributed mortality, of which 43 (68.3%) were bacterial, 14 (22.2%) were viral, and 10 (15.9%) were fungal. CONCLUSION: Infections remain a significant cause of death in the PICU. Further improvement of prevention programs and early therapy of severe infections could lower pediatric mortality. This report highlights the need for enhancing palliative care programs. The low rate of brain death diagnoses warrants further investigation.

Diagnostic accuracy of reticulocyte parameters on the sysmex XN 1000 for discriminating iron deficiency anaemia and thalassaemia in Saudi Arabia.

INTRODUCTION: Iron deficient erythropoiesis and Thalassaemia are both associated with microcytic erythropoiesis albeit from different pathological mechanisms. Given the high prevalence of Hemoglobinopathies in the Mediterranean region, discriminating these two conditions is important. Several algorithms using conventional red cell indices have been developed to facilitate diagnosis, however, their diagnostic accuracy is low. The new generation haematology analyzers enabled the use of more innovative parameters such as reticulocyte parameters. We aimed to evaluate the diagnostic performance of the reticulocyte parameters on the Sysmex XN 1000 to distinguish between IDA and Thalassemia in our population. METHODS: We performed a retrospective analysis of blood samples sent to our laboratory for haemoglobin electrophoresis screening. We categorized our cohort into Thalassemia and Iron Deficient patients based on known diagnostic criteria. We analyzed the reticulocyte parameters using receiver operator curve analysis (ROC) and determined the cut off value for each parameter. RESULTS: Reticulocyte parameters most accurate for discriminating IDA from Thalassemia patients was: RET, RET-HE and IRF. The RET-HE had the best statistical significance for IDA patients with AUC = 0.69 for cut off 22.25. The RET-HE for dual positive patients was more accurate with AUC = 0.78 for cut off 21.25. The IRF had the best statistical significance for Alpha Thalassemia with AUC = 0.66 for cut off value 18. CONCLUSION: An IRF cut off below 15.5 and RET-HE cut off below 22.25 was the most accurate variable in predicting IDA with a sensitivity of 59.4% and 68.3%.

Levels of Practice and Determinants of Diabetes Self-Care in Primary Health Care in Jeddah City, Saudi Arabia.

Objective To assess the level and determinants of practice in diabetes self-management at primary health care centers (PHCCs) and to analyze the association of self-management with the level of glycemic control. Method A cross-sectional study was conducted among patients with type 1 and type 2 diabetes, aged ≥ 17 years, and being followed at PHCCs in Jeddah, Saudi Arabia, from December 1, 2019, to December 30, 2019. A multistage cluster sampling technique was used to select 350 participants from five PHCCs. The level of practice in self-management was assessed using the Arabic version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The tool was administered as a face-to-face interview, followed by the collection of sociodemographic and relevant clinical data. In addition, blood was collected to measure fasting blood glucose (FBG) and HbA1c levels. The association of the overall SDSCA score with diabetes control was analyzed using linear regression and the receiver operator characteristics (ROC) curve. Multivariate binary logistic regression was carried out to analyze independent factors of inadequate practice. Result The overall mean (SD) SDSCA score was 3.13 (1.13)/7. Of the five dimensions of self-care, medication adherence yielded the highest score (mean=5.39 days per week), followed by diet (2.83) and blood glucose monitoring (2.78), while footcare had the lowest level of practice (2.26). The SDSCA score showed a negative correlation with the level of HbA1c, with a correlation coefficient r-squared =0.530 and regression coefficient B=-0.648 (p <0.001). ROC curve analysis showed that optimal glycemic control was associated with SDSCA score cutoff ≥3.5 with 82.0% sensitivity and 77.0% specificity, and the model showed that 38.0% of participants had adequate practice in self-management. Inadequate practice in diabetes self-management was independently associated with age >50 years (OR=2.00 [95%CI=1.02, 3.89]), rental accommodation (OR=0.42 [95%CI=0.23, 0.76]), independent job (OR=3.98 [95%CI=1.66, 9.57]), and longer duration of diabetes (≥8 years) (OR=4.25 [95%CI=1.82, 9.92]). Conclusion There are low levels of diabetes self-management among patients being followed at Jeddah PHCCs. This is associated with suboptimal glycemic control among the majority of the patients, indicating the importance of self-management to improve diabetes control. Patient health literacy and education for self-management should be considered the standard of care for diabetic patients in all PHCCs, with specific attention to subcategories of patients with the lowest levels of practice in self-management such as those with a longer duration of diabetes and the elderly.

Gingival Crevicular Fluid Release Profile of Vascular Endothelial Cell Growth Factor and Platelet-Derived Growth Factors-BB Following Minimally Invasive Flap Reflection during Treatment of Intrabony Defects: A Randomized Clinical Trial.

OBJECTIVES: As a primary objective, we examined the gingival crevicular fluid (GCF) levels of the endogenously released platelet-derived growth factor (PDGF-BB) and vascular endothelial growth factor (VEGF) following the use of minimally invasive surgical flap reflection (MIS) and compared them with those in traditional open flap debridement (OFD). The secondary objective was to determine if any correlation exists between the expression of growth factors (GF), indicated by their levels, and associated clinical outcomes. MATERIALS AND METHODS: Twenty-eight non-smoking individuals with severe chronic periodontitis were recruited in this prospective, randomized and single-blinded trial. Each person presented one interproximal defect that was randomly assigned to either the experimental MIS group (14 sites) or the open flap debridement (OFD) control group (14 sites). Plaque index, gingival index, probing depth (PD), clinical attachment level (CAL) and the intra-bony depth of the defect (IBD) were measured at baseline for the patient's enrollment. Gingival crevicular fluid (GCF) samples were collected on days 1, 3, 7, 14, 21 and 30 after therapy. Clinical follow-ups were scheduled at 6 and 9 months following the therapy. RESULTS: In both groups, the highest levels of VEGF and PDGF-BB concentrations were found in the GCF during the period from 1 to 14 days. During the early stages of healing (1, 3, 7 and 14 days), the mean VEGF and PDGF-BB levels at sites treated with MIS were significantly higher than those at the OFD-treated sites. Growth factor levels decreased sharply in the samples obtained at days 21 and 30 in both groups, with non-significant differences between the patient and control groups. MIS-treated sites reported significantly more PD reduction and attachment gain 9 months following therapy. No significant difference in intrabony defect reduction was reported between the patient and control groups. CONCLUSIONS: Within the limits of the present study, we can surmise that MIS treatment of periodontal defects is associated with initially higher GCF levels of the studied growth factors. These increased GF levels are well correlated with the improved soft-tissue parameters of the periodontal defects.

To what extent should dental implant placement be adopted as a standard for diabetic patients?

Diabetes mellitus (DM) is considered one of the major chronic diseases in the world. Long-term hyperglycemia considerably affects the body tissues, and consequently, can lead to morbidity and mortality. Moreover, many oral complications have been observed with DM but little consideration in relation to the placement of dental implants has been investigated. Dental research has analyzed the relation of dental implants and bone osseointegration in diabetic patients. Theoretically, an impaired immune system and delayed wound healing of these patients might decrease the success rate of implant placement; however, with noticeable advances in evidence-based dentistry and statistically significant results, successful implant treatment could be achieved significantly in well-controlled diabetic patients.

Reduced systemic inflammatory mediators after treatment of chronic gingivitis.

OBJECTIVE: To assess the changes in the level of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha) in gingival crevicular fluid (GCF) after treatment of chronic gingivitis in systemically healthy individuals. METHODS: This is a clinical trial conducted at Case Western Reserve University, Cleveland, Ohio, United States of America from February to December 2011. A total of 41 systemically healthy subjects were assigned to 2 groups according to the severity of gingival inflammation. Group I consisted of 18 subjects who had mild gingival inflammation; and group II consisted of 23 with more severe gingival inflammation. Periodontal assessment consisted of gingival index (GI), probing depths (PD), and GCF volume. Four to six weeks after prophylaxis and oral hygiene instruction, the same measurements were repeated. The level of CRP and TNF-alpha in the GCF was determined using enzyme-linked immunosorbent assays. RESULTS: A statistically significant reduction in the mean CRP and TNF-alpha levels after the treatment was found in the severe, but not in the mild gingivitis group. Both groups showed a statistically significant reduction in GI, PD, and periotron readings after the treatment. CONCLUSION: Treatment of severe chronic gingivitis reduces the levels of CRP and TNF-alpha in GCF of otherwise systemically healthy individuals, which could have an impact on preventing or controlling future or existing systemic disease conditions.