Consanguineous marriages, premarital screening, and genetic testing: a survey among Saudi university students.

Background: Marriage among cousins or close relatives, i.e., consanguinity, is prevalent in many parts of the world, especially the Muslim world. Across civilizations, cultural norms, religious beliefs, and economic factors affect consanguineous marriages (CMs); however, such marriages have social, genetic, and health repercussions. The present study investigated the university students' attitudes regarding CMs and factors influencing their attitudes at King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). Methods: This cross-sectional prospective study was conducted at KAU Jeddah in 2023. The questionnaire was distributed via electronic media (Emails, Facebook Messenger & WhatsApp). The convenience sampling technique was used to select participants, and descriptive and inferential statistics were used to analyze the data on SPSS-26. Results: A total of 1707 university students were part of the study (females, 1,198, 70.2%; males, 509, 29.8%). Almost half of the participants, 819 (48.0%), had parents with CMs. Most of the participants, 1,391 (81.5%), had CMs in the family. Half of the participants disagreed that parents consider marriage stable due to high compatibility and the same social relationship before and after marriage. About one-third of respondents said parents believe family marriage transmits cultural values and continuity and keeps wealth in the family. More than three-fourths of the participants stated that if marriage is arranged with first cousins, they will opt for genetic analysis (82.5%) and premarital counseling (85.2%). The personal attitudes of females (p < 0.001), undergraduate (p = 0.02), and health sciences students (p = 0.02) were more positive than their counterparts. Males (OR = 0.41; p < 0.001) and non-health sciences students (OR = 0.68; p = 0.01) were less likely to have significant positive attitudes than their counterparts. Among participants who had CM parents, males (OR = 0.397; p < 0.001) and non-health sciences students (OR = 0.60; p = 0.01) and urban residents (OR = 0.59; p = 0.01) had significantly lower odds of having a positive attitude than their counterparts. Conclusion: The practice of CMs is still prevalent in Saudi culture, with almost half of the participants having CM parents and the majority reporting these marriages in their families. Personal attitudes toward CMs were extremely positive. Most students prefer genetic testing and premarital counseling if marrying first cousins. Gender, faculty, parental income, and educational background influenced participants' attitudes.

Determinants of Vitamin D deficiency among type 2 diabetes mellitus patients: A retrospective study.

Recent studies have shown an association between vitamin D deficiency (VDD) and type 2 diabetes mellitus patients (T2DM), but the precise relationship between these conditions has yet to be clarified. In this study, we aimed to estimate the incidence of VDD among diabetic patients and identify any relationship between diabetes and the determinants of VDD among T2DM individuals. A retrospective cross-sectional study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Patients of either gender were selected from electronic records and checked for vitamin D levels, glycosylated hemoglobin (HbA1c), and other parameters. A total of 864 subjects were enrolled. Subjects were grouped according to HbA1c levels, with < 5.7%, 5.7% to 6.49%, and > 6.5% considered normal, impaired, and diabetic, respectively. VDD was common, with an incidence of 723 (83.7%) subjects. A significantly lower vitamin D level was found in diabetic subjects than in nondiabetic subjects (29.1 ±â€…12.0 vs 44.0 ±â€…28.3, P < .001). A total of 207/209 (99%) subjects with impaired HbA1c and 179/183 (97.8%) people with diabetes had VDD. Interestingly, none of the diabetic or impaired HbA1c subjects had normal vitamin D levels. A significant association was found between VDD and being > 50 years old, overweight, or obese, as well as HbA1c, fasting plasma glucose, calcium, and total cholesterol (TC) levels. A high rate of VDD and significantly lower vitamin D levels were found in diabetic subjects. Age, being overweight, obesity, HbA1c, and fasting plasma glucose were the few determinants of VDD among T2DM patients. These findings highlight the importance of addressing vitamin D status in managing and preventing T2DM, particularly in those over the age of 50, those who have higher body weight, and those with raised HbA1c and fasting plasma glucose levels.

Association Between Pfizer COVID-19 Vaccine Adverse Effects and Diabetes Mellitus: A Prospective Multicenter Study.

Introduction The epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered the contagion of coronavirus disease 2019 (COVID-19), which killed many individuals globally. The Pfizer BioNTech vaccine was the first messenger ribonucleic acid (mRNA)-based vaccine that boosted immunity against various adverse reactions. The objective of this study was to evaluate the frequency of Pfizer vaccine side effects among participants with and without diabetes mellitus (DM). Methods This multicenter study was cross-sectional and was performed using a non-probability consecutive sampling technique. The study duration was six months, from October 1, 2022, to March 31, 2023. A total of 750 participants who received both doses of the Pfizer vaccine were included in the study. Demographic details such as gender, age, comorbidities, preceding COVID-19 infection, and the occurrence of any local and systemic side effects of the first and second doses of vaccine were recorded. The association between local and general side effects and the presence of DM was assessed using the chi-square test. Results Of the 750 participants included in the study, 289 (77.1%) were males with diabetes mellitus (DM), and 217 (57.9%) were non-diabetic participants; however, 86 (22.9%) females had DM, and 158 (42.1%) were non-diabetic; their mean ages were 48.23 ± 16.22 and 37.56 ± 12.15 years, respectively. The most commonly occurring side effects after receiving the first dose of the Pfizer vaccine were: injection site burning in 251 (66.9%) diabetic and 254 (67.7%) non-diabetic participants. Likewise, the frequency of side effects of the second dose of the Pfizer vaccine showed that the most commonly reported side effects were: muscle pain, found in 240 (64.0%) diabetic patients and 194 (51.7%) non-diabetics, with a statistically significant association (p =0.001). Conclusion This study concluded that participants with DM had local and general adverse effects considerably more frequently than those without DM. The most frequently observed adverse effects in both diabetic and non-diabetic participants were injection site burning, rashes, muscle pain, and fever after receiving both doses of the Pfizer vaccine. Moreover, most of the side effects were minor.

Language Barriers in Understanding Healthcare Information: Arabic-Speaking Students' Comprehension of Diabetic Questionnaires in Arabic and English Languages.

Background Typically, disease-related information is available in English on the internet, and the bulk of medical research journals are likewise published in English. Therefore, in non-English-speaking countries, many people find it challenging to put that knowledge into practice. This study compared Arabic-speaking students' performance on a diabetic questionnaire presented in Arabic with their performance on the same questionnaire in English. Methodology The cross-sectional study was carried out at the King Abdulaziz University, Jeddah. Identical questionnaires in Arabic and English assessing knowledge, attitude, and practices (KAP) on diabetes mellitus (DM) were filled out by Arabic-speaking students. The English version was distributed to the same students four weeks after the Arabic version. A total of 507 students filled out the Arabic questionnaire, and four weeks later, they filled out the English version. Results Students' scores were significantly higher in the knowledge and attitudes domains (P < 0.001), with no significant difference observed in the practice domain on the Arabic language questionnaire compared to English. A gender-wise comparison showed that females had significantly higher knowledge scores in the Arabic and practice domains in the English questionnaires. According to the regression analysis, students were predicted to have good knowledge scores on the Arabic language questionnaire than on the English version (odds ratio [OR] = 4.537, P < 0.001). Similarly, students on the Arabic language questionnaire showed higher scores for positive attitudes (OR = 2.703, P < 0.001), and adequate preventative behavior (OR = 1.592, P < 0.001) than on the English version. Furthermore, being female is linked to having good knowledge scores (OR = 1.724, P < 0.001). Conclusions Results indicated that students' good knowledge, positive attitude, and adequate practice scores were associated with the Arabic language questionnaire than the English version. Our participants' KAP scores derived from an English language questionnaire were not up to the mark. There is a need to modify the school curriculum to increase students' English comprehension and command so they can perform better in professional courses.

Osteoprotegerin genetic polymorphisms and their influence on therapeutic response to ibandronate in postmenopausal osteoporotic females.

OBJECTIVES: The present study investigated osteoprotegerin (OPG) genetic polymorphisms and their influence on the therapeutic response to ibandronate in postmenopausal osteoporotic females. METHODS: This case-control study included 135 postmenopausal females (89 osteoporotic females and 46 non-osteoporotic females). Each osteoporotic patient received a monthly 150 mg ibandronate tablet for six months, and blood samples were taken before and after treatment. Bone mineral density (BMD) was measured using DEXA Scan. Three SNPs (A163G, T245G, and G1181C) of the OPG gene were selected for analysis. RESULTS: Serum OPG levels were significantly lower in osteoporotic subjects than in the control group. The percentage changes in OPG levels in the osteoporotic group before and after treatment with ibandronate were significant (p < .001). After six months of therapy with ibandronate, the percentage changes in OPG levels with AA, TT, TC, GC, and GG genotypes were significant. Following six months of ibandronate treatment, the AA genotype of rs3134069, TT, TC genotypes of rs3102735, GG, and GC genotypes of rs2073618 SNP showed a significant increase in OPG levels. Age, BMI, and GC polymorphism (rs2073618 (G/C) G1181C) were inversely associated with low BMD. Adjusted odds ratios (OR) showed that BMI, GC, GG polymorphism (rs2073618 (G/C) G1181C) and TC polymorphism (rs3102735 (T/C) A163G) were inversely associated with low BMD. CONCLUSION: The inverse association of rs2073618 and rs3102735 with low BMD indicates the protective role of these SNPs in our population. More research is needed to replicate these results in another cohort and to determine the molecular processes by which such SNPs may influence BMD.

Knowledge and awareness about colorectal cancer and barriers to its screening among a sample of general public in Saudi Arabia.

INTRODUCTION: The present study investigated knowledge, awareness, and barriers to colorectal cancer (CRC) screening from a sample of the general population in Saudi Arabia. METHODS: This cross-sectional study was conducted between August 2022 and January 2023 among a sample of the general population in Jeddah, Saudi Arabia. The questionnaire consisted of demographics, knowledge and awareness, and questions about CRC screening barriers. RESULTS: A total of 1105 adults belonged to the general public [505 females (45.7%) and 600 males (54.3%)] recruited in this survey. The mean age of the respondents was 39.79±12.49. The internet was the primary source of CC information for most participants, 661(59.8%). Gender-wise comparison of general public responses regarding CRC knowledge and awareness and barriers to screening showed a mixed response. Analysis of participants' knowledge regarding CRC and its risk factors and warning signs showed that 356(32.2%) people believed that the best age for the CRC test is 41-50 years, and 285(25.8%) responded they don't know. Almost half of the participants, 539(48.8%), were not interested in attending awareness seminars about CRC, while 371(33.6%) were interested in attending awareness seminars about CRC. Only one-third of the respondents, 368(33.3%), knew of any tests or examinations used to detect CRC. Participants' perceptions about colonoscopy-related and FOBT-related barriers to CRC screening disclosed that these are time-consuming, expensive, painful, embarrassing, etc. CONCLUSION: Insufficient information, poor awareness, and several assumed barriers to CRC screening were found among study participants. There is a need to close knowledge gaps and offer them comprehensive information regarding CRC, as well as the availability and benefits of screening. In this aspect, social media can be extremely beneficial.

Correlation between Subclinical Hypothyroidism and Metabolic Syndrome: A Retrospective Study.

Background: Several studies worldwide have studied the correlation between subclinical hypothyroidism (SCH), and metabolic syndrome (MetS), but have reported inconsistent findings. Objectives: To assess the correlation between SCH and MetS in a population from Saudi Arabia. Methods: This retrospective study was conducted at King Abdulaziz University Hospital and analyzed all thyroid function tests conducted between January 1, 2019, to December 31, 2021. A predesigned checklist was used to collect data about patients' characteristics such as age, gender, nationality, TSH, FT4 level, and MetS components. Results: A total of 41,519 thyroid function tests were conducted during the study period. From this, 1303 (3.1%) patients were found to have SCH, with the majority being females (74.4%). The prevalence did not differ according to gender but increased to 3.5% among those aged >60 years. MetS components between mildly and markedly elevated TSH were significant for total cholesterol (P < 0.001) and high-density lipoprotein cholesterol (P < 0.05). Male patients with SCH were at a higher risk of developing diabetes (P < 0.001) and hypertension (P < 0.02), than female patients with SCH. After adjusting for age, in the multiple stepwise linear regression analysis, a significant association was found between TSH levels and ALT (odds ratio: 0.77) and SBP (odds ratio: 0.35). Conclusion: The study demonstrated that the prevalence of SCH is similar between both genders but increases with age. MetS components were abnormal in patients aged >50 years and in males with SCH. SCH and MetS components were found to be correlated, and thus monitoring these variables in patients with SCH is advisable.

Correlation of bone density measured on CT chest with the severity of COVID-19 infection: A retrospective study.

PURPOSE: This retrospective study investigated the correlation between bone mineral density (BMD) and COVID-19 severity among COVID-19 patients who underwent chest computed tomography (CT) scans. METHODS: This study was carried out at the King Abdullah Medical Complex in Jeddah, Saudi Arabia, one of the largest COVID-19 centers in the western province. All adult COVID-19 patients who had a chest CT between January 2020 and April 2022 were included in the study. The pulmonary severity scores (PSS) and vertebral BMD measurements were obtained from the patient's CT chest. Data from the patients' electronic records were collected. RESULTS: The average patient age was 56.4 years, and most (73.5%) patients were men. Diabetes (n = 66, 48.5%), hypertension (n = 56, 41.2%), and coronary artery disease (n = 17, 12.5%) were the most prevalent comorbidities. Approximately two-thirds of hospitalized patients required ICU admission (64%), and one-third died (30%). The average length of stay in the hospital was 28.4 days. The mean CT pneumonia severity score (PSS) was 10.6 at the time of admission. Patients with lower vertebral BMD (< = 100) numbered 12 (8.8%), while those with higher vertebral BMD (>100) numbered 124 (91.2%). Only 46 out of the total survived patients (n = 95) were admitted to the ICU versus all deceased (P<0.01). The logistic regression analysis revealed that an elevated PSS upon admission resulted in a reduced chance of survival. Age, gender, and BMD did not predict survival chances. CONCLUSION: The BMD had no prognostic advantage, and the PSS was the significant factor that could have predicted the outcome.

Diabetes Mellitus Knowledge, Attitudes, Preventive Practices and Associated Factors Among a Sample of Adult Non-Diabetic Saudi Residents.

Purpose: To assess the diabetes mellitus (DM) knowledge, attitudes, preventive practices, and associated factors among a sample of adult non-diabetic Saudi residents. Methods: The present survey was conducted in April-June 2022. People from the general population were invited to participate in the study, and the data were collected using a validated questionnaire. Results: A total of 1207 non-diabetic subjects participated in the study [females 798(66.1%) and males 409(33.9%)], and the response rate was 80% (1207/1500). Two-thirds (66.86%) of non-diabetic adult community members had good knowledge of DM, 47.8% had positive attitudes, and 62.14% maintained a healthy lifestyle to avoid DM. There was a family history of DM in more than half of the subjects 723(59.9%). Participants who had a direct relative with diabetes scored higher on the knowledge question than those who did not (p<0.001). Practice questions responses for preventing DM showed that about 459(38%) were using fatty food less frequently, and only 338(28%) and 153(12.7%) were doing physical activities 30-60 minutes per day frequently and very frequently, respectively. Most participants were smoking tobacco, 890(73.7%), and getting checked their BP, 704(58.3%), very frequently. The participants with a master's and Ph.D. degree were likelier to have positive attitudes and good practices than students. Individuals with a history of DM in their families were 2.10 times (OR=2.10, p<0.001), 1.95 times (OR=1.95, p<0.001), and 2.03 times (OR=2.03, p<0.001) more likely to be knowledgeable, had positive attitudes and good practices than those with no DM in their family, respectively. Conclusion:  Over half of the individuals possessed a positive mindset, adequate knowledge, and good practicing behavior for preventing DM. Having Master's and Ph.D. degrees and a family history of DM were associated with a positive attitude and good practices. There is a need to expand community awareness campaigns utilizing social media channels.

Obesity and Its Associations with Gender, Smoking, Consumption of Sugary Drinks, and Hour of Sleep Among King Abdulaziz University Students in Saudi Arabia.

Background: This study investigated the prevalence of obesity among university students in Saudi Arabia's western region, as well as its association with gender, smoking, consumption of sugary drinks, and hours of sleep. Methods: A cross-sectional study recruited a simple random sample of students from King Abdulaziz University (KAU) in Saudi Arabia's western region. In this study, the Arab Teens Lifestyle (ATLS) questionnaire was used. The survey was conducted between April and June 2022. Results: In total, 659 students participated (313 males [37.3%] and 437 females [66.2%]). One-fourth of the students, 158 (24%), were overweight, and 83 (12.7%) were obese. Male participants were overweight or obese by a rate of 32.6% and 19.4%, respectively. Female overweight and obese rates were 16.2% and 6.6%, respectively. Moreover, obesity/overweight rates were 43.6% in the urban area and 36.9% in the rural area (P=0.03). A total of 370 participants (56.14%) slept less than 8 hours per day, 185 (28.1%) spent more than five hours per day watching television or using the internet, and 303 (46%) ate breakfast on a regular basis. Obesity/overweight was more common in smokers than in nonsmokers (59.7% vs 32.8%, P=0.01). The prevalence of obesity was lower among those who walked three days or more per week (28.1% vs 44.1%; P=0.01) and ran/jogged outside or on a treadmill three days or more per week (29.5% vs 39.8%; P=0.03) than among those who ran/jogged less than three days per week. Student obesity was independently predicted by being male (P=0.01), drinking more sugary drinks (P=0.01), smoking (P=0.03), and sleeping for fewer hours (P=0.03). Conclusion: Obesity was more prevalent in male students, with a prevalence of 24%. Male gender, consumption of more sugary beverages, smoking, and sleeping for fewer hours were all independent predictors of obesity among university students.

Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia.

Introduction: The current study evaluated obesity prevalence, physical activity, and dietary practices among Saudi adults in the Makkah region of the Kingdom of Saudi Arabia (KSA). The current survey was accomplished between November 2021 and March 2022. Method: A validated questionnaire, Arab Teens Lifestyle Study (ATLS), was used to evaluate all participants' physical activities, sedentary behaviors, and nutritional habits in addition to demographic data. Result: A total of 2,115 people [1,238 (58.5%) women and 877 (41.5%) men] participated in this survey. Being overweight was prevalent in 32.8% of the population (41% of men and 28.9% of women), obesity was prevalent in 23% of the population (males 23.1% and females 24.2%). Obese people consumed more soft drinks, and overweight people did not consume enough vegetables (fresh/cooked). Obese people consumed fast food (e.g., burgers, sausage, pizza, or Arabic shawarma) over three times each week. The mean (SD) number of days of practice walking was 2.51 (2.05) vs. 1.3 (1.87) (p < 0.001) for lean and obese individuals, respectively. In addition, individuals with normal BMI had more days of jogging, moderate and high-intensity exercise, dancing, and strength training than those with obesity. The odds of being obese increased with age (OR: 1.07; p < 0.001), in males (OR: 2.16; p < 0.001), in participants earning <5,000 SR/month (1.3 thousand $) and 10-15 thousand SR/month (1.34-2.66 thousand $) (OR: 2.36; P = 0.01). Obesity was inversely associated with moderate-intensity exercise (OR: 0.802; p = 0.009), and regular walking (OR: 0.685; CI: 0.624-0.752; p < 0.001). Discussion: Overweight and obesity were prevalent in 32.8% and 23% of the population, respectively. Sociodemographic factors associated with obesity. Focused intervention strategies are needed to overcome the obesity issue.

The Role of Religious Culture in Medical Professionalism in a Muslim Arab Society.

Purpose: Calls have been made to integrate concepts and practices derived from Muslim culture into medical professionalism in Muslim societies. Little is known about how these religious cultural concepts (RCCs) influence medical practice and education. This study explored the influence of RCCs on medical professionalism in Saudi Arabia. Methods: This was a qualitative study that implemented a constructivist, grounded theory approach. Semi-structured interviews about RCCs and medical professionalism were conducted with 15 Saudi physicians at a single academic medical center. Purposive sampling was used to recruit participants of different genders, generations, and specialties. Data collection and analysis were iterative. A theoretical framework was formulated. Results: Key findings: (i) the role of RCCs in medical professionalism is perceived to be constantly evolving due to the evolution of societal interpretations of RCCs; (ii) participants described applying two standards to judge what is professional: a medical standard and a religious cultural standard. Participants shifted between these two standards variably and non-linearly. This variable shifting altered the values shaping medical professionalism, at times unpredictably. Discussion: Academic Saudi physicians argued against assuming a stable traditional interpretation of RCCs, emphasized the evolving contribution of RCCs to medical professionalism, and indicated that the process of merging religious cultural and medical standards in medical practice is variable and may alter medical practice values. Therefore, these physicians perceived RCCs to be useful as supplements to but not as a backbone for medical professionalism. Careful consideration of the potential impact of RCCs on the values of medical professionalism is warranted.

Quality of life, stress, anxiety and depression and associated factors among people with type 2 diabetes mellitus in Western region Saudi Arabia.

Introduction: The objective of this study is to evaluate the quality of life (QoL), depression, anxiety, and stress, along with associated factors among individuals with diabetes in Saudi Arabia. Methods: This survey was conducted at King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). The assessment of depression, anxiety, and stress related to Type 2 Diabetes Mellitus (T2DM) was conducted using the DASS-21 questionnaire, while diabetes-related QoL was evaluated using the revised version of the diabetes QoL questionnaire (RV-DQoL13). Data were analyzed using SPSS-26. Results: A total of 251 subjects were included in the study (165 [65.7%] males and 86 [34.3%] females, mean age 50.1 ± 14.5 years). The individuals with DM had a mean value of QoL of 29.16 ± 9.23, with 46.9% having poor QoL. Furthermore, in dimensions of QoL, almost half of the individuals reported high worry about the disease (49.6%), followed by a high diabetes impact (46.6%) and low life satisfaction (42.9%). The prevalence of depression, anxiety, and stress was 49.4, 71.7, and 49.8%, respectively. A significant correlation was found between depression, anxiety, and stress and DASS-21 scores with QoL (p < 0.001). The regression analysis indicated an association of distinct factors with QoL like age above 41 years (p = 0.004), being married (p < 0.001), being divorced (p = 0.04), higher education (p = 0.007), regular medicine intake (p = 0.01), regular exercise (p = 0.03), lipid profile (p = 0.01), HbA1c (p < 0.001), and DASS-21 scores (p < 0.001). Poor QoL score (TQoL score > 27) was significantly associated with depression, anxiety, and stress (p < 0.001). The participants with higher monthly income, shorter disease duration, regular medicine use, and altered lipid profile, and older subjects had a lower chance of depression, anxiety, and stress. Conclusion: Approximately half of individuals with T2DM experienced poor QoL, while the prevalence rates for depression, anxiety, and stress were 49.4, 71.7, and 49.8%, respectively. Scores in the domains of impact, worry, and satisfaction were below optimal levels. Several factors were linked to QoL and depression, anxiety, and stress, and an association was observed between DASS-21 scores and QoL.

Association of serum levels of Visfatin, Intelectin-1, RARRES2 and their genetic variants with bone mineral density in postmenopausal females.

Background: Adipokines are engaged in bone physiology and regulate bone mineral density (BMD) by playing protective or cynical role in bone metabolism. The study is designed to measure and compare BMD, adipokines (retinoic acid receptor responder protein-2 RARRES2, visfatin and Intelectin-1) and their genetic variants in postmenopausal osteoporotic, osteopenic and non-osteoporotic females. Methods: This comparative study included postmenopausal non-osteoporotic (n=72), osteopenic (n=72) and osteoporotic (n=100) females with two years of amenorrhea and age between 50 to 70 years. Gold standard DXA was used to measure BMD. Hardy-Weinberg equilibrium was established. Kruskal-Wallis test for comparisons, logistic and multivariate regression analysis were used to rule out the predictors of BMD. Results: On comparing the three groups, significant differences were observed in serum RARRES2 (p <0.001) and serum visfatin (p=0.050). The significant positive predictor of BMD at lumbar spine and total hip was serum visfatin. BMD at right and left femoral neck was predicted negatively by serum chemerin while BMD at left femoral neck was also predicted positively by serum calcium levels. There was significant difference in BMD at right femoral neck (p = 0.033) between rs7806429 genotypes. The odds of having low BMD increases with increasing serum levels of chemerin and decreasing serum levels of visfatin and calcium. Conclusion: The adipokines RARRES2 and visfatin are associated with BMD. RARRES2 is an independent negative and visfatin is positive predictor of BMD in postmenopausal females. BMD at right femoral neck was significantly low in RARRES2 rs7806429 TC heterozygotes.

A bibliometric analysis of the top 100 most cited papers and research trends in breast cancer related BRCA1 and BRCA2 genes.

This study aimed to identify, characterize, and map the important attributes of the top 100 most cited papers on BRCA1 and BRCA2 genes. The scientific literature on BRCA1 and BRCA2 was searched in the Web of Science Core Collection database using the keywords "BRCA1" OR "BRCA2" (Title). The top 100 most cited papers were selected based on citations. The obtained data were exported into HistCiteTM, RStudio, and VOSviewer software for prerequisite analysis. The top 100 most cited papers on BRCA1 and BRCA2 were authored by 932 authors from 24 countries and published in 27 journals. These papers were cited 79,713 times, ranging from 441 to 4671 citations. The highly cited paper was cited 4671 times and published in Science (1994). The leading author, journal, publication year, institution, and country were Easton DF (n = 16), Nature Genetics (n = 11), 2002 (n = 11), University of Pennsylvania (n = 17), and the USA (n = 76), respectively. The results show that all the top 100 papers were produced in developed countries. The collaboration index among the authors was 9.49. The most frequently appeared keywords were ovarian-cancer, breast-cancer, mutations, gene, and familial breast. In recent times, the trend topics were patients, mutations, carriers, ovarian, and risk.

Factors disturbing undergraduate students' interaction during lectures: A university-based survey.

Objectives: To explore the factors that disturb students' interaction during lectures and interfere with their active participation. Methods: This cross-sectional study was conducted at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. The study lasted approximately nine months, beginning on May 9, 2018, and ending on February 6, 2019. Students of different faculties participated in the study. A valid questionnaire was used after piloting. Four major categories were defined: classmate factors (CMFs), teacher-related factors (TRFs), personal factors (PFs), and class environment factors (CEFs). Results: A total of 658 students were included. Among all, 428 (65%) were females, and 230 (35%) were males. The comparison of main categories showed that CMFs, TRFs, PFs, and CEFs disturbed students' interaction 74%, 55%, 50%, and 84%, respectively. The comparison of the factors disturbing students' interaction showed that females were more disturbed by the CMFs (p=0.036) and CEFs (p<0.001) than males. CMFs, PFs, and CEFs disturbed more married students' than unmarried. CMF more disturbed science faculty students' interaction compared to all other groups. CEF showed less disturbance among Engineering/Math group students' interaction compared to other groups. The male gender and sixth-year students were the predictors of TRF disturbance, while the married students were the predictors of disturbance by PF. Conclusion: Several factors (PF, CMF, TRF, and CEF) disturbed students' interaction during a lecture. Additionally, the male gender, married students, and sixth-year students were the associated factors of disturbed interaction during a lecture. We suggest that teachers and educational leaders need to devise a policy to overcome these factors to provide a conducive learning environment.