General Public Knowledge, Attitude, and Practice Regarding the Impact of Air Pollution and Cardiopulmonary Diseases in Jeddah, Saudi Arabia.

Introduction Air pollution is a critical public health issue associated with various respiratory and cardiovascular diseases. The lungs and heart are the organs most affected by air pollution, and damage to these organs is strongly associated with inhaled particulate matter produced by burning fossil fuels. Household and ambient air pollution have been closely linked to lower respiratory infections, with ambient air pollution alone estimated to be responsible for millions of deaths globally each year. Therefore, this study aimed to assess the general public knowledge attitude and practice regarding air pollution and cardiopulmonary morbidity in Jeddah, Saudi Arabia. Methods The study was conducted in Saudi Arabia using a self-administered questionnaire distributed through popular social media apps. A snowball sampling technique was used, including only Saudi citizens aged 18 or older. The questionnaire consisted of 30 questions derived from a comprehensive literature review on the subject matter. Questions were validated through face validity, pilot testing, and Cronbach's alpha reliability measurement. The questionnaire included questions on demographic data, knowledge of air pollution, the relationship between air pollution and cardiopulmonary diseases, and attitudes and practices toward lowering exposure to air pollution. Results The study included 649 participants, with a mean age of 32.11 ± 13.47 years, and over half were females (54.7%). Most participants were aware of outdoor and indoor air pollution, but only a tiny percentage recognized cooking as a primary indoor source of pollution. However, the majority believed that indoor pollution could contribute to outdoor pollution. Participants associated air pollution with cardiopulmonary diseases, mainly secondhand tobacco smoke and outdoor air pollution caused by factories and industrial facilities. Knowledge and practice levels varied, with older individuals, females, and those in non-health-related occupations having higher levels of knowledge. Positive attitudes, particularly believing that moving to a less polluted area improves health, were associated with better knowledge. Females exhibited better air pollution-related practices, and there was a positive correlation between knowledge and practice scores. Conclusion The study highlighted the need for targeted public health campaigns to improve awareness and promote healthier practices, particularly among young adults, to mitigate the potential health impacts of air pollution, especially cardiopulmonary health.

The prevalence of self-medication and its associated factors among college students: Cross-sectional study from Saudi Arabia.

Background: Self-medication with OTC or prescription drugs is widespread, may impair health, and leads to microbial resistance. Self-medication treats symptoms without a prescription. Self-medication is common among students across disciplines. Thus, this study evaluates medical and non-medical students' self-medication prevalence, knowledge, and variables. Methods: 352 people completed a verified 25-item online questionnaire from September 5 to November 17, 2021. Self-medication and demographic characteristics such as gender, professional college, and family income were examined using a chi-square test of independence. Results: 210 (59.6 %) participants were from the College of Medicine, and 142 (40.34 %) were from other professional health colleges. Health professional students self-medicated 55.9 %. This research found substantial connections between self-medication knowledge, gender, and family income. With a p-value of 0.0001, 32 % of women agreed that self-medication is safe, compared to 15.8 % of men. Female students were more likely than boys (61.9 % vs 38.1 %, p-value = 0.0291) to self-medicate as their initial therapy. Family income was also related to self-medication; 69.6 % of low-income pupils self-medicated to reduce doctor visits, p-value = 0.0477. Conclusion: Students of all majors self-medicate. Medical students were more informed about generic drug safety and administration. There were substantial unfavorable sentiments regarding self-medication, highlighting the need for educational health activities to raise student understanding of its risks.

Public knowledge, attitudes, and practices towards herbal medicines; a cross-sectional study in Western Saudi Arabia.

BACKGROUND: Herbal medicines, derived from medicinal plants, are among the most popular alternative remedies around the globe. In Saudi Arabia, herbal medicines are extensively used by public as part of the culture as well as religious norms. Therefore, this study aimed to evaluate knowledge, attitudes, and practices regarding herbal medicines among the general population in Saudi Arabia. METHODS: A descriptive cross-sectional survey study was conducted on the general population of Jeddah city with the help of a validated and self-administered questionnaire. Sample size was calculated to be 450 with subjects between 20 and 60 years of either gender. Descriptive and inferential statistical analysis was performed using SPSS. RESULTS: Results of our data showed that 173 (42.2%) of the total participants used herbal medicines, however, significant association was found between female gender and the usage of herbal medicines (p < 0.001). Approximately, more than half (56.0%) of the respondents agreed that herbal medicines could be used to promote health and treat illnesses, and 45% respondents agreed that herbal medicines are safe. 153 (37.4%) of the participants opined that herbal medicines could be taken with conventional or allopathic medicine. The data also showed a significant (p < 0.05) association between knowledge about the source of herbal medicine and gender where females were found to have more knowledge compared to males. Moreover, a significantly higher number of chronic disease patients were using herbal medicines compared to individuals with no medical problems (p < 0.001). Strikingly, majority (n = 204; 49.9%) of the respondents used herbal medicines as a first choice when sick, while a good number (n = 172; 42.1%) of respondents did not consult doctors before taking herbal medicines. CONCLUSION: The use of herbal medicines is common among the general population of Jeddah. Although most of the participants believed that the herbal medicines are safe and do not require consultation, there is a dire need to increase awareness as well as to establish effective strategies to evaluate the safety, efficacy and quality of the herbal medicines for propitious consequences of this commonly used entity in the local society.

Assessment of Pre-existing Type 2 Diabetes Mellitus Prevalence and Risk Factors Among Colorectal Cancer Patients in King Abdulaziz Medical City, Jeddah.

BACKGROUND: Diabetes mellitus (DM) and cancer are recognized as non-communicable chronic disorders which are among the top ten causes of death globally. In Saudi Arabia, the prevalence of type 2 DM (T2DM) and colorectal cancer (CRC) is alarmingly high. Both T2DM and CRC share common risk factors. In this study, we aim to assess the prevalence of pre-existing T2DM among CRC Saudi patients. METHODS: In this cross-sectional study, data were collected from the medical records of 275 Saudi adult patients with CRC from 2009 to 2018 at King Abdulaziz Medical City, Jeddah (KAMC-J). RESULTS: Participants had a mean age of 57.0 years, standard deviation (SD) of 13.0, and were mostly males (60.00%) and Saudi (100.0%). Participants had a mean BMI of 26.42 (7.35) kg/m2. The prevalence of pre-existing T2DM in this study was 40.80%. 15.8% of participants were overweight and obese (BMI>30), respectively. The average age of diabetics and non-diabetics was 63.6 (10.64) and 52.73 (12.43), respectively. Diabetic patients are significantly older than non-diabetic patients (p<0.001). The average BMI for diabetics was 26.96 (7.26) kg/m2, whereas the average BMI for non-diabetics was 25.93 (7.48) kg/m2. No significant differences were found between the two groups. CONCLUSION: This study provides new insight into the high prevalence of pre-existing T2DM in CRC patients in Saudi Arabia. In particular, the age of diagnosis of CRC in diabetic patients was significantly higher than in non-diabetics.

Laparoscopic Cholecystectomy Operative Time and Hospital Stay Differences Between Sicklers and Non-sicklers: A Five-Year Comparative Cross-Sectional Study at King Abdulaziz Medical City, Jeddah.

Background Sickle cell disease (SCD) is one of the most important hemoglobinopathies that result in the formation of pigment gallstones. Laparoscopic cholecystectomy (LC) is a safe surgical procedure for gallstones in SCD. Currently, there is no standard or guidelines for the preoperative preparation of these patients. This study aims to estimate the difference in pre-operative length of stay, operative time, postoperative length of stay, and total hospitalization length of stay among patients with and without SCD in a tertiary hospital in Jeddah, Saudi Arabia. Such knowledge would aid in establishing a standard for the preoperative preparation of SCD patients for LC. Methods Data from all patients undergoing laparoscopic cholecystectomy between January 2013 and December 2018 were collected retrospectively with a comparative cross-sectional study design. Data included age, sex, BMI, clinical presentation, mode of admission (elective or emergency), preoperative length of stay, operative time, postoperative length of stay, total hospitalization length of stay, and type of surgery (day or inpatient). JMP 15.2.1 was used for statistical analysis. Results From 2013 to 2018, 793 patients underwent LC, and of those, 16 (2.018%) were SCD patients. The results showed significant differences in preoperative (p<0.001), postoperative (p<0.001), and total hospitalization stay time (p<0.001) between the SCD patients and non-SCD patients. However, the data show no significant difference in the operative time of LC between the two studied groups. Conclusion SCD is the most common hemoglobinopathy-causing gallstone. Challenges in these patients are mainly in peri-operative management. Further prospective cohort studies are needed to create a standardized approach for peri-operative management of SCD patients to facilitate delivery of the same level of care and shorten total hospitalization time.

Use of Complementary and Alternative Medicine in the General Public of Western Saudi Arabia: A Cross-Sectional Survey.

BACKGROUND: Complementary and alternative medicine (CAM) has been continuously used worldwide. Various cultures have used this path of healing, and to our date, people are still using it and some even prefer it to modern medicine. Thus, this study aims to analyze awareness, self-use, perceptions, beliefs, and attitudes toward CAM in the general public of Jeddah, Saudi Arabia. METHODS: A descriptive observational cross-sectional study was conducted in the public places of Jeddah. Data were collected from 784 participants using a self-administered paper-based questionnaire, and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS). RESULTS: The majority of the population was aware of massage (91.8%), herbs (90.7%), nutritional supplements (89.8%), and prayers (88.1%). With regards to usage and effectiveness, prayers and spirituality is used by 75.5% of the population and considered to be the most effective by 76.0%. Respondents obtained information about CAM mostly from friends and relatives (76.6%), followed by media (67.2%), while lack of knowledge about CAM and lack of trained professionals are the most perceived barriers to CAM implementation. Data showed a significant association (p < 0.05) between gender, awareness, and self-use of CAM modalities. Yoga (44.2%) and herbs (72.6%) were mostly used by females, whereas males were mostly aware of cupping (90.4%) and cauterization (76.2%). Another significant association was found between the level of education, awareness, and self-use of CAM modalities indicating that those who were not educated were aware of and used cauterization the most, while those who went to college were more aware of yoga (75.4%). Lastly, having a relative in the healthcare field showed a significant association with awareness of yoga, prayers, and spirituality compared to other CAM modalities. CONCLUSION: In conclusion, the present study revealed that the majority of the Western Saudi Arabian population was aware of several CAM modalities and practiced some form of CAM. However, awareness of specific types of CAM may relate to gender, educational level, and relationship to the medical field.

Awareness regarding COVID-19 and its effects on mental health among pre-professional health sciences students at King Saud bin Abdulaziz University for health sciences in Riyadh and Jeddah, Saudi Arabia.

In light of the outbreak caused by the COVID-19 and its impact on the physical and mental wellbeing, we explored the consequences of this pandemic on the mental health among pre-professional health sciences students and their awareness regarding the virus. A descriptive observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah and Riyadh campuses. Data was collected from 770 participants using an online questionnaire, and statistical analysis was performed using SPSS. The majority of the participants (87.5%) considered governmental authorities as their main source of information, and therefore, they were up to date on the general information regarding COVID-19. For findings on mental health, it was found that 61.9% were exhibiting variant degrees of depression, as well as 50% expressing signs of extremely severe anxiety. However, 50.9% of the participants expressed no signs of stress during this pandemic. An association was found between gender and mental health showing females to have higher tendencies to express signs of extremely severe depression, anxiety, and stress. An association was also found between parents' marital status and anxiety. Analysis revealed that participants with separated parents were the least among the participants to show no signs of anxiety, as well as reporting the highest numbers in the "extremely severe" anxiety category. With the increased awareness and higher than normal levels of the investigated mental illnesses, we advise that proper action should be considered to address this issue.

Pattern and Factors Associated With the Utilization of Herbs As Medications Among Patients in a Tertiary Care Hospital in Western Saudi Arabia.

BACKGROUND: Herbs are used worldwide as a treatment for plenty of diseases, and some herbs are used as the origin of modern medications. Although the therapeutic benefit was reported mostly from China, over time the world seemed to realize its importance. The use of herbs as medicine is also very common in the Arab region and Saudi Arabia. OBJECTIVES: This study was conducted to assess the pattern of use of herbs as medications in Saudi Arabia and factors associated with its use. METHODS: A convenience sample of adult patients in a tertiary care hospital in Jeddah, western Saudi Arabia was used. A questionnaire consisted of two sections, i.e., demographic characteristics and the knowledge, attitudes, and practices on the use of herbs. The data collection was conducted during December 2019. RESULTS: Three hundred and eighty patients were included, of which 53.3% were female. Almost half (49.7%) were college graduates. More than half of patients (55.6%) used herbs themselves, and (59%) reported members of the family used herbs for the past 12 months. Most patients (62.6%) use herbs without medical consultation. Patients used herbs following information received from family members (57.8%), social media (22.5%), doctors (8.1%), books (6.6%), or TV (5%). The most-reported herb was Anise followed by cumin and cinnamon. CONCLUSION: The use of herbs is common in Saudi Arabia. Herbs are mostly used for a variety of medical conditions following family members' experience and social media recommendations. Detailed information on the type of herbs used, doses, and effects are worth further study with a focus on variation based on different regions.

Electronic cigarettes consumption and associated factors among general population in Western Saudi Arabia.

BACKGROUND: In recent years, consumption of E-cigarettes has increased dramatically. Several studies have focused on the prevalence of E-cigarettes among specific groups of people, using it as a substitute to traditional cigarettes, or the participant knowledge regarding risks. This research was aimed on E-cigarettes' prevalence and its association to several factors in the general population of Western Saudi Arabia. DESIGN AND METHODS: Using an observational cross-sectional study, data were collected from (n=465) above 18 years old smokers during the survey at public attractions. A validated self-administered questionnaire acquired from previous studies was employed to insure the suitability for the general population of Jeddah Saudi Arabia. Sample size was calculated via Raosoft@ and adults of either gender were included in the study. Descriptive or inferential statistical analysis was performed using SPSS. RESULTS: The preponderance of e-cigarette smokers used entertainment as the reason for smoking, with an average of (33.9%). Although one reason for e-cigarette consumption was to cease traditional smoking, results showed an average of (49.4%), which is the majority of those who attempted to cease traditional smoking via e-cigarette, did not succeed in quitting traditional smoking. This study also demonstrated that participant that believed that e-cigarette is beneficial had a higher chance to cease conventional smoking than who did not (32.1% versus 14.6%) which is significant (p<0.001). CONCLUSIONS: In conclusion, this study estimated the prevalence of e-cigarette consumption among the population of Jeddah, Saudi Arabia along with assessment of elements which help increase the overall e-cigarette consumption in Jeddah.

Pathophysiological Roles of Neuro-Immune Interactions between Enteric Neurons and Mucosal Mast Cells in the Gut of Food Allergy Mice.

Recently, the involvement of the nervous system in the pathology of allergic diseases has attracted increasing interest. However, the precise pathophysiological role of enteric neurons in food allergies has not been elucidated. We report the presence of functional high-affinity IgE receptors (FcεRIs) in enteric neurons. FcεRI immunoreactivities were observed in approximately 70% of cholinergic myenteric neurons from choline acetyltransferase-eGFP mice. Furthermore, stimulation by IgE-antigen elevated intracellular Ca2+ concentration in isolated myenteric neurons from normal mice, suggesting that FcεRIs are capable of activating myenteric neurons. Additionally, the morphological investigation revealed that the majority of mucosal mast cells were in close proximity to enteric nerve fibers in the colonic mucosa of food allergy mice. Next, using a newly developed coculture system of isolated myenteric neurons and mucosal-type bone-marrow-derived mast cells (mBMMCs) with a calcium imaging system, we demonstrated that the stimulation of isolated myenteric neurons by veratridine caused the activation of mBMMCs, which was suppressed by the adenosine A3 receptor antagonist MRE 3008F20. Moreover, the expression of the adenosine A3 receptor gene was detected in mBMMCs. Therefore, in conclusion, it is suggested that, through interaction with mucosal mast cells, IgE-antigen-activated myenteric neurons play a pathological role in further exacerbating the pathology of food allergy.

Cross-Sectional Survey among General Population Regarding Knowledge and Attitude toward Antibiotic Usage in Western Saudi Arabia.

BACKGROUND: Antibiotic resistance is a threatening issue to human wellbeing and an obstacle in the treatment process of many life-threating illnesses. This study aims to assess the knowledge and attitudes toward antibiotic usage among the general population in Jeddah, Saudi Arabia. METHODS: A self-administered cross-sectional survey of 460 participants was distributed among the general population in Jeddah in the form of a validated questionnaire. Sample size was calculated to be 460 adults of either gender. Descriptive and inferential statistical analyses were performed using the Statistical Package for Social Sciences. RESULTS: the age of more than half of participants (55.6%) was 18-30 years old, followed by the age group 31-40 years old (26.6%), with the smallest age group >60 years old (1.9%). More than two thirds of participants were male (69.5%), while 131 were female, accounting for 30.5%. Almost one third of participants had poor knowledge about antibiotics (30.5%), 51.0% had used antibiotics without any prescriptions, 54.6% of participants thought antibiotics could be used to treat viral infections, and 55.1% thought it was acceptable to stop taking antibiotics if symptoms start to improve. In addition, 49% believed that taking antibiotics would help them get better more rapidly when suffering from the common cold. Some personal characteristics were significantly associated with the public's knowledge (e.g., age, education, and monthly income) and their attitudes (e.g., monthly income). CONCLUSION: Findings revealed a low level of knowledge on the use of antibiotics among the general public in Jeddah. This study signifies the need for improvement in the public's knowledge and enhancement of their attitudes toward proper utilization of antibiotics.

Assessing the Effects of Basic Medical Science Courses on the Knowledge and Attitude towards Antibiotic Usage among Pre-Professional Students in Saudi Arabia.

The curriculum of medical schools includes courses on antibiotics. Therefore, it is worth exploring information related to the knowledge and attitudes about antibiotics. In this cross-sectional study the questionnaire was administered to the undergraduates in two phases, before and after attending the basic medical science courses. The data were collected on demographic variables, source of antibiotics, level of knowledge, and changes in attitude statements. Data analysis was implemented using SPSS. The mean age of participants was 19.87 and 20.15 in phases I and II, respectively. Most of the participants' parents had education at the university level and a monthly income above 15,000 SAR. Generally, students had good knowledge and attitude about antibiotics. A significant improvement in students' knowledge in phase-II was noticed in "level of knowledge" (p-value = 0.044), "paracetamol is considered an antibiotic" (p-value < 0.001) and "overuse of antibiotics can cause antibiotics resistance" (p-value = 0.003). The overall knowledge and attitude of pre-professional students were good in both phases, but their attitude did not improve at a significant level in phase-II. There is a need to put more focus on antimicrobial therapy in their training.

Ins and outs of cadmium-induced carcinogenesis: Mechanism and prevention.

Cadmium (Cd) is a heavy metal and a highly toxic pollutant that is released into the environment as a byproduct of most modern factories and industries. Cd enters our body in significant quantities from contaminated water, cigarette smoke, or food product to many detrimental health hazards. Based on causal association all the Cd-related or derived compounds have been classified as carcinogens. In this study, we present an overview of the published literature to understand the molecular mechanisms for Cd-induced carcinogenesis and its prevention. In acute Cd poisoning production of reactive oxygen species is a key factor. However, chronic Cd exposure can transform cells to become more resistant to oxidative stress. Also, as an epigenetic mechanism Cd acts indirectly on DNA repair mechanisms via alteration of reactions upstream. Those transformed cells acquire resistance to apoptosis and deregulation of calcium homeostasis. Leading to uncontrolled carcinogenic cell proliferation and inherent DNA lesions. Flavonoids commonly found in plant foods have been shown to have a protective effect against Cd-induced carcinogenicity. A wide variety of tumorigenic mechanisms involved in chronic Cd exposure and the beneficial effects of flavonoids against Cd-induced carcinogenicity necessitate further investigations.

A Questionnaire-Based Survey to Assess the Level of Knowledge and Awareness about Drug-Food Interactions among General Public in Western Saudi Arabia.

Introduction: Various drug-food interactions exist that may hinder treatment and can sometimes be lethal. Our aim was to assess the level of public knowledge and awareness in Jeddah city, Western Saudi Arabia, about drug-food interactions, along with the effects of demographics on their knowledge. Methods: A survey questionnaire was administered in this cross-sectional study to participants spread across multiple locations in Jeddah, including in malls and public gatherings. Participants included both males and females. Sample size was calculated through Raosoft® software. Data analysis was executed using IBM Statistic SPSS and the level of statistical significance was set at p < 0.05. Results: A total of 410 people participated in the study and only 92.68% (380) of responses were enrolled in the study; 7.32% (30) were not enrolled due to the exclusion criteria. Surprisingly, only six out of eighteen questions regarding drug-food interactions in the administered questionnaire were correctly answered by 380 participants. Data indicated that the participants had a poor to intermediate level of both knowledge and awareness with respect to drug-food interactions. Furthermore, participants showed moderate to strong awareness of the effects of alcohol and tea generally, and their interaction with medication. Conclusion: Participants in our study showed inadequate knowledge of basic and fundamental information about drug-food interactions, which highlights the dire need to increase awareness.

Hyperthermia and protein homeostasis: Cytoprotection and cell death.

Protein homeostasis or proteostasis, the correct balance between production and degradation of proteins, is an essential pillar for proper cellular function. Among the several cellular mechanisms that disrupt homeostatic conditions in cancer cells, hyperthermia (HT) has shown promising anti-tumor effects. However, cancer cells are also capable of thermoresistance. Indeed, HT-induced protein denaturation and aggregation results in the up regulation of heat shock proteins, a group of molecular chaperones with cytoprotective and anti-apoptotic properties via stress-inducible transcription factor, heat shock factor 1(HSF1). Heat shock proteins assist in the refolding of misfolded proteins and aids in their elimination if they become irreversibly damaged by various stressors. Furthermore, HSF1 also initiates the unfolded protein response in the endoplasmic reticulum (ER) to assist in the protein folding capacity of ER and also promotes the translation of pro-survival proteins' mRNA such as activating transcription factor 4 (ATF 4). Moreover, HT associated induction of microRNAs is also involved in thermal resistance of cancer cells via up-regulation of anti-apoptotic Bcl-2 proteins and down regulation of pro-apoptotic Bax and caspase 3 activities. Another cellular protection in response to stressors is Autophagy, which is regulated by the Mammalian target of rapamycin (mTOR) protein. Kinase activity in mTOR phosphorylates HSF1 and promotes its nuclear translocation for heat shock protein synthesis. Over-expression of heat shock proteins are reported to up-regulate Beclin-1, an autophagy initiator. Moreover, HT-induced reactive oxygen species (ROS) generation is sensitized by transcription factor NF-E2 related factor 2 (Nrf2) and activates the cellular expression of antioxidants and autophagy gene. Furthermore, ROS also potentiates autophagy via activation of Beclin-1. Inhibition of thermotolerance can potentiate HT-induced apoptosis. Here, we outlined that heat stress alters cellular proteins which activates cellular homeostatic processes to promote cell survival and make cancer cells thermotolerant.

Awareness, Self-Use, Perceptions, Beliefs, and Attitudes toward Complementary and Alternative Medicines (CAM) among Health Professional Students in King Saud bin Abdulaziz University for Health Sciences Jeddah, Saudi Arabia.

BACKGROUND: Around 75% of the world's population relies on the use of complementary and alternative medicines (CAM) for their healthcare. Thus, we aimed at assessing the attitude and perception of health professional students about CAM and correlate the results with their demographical data. METHODS: An observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia, by enrolling 350 students. A self-administered questionnaire was used for data collection. Descriptive and inferential statistical analysis was performed using SPSS. RESULTS: Results of our data suggested that majority of students were aware of the CAM modalities and considered prayers/spirituality (83.6%), massage (72.5%), nutritional supplements (74.1%), cupping (68.5%), herbal medicine (66.2), and yoga (61.6%) as most effective and least harmful CAM modalities. The students acquired more information about CAM from media (55%), books (56%), friends/relatives (59.7%), and other health professionals (58.4%), however, very little information from formal CAM courses or training (36.7%), which shows the lack of courses and trained health professional in the field of CAM. Despite utilizing nonreliable sources of CAM information, the majority of students had positive attitudes and perceptions about CAM usage. Majority of the students (75.8%) believe in the use of CAM for the mental and spiritual aspect of health and think that CAM providers give good information on maintaining a healthy lifestyle. The data also showed a significant (P < 0.05) association between awareness about CAM and gender. A significantly higher percentage of female students were using yoga and aromatherapy, while cupping was mostly used by male students. Similarly, a significant association was found among the different colleges and level of students in most of the CAM modalities. However, no association was found between the awareness and use of CAM with the educational level of parents or relatives in health sector except for acupuncture and cupping, where student's awareness about acupuncture and cupping was found to have a significant positive association with mother educational level. On the other hand, a significant inverse association was found between acupuncture, yoga, cupping, and aromatherapy with family income. CONCLUSION: In conclusion, despite the lack of proper courses and professionally trained healthcare providers in the field of CAM, students demonstrated positive attitudes and beliefs toward the safety and effectiveness of CAM.

Knowledge and Attitude Towards Antibiotic Usage: A Questionnaire-Based Survey Among Pre-Professional Students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia.

Introduction: Knowledge and attitudes towards proper antibiotic usage among students in medical and other health allied fields play a vital role in limiting the pandemic of antibiotic resistance. This study aimed to assess knowledge and attitudes toward antibiotic usage among pre-professional students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Methods: A self-administered cross-sectional survey of 347 first year students was conducted at the College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences using a validated questionnaire. Results: Nearly 63% of the students had a moderate level of knowledge. Two third of the students (69.7%) correctly knew that antibiotics are indicated for the treatment of bacterial infections. However, about 36% of the students incorrectly thought that antibiotics are also used to treat viral infections, while 28.5% were not sure. Only 38.8% of the students were aware of antibiotic resistance phenomena in relation to the overuse of antibiotics. Furthermore, only 27.3% correctly knew that penicillin is an antibiotic, and 74.4% were not sure if Paracetamol is an antibiotic. With regard to attitudes, 25.7% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 39.6% expected antibiotics to be prescribed for common cold symptoms. Conclusion: The students have misconception regarding antibiotic use indications. Therefore, awareness campaigns are needed to promote student's use of antibiotics in young generations particularly among the pre-professional health sciences students.

In vitro and in vivo anti-Helicobacter pylori activity of selected medicinal plants employed for the management of gastrointestinal disorders.

Five medicinal plants Mentha piperita L., Trachyspermum ammi L., Viola odorata Linn., Matricaria chamomilla L. and Foeniculum vulgare Mill. were selected for their in vitro and in vivo evaluation of anti-Helicobacter pylori activity. In vitro evaluation was performed by using disk diffusion method and minimum inhibitory concentrations were noted while rat models were selected for in vivo activity against four Helicobacter pylori strains isolated form gastric mucosa. Mentha piperita showed largest zone of inhibition with 9 mm diameter among all other extracts. All the plants showed promising anti-Helicobacter pylori activity against four isolates and a reference strain at concentrations of 125, 250, 500 and 1000 µg/ml in comparison with Amoxicillin 1 µg/ml but least MIC was exhibited by Mentha piperita followed by in vivo testing where it competed Amoxicillin at 1000 mg/kg by achieving 80% eradication of Helicobacter pylori in mucosa of infected rats justified by histological examination of stomach. It was concluded that medicinal plants possess strong anti-Helicobacter pylori activity and can be considered a potential source of safe and effective alternative regimens for the eradication of Helicobacter pylori.

Survival Time in Treatment Modalities of Gastric Carcinoma at King Khalid Hospital- Jeddah Saudi Arabia: a Retrospective Cohort Study.

BACKGROUND: Gastric cancer (GC) is the fifth most common cancer worldwide and is responsible for 10% of annual cancer deaths. Gastric cancer treatment requires a multimodality approach involving surgery, adjuvant chemotherapy (AC), and neoadjuvant chemotherapy (NAC) for locally advanced tumors. Surgical removal of the tumor is the most common and effective curative approach with a more promising survival rate. OBJECTIVES: Due to the scarcity of studies in the kingdom of Saudi Arabia, this study aims to provide an epidemiological background on the subject and compare multiple treatments and their survival outcomes in a tertiary hospital in the western region. METHODS: After obtaining the IB approval, data was collected from medical files of all histologically confirmed GC patients (101) between the years 2000-2015. In this study, patients' demographics, tumor characteristics, treatment types, and patients' vital status (deceased or alive) were collected. Survival analysis between treatment modalities subgroups was carried out using the Kaplan-Meier test and Cox regression model. RESULTS: Out of 101 patients with GC, 65.35% were males with a mean age of 64.9±19 years and 61.71±17.83 years for female patients. Most patients had a stage IV tumor 47 (74.6%). The adjuvant chemotherapy group had a median survival time of 140 months (95% CI 33.72-246.29), while the neoadjuvant chemotherapy was 69 months. Patients who only underwent surgery had a median survival time of 28 months (95% CI 0-56.14), whereas patients who received no intervention had a median survival time of 8 months (95% CI 1.47-14.53) (log-rank = 0.002). The median overall survival time for all patients was 28 months (95%CI 0-77.68) with an overall five-year survival rate of 19.6%. Cox regression model revealed that treatment type and tumor stage were significant predictors of survival with p values of 0.001 and 0.009, respectively. CONCLUSION: Adjuvant, neoadjuvant, and palliative chemotherapy constitute the paramount treatment modalities of GC with adjuvant treatment having the highest survival time. However, these modalities necessitate further understanding as to whether other factors play a role in the selection of one treatment with the preferable outcome.