The Effects of Laparoscopic Sleeve Gastrectomy on Body Mass Index (BMI) and Glycated Hemoglobin (HbA1c) Levels.

Background and significance Bariatric surgery is an effective surgical intervention for weight loss and metabolic improvement. Articles tackling obesity and bariatric surgery with its preoperative preferences and postoperative findings are needed. From that stance, we aim to accurately document the impact of bariatric surgery, particularly laparoscopic sleeve gastrectomy (LSG), on body mass index (BMI) and glycated hemoglobin (HbA1c) levels. Patients and methods We present a retrospective cohort study conducted on 111 LSG patients from a total of 1633 patients who underwent bariatric surgery from January 23, 2018, to December 31, 2019, at King Saud University Medical City in Riyadh, Saudi Arabia. Patients were divided into three groups: nondiabetics, prediabetics, and diabetics. For each group, demographic characteristics as well as preoperative and postoperative BMI and HbA1c values were collected. Results The mean patient age was 41.35±11.8 years, with 56.8% being female. Our analysis showed that BMI values for all three groups had a significant and nearly similar overall decrease in value postoperatively (mean difference: 14.43, p<0.001). HbA1c levels also significantly improved, with the largest reduction seen in the diabetic group (from 8.7±1.5 to 6.6±1.4, p<0.001), followed by the prediabetic group (from 5.9±0.2 to 5.4±0.3, p<0.001) and the nondiabetic group (from 5.4±0.1 to 5.2±0.3, p=0.003). Conclusion LSG leads to significant improvements in BMI and HbA1c levels. Postoperatively, diabetic patients showed the greatest reduction in HbA1c percentage, supporting LSG's role in enhancing metabolic health.

Knowledge and Attitude Towards Botulinum Toxin Use in Cosmetic Injections Among the Arar Population in Saudi Arabia: A Cross-Sectional Study.

Background The use of botulinum toxin (BT), commonly known as Botox, has become increasingly popular for cosmetic purposes, particularly in treating wrinkles and facial rejuvenation. While the efficacy of botulinum toxin in achieving desired aesthetic outcomes is well-established, it is also important to consider the level of public knowledge and awareness regarding this potent neurotoxin. This study investigates the knowledge and attitude towards botulinum toxin use in cosmetic injections in the Arar population. Methods This cross-sectional study utilized a self-report questionnaire distributed via social media platforms, employing randomized sampling from May to July 2024. The target population included adults aged 18 and older, regardless of gender, living in the city of Arar, Saudi Arabia. The data were collected through an online self-administered survey using a Google Forms questionnaire template, which was translated into the appropriate language. The collected data was analyzed using descriptive and inferential statistics. Results A total of four hundred and ten (410) participants responded to this study. The maximum number of participants, 149 (36.3%), were in the age group of 20-25 years, while the minimum number of participants, 6 (1.5%), was in the age group of 50-55 years. The results also showed that 341 (83.2%) of participants were females and 69 (16.8%) were males; 262 (63.9%) participants were aware of Botox treatment used in cosmetic clinics. Concerning the most prevalent non-surgical cosmetic treatments, 29 (7%) answered dental procedures, and 19 (4.6%) mentioned its use in pain. Conclusion This study found that 262 (63.9%) of the study population showed knowledge about botulinum toxins used in cosmetic injections. The majority of them were young individuals, females, or unmarried people. Only 83 (20%) were aware of the adverse effects of botulinum toxin. This low level of awareness about the potential risks associated with the use of botulinum toxins for cosmetic purposes is concerning and suggests the need for improved education and information dissemination.

Knowledge and Attitude of Celiac Disease Among the Population of Riyadh, Saudi Arabia.

Background and aims Celiac disease (CD) is a chronic autoimmune disease that is characterized by inflammation of the intestinal mucosa, primarily triggered by gluten. So far, the effective management of CD only includes a gluten-free diet. For early diagnosis and management, adequate knowledge and a positive attitude towards CD are crucial. This study aims to investigate the CD-related knowledge and attitudes of the public in Riyadh, Saudi Arabia. Methods A cross-sectional online survey was conducted among individuals aged 16 and older. The data regarding demographic factors, knowledge, and attitudes about CD was collected via an online questionnaire. Statistical analysis was conducted using version 26 of SPSS (IBM Corp., Armonk, NY). Results In the current study, 669 individuals responded to the online survey. The majority of participants (82.1%) were familiar with CD. A total of 59.9% of respondents had adequate knowledge, 32.3% had outstanding knowledge, and 7.8% reported no knowledge of CD. The majority (69.5%) of respondents held negative attitudes concerning CD. The correlation between age and CD knowledge (P<0.05) and attitude (P<0.05) was statistically significant. Similarly, the correlation between occupation and CD knowledge (P<0.05) and attitude (P<0.05) was statistically significant. However, no significant association between gender and CD knowledge (p=0.720) or attitude (p=0.244) was found in males and females. Conclusion This study revealed that the majority of the residents of Riyadh, Saudi Arabia, had an adequate or excellent understanding of CD. However, the majority of respondents had a negative attitude towards CD management.

Prevalence and correlates of mental disorders among women: results from the Saudi National Mental Health Survey.

BACKGROUND: Mental disorders account for a significant proportion of the world's disease burden and are more significant among females than males. However, most global mental health research is sex neutral, including in the Kingdom of Saudi Arabia. This study, therefore, estimated the prevalence of mental disorders and investigated the sociodemographic correlates, sex disadvantage factors, and treatment-seeking in Saudi women concerning lifetime and 12-month mental disorders. METHOD: The Saudi National Mental Health Survey is a stratified multistage clustered area probability design. Lifetime and 12-month mental disorders were assessed through the Composite International Diagnostic Interview (CIDI 3.0). The correlates considered for this study included age-at-interview, education, marital status, employment status, socioeconomic status (SES), any chronic condition and household characteristics (region, urbanicity, and income), as well as domestic violence, age at marriage and in a polygamous marriage. Data was analysed using PROC SURVEYFREQ procedure as well as logistic regression in SAS 9.2. RESULTS: Overall, 24.7% and 35.9% of Saudi women experienced at least one of the disorders in the prior 12 months and at least once in their lifetime, respectively. Anxiety disorders were the most frequently reported 12-month and lifetime disorders, followed by mood disorders. The region, urbanicity, chronic conditions, employment status, as well as certain sex disadvantage factors were significantly associated with both 12-month and lifetime disorders. Most women did not seek treatment for 12-month mental disorders (86.2%) and lifetime disorders (73.8%). CONCLUSION: Our study confirms that mental health issues, particularly anxiety and mood disorders, are highly prevalent among Saudi women, influenced by chronic conditions and sex-related factors like domestic violence and polygamy. Future research should focus on improving mental health literacy, using rigorous study designs to explore female-specific variables, and investigating genetic and environmental factors.

Assessment of Chronotype Distribution Among University Students and Its Association With Lifestyle Characteristics and Academic Performance.

BACKGROUND:  Chronotype is associated with the timing of peak physical and mental performance and activity levels. University students may experience changes in their chronotype, influencing their daytime activity and academic performance. This study aims to assess the distribution of chronotypes among a sample of university students from southern Saudi Arabia, examining its association with demographic, academic, and lifestyle factors. METHODS:  A cross-sectional study was conducted at Jazan University, located in the southwestern region of Saudi Arabia, between February and March 2023. Data collection was carried out using a structured questionnaire comprising three main components: demographic and academic data of participants, lifestyle characteristics, and an assessment of chronotype using the reduced version of the Horne and Östberg morningness-eveningness questionnaire. Associations between chronotype and demographic/lifestyle characteristics were analyzed using Pearson's chi-squared test or Fisher's exact test. RESULTS:  The study included 507 students. The mean age of the participants was 22 years (standard deviation: 2.07), with over half being male 277 (54.6%). The chronotype assessment indicated that 139 (27.4%) of students were morning types, 112 (22.1%) evening types, and 256 (50.5%) were neither type. Statistically significant variations in chronotypes were found in relation to the year of study, perceived influence of sleep habits on academic performance, meal frequency, consumption of fast food and certain caffeinated beverages, and smoking or Khat chewing habits (P < 0.05). CONCLUSION:  The findings suggest that an unhealthy lifestyle and the use of certain stimulants can influence chronotypes. Students with an evening chronotype should be a focus for university health services, allowing early identification and counseling to mitigate the negative impact of a disturbed chronotype on academic performance and reduce the risk of study-related stress.

Evaluating Leadership Dynamics: A Comprehensive Cross-Sectional Study of Madinah's Primary Healthcare Centers.

OBJECTIVES: This study focuses on the effectiveness of healthcare leadership in primary healthcare centers in Madinah, Saudi Arabia, examining the interplay between leadership styles, emotional intelligence, and their impact on leadership effectiveness. Emphasizing the critical role of primary healthcare as outlined by the World Health Organization, the research addresses the gap in understanding leadership dynamics within the Saudi healthcare context. METHODS: A cross-sectional design was used, involving 89 managers and deputies from 48 primary healthcare centers in Madinah City, Saudi Arabia in 2023. The methodology included a comprehensive questionnaire assessing leadership effectiveness, emotional intelligence, and socio-demographic variables. Data analysis was performed using SPSS version 26 (Armonk, NY: IBM Corp), incorporating chi-square tests, t-tests, analysis of variance (ANOVA), Pearson correlation, and binary logistic regression for statistical evaluation. RESULTS: The findings revealed a high level of leadership effectiveness (79.8%; 95% CI: 62.7±10.2) among the study participants. Emotional intelligence emerged as a significant factor in effective leadership, evidenced by a strong positive correlation (r=0.75; p=0.001) between emotional intelligence and leadership effectiveness. The study also observed a predominant preference for democratic leadership styles among participants, with no significant variance in leadership effectiveness across different styles. A notable area for improvement identified was self-awareness among healthcare leaders. CONCLUSION: The research concludes that effective healthcare leadership, significantly influenced by emotional intelligence, is essential for reaching high-quality primary healthcare. It advocates for the integration of emotional intelligence training, especially focusing on self-awareness, in leadership development programs for healthcare professionals.

Practices, Attitudes, and Knowledge Regarding Recombinant Zoster Vaccine Among Family Medicine Residents in Riyadh, Saudi Arabia.

Background The aim of the research is to determine the existing knowledge, perceived practices, and attitudes toward the recombinant Zoster vaccine among family medicine residents (FMR) included in the medical profession. The present study aims to narrow down the identified gap in knowledge and develop vaccinations that will assist the targeted deme to eradicate zoster and the aftermaths that accompany it. Methods This research utilizes a descriptive cross-sectional survey design to assess the knowledge, practices, and attitudes of FMR toward the zoster vaccine in Riyadh, Saudi Arabia. By quantifying data at a specific point in time, this design allows for a detailed examination of the current status across various levels of residency programs. Participants from different institutions are interviewed simultaneously, enabling a thorough study of the targeted population group. The study includes 154 FMR from three different levels (R1, R2, R3) enrolled in residency programs at various institutions in Riyadh, Saudi Arabia. These participants were selected from a group of individuals invited to share their prior knowledge, habits, and beliefs regarding the recombinant Zoster vaccine. The study offers detailed statistical insights into demographics, vaccination attitudes, and knowledge among healthcare professionals. Key findings highlight diverse recommendations for different adult groups, the prevalence of vaccine availability, and the main sources of immunization information. Results The study found diverse recommendations for vaccination among different adult groups, with mean recommendations ranging from 2.50 to 2.94. Nearly all respondents (96.8%) reported having the vaccine available at their place of practice. However, knowledge gaps were evident, particularly concerning vaccination timing and specific requirements, highlighting the need for targeted education and clearer guidelines in vaccination practices among healthcare providers. Conclusion The study highlights the nuanced vaccination recommendations among healthcare professionals, particularly for different adult populations, and the availability of varicella-zoster virus (VZV) vaccines. The reliance on diverse information sources underscores the need for targeted educational efforts to ensure accurate and consistent immunization practices across healthcare settings. Addressing uncertainties and promoting informed decision-making can enhance vaccination uptake and patient care outcomes in clinical practice.

The Prevalence and Related Risk Factors of Urinary Incontinence Among Adult Women in Al Medina Al Munawara, Saudi Arabia.

Introduction Urinary incontinence (UI) is a common clinical problem. It has an impact on an individual's social, professional, psychological, and physical elements of life. The present study aimed to identify the prevalence of UI and associated risk factors among Saudi women in Al Medina Al Munawara, Saudi Arabia. Methods A cross-sectional study was conducted using an online questionnaire among 430 women aged 18-60 in Al Medina Al Munawara. The participants completed the validated Arabic version of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) to assess the prevalence of UI and its associated factors. Results Among the participants, 64.8% did not experience urine incontinence, while 17.8% reported slight, 14.0% reported moderate, and 3.3% reported severe incontinence. Stress incontinence caused by coughing or sneezing was the most common cause (48.6%), followed by before reaching the toilet (urge incontinence) (34.5%) and after urination (15.5%). Significant associations were found between age, marital status, number of children, diabetes mellitus, urinary tract diseases, previous abdominal or pelvic surgery, obesity, constipation, and menopausal symptoms. However, no significant association was found between pregnancy and urine incontinence. Conclusions This study reveals a moderate prevalence of UI among Saudi women in Al Medina Al Munawara. The findings highlight the importance of early detection, treatment, and education on pelvic floor exercises to address UI. Factors such as age, marital status, number of children, and various medical conditions are associated with this condition, emphasizing the need for comprehensive management strategies.

Pediatric Respiratory Infections After the COVID-19 Pandemic: A Single-Center Experience.

Background Pediatric respiratory infections, mainly bronchiolitis, are a substantial clinical burden. The most common etiology is respiratory syncytial virus (RSV). Other viruses include human rhinovirus, human metapneumovirus, influenza, adenovirus, coronavirus, and parainfluenza viruses. Objective We aimed to study the epidemiology and clinical characteristics of children with confirmed viral bronchiolitis and flu after the COVID-19 pandemic season and compare the behavior of each virus. Methods This retrospective observation study was done over seven months, from October 2022 to April 2023. All children (0-14) were included in the study if they met the clinical diagnosis of bronchiolitis or flu. Viral etiology is confirmed by PCR, using the respiratory panel available in our center which included the detection of four viruses: COVID-19, RSV, influenza A, and B. Clinical data, lab results, and X-rays were collected and correlated with each viral infection for all admitted patients. Results We recruited 237 children with bronchiolitis and flu symptoms from October 2022 to April 2023. The peak of infections (41%) was in November. Seasonal variations for each virus showed distinct patterns across the year. RSV peaked at the beginning of the season, gradually declining after that. In contrast, influenza A and B maintained a relatively consistent presence throughout the season. Meanwhile, COVID-19 reached its peak during March and April. One hundred forty-four (60%) of the patients were under two years of age. RSV was predominant in 150 patients (63.3%). COVID-19 was only detected in 25 patients (10%), whereas influenza A and B were equally isolated in 31 (13%) patients each. Fifty-one children (21%) were initially sick and required pediatric intensive care unit (PICU) admission, with no deaths reported. Notably, COVID-19 had a milder disease course, a shorter length of stay (LOS) in the hospital (two days) and a shorter duration of illness (five days) compared to other viruses. RSV infection was linked to more profound hypoxia and more sick children with more extended hospital stays. Conclusion Our study showed that, following the pandemic and the release of lockdown measures, there was another peak of upper respiratory tract infections (URTI) and flu, which was more aggressive, primarily due to other viruses, especially RSV. This resurgence was associated with more severe respiratory symptoms and an increased need for hospitalization. Notably, children with COVID-19 were in better condition compared to those with RSV.

Appraising critical success factors in sustainable housing projects: A comparative study of PPP modalities in Saudi Arabia.

This study examines the critical success factors (CSFs) crucial for the effective deployment of public-private partnership (PPP) models in sustainable housing projects in the Kingdom of Saudi Arabia (KSA), underpinning the nation's Vision 2030. Through a robust methodology that incorporates a profound literature review, structured interviews, and a survey involving key stakeholders, the study prioritizes fourteen significant CSFs integral to PPP efficacy. Employing Analytical Hierarchy Process analysis, key outcomes underscore the paramount importance of technical aspects with an emphasis on sustainability, tailoring risk-sharing and allocation to encompass green technologies and eco-friendly practices, and economic stability in the light of long-term environmental sustainability in fostering successful sustainable housing projects. Notably, the Build-Operate-Transfer (BOT) model is categorized as the most effective PPP modality, attaining a mean importance score of 4.07. This model is contrasted with other modalities such as Design-Build-Operate (DBO) and Build-Own-Lease-Transfer (BOLT), which scored lower in effectiveness. This comprehensive evaluation provides crucial insights for policymakers and practitioners, emphasizing the strategic selection of PPP modalities and the prioritization of CSFs to enhance the sustainability and effectiveness of housing projects in KSA.

Saudi parents' perspectives of the factors influencing the quality of life of their children with autism spectrum disorder.

BACKGROUND: Research indicates that the deficits in social communication and the repetitive, restrictive behaviour of persons with Autistic Spectrum Disorder (ASD) can pose challenges to their functioning in different Quality of Life (QoL) domains, leading to lower levels of life satisfaction. Evidence also indicates that various social and family factors, such as the support received in the community/environment and the composition of the family, could impact the QoL of persons with ASD. AIM: To study the factors influencing the QoL of children with ASD in the Kingdom of Saudi Arabia (KSA) by investigating the perspectives of their parents. METHOD: Questionnaires were completed by 110 parents who had a child with ASD. The questionnaire included the 96-item KidsLife-ASD scale to capture parents' perspectives regarding the difficulties experienced by their child, the ASD support received by their families, and the QoL of the child. The data obtained from the questionnaire were statistically analysed using IBM SPSS software. RESULTS: The difficulties experienced by children with ASD and aspects of the support (services and interventions, and challenges) they receive are factors that influence the QoL of children with ASD in the KSA. Moreover, the number of children in the family, the birth order of child with ASD, and the severity of ASD symptoms are factors that influence parents' perceptions of their children's difficulties, family ASD support, and the child's QoL. CONCLUSIONS: Saudi parents who have one child with ASD believed that the QoL of their child was high and confirmed that the difficulties experienced by the child and the support received by the family were factors which influenced the QoL of a child with ASD.

The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia.

Background Preoperative investigations are important to assess the clinical condition of patients who undergo elective surgical procedures. However, there is still debate about the usefulness of performing preoperative investigations. We aimed to determine the prevalence of routine preoperative investigation abnormalities among elective general surgery patients. Methodology This retrospective hospital-record-based study was conducted at the King Abdullah Hospital in Bisha Province, southern Saudi Arabia. General and clinical data of 968 patients who underwent elective surgical interventions from February 2022 to January 2023 were retrieved and analyzed. Result A total of 968 patients (578 females and 390 males) aged between 14 and 80 years were included in the study. Four hundred and eleven (42.5%) patients were in the age group of 40 years and above. The commonly detected comorbidities among the patients were diabetes (15%), hypertension (12%), respiratory diseases (7.5%), and cardiac diseases (2.5%). Abnormalities related to hemoglobin (31%), total leucocyte count (12.7%), and platelets (8.5%) were found in 968 patients. Around 15% of patients had increased creatinine levels. Hypokalemia was observed in 6.8% of patients. Increased liver enzymes were reported in limited proportions (10% to 14%) of patients. Slightly abnormal radiological findings were reported for chest X-ray (CXR) (2.8%), electrocardiogram (ECG) (2%), and Doppler echocardiography (Echo) (0.8%). A statistically significant association between the age of the patient and abnormal findings of ECG (p <.001), Echo (p = .001), and CXR (p <.001). Cardiac abnormalities were commonly associated with patients of ≥ 40 years. Abnormal cardiac findings (CXR, ECG, Echo) were significantly (p<.05) increased with the presence of diabetes, hypertension, and cardiovascular comorbidities. Conclusions Preoperative testing revealed limited proportions of abnormal findings among patients with elective surgical procedures. Routine ordering of many preoperative investigations without specifications may not predict postoperative complications of the patients. Therefore, undertaking preoperative testing should be guided by targeted history, physical examination, clinical risk factors, and type of surgical procedure intended to be performed.

Assessment of the Level of Knowledge About Risk Factors, Prevention, and Treatment of Gestational Diabetes Mellitus in a Community Sample From Saudi Arabia.

Introduction Gestational diabetes mellitus (GDM) is a common disease affecting pregnant females, and it carries a major risk of short and long-term health problems for both mothers and their offspring. Multiple factors like advanced maternal age, obesity, and unhealthy lifestyle can increase the risk of GDM. The current guidelines recommend screening all pregnant females for risk factors during the first trimester with subsequent testing of the blood glucose level at 24 weeks gestation. Lack of awareness about GDM is a main contributing factor in the delay in screening and diagnosis of GDM with subsequent fetal and maternal complications. This study aims to identify the level of knowledge about GDM among the adult population in the Kingdom of Saudi Arabia (KSA). Material and methods A descriptive cross-sectional questionnaire-based study was conducted to identify the level of knowledge about risk factors, prevention, and treatment of GDM in a community sample from Saudi Arabia. A self-administered electronic questionnaire was designed, tested for validity and reliability, and distributed through social media platforms. It consisted of 18 questions asking about the socio-demographic characteristics, the type of hospital in which the participant receives their medical care, whether the participant heard about GDM or not, and if they know someone with GDM, in addition to questions to assess the level of knowledge about risk factors, complications, prevention, and treatment of GDM. The total score of knowledge was calculated. The multivariate regression analysis test was employed to analyze the relationship between various demographic variables and the level of knowledge about GDM among the study population. A p-value of 0.05 or less was considered statistically significant. Results A total of 539 (100%) participants completed the questionnaire: 263 (48.8%) of them were in the age category (18-25 years), 440 (81.6%) of them were females, 307 (57%) had a bachelor's degree, 275 (51%) were single, 454 (84.2%) had heard about GDM, and 258 (47.9%) of them have or know someone with GDM. The total score of knowledge revealed excellent, good, fair, and poor levels among 334 (62%), 140 (26%), 49 (9%), and 16 (3%) of participants, respectively. The multivariable linear regression model revealed that participants who received health care from governmental hospitals heard about GDM and had or knew someone with GDM were positively associated with a higher level of knowledge. Conclusions The findings revealed that among participants, 62% showed excellent knowledge about GDM, although, the other 38% had non-optimal levels of knowledge. Awareness campaigns are recommended to improve the level of knowledge about this disease, its risk factors, treatment, and complications.

Cardiac Complications in Trisomy 21 Patients in a Secondary Hospital: A Descriptive Study.

This retrospective study addresses the intersection of Down syndrome (DS) and congenital heart defects (CHD), including the prevalence and characteristics of CHD in trisomy 21 patients at a secondary hospital in the Eastern Province of Saudi Arabia. The study investigated the electronic medical records retrieved from the Qatif Central Hospital database, specifically targeting individuals diagnosed with DS (identified by the International Classification of Diseases, Tenth Revision (ICD-10) code Q90.9) between March 2012 and March 2022. The primary aim was to detect cardiac anomalies diagnosed via echocardiography performed at the hospital, along with subsequent follow-up assessments and documented patient outcomes. Among the 161 patients reviewed, the study revealed a significant prevalence of diagnosed heart defects through echocardiograms, constituting approximately 72.7%. Notably, patent ductus arteriosus was the most common condition, found in 29.81% of cases, followed by atrial septal defect (27.95%) and atrioventricular septal defect (17.39%). Among the study participants, 22.98% required surgical intervention. Unfortunately, mortality impacted 32.3% of individuals, while the majority (60.87%) remained alive. In addition, a small percentage (6.83%) discontinued follow-up within our center. This study contributes significant data on cardiac anomalies in DS patients in Saudi Arabia, highlighting a high prevalence of CHD with specific patterns of anomalies. The need for early diagnosis, timely surgical intervention, and ongoing management is evident. These findings provide a foundation for improving clinical practices and shaping public health policies tailored to the needs of this population in Saudi Arabia and similar regions.

Association of Anxiety and Depressive Symptoms and Treatment Adherence Among Patients With Type 2 Diabetes Mellitus in Jazan, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Diabetes mellitus is a serious public health concern. It is associated with many psychological problems, such as depression, anxiety, and eating disorders. These co-morbidities are associated with improper adherence to treatment, self-care, poor glycemic control, more complications, and worse outcomes. METHODS: This study aimed to measure the level of medication adherence among type 2 diabetics in Jazan, Saudi Arabia, and to find its association with their psychological status (specifically, depression and anxiety). A cross-sectional descriptive design was used among adults with type 2 diabetes at the Diabetes and Endocrinology Center in Jazan, Saudi Arabia. The estimated sample size was 480 patients. The General Medication Adherence Scale and Patient Health Questionnaire-4 (PHQ-4) were used as tools to achieve the study objectives. RESULTS: A total of 449 diabetic patients completed the survey (93.5% response rate). Patients with poor, low, and partial adherence account for 337 (75%) of patients and only 112 (25%) have good and high medication adherence. Employment and duration of illness were highly significant with a positive relationship to treatment adherence (p = 0.010 and 0.000, respectively). On the other hand, age and disease duration had a significant relationship with psychological disorders (p = 0.029 and 0.002, respectively). Of the patients, 64 (14.3%) had high scores on the PHQ-4, with depressive symptoms in 46 (10.24%) and anxiety symptoms in 75 (16.7%). Correlation analysis reveals that there is a highly significant negative correlation between psychological disorders and adherence to medications (r = -0.288, p = 0.000). CONCLUSION: A negative correlation between psychological disorders and adherence to medications was found. The findings indicate the importance of psychological support for diabetic patients for better treatment adherence.

Prevalence of Anxiety and Depression and Their Association With Migraine Among PHC Center Visitors in Madina, Saudi Arabia.

INTRODUCTION: This cross-sectional study addresses the global rise in mental health disorders, emphasizing the bidirectional relationship between migraines and conditions such as depression and anxiety. This study seeks to bridge a crucial gap by examining the prevalence of depression and anxiety and their potential role as predictors of migraine. METHODS: This study included 407 participants aged 16 and above, attending one of the major PHC centers in Madinah city between August 1, 2023, and October 1, 2023. The study employed the Migraine Screening Questionnaire (MS-Q) for migraine screening and the Patient Health Questionnaire-4 (PHQ-4) for identifying anxiety and depression. RESULTS: Among the 407 participants included in our study, the prevalence of anxiety and depression was 9.1% and 5.9%, respectively. The prevalence of individuals experiencing both anxiety and depression was 3.7%. Anxiety exhibited a robust and statistically significant prediction of having migraines (OR: 4, P<0.05), while depression showed no statistically significant association. Gender, working frequency, and a higher level of education emerged as significant predictors of anxiety. Conversely, working multiple shifts and increased coffee consumption were found to be protective against anxiety. Regarding depression, spending more screen time and a higher education level were identified as significant predictors, while higher coffee intake and current smoking status were protective against depression. CONCLUSIONS: This cross-sectional study concluded that anxiety significantly predicts having migraines, while depression did not emerge as a statistically significant predictor. The study's outcomes underscore the imperative for mental health screening and management in individuals with migraines in PHC settings. However, comprehensive efforts are warranted to be applied across diverse cities and demographics to attain a more nuanced understanding of this association.

Survival Rates of Extremely Low-Birth-Weight Infants in a Tertiary Care Center in Saudi Arabia.

Introduction Extremely low birth weight (ELBW) refers to the condition in which an infant is born with a weight of less than one thousand grams (2.2 pounds) at birth. ELBW infants face significant challenges and are at increased risk for various medical complications and developmental issues. ELBW poses unique challenges for infants, families, and healthcare providers. Understanding the causes, consequences, and appropriate management strategies for ELBW is crucial for improving the survival rates of these vulnerable infants. Aim This study aimed to measure the survival rates of ELBW infants in Saudi Arabia and its correlated risk factors. Patients and methods This case-control study was a retrospective chart review analysis of data from King Abdulaziz Medical City (KAMC), a single tertiary care center in Riyadh, Kingdom of Saudi Arabia, and conducted over a four-year period. To estimate the survival rate among all live-birth newborn infants who were born with ELBWs of less than 1000 grams, collected data were tabulated and cleaned in MS Excel, and all data were analyzed using IBM SPSS Statistics for Windows, version 26 (released 2019; IBM Corp., Armonk, New York, United States). Results Two hundred and fifty-six patients were involved. Non-survival rates were 12.9%. In a multivariate regression model, prolonged rupture of membranes (PROM), periventricular leukomalacia (PVL), major intraventricular hemorrhage (IVH), and longer length of stay had increased risks for non-survival, while increasing gestational age, APGAR scores, and cesarean section had decreased risks for non-survival. Survival analysis found that there was a significant mean difference in gestational age (weeks) survival time between normal spontaneous vaginal delivery (NSVD) and cesarean section based on log-rank (Mantel-Cox) (p = 0.008). Conclusion Consistent with the literature, a greater prevalence of ELBW infants survived during hospital stay. Independent risk factors for non-survival include PROM, PVL, major IVH, and long length of stay. Cesarean section, increasing gestational, and APGAR scores were identified as the independent predictors of survival. Prospective studies in nature are required to determine these factors' cause and effect.

Health-Related Quality of Life of Asthmatic Patients in Al-Baha City, Saudi Arabia.

Introduction According to disability-adjusted life years (DALY), bronchial asthma (BA) is rated 28th among the top causes of disease burden globally and among the most significant reasons for years lived with disability. Internationally, 300 million people have asthma, and another 100 million individuals may develop it by 2025. In Al-Baha City, where environmental factors such as dust and pollen levels can exacerbate asthma symptoms, understanding and addressing the health-related quality of life of asthmatic patients is crucial. Understanding the health-related quality of life of asthmatic patients can inform public health policies and initiatives aimed at reducing environmental triggers and promoting better asthma management in the city. Objectives The study aims to assess the impact of asthma regarding physical, emotional, and social activities that affect health-related quality of life.  Subjects and methods A cross-sectional study was conducted from January 2023 to May 2023 at King Fahad Hospital in Al-Baha City, Saudi Arabia. The study used a Mini Asthma Quality of Life Questionnaire that measures physical, emotional, and social activities that affect health-related quality of life.  Results One hundred and fifty-one out of 185 participants responded, yielding a response rate of 81.6%. The average age of the participants was 52, with a standard deviation of 15.4 years. Participants' responses regarding symptoms related to the environment during the last two weeks indicated "all the time" experiencing feeling bothered by or having to avoid cigarette smoke (n=104, 69%) and dust (n=92, 61%) in the environment. Moreover, considering emotion-related symptoms, 54% reported they did not feel afraid of not having their asthma medication available. Similarly, 46% reported never feeling frustrated because of asthma, whereas 3.3% of the participants documented hardly ever feeling frustrated. Regarding social activity limitations, 44 individuals (29%) reported no limits in these activities, while 43 (28%) reported being completely limited. While there were limitations in work-related activities, 42 participants (28%) reported no restrictions, whereas 34 (23%) reported being completely limited.  Conclusion The study findings highlight a concern about suboptimal asthma control and the need to attain more satisfactory levels of asthma management.

The Association Between Shift Work and Migraine Attacks Among Healthcare Workers in the Kingdom of Saudi Arabia.

Introduction Migraine, a prevalent condition in Saudi Arabia, is linked to various risk factors, including night shifts. Existing literature, mainly outdated, suggests conflicting findings on the relationship between sleep, night shifts, and migraines. Our study aims to investigate the specific association between shift work and migraine attacks among healthcare workers in the Kingdom of Saudi Arabia (KSA), addressing a notable research gap. Methodology This is a cross-sectional study conducted in Saudi Arabia. Data were collected by using a non-probability convenience sampling technique. Data were collected through an online questionnaire and analyzed using SPSS version 26 (IBM Corp., Armonk, NY). Results Our study on 342 healthcare workers in the KSA revealed the majority of participants were females (70.5%, n = 241), aged between 25 and 29 years (38.9%, n = 133), with doctors being the predominant profession (51.5%, n = 176). Participants had an average of 5.9 years of healthcare experience. Work shifts included rotating (43.3%, n = 148), day (48%, n = 164), evening (3.8%, n = 13), and night shifts (5%, n = 17). Notably, 89.2% (n = 305) experienced headaches with varying characteristics and triggers. Management strategies included over-the-counter painkillers (56.1%, n = 192) and rest (50.5%, n = 173). Gender was significantly associated with migraines (p = 0.020), while night shift frequency and years in health care showed no significant associations. Higher weekly working hours relate significantly to migraines (p = 0.034). Conclusion Our study highlights a significant association between migraines and gender, with females being more prone. Night shift frequency and years in health care showed no significant associations, while higher weekly working hours were linked to migraines.

Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia.

BACKGROUND: Cervical cancer is the ninth diagnosed cancer among Saudi women. The majority of cervical cancer cases occur in women who did not undergo screening. However, the screening rates in several countries, including Saudi Arabia, remain suboptimal. It is important to identify the factors associated with the uptake of screening and predictors of screening in order to increase the uptake rate. AIM: To determine the factors associated with the uptake of cervical cancer screening among family medicine physicians (FMPs), compared with women of the community. METHODS: This was a cross-sectional study conducted in the central region (Riyadh), Kingdom of Saudi Arabia from February 2021 for 12 months on female physicians and women of the community. An electronic questionnaire was used to investigate the demographics of women and variables related to the uptake of screening. RESULTS: A total of 126 FMP and 127 women from the community were included. The factors affecting screening among FMP included age (P=0.013), health insurance (P=0.002), availability of Pap smear (P˂0.001), and physician encouragement (P˂0.001). The factors affecting the screening of community women included the availability of Pap smears (P˂0.001) and physician encouragement (P˂0.001). Multivariate analysis revealed that physician encouragement of Pap smear was a significant predictor of screening among FMP (OR=8.26, P˂0.001) and community women (OR=6.67, P˂0.001). The perceived benefit was the only predictor for screening among FMP (OR=0.75, P=0.004). CONCLUSION: The uptake of cervical cancer screening was higher in the community women. The factors linked to the uptake differed among the two groups, but the support of doctors played a significant role in the likelihood of uptake, regardless of the group of women. It is recommended to enhance the guidance of medical personnel in recommending screening during clinic visits for the specific target group. Additionally, there should be increased education on the significance of screening and efforts to educate the community about cervical cancer and screening.