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BACKGROUND: Motorcycle crashes are a major source of road traffic deaths in northern Ghana. Helmet use has been low. The last time it was formally assessed (2010), helmet use was 30.0% (34.2% for riders and 1.9% for pillion riders). We sought to determine the current prevalence of helmet use and its associated factors among motorcyclists in northern Ghana. METHODS: Cross-sectional observations of motorcycle helmet use were conducted among 3853 motorcycle riders and 1097 pillion riders in the Northern Region at 12 different locations near intersections, roundabouts and motorcycle bays. Modified Poisson regression was used to assess the factors associated with helmet use. RESULTS: The prevalence of helmet use was 22.1% overall: 26.7% among motorcycle riders and 5.7% among pillion riders. On the multivariable regression analysis, the prevalence of helmet use among motorcycle riders was 69% higher during the day compared with the night, 58% higher at weekend compared with weekday, 46% higher among males compared with females, but it was 18% lower on local roads compared with highways, 67% lower among young riders compared with the elderly and 29% lower when riding with pillion rider(s). CONCLUSION: Despite small increases in motorcycle helmet use among pillion riders, helmet use has declined overall over the past decade. Immediate actions are needed to promote helmet use among motorcyclists in northern Ghana. This calls for a multisectoral approach to address the current low helmet use, targeting young riders, female riders, pillion riders, evening riding and riding on local roads.
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BACKGROUND: This study aimed to evaluate the outcomes of calcaneal lengthening osteotomy (CLO) and double arthrodesis of the talonavicular and calcaneocuboid joints (DA) for correcting planovalgus foot deformity exclusively in patients with generalised joint hypermobility. METHODS: We retrospectively reviewed 29 feet in 17 consecutive patients who underwent either CLO or DA. The mean age at surgery was 11.3 ± 2.3 years, and the mean follow-up duration was 7.7 ± 3.2 years. Preoperative and final follow-up radiographs and dynamic foot-pressure measurements were analysed. RESULTS: Both operations significantly improved the radiographic parameters, except for the lateral talocalcaneal angle in the CLO group. Pedobarographic study demonstrated an elevation of the medial longitudinal arch and an improved foot-pressure distribution after both surgeries. The plantar pressure in the lateral forefoot significantly increased only in the DA group, while the pressures exerted on the medial forefoot and hindfoot and the arch index improved only in the CLO group. CONCLUSIONS: Both CLO and DA effectively improve the foot alignments of the deformity in patients with generalised joint hypermobility. However, differences were observed in the changes in the lateral talocalcaneal angle and plantar pressure distribution between the two procedures. LEVEL OF EVIDENCE: Therapeutic Level III.
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BACKGROUND: Globally, the increasing rate of caesarean section (CS) delivery has become a major public health concern due to its cost, maternal, neonatal, and perinatal risks. In Ghana, the Family Health Division of the Ghana Health Service in 2016 opted to initiate a program to prevent the abuse of CS and identify the factors contributing to its increase in the country. This study aimed to determine the prevalence and factors influencing CS deliveries in the Kintampo Districts of Ghana. METHODS: The current study used secondary data from the Every Newborn-International Network for the Demographic Evaluation of Populations and their Health (EN-INDEPTH) project in Kintampo, Ghana. The outcome variable for this study is CS delivery. The predictor variables were socio-demographic and obstetric factors. RESULTS: The prevalence of CS delivery in the study area was 14.6%. Women with secondary education were 2.6 times more likely to give birth by CS than those with primary education. Unmarried women were about 2.5 times more likely to deliver by CS compared to those who were married. There was an increasing order of CS delivery among women in the wealthy quintiles from poorer to richest. The likelihood of women with gestational ages from 37 to 40 weeks to give birth by CS was about 58% less compared to those with less than 37 gestational weeks. Women who had 4-7 and 8 or more antenatal care (ANC) visits were 1.95 and 3.5 times more likely to deliver by CS compared to those who had less than 4 ANC visits. The odds of women who have had pregnancy loss before to deliver by CS was 68% higher compared to women who have not lost pregnancy before. CONCLUSIONS: Caesarean section delivery prevalence in the study population was within the Ghana Health Service and World Health Organization ranges. In addition to known socio-demographic and obstetric factors, this study observed that a history of pregnancy loss increased the chances of a woman undergoing a CS. Policies should aim at addressing identified modifiable factors to stem the rise in CS deliveries.
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Cesárea , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Aborto Espontáneo , Ghana/epidemiología , Parto , Atención Prenatal , PrevalenciaRESUMEN
BACKGROUND: First aid measures in cases of epileptic seizures are crucial. Misconceptions about seizure first-aid measures are probably common. Most of the previous data focused on teachers and healthcare providers. The objective of this study was to assess the awareness of seizure first-aid measures and their associated factors in a community sample in Saudi Arabia. METHODS: A cross-sectional study was carried out using an online questionnaire between July 2020 and February 2021. Those who had never heard of epilepsy and healthcare workers were excluded. Overall and individual scores were calculated for first-aid measures during and after the seizures as well as calling the ambulance. RESULTS: A total of 1542 participants were included in the study. The overall awareness score of seizure first-aid measures was 57.3%. The awareness of the need to call the ambulance in special circumstances was the highest individual score (78.3%), followed by measures after the seizure (54.2%), and finally measures during the seizure (48.4%). For the latter, the awareness of injury prevention measures was the highest (74.9%), while the awareness of treatment options was the lowest (12.2%). Overall awareness score was significantly higher in older age (pâ¯=â¯0.015), female gender (pâ¯<â¯0.001), divorced status (pâ¯=â¯0.014), knowing someone with epilepsy (pâ¯<â¯0.001), attending a course or workshop about seizure first-aid (pâ¯<â¯0.001), watching a video on seizure first-aid on any platform (pâ¯<â¯0.001), and having basic life support training (pâ¯<â¯0.001). CONCLUSIONS: The awareness of seizure first-aid measures is still inadequate among the public in Saudi Arabia. The current finding underscores the importance of simulation videos on social media and/or field-training campaigns to improve the public awareness of seizure first-aid measures.
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Primeros Auxilios , Conocimientos, Actitudes y Práctica en Salud , Estudios Transversales , Femenino , Humanos , Arabia Saudita/epidemiología , Convulsiones/epidemiología , Convulsiones/terapia , Encuestas y CuestionariosRESUMEN
Inflammation is a physiological process essential for maintaining homeostatic mechanisms in human, but however, exaggerated inflammatory responses are closely related to many chronic diseases. Cadmium (Cd) is a heavy metal with high toxicity when present in food, water and air has the potential of eliciting inflammatory reactions, with a major health risk to human. This review aimed to elucidate on the major routes of Cd exposure, the main organs affected by the exposure, the degree of toxicity as well as the roles of the toxic effects on the immune system which results to inflammatory responses. Immune modulation by Cd may cause serious adverse health effects in humans. Various studies have highlighted the ability of Cd as an environmental pollutant involved in the modulation of the innate, adaptive and mucosal immune responses in relations to the release of chemokine, gene expression, and susceptibility to microbial infections.
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Inmunidad Adaptativa/efectos de los fármacos , Cadmio/toxicidad , Contaminantes Ambientales/toxicidad , Inmunidad Innata/efectos de los fármacos , Inmunidad Mucosa/efectos de los fármacos , Infecciones , Animales , Quimiocinas/inmunología , Regulación de la Expresión Génica/efectos de los fármacos , Humanos , Infecciones/inducido químicamente , Infecciones/inmunología , Infecciones/patología , Inflamación/inducido químicamente , Inflamación/inmunología , Inflamación/patologíaRESUMEN
The second leading cause of maternal mortality in Ghana is unsafe abortion. Research in Ghana shows that men's support influences women's use of safe abortion services. The aim of this study was to understand what men know about abortion, why they support their partners to seek an abortion, and to identify effective ways to reach men with abortion information. We conducted eleven focus groups and ten in-depth interviews with men of reproductive age in rural Ghana. Inclusion criteria were written consent, age and marital status. Focus groups and interviews were conducted in local languages using a semi-structured guide. Focus groups and interviews were audiotaped, transcribed, translated, computerised and coded for analysis. Most men knew the difference between unsafe and safe abortion and would support their partner to have an abortion. Messages that reinforce safe abortion as acceptable and that address fears of death or barrenness should be developed to educate men about safe abortion. Multiple channels to communicate these messages should be used and include pictures, video or audio for those men who cannot read. Through an intensive intervention inclusive of men, women's access to safe abortion services can be improved in Ghana.
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Aborto Inducido/mortalidad , Relaciones Interpersonales , Mortalidad Materna , Hombres/psicología , Apoyo Social , Aborto Inducido/legislación & jurisprudencia , Adolescente , Adulto , Femenino , Grupos Focales , Ghana , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Embarazo , Población Rural , Parejas Sexuales , Adulto JovenRESUMEN
Autoimmune diseases are pathological conditions characterized by abnormal responses, accompanied by autoantibodies to self-molecules. The role of vitamin D in autoimmune diseases has increased significantly in the recent past from its functions in calcium and phosphate homoeostasis, and it is now involved in the regulations and proliferations of Th1 and Th17 lymphocyte. 1α,25(OH)2D3 is very important in ameliorations of inflammatory disorders arising from autoimmune diseases, but the mechanism by which this is performed is still a bone of contentions. This review aimed to highlight the existing facts about the roles of Vitamin D in the treatment and management of autoimmune diseases. An extensive online literature search was conducted using PubMed, MEDLINE and Scopus. Accumulated bodies of research evidence are available which demonstrates that Vitamin D has a very important part to play in the regulation of immune responses in autoimmune diseases. Some of the authors suggested that Vitamin D3 carry-out its immunosuppressive and immune modulatory action, through its actions on antigen-presenting cells and activated T and B cells with the help of Vitamin D receptors present on the each of these cells. Vitamin D supplementation assists in autoimmune disorders by making qualitative and quantitative changes in the immune system (downregulation of Th1 and upregulations of Th2 cells). This resulted in the body to be more tolerant of self and less likely to mount autoimmune responses.
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Enfermedades Autoinmunes/inmunología , Calcitriol/inmunología , Factores Inmunológicos/inmunología , Inmunosupresores/inmunología , Vitaminas/inmunología , Animales , Enfermedades Autoinmunes/tratamiento farmacológico , Calcitriol/uso terapéutico , Citocinas/inmunología , Citocinas/metabolismo , Humanos , Factores Inmunológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Modelos Inmunológicos , Linfocitos T Colaboradores-Inductores/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Colaboradores-Inductores/metabolismo , Vitaminas/uso terapéuticoRESUMEN
Inflammatory bowel disease (IBD) is a group of idiopathic, chronic and relapsing inflammatory conditions of the gastrointestinal tract, caused by an aberrant and exaggerated immunological response in the gut. Supplementation of vitamin D3 in patients with IBD exerts both direct and indirect regulatory roles on the naïve T cells, thereby maintaining a balance between inflammatory and inhibitory cytokines. The direct actions of vitamin D3 on naïve T cells result in the proliferation of more regulatory T cells and inhibitory cytokines such as IL-4, IL-10 and IL-5. The binding of vitamin D to dendritic cells (DCs) through vitamin D receptors inhibits the action of IL-12 on DCs, resulting in the downregulation of Th1 and Th17. On the other hand, this interaction favours Th2 and Treg upregulation and facilitates the maintenance of immune homoeostasis between inflammatory and inhibitory cytokines which is essentially significant in the management of patients with IBD. The aim of this review was to explore the current and mounting scientific evidence on the roles of vitamin D3 in immunoregulation of inflammatory and inhibitory cytokines in patients with IBDs. An extensive literature search was conducted using keywords such as Vitamin D3*, IBD*, inflammatory cytokines*, inhibitory cytokines*, naïve-T-cells* and antigen presenting cells* through PubMed, SCOPUS and MEDLINE search engines. The results of the accumulated bodies of research that have been conducted demonstrate that vitamin D3 plays a major role not only in the immunoregulation of cytokines involved in the pathogenesis of IBDs but also in many other inflammatory disorders.
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Colecalciferol/inmunología , Citocinas/inmunología , Factores Inmunológicos/inmunología , Mediadores de Inflamación/inmunología , Enfermedades Inflamatorias del Intestino/inmunología , Colecalciferol/administración & dosificación , Colecalciferol/uso terapéutico , Citocinas/metabolismo , Humanos , Factores Inmunológicos/administración & dosificación , Factores Inmunológicos/uso terapéutico , Mediadores de Inflamación/metabolismo , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/metabolismo , Modelos Inmunológicos , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Linfocitos T/metabolismo , Linfocitos T Reguladores , Vitaminas/administración & dosificación , Vitaminas/inmunología , Vitaminas/uso terapéuticoRESUMEN
OBJECTIVE: To assess glycemic control and associated factors in children with type 1 diabetes mellitus (T1DM) attending the pediatric diabetes clinic in Wad-Madani City, Sudan. METHODS: This cross-sectional observational study was conducted at a referral center in Sudan. The study population consisted of children aged 1-18 years who had been diagnosed with T1DM for more than 1 year and were under regular follow-up in the clinic. Data on their glycemic control and sociodemographic and clinical characteristics were captured. RESULTS: Out of 211 enrolled patients, 120 (56.9 %) were females. The mean age was 11.7 years (SD = 4.0), with the mean age at diagnosis of 6.7 years (SD = 4.0). Only 6.2 % achieved adequate glycemic control. Adolescents had particularly poor control (97.8 %). The mean glycosylated hemoglobin (HBA1c) level was 10.4 % (90 mmol/mol). Inferior glycemic control was associated with advancing age, older age at diagnosis, belonging to single-parent households, less frequent self-monitoring of blood glucose (SMBG), and having a greater number of siblings or household members. A third of patients (33.8 %) had had one or more diabetes ketoacidosis (DKA) episodes in the previous year. There was a high prevalence of lipodystrophy (34.1 %) and arthropathy (25.1 %). CONCLUSIONS: An exceptionally low proportion of children with T1DM achieved adequate glycemic control, with adolescents particularly struggling. SMBG frequency and family dynamics emerged as potential factors, highlighting the urgent need for tailored interventions and improved diabetes education in resource-limited settings.
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Diabetes Mellitus Tipo 1 , Cetoacidosis Diabética , Femenino , Adolescente , Humanos , Niño , Masculino , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/epidemiología , Estudios Transversales , Glucemia , Control Glucémico , Sudán/epidemiología , Insulina , Cetoacidosis Diabética/epidemiología , Cetoacidosis Diabética/prevención & control , Cetoacidosis Diabética/diagnósticoRESUMEN
BACKGROUND: Trigeminal trophic syndrome is a rare cranial and facial condition caused by damage to the central or peripheral branches of the trigeminal nerve. This syndrome consists of a triad of anesthesia, paresthesia, and crescent-shaped facial ulcer involving the ala nasi and sometimes extending to the upper lip. Although previous screening for human immunodeficiency virus in some patients with trigeminal trophic syndrome was negative, we present a unique case of trigeminal trophic syndrome who tested positive for human immunodeficiency virus with eye complications. CASE PRESENTATION: We present a rare case of trigeminal trophic syndrome in a 44-year-old Black African woman who tested positive for human immunodeficiency virus. She presented with a 6-week history of progressive, persistent, and painless left sided facial and scalp ulcerations that started as small skin erosion. Diagnosis of trigeminal trophic syndrome was made on clinical grounds based on the triad of anesthesia, paresthesia, and unilateral crescent-shaped ulcer in the trigeminal dermatome and her past medical history. The ulcer healed completely after counseling and pharmacological therapy, but she later developed left periorbital cellulitis and left upper eyelid full-thickness defect. CONCLUSION: This is by far the first documented case of trigeminal trophic syndrome with a positive human immunodeficiency virus test. Testing for human immunodeficiency virus in patients with trigeminal trophic syndrome is necessary as this can help improve clinical management and treatment outcomes. Seeking the services of specialists remotely in resource constraint settings is beneficial for managing complications associated with trigeminal trophic syndrome.
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Infecciones por VIH , Humanos , Femenino , Adulto , Infecciones por VIH/complicaciones , Enfermedades del Nervio Trigémino/diagnóstico , Celulitis (Flemón)/diagnóstico , Úlcera Cutánea/etiología , Úlcera Cutánea/virología , Parestesia/etiología , Síndrome , Enfermedades de los Párpados/etiología , Enfermedades de los Párpados/diagnósticoRESUMEN
Premature physeal arrest can cause progressive deformities and functional disabilities of the lower limbs. This study addressed the outcomes after physeal bar resection with or without guided growth (temporary hemiepiphysiodesis) for the treatment of angular limb deformities. We retrospectively analyzed 27 patients (mean 9 years; range, 3-12 years) who underwent physeal bar resection of the distal femur (15 patients), proximal tibia (3 patients), and distal tibia (9 patients) between 2002 and 2020. Fifteen patients underwent physeal bar resection only (Group A), and the other twelve underwent simultaneous guided growth (Group B). The correction angle (angle change between the preoperative and last follow-up values) was compared and analyzed. The overall mean correction angle was 2.9° (range, - 9 to 18.3°). A total of 12 (45%) patients had a > 5° angular deformity improvement (mean, 9.6°; range, 5-18.3°), 9 (33%) had a < 5° angular change; and 6 (22%) had a > 5° worsening of the angular deformity (mean, 6.7°; range, 5.2-9°). The correction angle in Group B (mean 7.6° ± 6.2) was significantly higher than that in Group A (mean - 0.77° ± 6.3) (P = 0.01). We found six (40%) and zero patients with a > 5° angular deformity increase in Groups A and B, respectively (P < 0.047). The group that underwent physeal bar resection with guided growth showed significantly higher correction angles than the group that underwent physeal bar resection alone. Additionally, none of the patients in the guided growth group experienced an increased angular deformity. Therefore, combining guided growth with physeal bar resection may lead to better outcomes in the treatment of growth arrest with angular deformities.
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Fémur , Tibia , Humanos , Niño , Masculino , Femenino , Preescolar , Estudios Retrospectivos , Fémur/cirugía , Fémur/anomalías , Fémur/crecimiento & desarrollo , Tibia/cirugía , Tibia/anomalías , Tibia/crecimiento & desarrollo , Resultado del Tratamiento , Placa de Crecimiento/cirugíaRESUMEN
Ghana is a majority youthful population, but is only able to meet 60% of its annual blood donation requirements. Although tertiary students in Ghana may serve as important blood donor resource by virtue of their higher educational attainment, data about their blood donation processes-specific knowledge are scarce. This study therefore explored the perspectives, and experiences of young adults regarding blood donation processes. This exploratory study employed mixed-methods approach (semi-structured questionnaire and focus group discussion, [FGD]). Data collection was sequential; the questionnaire distribution was completed before FGD commenced; themes that emerged from the questionnaire responses guided FGDs. Convenience sampling technique was used to recruit 382 young adults (15-49 years). All statistical analyses were undertaken using the two-tail assumptions; p<0.05 was considered statistically significant. Majority (79.3%) of the participants were in their twenties, with only 1.3% being 40-49 years old. Although two-thirds of participants expressed willingness to donate blood, less than a-third (31.7%; 127/382) had previously donated blood. Overall, less than one-third of participants could correctly identify the minimum weight (26.4%), or the inter-donation interval (14.7%); 37.4% and 58.1% could respectively indicate the required donor age or ≥3 infectious agents screened for prior to blood collection. Among previous donors, 37.2%, 28.1% and 43.0% could identify the required weight, acceptable inter-donation period, and donor age respectively. Two-thirds and a-third of participants preferred voluntary unrelated, and paid donations respectively. Whereas 42.4% of participants indicated intrinsic health benefits of blood donation, 17.0% suggested that blood donation was associated with disease risks. Both previous donors and non-donor groups considered lack of education, fear of post-donation health issues and lack of privacy at blood collection centers as main hindrances to donor recruitment. Targeted intentional blood donation-specific educational campaigns are warranted to address the blood donation processes knowledge gap among the study population.
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Donación de Sangre , Instituciones de Salud , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Transversales , Proyectos de Investigación , Donantes de SangreRESUMEN
Background: The exploitations of non-conventional feeds for livestock have sparked great interest due to human-animal competition for conventional feedstuffs. The majority of animal feedstuffs are formulated with grains as the major ingredient, resulting in tautness and an increase in the costs of conventional feeds. This practice has underscored the necessity for an alternatively cheap and sustainable non-conventional feedstuff to salvage the feeding restraint to animal production. With this, the present study aimed at evaluating the effect of soaked false yam tuber meal (SFYTM) on the haematological indices and serum biochemical profile of weaner rabbits. Methods: Sixteen local weaned rabbits of diversified breeds and sexes were randomly apportioned to dietary treatments containing 0, 10, 15, and 20 % of soaked false yam tuber in replacement for maize in a maize-fishmeal-based diet. Following feeding trials, blood samples from the rabbits were taken and analyzed using haematology and chemistry analyzers. Results: The haematological assay revealed significant differences (P < 0.05) among treatments for red blood cells (RBCs), total white blood cells (TWBCs), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and monocytes. For haemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), platelet, lymphocytes, neutrophils, esoniphiles, and basophils, no significant differences (P > 0.05) were achieved. With the serum biochemical tests, significantly higher values were obtained for alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and sodium relative to the control. Despite some of the evaluated parameters having relatively high values, they tumbled within the normal range of values for a healthy weaned rabbit. Conclusion: False yam tuber can therefore be exploited as a substitute for maize in rabbits' diets without detrimental effects on the haematological and biochemical markers of the farm animals.
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Street children are particularly susceptible to health-related adversities, including those resulting from substance abuse and child abuse. Information on street children is deficient in Sudan. This study provides basic data on characteristics, factors for leaving home, the pattern of child abuse and substance misuse among street children in Khartoum State, Sudan. This is a descriptive, cross-sectional, and community-based study. Data were collected through direct questioning of a sample of street children using a structured, standardized, and pretested interview-administered questionnaire. Two hundred and seventy-five (275) street children were interviewed. Most street children were males (83%). Of the interviewed children, 36.7% were illiterate, 66.1% had a single parent, and 36% did not recognize a home to return to. The commonest reported reasons for being on the streets were family conflicts and financial/economic difficulties (28.4 % and 27.5%), respectively. 89.1% of the children admitted to being substance abusers, mostly of glue (86.5%) and smoked tobacco (67.3%). Seventy-five-point three percent 75.3% of the children reported being subjected to a form of abuse, with physical and sexual abuse reported by 70.2% and 27%, respectively. Of the 74 children who reported sexual abuse, 49 were males (29% of males), and 25 were females (65% of females). The survey results are thought to guide further research and shape appropriate policymaking and coordinated interventions by concerned stakeholders, whether governmental or non-governmental.
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Maltrato a los Niños , Jóvenes sin Hogar , Trastornos Relacionados con Sustancias , Masculino , Femenino , Humanos , Niño , Estudios Transversales , Sudán/epidemiología , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Reliance on PowerPoint (PPT) slides for self-studying may encourage lower-order cognition due to learning by rote dominating the educational process. On anecdotal evidence, PPT slides have become ubiquitous among Saudi medical students as the chief format of self-study material. We present the scale of the problem in Saudi medical colleges and then discuss the relevant potential implications and remedies. Using a piloted, face-validated, web-based, and self-administered questionnaire, we asked 379 medical students from 22 Saudi medical colleges to answer a few questions related to the use of PPT slides (and other resources) to self-study in preparation for the pediatric course final exam. By far, PPT slides represented the dominant format of self-study resources for most students (n = 359; 94.7%). One-third of students (n = 115; 30.3%) reported they had never or only rarely to occasionally used their basic pediatric textbooks for self-study. Most students (n = 260; 68.6%) reported that > 80% of the final written exam questions stemmed from the PPT slides provided by lecturers. As this study's result underscores the notion that PPT slides have become the customary primary self-study material used by Saudi medical students, we tried to discuss the associated threats to learning and teaching and suggest practical solutions.
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Background: Rheumatoid arthritis (RA) can cause depression and anxiety. This study evaluated the factors associated with depression and anxiety in patients with RA and examined the effect of conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Methods: This cross-sectional study was conducted in a regional hospital in Riyadh between March and November 2022 and included 213 patients with RA. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS) and data about patients' DMARDs use was obtained from the hospital's medical records. Results: Based on the HADS scores, 35 (16.4%) and 49 (23%) patients with RA had depression and anxiety, respectively. There was a significant association between the level of depression and anxiety and the use of leflunomide and tocilizumab among patients with RA (p = 0.006 and p = 0.009, respectively). Patients with RA who took leflunomide had significantly higher scores for anxiety (ß = 0.158, value of p = 0.037) when compared to patients who did not take leflunomide. Patients with RA who took etanercept showed a significantly lower depression score even after adjusting for confounders, including sociodemographic, clinical, and lifestyle factors (ß = -0.189, p = 0.043). Conclusion: The present study highlighted the prevalence of psychiatric disorders among patients with RA and the level of depression and anxiety may differ between patients with RA depending on the type of DMARDs used. We recommend patients with RA be screened regularly for depression and anxiety to avoid further extra-articular systemic complications associated with RA.
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BACKGROUND: Electronic cigarettes are immensely popular among youths across the globe. However, knowledge, attitudes, and perceptions regarding their use vary by country. The present study investigated the knowledge and attitudes toward e-cigarette use among first-year university students in Saudi Arabia. METHODS: A cross-sectional design was adopted, and an online, self-administered questionnaire assessing the knowledge of and attitudes toward e-cigarette use was utilized to conduct this study. The study population included students from all streams enrolled in their first year of university. Descriptive statistics were used to report percentages and frequencies, while advanced statistics, such as multiple logistic regression analyses, were used to determine associations. RESULTS: The lifetime and current prevalence of e-cigarette use was 27.4% and 13.5%, respectively, among first-year university students. The mean age of smoking initiation was 16.4 ± 1.2 years. Of e-cigarette users, 31.3% smoked every day and 86.7% used flavored e-cigarettes. Knowledge of the harmful effects of e-cigarettes was high (addiction, 61.2%; asthma, 61%; nicotine content, 75.2%). However, when comparing e-cigarettes to regular cigarettes, only 22.5% and 48.4% of the students reported that they carry the same risk and contain the same chemicals as regular cigarettes do. There was a lack of knowledge (17.1%) regarding government regulations related to e-cigarettes. An attitude of support was observed regarding banning e-cigarettes (2.6 ± 1.5 on a scale of 0 to 4), while at the same time, some associated e-cigarette use with helping to reduce tobacco dependency (2.1 ± 1.2). Marketing adverts were agreed upon to positively influence youth (1.9 ± 1.4). However, the participants' perceptions relating e-cigarette use to style were not well articulated. Significant gender differences were found: most of the women who participated in the study had better knowledge of e-cigarettes (p < 0.001). Being male, having higher income status (OR = 1.67; p = 0.013), being a current smoker (OR = 11.6; p < 0.001), and having intention for future use (OR = 3.45; p < 0.001) were strong predictors of e-cigarette use. CONCLUSIONS: These findings suggested the increasing popularity of e-cigarette use among male first-year university students. More educational campaigns and stricter regulations are needed to curb this trend.