Musculoskeletal disorders among dental students: a survey from Saudi Arabia.

BACKGROUND: Work-related musculoskeletal disorders (WMSD) are injuries affecting bones, joints, muscles, and tendons due to improper working conditions with serious consequences on health and career. Dentists were found to be at greater risk of developing WMSD compared to other healthcare providers. This study aimed to investigate the prevalence and risk factors of WMSD among dental students in Saudi Arabia. METHODS: This cross-sectional survey-based study recruited dental students across the kingdom using respondent-driven sampling technique. Data was collected using the Nordic Musculoskeletal scale and a validated, self- administered, close-ended questionnaire which assessed WMSDs predisposing factors, enabling factors and musculoskeletal disorders consequences and management. The questionnaire was administered in both Arabic and English languages and was distributed online using google forms. Data analysis was performed using SPSS, Chi-square test or Fisher Exact test was used where appropriate and Multivariate Logistic regression analysis was performed to identify predictors of developing WMSDs. RESULTS: The prevalence of WMSD was 87% (95% CL; 83.9% to 90.3%) among the 462 respondents. Gender, study year, type of practice, having clinics for left-handed, hours of clinical practice, sitting in the proper position while working, use of coping strategies were significantly associated with WMSD prevalence (P < 0.05). Males were OR = 10 times at higher risk of WMSD compared to females (P = 0.0001). Those with daily clinical practice were OR = 5 times at higher risk of WMSD than those who have weekly practice. Those practicing walking, workout, and yoga showed lower prevalence of WMSD (OR = 0.377 & 0.323, p = 0.015, 0.010 respectively). CONCLUSIONS: The prevalence of WMSD among dental students in KSA was high. Males and those with prolonged clinical sessions were at greater risk of WMSD. There is a need for awareness campaigns to educate dental students about risk factors of WMSD. Collegesy, dental colleges should adopt policies in reducing WMSD among their students.

Influence of denture brushing on the surface properties and color stability of CAD-CAM, thermoformed, and conventionally fabricated denture base resins.

PURPOSE: To assess the influence of denture brushing on the surface roughness, hardness, and color stability of conventional, thermoformed, and CAD-CAM denture base materials. MATERIALS AND METHODS: Seven different denture base materials were included in this study; conventional heat-polymerized acrylic resin (PMMA) served as control, polyamide, acetal, two categories of milled acrylic discs (AvaDent and IvoCad), and two categories of 3D-printed resins (NextDent and FormLabs). The specimens were constructed according to manufacturers' instructions and then subjected to simulated brushing (20,000 cycles). According to the brushing method, the specimens were split into three groups, no brushing, brushing with water, and brushing with toothpaste. Surface roughness, hardness, and color change were evaluated before and after brushing. Collected data were analyzed using ANOVA, and post-hoc Tukey's tests (α = 0.05). RESULTS: A significant difference was noted between the surface roughness of the tested materials before and after denture brushing (p < 0.05), and milled resin showed the least Ra values. Denture brushing with water significantly increased the Ra of PMMA (p = 0.004) and IvoCad (p = 0.032), while brushing using toothpaste did not show a significant increase. The brushing protocols did not alter the hardness of tested materials except that of PMMA (p = 0.001). The color stability of the tested materials showed comparable results with both brushing protocols. CONCLUSION: The tested properties showed variations between the types of denture base resins. Hardness and color stability of CAD-CAM and thermoformed denture base resins were not altered by denture brushing and showed comparable results with both brushing methods. Surface roughness was the only property that showed alteration after denture brushing.

Oral health-related interdisciplinary practices among healthcare professionals in Saudi Arabia: Does integrated care exist?

BACKGROUND: There is a bidirectional relation between oral and general health, therefore collaboration between healthcare providers is needed. This study investigated current interdisciplinary practices (IDP) and the associated factors among healthcare professionals in Saudi Arabia. METHODS: A cross-sectional study was conducted in the Eastern Saudi Arabia recruiting four groups of health professionals (nurses, physicians, pediatricians and Ear-Nose and Throat (ENT) specialists). A validated, self-administered questionnaire was distributed online and shared through social media platforms. The questionnaire explored predisposing factors (demographics) and facilitating factors (knowledge, attitudes, attendance of oral health training and source of knowledge) associated with IDP. RESULTS: A total of 1398 health professionals were recruited. Participants showed fair oral health knowledge (7.1 ± 2.1) and attitudes (22.2 ± 3). Three-fourths (74.6%) reported always providing oral health education (OHE) to their patients, more than half (59.6%) reported always conducting an oral health screening (OHS), two-thirds (66.7%) reported responding to patients' questions about oral health or conditions and 58.7% reported referring patients to dentists. Pediatricians and physicians had greater odds of IDP compared to other health professionals. Source of oral health knowledge (Ministry of Health (MOH) and formal education) was significantly associated with increased odds of IDP. Participants with good oral health knowledge had greater odds of responding to patients' oral health question as well as have more referral practices. CONCLUSION: The results reveal a discrepancy between participants' IDP, knowledge, and attitudes. Incorporating dental component to medical curricula, continuous education and training programs targeting health professionals through Ministry of Health should be considered.

An investigation of dental students' perceptions about the characteristics of effective instructors and their related factors.

BACKGROUND: The characteristics of effective teachers can be used to improve student learning, support their academic achievement outcomes and promote faculty development and career advancement. OBJECTIVES: To assess dental students' perceptions about the characteristics of effective instructors and related factors. MATERIALS AND METHODS: This cross-sectional study analysed data collected from students at a dental college in Saudi Arabia. A pilot-tested questionnaire with satisfactory internal consistency was distributed amongst all students. The questionnaire contained 21 items related to the characteristics of effective instructors on a 5-point Likert-type scale. Student's t test was performed to analyse the association of factors like gender, last year's GPA, academic year, paternal income, education and employment with three highly rated items of the characteristics of effective teachers. RESULTS: The response rate was 85.4%. There were 53.6% female and 46.4% male students in the study. The provision of learning resources (mean 4.3 ± 1.06), demonstration of honesty, ethics and integrity (mean 4.28 ± 0.99) and showing respect and caring attitude (mean 4.24 ± 0.94) were three most highly rated characteristics of effective instructors. Using the latest technology, acting as a role model and maintaining class discipline were the least rated traits of good teachers. A significantly higher percentage of female students considered these three items more important than male students (P < 0.05). The students with last year GPA > 4 considered providing learning material as an attribute of effective teacher significantly more important than the students with GPA ≤ 4 (P < 0.001). In addition, the characteristics of effective instructors (75.1%) were considered more important in providing students with rewarding learning experience than their teaching experience (15.4%) and educational attainment (9.5%). CONCLUSION: The most important attributes of effective teachers included providing learning resources, demonstrating honesty/integrity and showing respect/care.

The Effect of Listening to Holy Quran Recitation on Weaning Patients Receiving Mechanical Ventilation in the Intensive Care Unit: A Pilot Study.

Mechanical ventilation (MV) causes high level of stress in hospitalized patients. Weaning is the gradual process of decreasing ventilator support that in turn lead to termination of MV and increased respiratory effort, which may exacerbate symptoms and prolong MV. This study aimed to investigate the effect of listening to Holy Quran recitation (HQR) as a non-pharmacological intervention in patients during weaning from mechanical ventilation. This is a randomized controlled trial in which 55 patients admitted in the intensive care unit (ICU) and on mechanical ventilation were recruited. Patients were divided into experimental (case) and control group. In the experimental group, patients received 30 min of HQR, whereas in the control group, patients had 30 min of rest in bed before the start of the weaning. The physiological and/or clinical parameters of weaning were recorded. These parameters include rapid shallow breathing index, respiratory rate, heart rate, oxygen saturation, exhaled carbon dioxide, and blood pressure. The baseline demographic data for groups were presented in tables. The mean age was 54 ± 0.5 years for the experimental and 56.4 ± 18.5 years for the control groups. The physiological and clinical parameters were compared between case and control and found no significant difference. The preliminary findings of this pilot study suggest that there is no negative effect of HQR on weaning patients from mechanical ventilation in the ICU. The results also outline and explorthe possible utility of HQR further in ICU patients as an intervention in weaning patients off from ventilator in the ICU. Although there remains much to be done, our work generates important findings in the field of critical care management.

Out of pocket (OOP) cost of treating hypertension in Karachi, Pakistan.

Pakistan is categorized to below to middle income countries where two third of the national annual health expenditure is in the form of out of pocket (OOP) cost. A prevalence based study was conducted to determine the OOP cost treatment of hypertension in Karachi by interviewing 350 hypertensive patients aged >30 years through a validated questionnaire. Hypertension (HTN) was classified into stage 1 and stage 2 and was found to be common in females (53.42%) than males (46.57%). The total costs of stage 1and stage 2 HTN were calculated to be 217869.7PKR and17545457.6 PKR respectively. The average treatment cost of stage 1 was observed to be significantly lower (p=0.006) than the cost of stage 2 HTN. Moreover; the cost of antihypertensive drugs, physician fees and laboratory tests were considerably different however; no variation was seen in cost of transport and loss of productivity through absenteeism from work. Overall, the present study indicates that the antihypertensive treatment has imposed a high burden on the pocket of common man and this is a major reason for treatment non-adherence. Consequently, it increases the risks of cardiovascular events, morbidity and mortality. Therefore, effective strategic planning is need of time to reduce OOP cost for better control on hypertension in Pakistan.

Peer evaluation as an alternative assessment method for case presentations: A cross-sectional study of dental students' perception.

INTRODUCTION: Peer assessment in dental and medical education is a key tool for evaluating attitudes and communication skills, serving as an effective formative learning method. It not only boosts academic performance and encourages lifelong learning and reflective practice but also fosters collaboration, effective communication, and constructive feedback among peers. OBJECTIVE: This study aimed to assess dental students' satisfaction and perceptions regarding implementing peer assessment in case presentations, including contribution to their learning. METHODS: This cross-sectional study involved third (n = 26), fourth (n = 54), and sixth (n = 71) dental students divided into five groups. Each student received peer assessments (n = 8) from the students of the other groups regarding their clinical presentation. At the end of the process, students were invited to complete an anonymous 9-item questionnaire to assess student perceptions of the peer-assessment process. Data were analyzed to evaluate students' perception and satisfaction with the peer assessment task. The bivariate analysis explored associations among questionnaire items. RESULTS: A total of 151 students participated in the current study. Results showed a high level of agreement for most of the students regarding their preparedness for peer and self-assessment. More than 75% of the students at all academic levels found it challenging to evaluate their peers. Student satisfaction scores increased with the level of education, (4.076, 4.214, and 4.246 out of five, respectively) with moderate correlations between peer evaluation characteristics. CONCLUSION: Peer assessment appears to enhance learning and professional development in dental students. Students' satisfaction with peer assessment grows with education level, reflecting its role in fostering critical evaluation skills and feedback.

Salivary interleukin-17A and interleukin-18 levels in patients with celiac disease and periodontitis.

Background: An increased level of interleukin-17A and interleukin-18 in the serum and intestinal mucosa of celiac disease patients reflecting the severity of villous atrophy and inflammation was documented. Thus, the objective of this study was to evaluate the concentrations of salivary-17A, interleukin-1 beta, and interleukin-18 in patients with celiac disease who are on a gluten-free diet, both with and without periodontitis, and to compare these levels with those in healthy individuals. Methods: The study involved 23 participants with serologically confirmed celiac disease (CD) and 23 control subjects. The CD patients had been following a gluten-free diet (GFD) for a minimum of 1 year and had no other autoimmune disorders. The research involved collecting demographic data, conducting periodontal examinations, gathering unstimulated whole saliva, and performing enzyme-linked immunosorbent assays to measure salivary interleukin-17A, interleukin-1 beta, and interleukin-18 levels. Spearman's correlation analysis was utilized to explore the relationships between CD markers in patients on a GFD and their periodontal clinical findings. Results: The periodontal findings indicated significantly lower values in celiac disease patients adhering to a gluten-free diet compared to control subjects (p = 0.001). No significant differences were found in salivary IL-17A, IL-18, and IL-1B levels between celiac disease patients and control subjects. Nevertheless, the levels of all interleukins were elevated in periodontitis patients in both the celiac and control groups. The IL-1 Beta level was significantly higher in periodontitis patients compared to non-periodontitis patients in the control group (p = 0.035). Significant negative correlations were observed between serum IgA levels and plaque index (r = -0.460, p = 0.010), as well as gingival index (r = -0.396, p = 0.030) in CD patients on a gluten-free diet. Conclusion: Celiac disease patients on gluten-free diet exhibited better periodontal health compared to control subjects. However, increased levels of salivary IL-17A, IL-18 and IL-1B levels were associated with periodontitis. Additionally, serum IgA level was significantly inversely associated with periodontitis clinical manifestations and with salivary inflammatory mediators in CD patients on GFD.

COVID-19 vaccine hesitancy in the Saudi Arabian population.

This study aimed to measure the level of vaccine hesitancy among the Saudi population using the WHO Vaccine Hesitancy Scale (VHS). A cross-sectional study using a modified vaccine hesitancy scale (VHS) was conducted among Saudi Arabian residents between April 4 and May 24, 2021. The relationship between participants' willingness to uptake COVID-19 vaccines and their demographics, awareness of COVID-19, and health status was evaluated. The chi-square test was employed to compare categorical variables and logistic regression for the associations of demographical characteristics with acceptance of the vaccine. We received a total of 1657 completed responses. 1,126 participants (68%) were vaccinated, of which 19% were vaccinated with one dose only, and 49% were fully vaccinated (with two doses). Safety concerns and worries about side effects were higher among the hesitant group (p<0.001). 96% of the participants from the willing group were not hesitant to have the vaccine, whereas in the same group, 70% thought they had good health and the vaccine was not needed. Logistic regression analysis revealed that participants with chronic diseases had lower odds of being willing to be vaccinated (OR=0.583, p-value 0.04). The study findings suggest key factors associated with COVID-19 vaccine hesitancy in the Saudi population and can help public health authorities plan strategies to minimize vaccine hesitancy and improve awareness about vaccine acceptance.

Clinical chemistry laboratory test overuse in a cardiology clinic: a single-center study.

Diagnostic laboratory tests are frequently overused in healthcare entities, leading to an increased strain on laboratory resources, additional workload, and wastage of resources. Continuous monitoring of test ordering behavior is crucial to evaluate clinical necessity. This cross-sectional study aimed to estimate the necessity of ordering clinical chemistry tests in the cardiology clinic of a tertiary center in Saudi Arabia. We retrieved medical records of patients diagnosed with cardiovascular problems admitted at the cardiology clinic in 2020. The frequency and percentages of the ordered tests were calculated upon admission and follow-up, and the difference between necessary and unnecessary tests was compared for each category. Test ordering assessment included cardiac, renal, and liver functions, blood gases, thyroid and diabetic profile, iron indices, hormones, water and electrolytes, and inflammatory markers. The results showed a large number of clinical chemistry tests ordered without clinical necessity. While the number of necessary tests was significantly higher than that of unnecessary tests, 21% of the tests ordered between June-December 2021 at the center were unnecessary. Further studies are necessary to identify driving factors and develop strategies to reduce the overutilization of diagnostic laboratory tests in clinical practice. Eliminating this phenomenon will reduce the risk of unnecessary medical interventions and associated costs, improve patient outcomes, and reduce the overall burden on the healthcare system.

The Effect of Coronal Pre-flaring and Type of Root Canal Irrigation on Working Length Accuracy Using Electronic Apex Locators.

Background: Successful root canal treatment is influenced by the apical extent of root canal preparation and the eventual root canal filling. Achieving the full working length until the apical constriction, which is usually 0.5 - 1 mm shorter than the anatomical apex, is crucial. Electronic apex locators were used to detect the working length more accurately. There are six generations of electronic apex locators in the market. The selection of the appropriate irrigation with each apex locator for accurate working length determination is not fully investigated. Methods: The actual working lengths of 120 freshly extracted human single-rooted teeth were measured and compared with their working lengths using 3 rd generation (Root ZX) followed by 6 th generation (Raypex 6) apex locators in dry medium, presence of 5.25% sodium hypochlorite, and 2% chlorhexidine, without coronal pre-flaring and after coronal pre-flaring using the same irrigating media. Data were collected, tabulated, and afterward analyzed using one-way ANOVA with post-hoc to evaluate the significant difference in average working length between actual working length, Root ZX, and Raypex 6 apex locator working lengths accuracy. Results: The significant results were shown in roots that were coronally pre-flared and their working lengths were measured in a dry medium using Raypex 6 apex locator. While using the Root ZX apex locator, the most accurate results were shown in roots that were coronally pre-flared and their working lengths were measured while using a chlorhexidine irrigating solution. Conclusions: It is concluded that it is very important to know the specific irrigating medium to be used with each specific electronic apex locator to achieve the most accurate working length results.

The impact of SELP gene Thr715Pro polymorphism on sP-selectin level and association with cardiovascular disease in Saudi diabetic patients: A cross-sectional case-control study.

Background: Cardiovascular diseases (CVD) are leading cause of mortality in patients with type 2 diabetes mellitus (T2DM). Increased soluble sP-selectin and 715Thr > Pro polymorphism were studied in CVD and T2DM, but association between them hasn't been explored in Saudi Arabia. We aimed to assess sP-selectin levels in T2DM and T2DM-associated CVD patients in comparison to healthy control cohort. Also, we sought to investigate relationship between Thr715Pro polymorphism and sP-selectin levels and disease state. Methods: This is a cross-sectional case-control study. sP-selectin level (measured by Enzyme-linked immunosorbent assay) and prevalence of Thr715Pro polymorphism (assessed by Sanger sequencing) were investigated in 136 Saudi participants. The study comprised 3 groups: group1 included 41 T2DM patients; group 2 (48 T2DM patients with CVD), and group 3 (47 healthy controls). Results: sP-selectin levels were significantly higher in diabetics and diabetics + CVD groups as compared to the corresponding control. In addition, results showed that the prevalence of 715Thr > Pro polymorphism is 11.75 % in the study population amongst the three study groups (9.55 % Thr/Pro, and 2.2 % Pro/Pro). No statistical difference was found between sP-selectin levels in subject carrying the wildtype genotype of this polymorphism and these who carry the mutant gene. There could be an association between this polymorphism and T2DM, whilst the polymorphism may protect diabetic patients from having CVD. However, odds ratio is not statistically significant in both cases. Conclusion: Our study supports the previous researches' results that Thr715Pro is neither influencing the sP-selectin level nor the risk of CVD in T2DM patients.

The Prevalence of Body Dysmorphic Disorder and Its Associated Risk Factors Among Dental Patients: Why Are My Patients Not Satisfied?

BACKGROUND: Body dysmorphic disorder (BDD) is a common disorder that consists of a distressing or impairing preoccupation with imagined or slight defects in appearance. In dentistry, those patients will have unrealistic expectations and usually will be unsatisfied with the outcomes of dental treatment. This study investigated the prevalence of BDD and its associated factors among dental patients. MATERIAL AND METHODS: In this cross-sectional survey-based study, a purposive sample was used to recruit adult patients seeking dental treatment in private and public facilities. Data was collected using the validated Arabic version of the Cosmetic Procedure Screening Questionnaire (COPS) for Body Dysmorphic Disorder, a validated nine-item self-administrated instrument that is scored from zero (least impaired) to five (most impaired). Chi-Square, Mann-Whitney U, and Fisher's Exact tests were used to compare the associations between the study variables and BDD. RESULTS: A total of 507 patients responded to the questionnaire. The prevalence of BDD was 34.1%. The average age of the participants was 35.2 years; the majority were males 290 (57%) and Saudis 436 (86%) with a college education 304 (60%). None of the demographics was associated with BDD but the type of treatment was significantly associated with BDD with teeth crowning and restorations. CONCLUSION: This study provides insights into the prevalence of BDD and its associated factors among dental patients in Eastern Saudi Arabia. The findings highlight the need for further research to better understand the factors contributing to the development of BDD and to guide prevention and intervention strategies in dental settings.

In Vitro Evaluation of Candida albicans Adhesion and Related Surface Properties of CAD/CAM Denture Base Resins.

OBJECTIVE: The aim of this study was to evaluate the surface roughness, contact angle, and adhesion of Candida albicans to computer-aided designing/computer-aided manufacturing (CAD/CAM) and heat-polymerized (HP) denture base materials. MATERIALS AND METHODS: Specimens were allocated to six groups based on the composition of studied denture base materials, HP acrylic resin, milled resins (AvaDent and IvoCad), and 3D-printed resins (ASIGA, FormLabs, and NextDent). Ten specimens per group were used for each test (n = 10/test). Surface roughness and contact angles were analyzed using profilometer and goniometer, respectively. Adhesion of C. albicans was counted using colony-forming unit (CFU/mL). Means and standard deviations were calculated, and then one-way analysis of variance (ANOVA), followed by Tukey's post hoc test. Correlation of Candida adhesion and surface parameters was determined by using Pearson's correlation analysis. RESULTS: No statistically significant difference was noted in surface roughness between HP, milled, and 3D-printed denture base resins except NextDent, which showed significantly higher roughness in comparison to all other resins (p = 0.001). In terms of contact angle, milled resins had the lowest value, followed by HP, ASIGA, and FormLabs, whereas NextDent showed the highest contact angle (p = 0.001). C. albicans adhesion showed no significant difference between all denture base resins. A positive and significant correlation was found between C. albicans adhesion and contact angle (p = 0.003), while no correlation was reported between C. albicans adhesion and surface roughness (p = 0.523). CONCLUSION: Adhesion of C. albicans was similar in all tested specimens. Surface roughness showed no significant difference between all groups except NextDent, which had the highest value. Milled denture base resins had the lowest contact angle among all groups.

Is It Mum or the Dad? Parental Factors That Influence the Use and Acceptance of Fluoride Varnish among Parents in Eastern Saudi Arabia.

Objective: To investigate parental factors that influence knowledge, use, and acceptance of fluoride varnish (FLV) application. Methods: This cross-sectional study was conducted during December 2021. A multistage sampling technique was used to recruit parents with children aged 3 to 6 years and residing in Eastern Saudi Arabia, excluding those working in the dental field. The questionnaire consisted of four parts: demographics, knowledge, previous experience, and acceptance of FLV and was pilot-tested and distributed online using social media. Results: A total of 623 parents responded to the survey. Only 36.9% of parents had good FLV knowledge with dentists being the main source of information. Gender, educational level, family income, being in the medical field, and source of knowledge were factors that significantly (P < 0.05) influenced parental knowledge. Only 24.6% of the parents applied fluoride varnish to their children before, of whom only 29% were satisfied with the experience. Parent's FLV knowledge, view of dental visits, satisfaction with previous experience, perception of children's oral health, and willingness to reapply FLV were factors that significantly (P < 0.05) influenced FLV use. Working in the medical field, perception of dental visits, and the source of knowledge were factors that significantly (P < 0.05) influenced the parent's acceptance to apply FLV. While lack of knowledge about fluoride benefits (15%) was the main reason for parental refusal to apply FLV. Conclusions: The current study highlights the lack of knowledge and application of FLV among parents. There were more factors influencing mothers' acceptance of FLV application compared to fathers. Age, educational level, working in the medical field, perception, and patterns of dental visits were some of the identified factors. Dentists played a major role in parental knowledge and FLV acceptance. In a country with high caries prevalence, preventive programs such as FLV education and application are crucial.

Hesitancy towards the COVID-19 vaccine among health care practitioners in the Kingdom of Saudi Arabia: a cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a major public health crisis worldwide. In less than 12 months since the World Health Organization declared the outbreak, several different COVID-19 vaccines have been approved and deployed mostly in developed countries since January 2021. However, hesitancy to accept the newly developed vaccines is a well-known public health challenge that needs to be addressed. The aim of this study was to measure willingness and hesitancy toward COVID-19 vaccines among health care practitioners' (HCPs) in Saudi Arabia.   Methods: A cross-sectional study using an online self-reported survey was conducted among HCPs in Saudi Arabia between April 4th to April 25th 2021 using snowball sampling. Multivariate logistic regression was employed to identify the possible factors affecting HCPs' willingness and hesitancy to receive COVID-19 vaccines.   Results: Out of 776 participants who started the survey, 505 (65%) completed it and were included in the results. Among all HCPs, 47 (9.3%) either said "no" to receive the vaccine [20 (4%)] or were hesitant to receive it [27 (5.3%)]. Of the total number of the HCPs, 376 (74.5%) already received the COVID-19 vaccine, and 48 (9.50%) were registered to receive it. The main reason of agreement to receive the COVID-19 vaccine was "wanting to protect self and others from getting the infection" (24%).   Conclusion: Our findings have shown that hesitancy toward receiving COVID-19 vaccines among HCPs in Saudi Arabia is limited and therefore may not be a serious issue. The outcomes of this study may help to understand factors that lead to vaccine hesitancy in Saudi Arabia and help public health authorities to design targeted health education interventions aiming to increase uptake of these vaccines.

Early Determinants of Mortality in Hospitalized COVID-19 Patients in the Eastern Province of Saudi Arabia.

PURPOSE: This study investigated the clinical determinants of mortality in hospitalized patients infected with COVID-19. PATIENTS AND METHODS: A retrospective multicenter large cohort of COVID-19 patients hospitalized between March 2020 and February 2021. We included patients admitted with a confirmed COVID-19 infection with positive COVID-19 through real-time polymerase chain reaction (RT-PCR). SPSS version 25.0 (Armonk, NY: IBM Corp.) was used to analyze the data. RESULTS: Among the study participants (n = 1444), the mean age of the population was 49.22±17.69 years, of which 63.9% were males (n = 924). Overall, the mean age for non-survivors was 55.65 ±16.41 years and the length of ICU stay was 13.95 ±12.4 years. The most common comorbidity among the study subjects was hypertension (HTN) (32.7%), followed by cardiovascular disease (CVD) (10.7%). Patients who were mechanically ventilated (MV) had higher mortality than those who did not require MV (p < 0.001). CONCLUSION: Our study concluded that old age, the presence of underlying cardiovascular conditions, an abnormal WBC count (leukopenia or leukocytosis), and abnormal blood urea nitrogen (BUN) levels are among the independent predictors of mortality in the Saudi population. These findings may guide health care providers to manage COVID-19 patients more effectively with better outcomes.

COVID-19 Myth Busters: Comparing knowledge and perceptions amongst the dental workforce at an institution in the Eastern Province, Saudi Arabia.

BACKGROUND: Currently, world is suffering from a respiratory disease names as COVID-19. This is a novel coronavirus (n-CoV), a new strain which has not been previously identified in humans and it has spread in more than 100 locations internationally due to which it is termed as "public health emergency of international concern" (PHEIC) by the World Health Organization So far, no study done as yet to assess whether the dental workforce is aware about the facts and myths related to Covid-19 awareness. OBJECTIVE: This study aims to analyze and compare the level of awareness about the facts and myths related to COVID-19 amongst faculty, dental students and prep year students of the College of Dentistry (COD) as part of an awareness campaign. METHODS: An awareness test about COVID-19 was designed using information from the World Health Organization's (WHO) Myth Busters Awareness webpage. The questionnaire was administrated online to faculty and students, of the College of Dentistry and preparatory year students who had applied for the admission to the dental college using a secure enterprise online assessment platform (Blackboard). The tests were administered over a period of three months from March to June 2020. A written informed consent was obtained. RESULTS: The online COVID-19 awareness test was administered to 810 participants, out of which 325 (40%) were prep year students, 429(53%%) were dental students, and 56 (7%) were faculty members. Analysis of the results showed that 86% of the Faculty were able to correctly identify the facts and the myths related to COVID-19 followed by 81% of the prep year students and 74% of the dental students. Preparatory year student's knowledge related to COVID-19 was found to be high when compared to dental students (26.47±4.27, 23.67±6.2). Student to faculty knowledge score did not differ significantly (p = 0.808). CONCLUSION: This study reports about a successful pilot test conducted to assess the perceived knowledge about facts and myths related to corona virus amongst the dental workforce.

Under-reported COVID-19 cases in South Asian countries.

Background: The purpose of the study was to compare  trends in the progression of COVID-19 among South Asian countries with more developed Western countries. Methods: COVID-19 data from South Asian countries were used for this observational study. Data were taken up to April 21, 2020 from the outbreak of the COVID-19. Four of the seven countries met the inclusion criteria and were included in the analysis. Results: An exponential increase in the average number of weekly cases was reported after the fifth week following the first case. The correlation between reported cases and tests was found to be strong and significant (r=0.90, p=0.037). However, on average, 315.25 tests per million population were performed, which was at least 12 times lower than the number of tests performed in countries with a large number of COVID-19 cases. Conclusions: At present, the number of confirmed cases from South Asia was found to be significantly lower than in Western countries. Hence, an increase in the strength of performing diagnostic tests is highly recommended. Strict measures are required to make the people of these countries follow the instructions of social distancing and comply with preventive measures.

Impact of Sugar Tax on Sugar-sweetened Beverage Consumption among Saudi Schoolchildren.

PURPOSE: In 2017, Saudi Arabia introduced a 120% tax on energy drinks and a 50% tax on soft drinks. The impact of this policy on the consumption of sugar-sweetened beverages (SSB) among schoolchildren is not known in this country. The present study evaluated the impact of the excise tax on SSB consumption in the tri-city metropolitan area of Dammam-Khobar-Dhahran, Eastern Province, Saudi Arabia. MATERIALS AND METHODS: A repeated cross-sectional design was used to examine the difference between pre- and post-tax SSBs consumption among schoolchildren (12-14 years old) in Dammam-Khobar-Dhahran cities. A beverage-consumption frequency questionnaire was completed by 453 participants before the tax implementation and 334 participants after the tax implementation. The tax on soft drinks was increased by 50% and on energy drinks by 120%. Pre-tax data were collected in May 2017 and post-tax data in April 2018. RESULTS: The proportion of participants who consumed energy drinks was 46.1% (95% CI: 42-51) before tax implementation, decreasing to 38.4% (95% CI: 33-44) after tax implementation, a reduction of nearly 8%. 92.5% (95% CI: 90-95) of the participants consumed soft drinks before tax implementation and 94.6% (95% CI: 92-97) did so after tax implementation, an increase of about 2%. CONCLUSIONS: The study showed no statistically significant impact of tax implementation on the consumption of energy drinks and soft drinks in this sample of children.