Public awareness of first-aid management of seizures in Saudi Arabia.

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 (p = 0.015), female gender (p < 0.001), divorced status (p = 0.014), knowing someone with epilepsy (p < 0.001), attending a course or workshop about seizure first-aid (p < 0.001), watching a video on seizure first-aid on any platform (p < 0.001), and having basic life support training (p < 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.

Pharmaceutical companies' views on a health technology assessment (HTA) entity in Saudi Arabia.

Saudi Arabia is undergoing a massive healthcare transformation to fulfill its new, national "Vision 2030." To align with this objective, Saudi Arabia is establishing a new, independent and evidence-based health technology assessment (HTA) entity to help it maximize health gains through efficient use of resources. This study was designed to ascertain how pharmaceutical companies perceive the creation of such a national HTA entity in Saudi Arabia; what they think about it and expect from it. To achieve the study's aim, we held a workshop in Riyadh, Saudi Arabia, lasting four and a half hours and hosted by the Saudi Ministry of Health (MOH). We invited 16 market access directors and managers from different multinational pharmaceutical companies to discuss the establishment of a national HTA entity. The findings from the workshop were structured around three axes: vision and remit; HTA method; and implementation and practical considerations. Overall, the pharmaceutical company participants were positive about HTA's value for the Saudi healthcare system and expressed willingness to adapt to meet its future requirements.

A case of urinary bladder agenesis and bilateral ectopic ureters: a case report.

BACKGROUND: Urinary bladder agenesis is a very rare congenital anomaly with very few cases reported in the literature. CASE PRESENTATION: We report a one-month-old baby presenting with ambiguous genitalia and recurrent urinary tract infections. Her clinical course was complicated by renal impairment. Magnetic resonant imaging (MRI) revealed a diagnosis of bladder agenesis with bilateral ectopic insertion of the ureters into the vagina, associated with several other anomalies. The patient underwent bilateral high anterior ureterostomies in an hospital abroad at 5.5 months of age. She then developed ureteral necrosis that had to be corrected with left pyeloplasty and by placing a left nephrostomy tube for drainage. Eventually, the patient's renal function declined, and she developed chronic kidney disease (CKD).The case with its imaging findings and pathogenesis as well as a review of the literature are presented. CONCLUSIONS: Urinary bladder agenesis is a rare congenital condition that can be associated with multiple anomalies. Early diagnosis and therapeutic intervention can prevent progression to chronic kidney disease.

Pheromone-based communication influences the production of somatic extracellular vesicles in C. elegans.

Extracellular vesicles (EVs) are integral to numerous biological processes, yet it is unclear how environmental factors or interactions among individuals within a population affect EV-regulated systems. In Caenorhabditis elegans, the evolutionarily conserved large EVs, known as exophers, are part of a maternal somatic tissue resource management system. Consequently, the offspring of individuals exhibiting active exopher biogenesis (exophergenesis) develop faster. Our research focuses on unraveling the complex inter-tissue and social dynamics that govern exophergenesis. We found that ascr#10, the primary male pheromone, enhances exopher production in hermaphrodites, mediated by the G-protein-coupled receptor STR-173 in ASK sensory neurons. In contrast, pheromone produced by other hermaphrodites, ascr#3, diminishes exophergenesis within the population. This process is regulated via the neuropeptides FLP-8 and FLP-21, which originate from the URX and AQR/PQR/URX neurons, respectively. Our results reveal a regulatory network that controls the production of somatic EV by the nervous system in response to social signals.

High-quality genome assembly and annotation of five bacteria isolated from the Abu Dhabi sabkha-shore region.

OBJECTIVES: Sabkhas represent polyextreme environments characterized by elevated salinity levels, intense ultraviolet (UV) radiation exposure, and extreme temperature fluctuations. In this study, we present the complete genomes of five bacterial isolates isolated from the sabkha-shore region and investigate their genomic organization and gene annotations. A better understanding of the bacterial genomic organization and genetic adaptations of these bacteria holds promise for engineering microbes with tailored functionalities for diverse industrial and agricultural applications, including bioremediation and promotion of plant growth under salinity stress conditions. DATA DESCRIPTION: We present a comprehensive genome sequencing and annotation of five bacteria (kcgeb_sa, kcgeb_sc, kcgeb_sd, kcgeb_S4, and kcgeb_S11) obtained from the shores of the Abu Dhabi Sabkha region. Initial bacterial identification was conducted through 16 S rDNA amplification and sequencing. Employing a hybrid genome assembly technique combining Illumina short reads (NovaSeq 6000) and Oxford Nanopore long reads (MinION), we obtained complete annotated high-quality gap-free genome sequences. The genome sizes of the kcgeb_sa, kcgeb_sc, kcgeb_sd, kcgeb_S4, and kcgeb_S11 isolates were determined to be 2.4 Mb, 4.1 Mb, 2.9 Mb, 5.05 Mb, and 4.1 Mb, respectively. Our analysis conclusively assigned the bacterial isolates as Staphylococcus capitis (kcgeb_sa), Bacillus spizizenii (kcgeb_sc and kcgeb_S11), Pelagerythrobacter marensis (kcgeb_sd), and Priestia aryabhattai (kcgeb_S4).

Epilepsy first aid awareness among healthcare workers in Saudi Arabia: A cross-sectional study.

Objectives: Epilepsy is a neurological disorder affecting more than 50 million human lives of all ages, its social, physical and psychological implications is of huge concern. The current study and as a continuation of epilepsy knowledge assessment projects conducted by our research team is aimed to assess the knowledge of healthcare workers regarding epilepsy first aid in Saudi Arabia. Methods: A cross-sectional questionnaire-based study was carried out from 2020 to 2021. Results: During the study period, 272 healthcare workers were recruited; participants were males and females from different nationalities in various Saudi Arabian cities, possess diverse qualifications, and belong to several healthcare-related professions. The question, "Did you witness an epileptic seizure"? was answered as "Yes" by 42% of participants, and in response to the question "If you know that this patient struggles during seizure attacks," 58% of respondents stated that they would not call an ambulance. Moreover, the question "Put something in his/her mouth to prevent tongue biting" was incorrectly answered as "Yes" by 42% of respondents, and the question "Try to catch him/her and stop his/her movement" in order to control the attack was answered "Yes" by 21% of respondents. Furthermore, almost 90% of healthcare participants do not know how to use the Vagus Nerve Stimulation device. The mean knowledge score among participants was 23.7; sex, as well as type of higher qualification obtained, was found to be significantly associated with the score of knowledge. Conclusion: Knowledge toward epilepsy and epilepsy first aid among healthcare workers in Saudi Arabia was found fragile. Further research is appreciated to support the current findings.

Level and relationships of academic skills and family functions with academic performance during Covid 19 pandemic.

Background: The research indicates that academic skills and family function may influence academic achievement. The Covid 19 epidemic has impacted regular academic and family function. However, there is a dearth of studies evaluating the relevance of academic skills and family function on college students' academic achievement. This research was done to determine the levels and relationships between academic achievement and study skills and family functions. Two hundred seventy-nine college students were assessed with Sociodemographic and academic proforma, Study Skills Assessment Questionnaire (SSAQ), and The McMaster Family Functioning Scale (MFFS). Results: Results revealed that the mean score of SSAQ and MFFS were 179.92 and 17.88, respectively. Multiple regression analysis showed that the score of reading skills and the MFFS score statistically significantly predicted the score of the exam. Conclusions: On the basis of this study's results, it is possible to conclude that reading skills and family functioning may influence academic success.

Meta-analysis of HNF1A-MODY3 variants among human population.

Background: Previously, numerous case-control studies have highlighted variants responsible for Maturity onset diabetes of young (MODY). However, these studies have been conducted among diverse populations and hence yielded contradictory results. We, therefore, performed a meta-analysis to precisely find the association of SNPs with the disease for the HNF1A gene. Objective: Meta-analysis of clinically defined studies deciphering mutations in the HNF1A gene responsible for the development of MODY3 was conducted among various populations to determine associations using statistical approaches. Methods: The curation of 505 research articles published between the years 2000-2021 was carried out. Visualization of data-related protocols and statistical-analysis were conducted, which led to the identification of highly prevalent mutations among different populations (majorly Europe). Further comparison between the frequencies of the control (healthy population) and test (diseased population) dataset generated through curation was performed. Results: We identified nine MODY3 mutations (rs587776825, rs1169288, rs1800574, rs2464196, rs137853244, rs137853238, rs587780357, rs137853240 and rs137853243) at the genome-wide significance level ( p < 5.0 × 10-8). The present study confirmed that the data does not follow a normal distribution. Further, the data was confirmed to be a more homogenous type with frequencies having a significant association with the disease. Conclusion: This meta-analysis found significant associations of mutations in HNF1A with MODY3, consistent with previous studies. Our findings should help elucidate the mutations in a compiled form responsible for causing MODY3. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-00975-8.

Diagnostic and Therapeutic Applications of Extracellular Vesicles in Interstitial Lung Diseases.

Interstitial lung diseases (ILDs) are chronic irreversible pulmonary conditions with significant morbidity and mortality. Diagnostic approaches to ILDs are complex and multifactorial. Effective therapeutic interventions are continuously investigated and explored with substantial progress, thanks to advances in basic understanding and translational efforts. Extracellular vesicles (EVs) offer a new paradigm in diagnosis and treatment. This leads to two significant implications: new disease biomarker discovery that enables reliable diagnosis and disease assessment and the development of regenerative medicine therapeutics that target fibroproliferative processes in diseased lung tissue. In this review, we discuss the current understanding of the role of diseased tissue-derived EVs in the development of interstitial lung diseases, the utility of these EVs as diagnostic and prognostic tools, and the existing therapeutic utility of EVs. Furthermore, we review the potential therapeutic application of EVs derived from various cellular sources.

Exploring the status and views of managed entry agreements in Saudi Arabia: mixed-methods approach.

BACKGROUND: Healthcare payers are increasingly adopting managed entry agreements (MEAs) between themselves and manufacturers, to overcome the challenge of sustaining access in an era of innovative and high-cost medicines. This study aims to investigate current MEA activity in Saudi Arabia and explore the challenges encountered when implementing such agreements. METHODS: An explanatory sequential mixed-methods approach was used. Quantitative data on MEAs were collected, followed by qualitative semi-structured interviews with different stakeholders. RESULTS: Our questionnaire garnered responses from 18 pharmaceutical companies from 3 different continents and identified 25 agreements in Saudi Arabia since 2010. Financial-based agreements were more prevalent than outcomes-based agreements at 44% versus 32%, respectively. Stakeholders showed positive attitudes toward MEAs, valuing their benefits in facilitating market access for both costly and innovative medicines. The main challenges included data availability, administrative and financial burden, lack of expertise, confidentiality, and lack of clear regulations. CONCLUSIONS: Despite clear implementation challenges, a growing tendency toward MEAs exists in Saudi Arabia because of the potential benefits they bring to patients, healthcare providers, payers, and manufacturers. It is believed that the newly established health technology assessment center in Saudi Arabia will bring more clarity and shape the concept of MEAs in the country.

Engineered Fibroblast Extracellular Vesicles Attenuate Pulmonary Inflammation and Fibrosis in Bleomycin-Induced Lung Injury.

Pulmonary fibrosis is a progressive disease for which no curative treatment exists. We have previously engineered dermal fibroblasts to produce extracellular vesicles with tissue reparative properties dubbed activated specialized tissue effector extracellular vesicles (ASTEX). Here, we investigate the therapeutic utility of ASTEX in vitro and in a mouse model of bleomycin-induced lung injury. RNA sequencing demonstrates that ASTEX are enriched in micro-RNAs (miRs) cargo compared with EVs from untransduced dermal fibroblast EVs (DF-EVs). Treating primary macrophages with ASTEX reduced interleukin (IL)6 expression and increased IL10 expression compared with DF-EV-exposed macrophages. Furthermore, exposure of human lung fibroblasts or vascular endothelial cells to ASTEX reduced expression of smooth muscle actin, a hallmark of myofibroblast differentiation (respectively). In vivo, intratracheal administration of ASTEX in naïve healthy mice demonstrated a favorable safety profile with no changes in body weight, lung weight to body weight, fibrotic burden, or histological score 3 weeks postexposure. In an acute phase (short-term) bleomycin model of lung injury, ASTEX reduced lung weight to body weight, IL6 expression, and circulating monocytes. In a long-term setting, ASTEX improved survival and reduced fibrotic content in lung tissue. These results suggest potential immunomodulatory and antifibrotic properties of ASTEX in lung injury.

Clinical and epidemiological characteristics of road traffic accidents patients received at 2 intensive care units in Saudi Arabia-A cross-sectional study.

BACKGROUND: Road traffic accidents (RTAs) lead to major trauma, which is the greatest cause of morbidity and mortality worldwide. The purpose of the study was to determine the clinical epidemiological profiles of the patients received in intensive care units (ICU) with road traffic injuries (RTIs). METHODS: The study, which included 300 patients, was conducted at emergency departments and two reference ICUs in Saudi Arabia. The patients were of varying ages and genders from different demographic backgrounds with different modes of injuries, varying degrees of shock, and multiple types of injury. Study variables included demographics, clinical presentations, and the types of fractures and lacerations. RESULTS: Most of our study population was male (n = 273; 91%). Car accidents were found to be the prevalent cause of injury (n = 267; 89.0% cases). Only 21.7% of the study population (n = 65) needed ICU admission compared to non-ICU patients (n = 235; 78.3%). Injuries to the chest (P = 0.0001), abdomen (P = 0.0001), upper limbs (P = 0.022), and spine (P = 0.001) significantly contributed to ICU admissions. CONCLUSION: The burden on ICUs due to RTIs can be reduced in Saudi Arabia by adopting strict preventive measures against RTAs.

Public Knowledge, Attitudes, and Practice towards COVID-19 Pandemic in Saudi Arabia: A Web-Based Cross-Sectional Survey.

(1) Background: COVID-19 has become a worldwide public health problem. No previous study has investigated factors associated with COVID-19 knowledge, attitude, and practice (KAP) after completely lifting the curfew in all Saudi Arabia regions and cities. Therefore, adequate knowledge, a positive attitude, and correct control of COVID-19 are essential to eradicate the disease. Hence, this study aims to assess factors associated with KAP of COVID-19; (2) Methods: This cross-sectional web-based survey was performed with the participation of 4305 individuals aged over 15 years living in Saudi Arabia from 11 to 19 August 2020. They were included using the snowball sampling method; (3) Results: Of the 4305 participants, 94.9% were Saudis, 60% females, and 45.4% were in the age group of 20-34 years, 61.7% married, and 49.3% from the Eastern Province of Saudi Arabia. Most of the participants demonstrated good KAP levels (89.6%, 87.2%, and 87.2%) towards the COVID-19 pandemic, respectively. In addition, most of the participants (85.8%) used the internet and social media as a source for COVID-19 information (4) Conclusions: The finding showed that most of the participants demonstrated good knowledge of COVID-19, positive attitudes, and demonstrated good practices for preventing the spread of disease infection.

Think Melkersson-Rosenthal Syndrome: A Fissured Tongue With Facial Paralysis.

Melkersson-Rosenthal syndrome (MRS) was first described and named after E. Melkersson in 1928 and C. Rosenthal in 1931. MRS is a rare cause of recurrent facial nerve palsy and can manifest as facial paralysis, orofacial edema, and/or tongue fissuring. Presenting with the complete triad, it was scarcely reported in literature. However, the patient reported here had the complete triad. MRS should be considered when facial paralysis is recurrent or when it presents with orofacial edema, and/or tongue fissuring.

What local experts expect from a health technology assessment (HTA) entity in Saudi Arabia: workshop conclusions.

Objectives: Saudi Arabia is undergoing a massive health-care transformation to fulfill its new, national 'Vision 2030.' To align with this objective, Saudi Arabia is establishing a new, independent and evidence-based health technology assessment (HTA) entity to help it maximizes health gains through efficient use of resources. This study was designed to ascertain how local experts perceive the creation of such a national HTA entity in Saudi Arabia; what they think about it and expect from it.Methods: To achieve study aim, we held two workshops in Riyadh, Saudi Arabia, each lasting three and a half hours and each hosted by the Saudi Ministry of Health (MOH). We invited 26 local experts from a variety of professional backgrounds to discuss the establishment of a national HTA entity.Results: The findings from experts workshops were structured around four axes, namely vision and remit; services provided and technologies covered; process and method; and implementation and practical considerations.Conclusion: This paper discusses the findings of the local experts convened at the workshops relative to their expectations for and views about a national HTA entity within Saudi Arabia.

A descriptive online survey about the knowledge of palliative care residents of Saudi Arabia has compared to the general worldwide population.

OBJECTIVES: To assess communities' basic knowledge of palliative care by developing a questionnaire. METHODS: This prevalence study, an anonymous online questionnaire, was answered by 326 individuals living throughout Saudi Arabia over one month. The questions concerned the basic principles and knowledge of palliative care. We collected the data between February and May 2019. RESULTS: The results showed that 72% of the respondents had neither heard nor knew about palliative care. Those who know about palliative care assess their knowledge as the following: 17.8% of the respondents reported that they knew the meaning and could explain it to others. As well, 10.5% knew the meaning but could not explain it to others; 9.3% had heard of it but did not know the meaning, and 62.4% had never heard of it. CONCLUSION: The research showed that there is a lack of knowledge about palliative-care among the population of Saudi Arabia. Data shows that there should be more efforts toward providing the community with better knowledge about palliative care.

Monoanionic bis(carbene) pincer complexes featuring cobalt(I-III) oxidation states.

The synthesis and characterization of a series of cobalt complexes featuring a pincer bis(carbene) ligand of the meta-phenylene-bridged bis-N-heterocyclic carbene ((Ar)CCC, Ar = 2,6-diispropylphenyl or mesityl) are reported. Cleavage of the aryl C-H bond of the ligand was achieved in a one-pot metalation procedure using Co(N(SiMe3)2)2(py)2, an equivalent of exogenous base, and trityl chloride to form the ((DIPP)CCC)CoCl2py complex. This species could be reduced to the Co(ii) and Co(i)-N2 molecules with the appropriate equivalents of reductant. Subsequent generation of ((Mes)CCC)Co(I-III) derivatives with the mesityl ligand proceeded in good yields. A suite of characterization techniques and the interconversion between all three oxidation states of the cobalt complexes is described.

Nanoparticle formulation by Büchi B-90 Nano Spray Dryer for oral mucoadhesion.

Diabetes is considered one of the main threats to global public health in this era. It is increasing rapidly in every part of the world; the prevalence of the disease will grow to the point where 366 million people will be affected by 2030. The prevalence of diabetes mellitus (DM) in the Saudi population is high, and the majority of patients suffer from type 2 DM. Marketed oral antidiabetic drugs have indicated poor tolerability during chronic treatments, and this contributes to the moderately large proportion of type 2 DM patients that remain inadequately managed. Vildagliptin nanospheres were prepared with aminated gelatin using a spray-drying method; narrow particle-size distribution was seen at 445 nm. The angle of repose was found to be θ <33.5°. The nanospheres appeared to be spherical with a smooth surface. The drug content and percentage yield of the nanospheres were found to be 76.2%±4.6% and 83%±2%, respectively. The nanosphere-swell profile was found to be 165%±7%. The pure drug was 100% dissolved in 30 minutes, and the nanosphere formulation took 12 hours to dissolve (97.5%±2%), and followed a Korsmeyer-Peppas kinetic model with an R (2) of 0.9838. The wash-off test of nanospheres found that they exhibited an excellent mucoadhesive property at 86.7% for 8 hours. The stability-study data showed no changes in the physicochemical properties of the nanospheres, and suggested that the nanospheres be stored below room temperature. The amount of vildagliptin retained was 1.6% within 3 hours, and in comparison with the gelatin vildagliptin nanoparticles formulation, the percentage that was retained was much higher (98.2% in 12 hours).