Neuropsychiatric symptoms in post-COVID-19 long haulers.

BACKGROUND: Long haulers have been recently reported after contracting coronavirus disease (COVID-19). In the present study, we aimed to screen for the neuropsychiatric signs detected <1 to >6 months after infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to determine whether vaccination has an effect on them. METHODS: An online survey was conducted among participants who had been diagnosed with laboratory-confirmed SARS-CoV-2 infection. The clinical signs and durations of neuropsychiatric complaints and their correlations to sex, age, severity of COVID-19 signs, and vaccination status were screened. RESULTS: A total of 2218 individuals, including 1358 females and 860 males, with an age range of 12-70 years, submitted their responses. The respondents experienced cognitive dysfunction, mood alteration, depression, tinnitus, sleep disorders, and loss of taste and smell, with prevalence rates ranging from 18.9% (tinnitus) to 63.9% (loss of taste and smell). Of the respondents, 2.2-7.7% confirmed the persistence of symptoms for >6 months. Tinnitus was the least common complaint, and only 2.2% of the study participants had tinnitus for >6 months. Meanwhile, mood alteration persisted for >6 months in 7.6% of the study participants. More respondents who received two doses of BNT162b2 vaccine showed persistent symptoms than those in the other groups. Disease severity and female sex were identified as potential determinants of the development and persistency of such symptoms. CONCLUSION: Post-COVID neuropsychiatric symptoms were present in considerable percentages of the study participants with SARS-CoV-2 infection, persisting for >6 months in up to 7.6% of the participants.

Knowledge, Attitude, and Barriers Influencing Seasonal Influenza Vaccination Uptake.

BACKGROUND: Seasonal influenza is an acute respiratory infection caused by influenza viruses that are highly contagious and circulate in all parts of the world. It gives rise to an estimated 3 to 5 million cases of severe illness and about 250,000 to 500,000 deaths globally each year. Influenza tends to cause epidemics with serious illness and death among high-risk groups such as children aged 5 years and younger, pregnant women, elderly ≥65 years of age, and with chronic medical conditions. According to the Centers for Disease Prevention and Control (CDC), all people who are 6 months old and above are recommended to receive the seasonal influenza vaccine annually. Despite the fact that influenza vaccine is readily available, and the severity of the disease is known to adversely affect the individual's quality of life and well-being, vaccination uptake rates are still low, contributing to the increased burden of the disease worldwide. OBJECTIVES: To measure the influenza vaccine uptake among residents of Riyadh Province, Saudi Arabia, that determines their attitude, knowledge, and beliefs regarding the vaccine. METHODS: A cross-sectional study was conducted using a self-administered structured questionnaire distributed online targeting residents of Riyadh Province, Saudi Arabia, from 1st of August 2019 till 30th of September 2019. Participants were selected through volunteer sampling. The questionnaire included demographic data including age, gender, occupation, education level, marital status, and comorbidities. It also included questions regarding knowledge, attitude, and beliefs regarding influenza vaccine. After collection of data, statistical analyses were conducted by using Statistical Package for Social Sciences (SPSS) version 19.0. A P value of <0.05 was considered statistically significant. RESULTS: Our study included 503 participants, with age ranging from 18 to 65 years old and 324 (64%) were females. 100 participants (19.9%) had comorbid conditions, and 223 (44.3%) have been vaccinated against influenza in the past. A large portion of participants (41.2%) were familiar with seasonal influenza vaccination from the media. The knowledge part of the questionnaire showed that 302 (60%) participants knew how often they should receive the vaccine and 313 (62.2%) participants knew that the vaccine is provided freely in all of Saudi Arabia. In terms of belief and attitude, 371 participants (73.8%) thought they were susceptible to the disease and 365 (73.8%) believed that influenza vaccine is beneficial, while 446 participants (88.7%) thought that the general public need more knowledge and awareness on the scientific facts of influenza vaccine. Regarding barriers, 295 participants (58.6%) wanted to avoid vaccines and 252 (50.1%) were concerned about the vaccine's adverse effects. Participants with frequent health checkups and those who had previous knowledge on the availability of the vaccine for free were more likely to be vaccinated. Vaccinated participants (44.3%) were asked if they were willing to take the vaccine again when it is due, 158 (70.9%) answered yes. Those who elicited symptomatic reaction to the vaccine (26.0%) were less inclined to take it again (P = 0.035). CONCLUSION: We concluded that there is a low influenza vaccine uptake rate among our study population, considering that the barriers most commonly chosen by participants are solvable with health education and campaigns oriented towards delivering facts about the vaccine and dispelling misinformation; such measures are highly recommended and are postulated to carry a great benefit that should target common misconceptions identified in this study.

Correction: Menstrual cycle changes: A cross-sectional study of Saudi females following SARS-CoV-2 infection.

[This corrects the article DOI: 10.1371/journal.pone.0279408.].

The Health Impacts, Prevalence, and Acceptance Level of Cosmetics Interventions Among Females in Saudi Arabia.

Background: With the rising global desire for beauty, cosmetic interventions have increased. Saudi Arabia ranked 29 among the top 30 fastest growing countries for cosmetic procedures. Objectives: This study aims to investigate the prevalence, acceptance level, and health impacts of cosmetic interventions among females in Saudi Arabia. Methods: This cross-sectional study was conducted from December 2022 to January 2023 among females living in Saudi Arabia. Participants' acceptance of cosmetic interventions was assessed using an Arabic version of the validated Acceptance of Cosmetic Surgery Scale. The data were collected using a self-administered questionnaire. Results: The study included 3007 females living in Saudi Arabia. About 58% of the participants were aged 18 to 25, and 72.9% were single. The prevalence of cosmetic interventions among the participants was 10%. A higher prevalence was observed among participants over 25 years, married, high economic status, employed, postgraduate, and participants recognizing the necessity of cosmetic interventions (P < .001). High acceptance levels toward cosmetic interventions were observed among older, married, employed, and postgraduate respondents and those with high economic status (P < .001). Meanwhile, knowing the adverse events of cosmetic interventions was associated with a low level of acceptance with a P-value of <.001. Conclusions: The present study demonstrated a surprising prevalence of cosmetic interventions among females in Saudi Arabia. However, below-average acceptance of these interventions among the same population was reported. This could be a result of the surrounding culture that does not support or encourage undergoing cosmetic interventions. Further studies are recommended to assess the prevalence of those interventions using objective tools, such as medical records.

Quality of Life and Body Mass Index Changes Three Years After Laparoscopic Sleeve Gastrectomy in Taif City, Saudi Arabia.

Background Obesity has become a major global health challenge, and its prevalence has tripled in the last four decades. Impaired quality of life (QoL) is a strong incentive for severely obese patients to seek help. Sleeve gastrectomy (SG) is the most frequently practiced bariatric procedure worldwide. This study aimed to investigate the QoL and changes in body weight three years post laparoscopic SG. Methods A cross-sectional, observational study was performed in outpatient clinics in Taif city, Saudi Arabia. The study included 147 adult patients who underwent SG at least three years before inclusion in the study. Data were collected using a questionnaire designed based on the validated Bariatric quality of life (BQL) and Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQoL) surveys. Results All patients were suffering from class I, class II, or class III obesity before undergoing SG. Three years post-surgery, 72.8% reached their normal weight or were overweight (P<0.001). The mean± SD BMI (45± 7.0 kg/m2) significantly decreased to 26.8± 4.6 kg/m2 (P<0.001). Most of the participants (78.2%) achieved an excess weight loss percent (EWL%) of 75% or more. The mean± SD BQL score was 45.5± 5.2 points and the median (IQR) GERD-HRQoL score was 7 (15). Higher EWL% was significantly associated with a higher BQL score (P=0.041). Conclusions The current study revealed a better quality of life among patients experiencing higher rates of excess weight loss percent (EWL%) after three years of sleeve gastrectomy as compared to other patients.

Menstrual cycle changes: A cross-sectional study of Saudi females following SARS-CoV-2 infection.

Temporary changes in the menstrual cycle have recently been reported following SARS-CoV-2 vaccination. In the current study, we aimed to screen menstrual cycle changes following SARS-CoV-2 infection in Saudi Arabia. The type and duration of these changes have been screened in relation to the severity of coronavirus disease symptoms and vaccination status. In total, 956 individuals responded: sixty-nine did not get the COVID-19 vaccine, while the remaining were vaccinated with either a single dose of ChAdOx1 vaccine (n:45) or BNT162b2 vaccine (n: 142) or two doses of the vaccine (n:700) using BNT162b2 (n:477), ChAdOx1 (n:89) or ChAdOx1/ BNT162b2 (n:134). Approximately 26.1% (18/69) of the subjects who did not receive the SARS-CoV-2 vaccine and 15.3% (29/188) and 26.4% (185/700) of the subjects who received single and double doses of the vaccines, respectively, reported menstrual cycle changes. The persistence of menstrual cycle changes for more than six months was reported by 6.4% (61/956) of the participants. These changes were significantly correlated with the severity of COVID-19 infection. We concluded that menstrual cycle changes, associated with COVID-19 infection, increase due to the severity of COVID-19 infection. Thus, menstrual cycle changes are among the long-term effects associated with COVID-19 infection.

Reproducibility of shear wave elastography among operators, machines, and probes in an elasticity phantom.

PURPOSE: This study was aimed to investigate the reproducibility of shear wave elastography (SWE) among operators, machines, and probes in a phantom, and to evaluate the effect of depth of the embedded inclusions and the accuracy of the measurements. METHODS: In vitro stiffness measurements were made of six inclusions (10, 40, and 60 kPa) embedded at two depths (1.5 cm and 5 cm) in an elastography phantom. Measurements were obtained by two sonographers using two ultrasound machines (the SuperSonic Imagine Aixplorer with the XC6-1, SL10-2 and SL18-5 probes, and the General Electric LOGIQ E9 with the 9L-D probe). Variability was evaluated using the coefficient of variation. Reproducibility was calculated using intraclass correlation coefficients (ICCs). RESULTS: For shallow inclusions, low variability was observed between operators (range, 0.9% to 5.4%). However, the variability increased significantly for deep inclusions (range, 2.4% to 80.8%). The measurement difference between the operators was 1%-15% for superficial inclusions and 3%-43% for deep inclusions. Inter-operator reproducibility was almost perfect (ICC>0.90). The measurement difference between machines was 0%-15% for superficial inclusions and 38.6%-82.9% for deep inclusions. For superficial inclusions, the reproducibility among the three probes was excellent (ICC>0.97). The mean stiffness values of the 10 kPa inclusion were overestimated by 16%, while those of the 40 kPa and 60 kPa inclusions were underestimated by 42% and 48%, respectively. CONCLUSION: Phantom SWE measurements were only reproducible among operators, machines, and probes at superficial depths. SWE measurements acquired in deep regions should not be used interchangeably among operators, machines, or probes.

Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine.

BACKGROUND: Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines. OBJECTIVES: Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening. DESIGN: Analytical, cross-sectional. SETTING: Ultrasound department at a large tertiary care hospital in Riyadh. PATIENTS AND METHODS: Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility. MAIN OUTCOME MEASURE: Inter-system and intra- and inter-operator ICCs. SAMPLE SIZE: 114 males with repeated measurements by second operator on a subset of 35 participants. RESULTS: The median age (interquartile range) of participants was 68 years (62-74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, P=.007) and the Butterfly device (ICC=0.467, P=.037). The inter-system ICCs (95% CI) were 0.818 (0.736-0.874) and 0.879 (0.799-0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD (P=.34). CONCLUSIONS: Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening. LIMITATIONS: No cases of abdominal aortic aneurysm in the sample and lack of blinding. CONFLICT OF INTEREST: None.

Rivaroxaban Experience at Tertiary Care Centre in Saudi Arabia:A Retrospective Observational Study.

BACKGROUND: Atrial fibrillation (AF) and Venous Thromboembolism (VTE) are significant causes of morbidity and mortality. Direct oral anticoagulants (DOACs) are as effective as vitamin K antagonists (VKAs) with a propensity to cause less major bleeding. This study aimed to assess the safety and effectiveness of rivaroxaban in routine clinical practice in a large tertiary referral center in Saudi Arabia. MATERIALS AND METHODS: In this study, patients who received rivaroxaban at a tertiary referral hospital were included in this study. All adverse events were recorded, including major bleeding, non-major bleeding events, symptomatic thromboembolic events (deep vein thrombosis, pulmonary embolism) and all-cause death. RESULTS: A total of 509 patients were prescribed rivaroxaban during the study period. The most common indication for rivaroxaban was non-valvular AF (65.3%) and VTE (34.7%). The mean age was 60.4 ± 16.4 years, and 50.8% were female. The median CHA2DS2-Vasc score was 2.1 in patients on rivaroxaban for non-valvular AF. Bleeding occurred in 72 (14.1%) patients, of which 20 (3.9%) had major bleeds. Thrombosis events occurred in 13 (2.5%) patients in the overall cohort. Fourteen (2.7%) patients died during the study, including a case of fatal bleeding secondary to rivaroxaban. CONCLUSION: This study describes the use of rivaroxaban in a broad patient population in clinical practice in the Middle East. The overall bleeding and thrombosis rates in this study were comparable to those seen in major clinical trials.

Possible Protective Role of Panax Ginseng on Cisplatin-Induced Hepatotoxicity in Adult Male Albino Rats (Biochemical and Histological Study).

BACKGROUND: Cisplatin is one of the most effective chemotherapy antineoplastic drugs. Panax ginseng is a well-known medicinal herb and has a long history of medicinal use as a tonic to promote health. AIM: This work aimed to study the effect of ginseng on the liver damage induced by cisplatin in rats. It included biochemical and histological investigations. MATERIALS AND METHODS: Twenty adult rats were divided into four equal groups. Group I served as control. Group II received ginseng orally (100 mg/kg/day) for 4 weeks. Group III animals were injected intraperitoneally with cisplatin in three equal doses (each 3.3 mg/kg) daily for 3 consecutive days. Group IV animals received ginseng together with cisplatin by the same previously mentioned methods and doses. Rats were sacrificed after 4 weeks, and blood samples and liver tissues were collected for biochemical and histological examinations. RESULTS: Cisplatin-induced liver damage manifested biochemically by an increase in serum alanine aminotransferase and aspartate aminotransferase. Histologically, hepatocytes appeared with vacuolated cytoplasm and small dark-stained nuclei with dilatation of blood sinusoids as well as marked accumulation of collagen fibers around enlarged portal tracts. Administration of ginseng together with cisplatin improved the hepatic dysfunctions and damage caused by cisplatin. CONCLUSION: Ginseng has a protective role in the amelioration of cisplatin-induced hepatotoxicity.

Prevalence of short sleep duration and effect of co-morbid medical conditions - A cross-sectional study in Saudi Arabia.

BACKGROUND: Sleep is crucial to human's health and essential for a person's wellbeing. It is involved in multiple physiological mechanisms, such as metabolism, appetite regulation, immune and hormone function, and cardiovascular systems. The National Sleep Foundation recommends 7-9 h of sleep each night for adults. Short (<7 h) and long (<9 h) sleep duration has been reported to be associated with increased risk of morbidity and mortality. AIM: 1) To assess the prevalence of short sleep durations among Saudi adult population. 2) To examine comorbid medical condition's association with short sleep duration. METHODS: A nation-wide quantitative cross-sectional study using an online self-administered constructed questionnaire during the period from August to October 2018 was conducted. The questionnaire included demographic characters, such as age, gender, education level, height, and weight. As well as some of the participants' habits such as consuming coffee and/or tea, smoking status, and other habits known to be associated with shorter sleep hours. The questionnaire also included self-reported duration of sleep and history of diagnosed medical illnesses. RESULTS: The study included 805 adult Saudi participants with ages ranging from 15- to 60-year old and mean age of 21.8 ± 10.7-year old. About 63% of the participants were females. It was established that almost half 49.6% of the participants sleep for <7 h daily, and 39.3% of them sleep for 7-9 h. CONCLUSION: About half of Saudi adults do not get enough hours of sleep. Especially, people who are married, above 30-year old, students or tea drinkers (P < 0.05): furthermore, people with medical comorbidities such as anxiety, depression, and insomnia had a higher association with short sleep duration. Last, sleep deprivation adversely affects the physical wellbeing and quality of life of participants, demonstrated in bad mood, somnolence, and tiredness during the day time.

Prevalence and risk factors of gastroesophageal reflux disease among Shaqra University students, Saudi Arabia.

INTRODUCTION: Gastroesophageal reflux disease (GERD) is one of the most common chronic gastrointestinal disorders in adults, it develops when the stomach contents reflux and rise up into the esophagus as a result from lower esophageal sphincter dysfunction. Stomach acid that touches the lining of the esophagus causes symptoms and complications. The classical symptoms of GERD include heartburn, usually after eating, chest pain, and regurgitation. AIM: To measure the prevalence of gastroesophageal reflux disease and determine its risk factors among the students of Shaqra University. METHODS: A cross-sectional study was conducted using a structured questionnaire distributed among Shaqra University students after multistage stratification and random sampling technique to stratify students according to gender and the three main colleges in Shaqra city, Saudi Arabia. The sample size was determined to be 435 with the precision of ± 5% and a 95% confidence interval (CI). The questionnaire included demographic data like age, gender, height and weight, lifestyle, and dietary habits. Statistical data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16. Results with a P value of <0.05 were considered statistically significant. RESULTS: A total of 400 [227 (56%) male and 173 (43%) female] participants were evaluated. And 95 participants got a gastroesophageal reflux disease questionnaire score of ≥8 thus determining the prevalence of GERD to be 23.8%. Univariate analysis revealed that gender, smoking, familial history of GERD, high body mass index (>25 kg/m2), fast food, tea, carbonated beverages consumption, quick eating, and sleeping within 1 hour of dinner are associated with symptomatic GERD (P < 0.05). CONCLUSION: The results show a high prevalence of GERD in Shaqra university students and the presence of many modifiable risk factors which merits the conduction of public health campaigns to raise awareness about the disease and its risk factors.