Nicotine acute impact on RNFL: a comparative analysis of smoking cessation aids including nicotine gum and electronic cigarettes.

PURPOSE: To investigate the immediate impact of nicotine consumption on Retinal Nerve Fiber Layer (RNFL) thickness in healthy young individuals, comparing nicotine gum and electronic cigarette (vaping) as delivery methods. MATERIALS AND METHODS: Twenty participants underwent RNFL measurements at baseline, 30, and 60 minutes after consuming 4 mg of nicotine, based on product labeling and specifications. Measurements were obtained using optical coherence tomography (OCT) (Topcon 3D OCT-1 Maestro System). Nicotine was delivered through either nicotine gum or vaping. RESULTS: Both nicotine gum and vaping led to a statistically significant increase in RNFL thickness, with no significant difference between the two methods. The analysis revealed that area, time, and visit factors significantly affected RNFL scores. Stratification by smoking type (tobacco, vaping, dual) demonstrated significant effects for area, time, and visit factors, with an interaction effect among these factors. CONCLUSIONS: The findings highlight the acute impact of nicotine intake on RNFL thickness in young healthy smokers. Researchers and clinicians should account for recent nicotine exposure when evaluating RNFL thickness, particularly within the first hour post-smoking. The observed significant effects warrant further research, especially in older or health-compromised populations, to improve clinical protocols and diagnostic evaluations across different demographics.

Assessing acute nicotine impact on choroidal thickness: a randomized, double-blinded study comparing smoking cessation aids, including nicotine gum and electronic cigarettes.

PURPOSE: To explore whether differences in choroidal thickness arise from nicotine consumption in healthy young individuals, specifically comparing the effects of nicotine gum to electronic cigarette (vaping), while maintaining a consistent 4 mg nicotine dosage. METHODS: In a randomized double-blinded prospective cross-sectional study, 20 healthy participants (mean age ± standard deviation: 23 ± 2.36 years) were randomly assigned to either the nicotine gum or vaping group. Choroidal thickness (ChT) measurements were conducted using optical coherence tomography (OCT) (Topcon 3D OCT-1 Maestro System) at baseline, 30, and 60 min after ingesting 4 mg of nicotine, with ChT measurements taken from five different horizontal areas. RESULTS: Neither the nicotine delivery method (gum or vaping) demonstrated a statistically significant impact on ChT mean scores among subjects in the five measured areas at baseline, 30, and 60 min (p > 0.05). However, significant differences were observed in ChT mean scores within subjects across the five areas (F (1.83, 72) = 36.43, p < 0.001), regardless of other study factors such as group, time, and visit (p > 0.05). A statistically significant interaction was identified between the factors of area and time concerning participants' ChT mean scores when stratified by the type of smoking (tobacco, vaping, and dual) (p = 0.003). CONCLUSION: The results of this study revealed that nicotine, up to particular concentration of 4 mg, does not have a statistically significant vasoconstrictive effect on choroidal thickness, regardless of the delivery method, within the examined group. These findings offer valuable insights into the relationship between nicotine intake and choroidal dynamics in young adults.

Knowledge, attitude, and beliefs toward group behavior therapy programs among male adults attending smoking cessation clinics, cross-sectional analysis.

BACKGROUND: Group therapy assists individuals in learning many behavioral techniques for smoking cessation and providing each other with mutual support. Group behavior therapy is not routinely provided as a modality of tobacco cessation assistance in tobacco cessation clinics in Saudi Arabia despite it is effectiveness. Therefore, this study aimed to assess the knowledge, attitude, and beliefs toward group behavior therapy programs among male adults who attend smoking cessation clinics and to identify the associated factors. METHODS: A cross-sectional study was conducted with a targeted sample of 229 males aged 18 and above who were attending smoking cessation clinics. The participants were randomly selected. Data were collected using a paper-based questionnaire. One-way ANOVA and chi-square test were used for statistical analysis. RESULTS: Results showed a high percentage of the study participants were in the age group of 21-40 years. Most of them were consuming 10-20 cigarettes per day. Around 79% of the participants had previous attempted to quit smoking. This study demonstrated a deficit in knowledge about group behavior therapy. The mean score for attitude and beliefs was 5.3 out of 11. Multiple factors influenced their attitudes and beliefs, such as previous attempts to quit smoking (p-value < 0.05) and the number of cigarettes used per day (p-value = 0.03). The knowledge was found to be affected by the level of education (p-value = 0.04). CONCLUSION: The study demonstrates a deficit in knowledge about group behavior therapy and it shows that the level of education was associated with the knowledge. Additionally, previous attempts to quit smoking and the number of cigarettes used per day, influenced the participants' attitude and beliefs toward group behavioral therapy. Increase awareness about the role of group behavior therapy in smoking cessation is required before this method is implemented in the routine practice.

Reduction of severe intraventricular hemorrhage, a tertiary single-center experience: incidence trends, associated risk factors, and hospital policy.

OBJECTIVES: To determine the incidence, trends, maternal and neonatal risk factors of severe intraventricular hemorrhage (IVH) among infants born 24-32 weeks and/or < 1500 g, and to evaluate the impact of changing of hospital policies and unit clinical practice on the IVH incidence. STUDY DESIGN: Retrospective chart review of preterm infants with a gestational age (GA) of 24-326 weeks and/or weight of < 1500 g born at King Abdulaziz Medical City-Riyadh (KAMC-R), Saudi Arabia, from 2016 to 2018. Multivariate logistic regression model was constructed to determine the probability of developing severe IVH and identify associations with maternal and neonatal risk factors. RESULTS: Among 640 infants, the overall incidence of severe IVH was 6.4% (41 infants), and its rate decreased significantly, from 9.4% in 2016 to 4.5% and 5% in 2017 and 2018 (p = 0.044). Multivariate analysis revealed that caesarian section delivery decreased the risk of severe IVH in GA group 24-27 weeks (p = 0.045). Furthermore use of inotropes (p = 0.0004) and surfactant (p = 0.0003) increased the risk of severe IVH. Despite increasing use of inotropes (p = 0.024), surfactant therapy (p = 0.034), and need for delivery room intubation (p = 0.015), there was a significant reduction in the incidence of severe IVH following the change in unit clinical practice and hospital policy (p = 0.007). CONCLUSION: Cesarean section was associated with decreased all grades of IVH and severe IVH, while use of inotropes was associated with increased severe IVH. The changes in hospital and unit policy were correlated with decreased IVH during the study period.

The effect of age on lens parameters and axial length among wide age range of Saudis: A prospective, cross-sectional study.

PURPOSE: The purpose of the study is to establish normative values of eye parameters such as lens thickness (LT), lens diameter (LD), and axial length (AXL) among wide age range of Saudis using Pentacam AXL and compare these values between gender, in addition to that, to find the correlation between the age and those parameters. METHODS: In this prospective cross-sectional study, we measured LT, LD, and AXL in 125 healthy Saudi controls aged between 8 and 60 years using OCULUS Pentacam AXL. The screening tests were performed for each subject to exclude any ocular abnormalities using slit lamp (Haag-Streit BQ 900), refractive error measured using auto refractometer (Topcon KR-1 Autorefractor/Keratometer), and subject who has spherical equivalent more than ± 4.00D and astigmatism more than 1.00DC was excluded from the study. The mean of three readings of LT, LD, and AXL was taken. All examination was applied on one eye (right eye). RESULTS: The overall mean and standard deviation of LT, LD, and AXL was 2.2 mm ± 0.5, 2.7 mm ± 0.6, and 23.8 mm ± 1.0, respectively. There was no statistically significant difference between males and females in these parameters in all age groups, except in Group 2 (age: 19-30 years), there was a statistically significant difference between males and females in AXL, mean difference (M = 0.48), and P = 0.015. The mean of LT and LD was negatively associated with age. However, there was no significant correlation between AXL and age. CONCLUSION: Normative values of LT, LD, and AXL have been established in wide age group of healthy Saudis; the findings of the present study can highlight not only the normal range of the different ocular parameters, namely LT, LD, and AXL, but also their variation with age and gender.

Variations in choroidal thickness between emmetropic and myopic eyes after caffeine intake.

PURPOSE: To investigate the variations in choroidal thinning between emmetropic and myopic subjects after caffeine intake. METHODS: Forty-five healthy participants (age mean ± standard deviation [SD]: 20.75 ± 1.6 years) recruited in a prospective cross-sectional study. They were divided into three groups, based on refractive error status, emmetropes (spherical equivalent [SE] -0.25 to +0.25D), myopes (SE ≥-0.50D to ˂-6.00D), and high myopes (SE ≥-6.00D). The participants underwent choroidal thickness [ChT] measurements using optical coherence tomography [OCT] (Topcon 3D OCT-1 Maestro System) at baseline, 20, 40, and 60 minutes after consuming 200 mg of caffeine. The measurements of ChT were taken from five different areas horizontally. RESULTS: Compared to baseline measurement, the ChT significantly decreased after 200 mg caffeine intake in all conditions ( P < 0.001). There was a statistically significant difference in ChT at baseline between the refractive groups ( χ2 (2)=6.548, P = 0.038) as the high myope group showed lesser horizontal ChT within Nasal at (1 mm) area compared to the myope group ( P = 0.032), however, no other significant differences in mean scores of horizontal ChT at baseline were found. The thinning in ChT in the high myope group was lesser compared to both emmetrope and myope groups; however, it was not statistically significant ( P > 0.05). CONCLUSION: The results of this study suggest that the reduction in ChT due to caffeine consumption is not significantly affected by the refractive status of the eye. Thus, it is safe to hypothesize that the vascular part of the choroid behaves identically to vasoconstrictive in both emmetropic and myopic eyes. The choroidal thinning found in myopic and high myopic eyes and/or the reduced choroidal vascularity index were not apparent in this study. Therefore, further longitudinal studies recruiting greater numbers of participants, including myopes and high myopes, and measuring both vascular and stromal layers to investigate such variations are warranted.

Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes: a pilot study.

AIM: To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters. METHODS: This study enrolled 48 healthy participants aged 20-35y (both males and females). Clinical assessment included the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer pattern (LLP). Based on these initial results, participants were categorized as either non-dry eye or dry eye. Participants in each group were randomly allocated to either Blephaclean® or Systane® treatments. Changes in NITBUT, TMH, and LLP levels before and after lid wipe treatment were assessed. RESULTS: The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group (P<0.001). Following the application of eyelid wipes (Systane® wipes), dry eye subjects experienced a significant improvement in NITBUT levels (P=0.0014) compared to the non-dry eye individuals. Although the remaining participants showed a marginal increase in TMH and NITBUT levels, these changes did not achieve statistical significance (P>0.05). Similarly, the LLP levels were significantly improved with Systane® (P<0.001) post-treatment compared to individuals in the non-dry eye group. However, the dry eye subjects showed higher post-treatment LLP levels than the untreated group (P<0.02). CONCLUSION: The short-term effects of Systane® eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease. Nonetheless, further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

COVID-19 vaccine rejection causes based on Twitter people's opinions analysis using deep learning.

According to the World Health Organization, vaccine hesitancy was one of the ten major threats to global health in 2019, including the COVID-19 vaccine. The availability of vaccines does not always mean utilization. This is because, people have less confidence in vaccines, which resulted in vaccination hesitancy and developing global decline in vaccine intake and has caused viral disease outbreaks worldwide. Therefore, there is a need to understand people's perceptions about the COVID-19 vaccine to help the manufacturing companies of the vaccine to improve their marketing strategy based on the rejection causes. In this paper, we used multi-class Sentiment Analysis to classify people's opinions from extracted tweets about COVID-19 vaccines, using firstly different Machine Learning (ML) classifiers such as Logistic Regression (LR), Stochastic Gradient Descent, Support Vector Machine, K-Nearest Neighbors, Decision Tree (DT), Multinomial Naïve Bayes, Random Forest and Gradient Boosting and secondly various Deep Learning (DL) models such as Recurrent Neural Network (RNN), Long Short Term Memory (LSTM), Gated Recurrent Unit (GRU), RNN-LSTM and RNN-GRU. Then, we investigated the analysis of the negative tweets to identify the causes of rejection using the Latent Dirichlet Allocation (LDA) technique. Finally, we classified these negative tweets according to the rejection causes for all the vaccines using the same selected ML and DL models. The result of SA showed that DT gives the best performance with an accuracy of 92.26% and for DL models, GRU achieved 96.83%. Then, we identified five causes: Lack of safety, Side effect, Production problem, Fake news and Misinformation, and Cost. Furthermore, for the classification of the negative tweets according to the identified rejection causes, the LR achieved the best result with an accuracy of 89.97%. For DL models, the LSTM model showed the best result with an accuracy of 91.66%.

Comparison between dietary assessment methods and biomarkers in estimating dietary (poly)phenol intake.

Background: although widely used, there is limited understanding of the suitability of different dietary assessment tools to estimate (poly)phenol intake. This study aims to compare the agreement between a food frequency questionnaire (FFQ) and a 7-day food diary (7DD) in assessing (poly)phenol intake and explore their associations with the urinary and plasma (poly)phenol metabolites. Methods: healthy free-living participants aged 18-80 years (n = 413) completed a 7DD and an FFQ (EPIC-Norfolk) and provided a 24 h urine and a fasting plasma sample. A comprehensive in-house (poly)phenol database was used to estimate (poly)phenol intake. The phenolic metabolite levels were analysed using a validated LC-MS method. The agreement between dietary assessment methods and biomarkers were evaluated by intraclass correlation coefficients (ICC), weighted kappa, quartile classification, Bland-Altman plots and correlations. Results: the total (poly)phenol intake estimated from FFQ was higher than from 7DD (median 1463 and 1042 mg d-1, respectively). The agreement between FFQ and 7DD were moderate (ICC 0.51-0.59) for total (poly)phenols, flavan-3-ols, total phenolic acids, hydroxycinnamic acids and alkylmethoxyphenols, and were poor for all the other classes and subclasses (ICC 0.00-0.48). Positive correlations with total urine phenolic metabolites were found in FFQ estimated anthocyanins, dihydroflavonols, total lignans, tyrosols, alkylmethoxyphenols, total phenolic acids, and total stilbenes and the 7DD estimated theaflavins and thearubigins (all FDR adjusted p values < 0.1). No significant correlations were found between total plasma phenolic metabolites and (poly)phenol intake. Conclusion: agreements between dietary assessment tools were moderate for the major classes of (poly)phenols, while agreements between (poly)phenol intake and biomarkers were poor. Future research using biomarker approaches to increase the accuracy of estimating (poly)phenol exposure in larger populations is needed.

Mental Health and Sleep Quality of Healthcare Providers After Partial Relief of COVID-19 in Saudi Arabia: A Cross-Sectional Study.

Purpose: We aimed to assess sleep quality and psychological distress among healthcare workers (HCWs) in the context of mitigated governmental restrictions during COVID-19 pandemic in Saudi Arabia. Methods: This cross-sectional study included 370 HCWs from a single tertiary healthcare institution in Riyadh, Saudi Arabia. Sleep quality and psychological distress were measured using the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety and Stress Scale - 21 (DASS-21). Results: The median stress score for HCWs aged between 20 and 29 years was higher compared to HCWs aged between 30 and 39 years (p=0.002) and HCWs aged between 50 and 59 years (p<0.001). The median anxiety score of the age group between 20 and 29 years was also significantly higher compared to the age groups between 40 and 49 and 50-59 years (all p<0.05). HCWs living with family showed higher anxiety and depression scores compared to those living with non-family members (p=0.006 and p=0.005, respectively). Handling COVID-19 patients on multiple occasions during routine patient care was significantly associated with higher anxiety and depression scores among HCWs. The results also showed higher PSQI scores among younger HCWs (20-29 years) and trainees (all p<0.05). In addition, PSQI correlate significantly with depression (r=0.268) and anxiety (r=0.278) scores of DASS-21 scale (all p<0.001). Conclusion: Poor psychological well-being and sleep quality were observed among certain groups of HCWs, even after the mitigation of COVID-19 restrictions. This study highlights the need for strategies to manage HCWs at risk of developing psychological distress during future catastrophes.

Phenotypic Variability of MEGF10 Variants Causing Congenital Myopathy: Report of Two Unrelated Patients from a Highly Consanguineous Population.

Congenital myopathies are rare neuromuscular hereditary disorders that manifest at birth or during infancy and usually appear with muscle weakness and hypotonia. One of such disorders, early-onset myopathy, areflexia, respiratory distress, and dysphagia (EMARDD, OMIM: 614399, MIM: 612453), is a rare autosomal recessive disorder caused by biallelic mutations (at homozygous or compound heterozygous status) in MEGF10 (multiple epidermal growth factor-like domains protein family). Here, we report two unrelated patients, who were born to consanguineous parents, having two novel MEGF10 deleterious variants. Interestingly, the presence of MEGF10 associated EMARDD has not been reported in Saudi Arabia, a highly consanguineous population. Moreover, both variants lead to a different phenotypic onset of mild and severe types. Our work expands phenotypic features of the disease and provides an opportunity for genetic counseling to the inflicted families.

Quantitative Assessment of Dietary (Poly)phenol Intake: A High-Throughput Targeted Metabolomics Method for Blood and Urine Samples.

Many studies have associated the consumption of (poly)phenol-rich diets with health benefits. However, accurate high-throughput quantitative methods for estimating exposure covering a broad spectrum of (poly)phenols are lacking. We have developed and validated a high-throughput method for the simultaneous quantification of 119 (poly)phenol metabolites in plasma and urine using ultra high-performance liquid chromatography coupled with triple quadrupole mass spectrometry, with a very fast sample treatment and a single run time of 16 min. This method is highly sensitive, precise, accurate, and shows good linearity for all compounds (R2 > 0.992). This novel method will allow a quantitative assessment of habitual (poly)phenol intake in large epidemiological studies as well as clinical studies investigating the health benefits of dietary (poly)phenols.

Risk Factors of Saphenous Vein Insufficiency in Female Patients in Riyadh, Saudi Arabia.

BACKGROUND: Venous reflux most frequently occurs in the great saphenous vein (GSV), which is the most commonly diseased vein and is associated with venous insufficiency and varicose veins. OBJECTIVE: We aimed, in this study, to determine risk factors for saphenous vein insufficiency in female patients in Riyadh, Saudi Arabia. METHODS: This was a retrospective cohort study. Data were collected from the medical records of adult female patients who developed saphenous vein insufficiency at King Abdulaziz Medical City, between 2015 and 2017. RESULTS: A total of 97 subjects participated in the study, 53 patients had saphenous vein reflux while 44 patients did not have reflux. Leg swelling was the only symptom that showed a significant difference between the two groups (p<0.001); patients with reflux had significantly higher rates of endovenous laser therapy (p=0.021). While the same patient group showed significantly lower rates of sclerotherapy compared to patients without reflux (p=0.006). The proportion of hypertension patients without reflux (22.7%) was significantly larger than that of hypertension patients with reflux (1.9%) (p= 0.001). CONCLUSION: More research is encouraged to provide better understanding and management of saphenous vein insufficiency in the Saudi population, especially in females who are at high risk.

Comparative dietary sulfated metabolome analysis reveals unknown metabolic interactions of the gut microbiome and the human host.

The gut microbiome converts dietary compounds that are absorbed in the gastrointestinal tract and further metabolized by the human host. Sulfated metabolites are a major compound class derived from this co-metabolism and have been linked to disease development. In the present multidisciplinary study, we have investigated human urine samples from a dietary intervention study with 22 individuals collected before and after consumption of a polyphenol rich breakfast. These samples were analyzed utilizing our method combining enzymatic metabolite hydrolysis using an arylsulfatase and mass spectrometric metabolomics. Key to this study is the validation of 235 structurally diverse sulfated metabolites. We have identified 48 significantly upregulated metabolites upon dietary intervention including 11 previously unknown sulfated metabolites for this diet. We observed a large variation in subjects based on their potential to sulfate metabolites, which may be the foundation for classification of subjects as high and low sulfate metabolizers in future large cohort studies. The reported sulfatase-based method is a robust tool for the discovery of unknown microbiota-derived metabolites in human samples.