Postprandial fasting related headache during Ramadan in Saudi Arabia: A cross-sectional study.

BACKGROUND: Headache disorders are classified as primary or secondary; however, among the secondary headaches, those attributed to food ingestion are not well understood. Therefore, we conducted this study to describe and characterize a new headache entity that occurred during the holy month of Ramadan. This headache occurred within 4 h of breaking the fast. METHODS: This is a nationwide descriptive community-based cross-sectional study conducted during the last 10 days of Ramadan, based on a random sample of adults living in Saudi Arabia. The demographic data, headache symptomatology, nature and distribution of the pain, possible triggering and relieving factors, and patient management programs were analyzed. RESULTS: Completed questionnaires were obtained from 16,031 participants. Of those, 3147 (19.6%) reported headaches after breaking the fast in Ramadan. In 84.1% of cases, there was no previous diagnosis of headache or migraine. The characteristics of these postprandial fasting-related headaches mostly was episodic in nature (72%). The nature of the headache was variable, mostly heaviness or tightness (53.9%). Triggering factors included ingestion of fried food in (45%) and coffee (26.3%). Lying down and sleeping was found to be an important relieving factor (61%). CONCLUSION: A new headache entity is being described. Appears to be quite common, occurs less than 2 h following the first meal, and is mostly of the heaviness and tension type.

Community Pharmacy Staff Knowledge, Opinion and Practice toward Drug Shortages in Saudi Arabia.

Drug shortages continue to pose a significant threat to public health and safety. Drug shortages not only worsen patient outcomes, but also significantly burden healthcare systems with additional costs. This study aimed to assess community pharmacy staff knowledge, opinion, and practice toward drug shortages in Saudi Arabia from November 2019 to March 2020. This was a cross-sectional study carried out among 1,008 community pharmacists from Saudi Arabia using a validated, self-administered and Internet-based survey. Analysis was done using chi square and fisher exact tests. Most participants were males (97.2%), less than 30 years old (48.1%), and non-Saudi citizens (94.4%), and 72.0% had good knowledge of drug shortages (score = 4-5). Around 36.0% reported that it takes 1-3 days to receive a response to the shortage report. There was a statistically significant association between the professional level of the community pharmacists and their opinion about reporting drug shortages (P < .05). Most community pharmacies (56.2%) did not receive any notification about drug shortages. In conclusion, most community pharmacists are knowledgeable and have good practice regarding drug shortages, but their opinions about drug shortages differ according to each pharmacy reporting policy.

Gender Differences in Preoperative Opioid Use in Spine Surgery Patients: A Systematic Review and Meta-analysis.

OBJECTIVE: Opioids are frequently used in spine surgeries despite their adverse effects, including physical dependence and addiction. Gender difference is an important consideration for personalized treatment. There is no review assessing the prevalence of opioid use between men and women before spine surgeries. DESIGN: We compared the prevalence of preoperative opioid use between men and women. SETTING: Spine surgery. SUBJECTS: Comparison between men and women. METHODS: PubMed, Embase, and Cochrane were searched from inception to November 9, 2018. Clinical characteristics and prevalence of preoperative opioid use were collected. Where feasible, data were pooled from nonoverlapping studies using random-effects models. RESULTS: Four studies with nonoverlapping populations were included in the meta-analysis (one prospective, three retrospective cohorts). The prevalence of preoperative opioid use was 0.64 (95% CI = 0.40-0.83). Comparing men with women, no statistically significant difference in preoperative opioid use was detected (relative risk [RR] = 0.99, 95% CI = 0.96-1.02). Surgery location (cervical, lumbar) and study duration (more than five years or five years or less) did not modify this association. All involved open spine surgery. Only one secondary analysis provided data on both pre- and postoperative opioid use stratified by gender, which showed a borderline significantly higher prevalence of postoperative use in women than men. CONCLUSIONS: The prevalence of opioid use before spine surgery was similar between men and women, irrespective of surgery location or study duration. More studies characterizing the pattern of opioid use between genders are still needed.

Predictors of positive computed tomography pulmonary angiography results.

PURPOSE: Computed tomography pulmonary angiography (CT-PA) is the diagnostic modality used for pulmonary embolism (PE). This study aimed to estimate the positive CT-PA rate and identify the predictors of positive CT-PA results. METHODS: A retrospective observational study was conducted by examining the CT-PA data for ruling out PE in all adult patients who visited the King Fahd Hospital of Imam Abdulrahman Bin Faisal University. The data regarding background demographic information, clinical information, and CT-PA findings were collected from electronic health records. Data were analyzed descriptively using the chi-squared test. Multivariate regression analysis was used to identify the predictors of positive CT-PA results. RESULTS: In total, 548 patients (209 male, 339 female) who underwent CT-PA scans were included. The positive CT-PA rate was 18.8%. The Charlson Comorbidity Index was not significantly associated with positive CT-PA results (p = 0.456). Multivariate logistic regression analysis revealed that smoking (odds ratio [OR] 4.96; 95% confidence interval [95% CI] 2.05-12.02) was an independent factor associated with positive CT-PA results. The CT-PA scans performed in winter and spring were 43% (OR 0.43; 95% CI 0.22-0.84) and 52% (OR 0.52; 95% CI 0.28-0.97) less likely to show positive results compared with those performed in autumn, respectively. CONCLUSION: The positive CT-PA rate varied significantly between seasons. Smoking was a predictor of positive CT-PA results. These findings may assist in developing interventions for improving the utilization of CT-PA scans to avoid unnecessary exposure of patients to radiation. CLINICAL TRIAL REGISTRATION: N/A.

Prevalence of epilepsy in Saudi pregnant women and possible effects of anti-epileptic drugs on pregnancy outcomes.

OBJECTIVE: To determine the prevalence of epilepsy in Saudi pregnant women and estimate the frequency of seizure types in suffering individuals using different anti-epileptic drug modalities. It also aimed to report the teratogenic effects of anti-epileptic drugs as observed in neonates. METHODS: This prospective study was conducted at King Fahd University Hospital from June 2018 to July 2019. Sixty-eight pregnant women diagnosed with epilepsy were included in this study. Seizure types and their frequencies were recorded along with anti-epileptic drug therapies and their association with fetal/neonatal malformations RESULTS: Out of 68 epileptic pregnant females, 30 (44.1%) experienced focal seizures and 38 (55.9%) experienced generalized seizures. Thirty-nine (57.3%) received monotherapy, 21 (30.9%) received polytherapy and 8 (11.8%) did not take antiepileptic drugs during pregnancy. Thirty-six (52.9%) patients experienced no change in seizure frequency during pregnancy, 19 (27.9%) experienced increase in seizure frequency and 13 (19.1%) showed decreased seizure frequency. The pregnancy outcomes analysis showed 2 (2.9%) intrauterine fetal deaths, whereas 4 (4.9%) neonates showed facial and/or organ malformations. CONCLUSION: The frequency of seizures was found to increase in only 27.9% of the pregnant women in the sample. Malformation and mortality rates were higher in fetuses/neonates of patients with generalized seizures. It was observed that for the patient group using monotherapy, the rate of healthy babies was higher than that of the group using polytherapy.

Serum leptin level across different phases of menstrual cycle in normal weight and overweight/obese females.

We compared serum leptin levels during various phases of menstrual cycle and its correlation with serum estradiol between normal weight and overweight/obese young females. Fifty-six young females with normal menstrual cycle were grouped into 26 normal weight and 30 overweight/obese subjects. Serum leptin and estradiol levels were measured during early follicular, pre-ovulatory and luteal phases of menstrual cycle in both groups using ELISA technique. Serum leptin levels were significantly different across different phases of menstrual cycle with a steady increment from follicular phase (9.97 ± 5.48 ng/dl) through pre-ovulatory phase (11.58 ± 6.49 ng/dl) with their peaks in luteal phase (12.52 ± 6.39 ng/dl, p < .001). Same pattern of change during menstrual phases was observed when the normal weight and overweight/obese group were analyzed separately. Serum leptin levels were significantly higher in overweight/obese group compared to normal weight subjects. In any of the study groups, leptin levels were not found to be correlated with estradiol level during different phases of menstrual cycle.

A Comparison of Drug Shortages in the Hospital Setting in the United States and Saudi Arabia: An Exploratory Analysis.

BACKGROUND: Drug shortages are a problem that has been growing in recent years. This problem has an impact on patient outcomes and public health. Most countries have been affected by a diversity of drug supply chain problems. OBJECTIVE: To assess explanations for differences in drug shortages reported in the hospital setting in Saudi Arabia (SA) and the United States (US). METHODS: Data were collected in May-June 2014 from Brigham and Women's Hospital (BWH) and from 2 Saudi hospitals: King Abdulaziz University Hospital (KAUH) and King Faisal Specialist Hospital and Research Centre (KFSHRC). Drugs were classified using the World Health Organization (WHO) Anatomical Therapeutic Chemical (ATC) classification system. The drug shortages among the hospitals were compared using descriptive statistics and a chi-square test. RESULTS: The percentage of the total number of active ingredients reported in shortage was higher in the US hospital setting (15.1%) than in the Saudi hospitals (10.3%) (p < .0001). KAUH reported the highest number of shortages (n = 133), followed by BWH (n = 42) and KFSHRC (n = 27). A significantly higher percentage of shortages involved injectable drugs in the US hospital setting (78.1%) than the Saudi hospitals (34.43%) (p ≤ .0001). Nervous system (17%) and alimentary tract and metabolism agents (15.7%) were the therapeutic areas with the higher number of reported shortages in the US and SA hospital settings, respectively. CONCLUSIONS: The number and characteristics of shortages varied by country and hospital. Several factors, including differences in hospital characteristics, number and type of drugs available, and procurement systems, may explain differences in reported shortages.

Shikonin mitigates cyclophosphamide-induced cardiotoxicity in mice: the role of sirtuin-1, NLRP3 inflammasome, autophagy, and apoptosis.

OBJECTIVES: The aim of this study was to elucidate the protective potential of shikonin (SHK) on cyclophosphamide (CP)-induced cardiotoxicity in Swiss albino mice. METHODS: Mice received SHK in three different doses by oral gavage daily for 14 days and CP at 100 mg/kg, intraperitoneally once on the seventh day. On the 15th day, mice were euthanized, blood collected, and hearts were removed to estimate various biochemical and histopathological parameters. KEY FINDINGS: CP significantly increased serum lactate dehydrogenase, creatine kinase-MB, troponin I and NT pro-BNP, and cardiac malondialdehyde and decreased cardiac total antioxidant capacity and Nrf2, whereas increased inflammatory markers in the cardiac tissues. CP also caused hypertrophy and fibrosis in the cardiac tissues via activation of IL6/JAK2/STAT3 while depressed SIRT1 and PI3K/p-Akt pathway with consequent increased apoptosis and dysregulation of autophagy. SHK treatment reversed these changes in a dose-dependent manner and showed a significant protective effect against CP-induced cardiotoxicity via suppressing oxidative stress, inflammation, and apoptosis with modulation of autophagy via induction of SIRT1/PI3K/p-Akt signaling. CONCLUSIONS: Shikonin may be used as an adjuvant to cyclophosphamide in cancer treatment, but further research is needed to investigate its effects on cardiotoxicity in distinct animal cancer models.

Prospective Matched Case-Control Study of Over-Early P100 Wave Latency in Migraine with Aura.

A sizable portion of the world's population suffers from migraines with aura. The purpose of this research is to describe the findings of a case-control study that was carried out to gain a better understanding of how migraine with aura manifests. The research looked at the P100 delay of the visual-evoked potential in both eyes of 92 healthy people and 44 patients who suffered from migraines with visual aura. All of the participants in the study were recruited from King Fahad University Hospital in Saudi Arabia. Both sets of people had the same ancestry and originated from the same location. Patients who suffered from migraines with aura exhibited a significantly shorter P100 delay in both eyes compared to healthy controls (p = 0.001), which is evidence that their early visual processing was distinct. In order to arrive at these findings, we compared people who suffer from migraines with aura to people who do not suffer from migraines and used them as subjects. These findings contribute to the ongoing attempts to bring the disease under control and provide vitally significant new information regarding the functioning of headaches with auras. The primary focus of study in the future should be on determining the nature of the connection between issues with early visual processing and headaches with aura.

The Prevalence of Anxiety Among Children in Saudi Arabia During the COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: The year 2021 was a year that can be perceived as a stressful event given the considerable lifestyle changes that have occurred worldwide due to the pandemic. Several studies have investigated the psychological impact on people during this time period. However, only a few of them have investigated the impact on young children in Saudi Arabia (SA) specifically. Therefore, this study aimed to investigate the prevalence of anxiety in children living in Jeddah, Saudi Arabia. METHODS: This is a cross-sectional study that included the parents of 388 children aged 6-9 years living in Jeddah, Saudi Arabia. It was conducted from June to November 2021. The parents completed an electronic survey that included the Arabic version of the Spence Children's Anxiety Scale. The data were analyzed using John's Macintosh Project (JMP) software version 10.0 (SAS Institute Inc., Cary, NC). RESULTS: A total of 388 responses were collected. The data revealed that 37 (9.5%) participants experienced anxiety. Furthermore, the prevalence of anxiety was higher among females (5.15%) as compared to males (4.38%), but the difference was not statistically significant. CONCLUSION: These findings highlight the importance of recognizing the psychological burden in young populations and emphasize the importance of taking children's well-being into account.

Generic Substitutions and Therapeutic Interchanges in Hospital Pharmacies: A Qualitative Study from Western Saudi Arabia.

Background: The aim of the present study was to understand hospital pharmacists' views and practices regarding generic substitution and therapeutic interchange. Method: This was a qualitative study involving pharmacists from three Western Saudi governorates: Taif, Makkah, and Jeddah. It included respondents from the Ministry of Health (MoH), military and private hospitals. Pharmacists were selected using a convenient sampling technique and data were collected using a structured face-to-face interview. Results: Fifty-seven pharmacists agreed to participate in this study. In MoH and private hospitals, generic substitution is a pharmacist-initiated act, while therapeutic interchange requires physician approval. Medication unavailability, side effects, patient characteristics, outcomes, and economic status justified most substitution decisions. In military hospitals, both types of substitutions are controlled by an auto-switch policy and physicians should be informed. In all hospitals, there are policies regulating substitution. Medications eligible for interchange mentioned by pharmacists from different hospitals were comparable to some extent. Pharmacists from the private sector considered substitution a supportive economic measure for both hospitals and patients. Most pharmacists highlighted that patient convenience and physician approval are the most challenging situations in substitution practice. Conclusions: An enhanced understanding of substitution and knowledge about medications included in the hospital formulary will be valuable support to the implementation of substitution practice which responds to the patients' needs to improve their outcomes.

Neuroprotective effect of ranolazine improves behavioral discrepancies in a rat model of scopolamine-induced dementia.

Background: Ranolazine (Rn), an antianginal agent, acts in the central nervous system and has been used as a potential treatment agent for pain and epileptic disorders. Alzheimer's disease (AD) is one of the most prevalent neurodegenerative diseases and the leading factor in dementia in the elderly. Aim: We examined the impact of Rn on scopolamine (Sco)-induced dementia in rats. Methods: Thirty-two albino male rats were divided into four groups: control, Rn, Sco, and Rn + Sco. Results: A significant decrease in the escape latency in the Morris water maze test after pre-treatment with Rn explained better learning and memory in rats. Additionally, Rn significantly upregulated the activities of the antioxidant enzymes in the treated group compared to the Sco group but substantially reduced acetylcholinesterase activity levels in the hippocampus. Moreover, Rn dramatically reduced interleukin-1 ß (IL-1ß) and IL-6 and upregulated the gene expression of brain-derived neurotrophic factor (BDNF). Furthermore, in the Sco group, the hippocampal tissue's immunohistochemical reaction of Tau and glial factor activating protein (GFAP) was significantly increased in addition to the upregulation of the Caspase-3 gene expression, which was markedly improved by pre-treatment with Rn. The majority of pyramidal neurons had large vesicular nuclei with prominent nucleoli and appeared to be more or less normal, reflecting the all-beneficial effects of Rn when the hippocampal tissue was examined under a microscope. Conclusion: Our findings indicated that Rn, through its antioxidative, anti-inflammatory, and anti-apoptotic effects, as well as the control of the expression of GFAP, BDNF, and Tau proteins, has a novel neuroprotective impact against scopolamine-induced dementia in rats.

Assessment of dietary magnesium intake in the Eastern Province of Saudi Arabia.

Magnesium is an essential element and the most abundant intracellular cation after potassium. This cross-sectional study assessed the average dietary magnesium intake among residents of the Eastern Province of Saudi Arabia. Data was collected using a self-reported validated electronic questionnaire between April 2022 and July 2023. The first part of the survey included demographic data, and the second section comprised 33 items, including a semi-quantitative tool specifically designed to evaluate magnesium intake over the last three months. We included 1065 participants, out of whom 61.1% were women. The predominant age group was 19 - 26 years (56.9%), and most participants (83.3%) reported no comorbidities. The majority (48.5%) had normal weight, 246 (23%) were overweight, and 193 (18.1%) were obese. Most participants had low dietary magnesium intake, ranging from one to five times monthly. There was a positive correlation between age and dietary magnesium consumption. The study highlights a concerning trend of low magnesium intake, representing a risk for various chronic diseases. This trend could be linked to increased consumption of typical diets low in magnesium, such as those high in refined sugars, flour, and processed foods, prevalent among the younger Saudi population.

A National Survey of Community Pharmacists' Viewpoints About Pharmacovigilance and Adverse Drug Reaction Reporting in Saudi Arabia.

This study assessed the knowledge, attitudes, and practices of community pharmacists regarding pharmacovigilance and adverse drug reaction (ADR) reporting system in Saudi Arabia. A cross-sectional survey of community pharmacists from different regions in Saudi Arabia was performed through convenience sampling between November 2020 and January 2021. The responses were received from 1,172 community pharmacists. Most respondents (86.7%) were familiar with the National Pharmacovigilance and Drug Safety Center, and 830 (70.8%) knew about the ADR reporting form. The majority (94%) of the respondents agreed with the importance of reporting ADRs for patient care and national health. Although 92.2% of the participants asked their patients about ADRs, 90.2% agreed that more training programs are required to be organized by the Saudi Food and Drug Authority for healthcare professionals on the ADR detection and reporting system. Analgesic agents were the most common drug category for which ADRs were reported (67.4%). The majority (92.1%) of ADRs reportedly occurred in patients with chronic diseases. The study concluded that most community pharmacists in Saudi Arabia are knowledgeable and have good attitudes and practices regarding pharmacovigilance and ADR reporting.

Successful Treatment Using Apixaban in a Patient on Hemodialysis with Uremic Calciphylaxis.

Calciphylaxis is a rare but serious condition in which microvessel occlusion occurs within the subcutaneous adipose tissue and dermis, leading to painful lesions. End-stage renal disease requiring hemodialysis and warfarin therapy can increase the risk of calciphylaxis. In this report, we describe the evaluation and treatment of a 75-year-old female patient with warfarin-induced calciphylaxis who presented unique symptoms. The patient required intensive care unit admission due to hemodynamic instability, which was treated with inotropes and broad-spectrum intravenous antibiotics. This description of the patient's unusual symptoms has the potential to provide insights needed to improve the diagnosis of future patients. Due to the unavailability of FDA-approved treatment for calciphylaxis, its management is based on data from observational studies and clinical experience.

Developing and Mapping Entrustable Professional Activities with Saudi Meds Competency Framework: A Consensus Study.

Purpose: This study aimed at developing a national consensus on entrustable professional activities (EPAs) for Saudi undergraduate medical education and mapping them with the "Saudi Meds" competency framework. Methods: A three phased approach was used. Phase 1 consisted of identifying and developing EPAs; Phase 2 consisted of building a national consensus on developed EPAs (validation process); and Phase 3 consisted of mapping the validated EPAs with the Saudi Meds competency framework. Nominal group and modified Delphi techniques were used to develop consensus on EPAs. Classical test theory-based item analysis was conducted to establish validity and reliability of finalized EPAs. Results: Fifteen expert medical educationists and 109 academic leaders from 23 medical schools participated in the validation process. The study achieved a consensus on 10 core EPAs with an overall reliability (Cronbach's Alpha) of 0.814. The item-total correlation ranged from 0.341 to 0.642. Conclusion: This study results in a national consensus on generic, comprehensive and region-specific EPAs that have been mapped with Saudi Meds competency framework. Our study is the first step in the direction of facilitating EPA-based curricular reforms in Saudi medical schools.

Quercetin Nanoemulsion Ameliorates Neuronal Dysfunction in Experimental Alzheimer's Disease Model.

Aluminum is the most abundant metal that can get admission to the human through several means that include our food, drinking water, cans, drugs, and deodorants, causing neurodegenerative diseases such as Alzheimer's disease (AD). The present study aims to evaluate the role of quercetin nanoemulsion (QCNE) in attenuating neuronal dysfunction in aluminum chloride (AlCl3)-induced experimental AD. All animals were classified into six groups including negative control group (I): received a vehicle; QC group: received intraperitoneal (IP) injection of QC; Alzheimer's group: received AlCl3 orally; treated group (I): received AlCl3 orally and IP injection of QC; treated group (II): received AlCl3 orally and QC orally; and treated group (III): received AlCl3 orally and IP injection of QCNE. At the end of the experimental period (30 days), the brain was used to study biochemical parameters (measurement of neurotransmitters (serotonin, dopamine, and norepinephrine), oxidant/antioxidant parameters (reduced glutathione, malondialdehyde, superoxide dismutase, and advanced oxidation protein product), and inflammatory markers (adiponectin, interleukin 1ß, and plasma tumor necrosis factor-alpha)), while another part was for brain immune-histochemical analysis (study cyclooxygenases (COX-1 and COX-2)). Results showed that the mean value of oxidative stress markers was significantly increased in the AD group as well as the inflammatory biomarkers and all the study neurotransmitters, whereas these parameters were attenuated in treated groups, especially those that received QCNE. The immunohistochemistry findings confirm our results. Both approaches (QC and QCNE) succeeded in retracting the negative impact of AlCl3. Meanwhile, the effect of QCNE is more potent in mitigating the impact mediated by AlCl3 in treated animals. In conclusion, the treatment mainly by QCNE has huge potential in protecting against AlCl3-induced neuronal dysfunction, as shown in our results by the elevation of brain antioxidant/anti-inflammatory activities and neurotransmitter levels as well as mending of the histopathological changes in animal models.

Impact of smoking intensities on sleep quality in young Saudi males: a comparative study.

This study aimed to compare various components of sleep quality between cigarette smokers of various intensities and non-smokers in young Saudi males. In total, 73 healthy male participants (31 smokers and 42 non-smokers) aged 17-33 years were recruited over three months (August 2018 to October 2018). All participants completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The smokers were then divided into three groups, according to their Smoking Index* (SI) (Cigarettes Per Day (CPD) X Years of Tobacco Use), into mild, moderate, and heavy smokers. The PSQI was significantly higher in heavy smokers than in mild smokers (P=0.022) or non-smokers (p=0.013). A significant positive correlation was observed between the PSQI and the smoking index (p=0.005). Sleep duration was significantly longer in heavy smokers compared to mild (p=0.032) and nonsmokers (p=0.047). Sleep disturbance was significantly higher in moderate than nonsmokers (p=0.035) and moderate than mild smokers (p=0.028). Sleep latency was significantly longer in heavy than nonsmokers (p=0.011). Daytime dysfunction was significantly higher in moderate than mild smokers (p=0.041). Habitual sleep efficiency was significantly greater in moderate than in either mild (p=0.013) or nonsmokers (p=0.021). The use of sleep medication was significantly higher in moderate than nonsmokers (p=0.041). The findings suggest that poorer sleep quality is positively associated with smoking intensity among young Saudi males. Considering the importance of sleep quality for well-being and health, these results suggest exploring how improving sleep quality could inform future smoking cessation interventions.

Association of Sleep, Body Weight and Physical Exercise with Plasma BDNF Levels in Healthy Male Saudi Smokers.

Introduction: Brain-derived neurotrophic factor (BDNF) has been shown to impact neural function and development. The BDNF plasma levels may be affected by a smoker's behavior. Thus, the aim of this study was to investigate the association between sleep, body weight and physical exercise with brain-derived neurotrophic factor (BDNF) in healthy male Saudi smokers. Methods: A cross-sectional study, with a convenience sample, was conducted during personal visits to the Anti-Smoking Clinic and Family and Community Medical Center of Imam Abdurrahman Bin Faisal University (IAU) in Dammam at the end of 2018. Blood samples were taken from participants to measure the BDNF plasma levels. Multiple linear regression analysis was used to examine the relationship between plasma BDNF levels and participants' background characteristics, such as smoking index, physical activity, body mass index (BMI) and Pittsburgh sleep quality index (PSQI). Results: A sample of 73 (31 smokers and 42 non-smokers) males took part in the study. The results demonstrated a significant relationship between plasma BDNF levels with physical activity, smoking age, smoking index, PSQI and BMI 25-29.9 (overweight). However, the results showed no significant relationship between plasma BDNF levels and BMI (healthy weight) and obesity. Conclusion: This study shows that physical activity and sleeping quality can provide a positive impact against smoking-associated variation of the BDNF plasma levels, which may affect the health of Saudi males. Further investigation is needed to understand what other potential background characteristics are best predictive or correlated with BDNF plasma levels.

Home Drug Delivery Service from the Perspective of Community Pharmacy Staff in Saudi Arabia.

Background: In response to COVID-19, many big pharmacy chains in Saudi Arabia have started to provide home drug delivery services. This study aims to understand home drug delivery service from the perspective of community pharmacists in Saudi Arabia. Also, the study investigates the obstacles that may limit the use of home drug delivery service. Methods: A cross-sectional self-reported survey was distributed from February 2021 to May 2021. Descriptive analysis of sociodemographic characteristics was conducted and presented. Frequencies and percentages were calculated for all variables. Results: A total of 965 community pharmacists were surveyed. Most of the pharmacists, (73.5%) were young, aged 23 to 34 years old. The vast majority of the participants, (93.6%), said that the service will improve drug adherence. The lack of required knowledge and skills among pharmacists could be the main obstacle to implement home drug delivery service (34%). A shortage in the number of community pharmacists was the second main obstacle (24%). Conclusion: Home delivery services in the future may largely replace the tradition of going in person to the pharmacy. There are obstacles that may limit the full use of the service like shortage in number of pharmacists and the lack of required training.