In-silico and in-vitro studies revealed alpha-amyrin as a potent pnhibitor of TLR2 for the therapeutics of bacterial infection and sepsis.

This study employed a multifaceted approach to investigate the inhibitory potential of alpha-amyrin against TLR2, a key player in bacterial infection and sepsis. A high-resolution TLR2 model was constructed using Swiss-MODEL, exhibiting excellent quality with 100% sequence identity and coverage. Cavity detection revealed five significant cavities on TLR2. Molecular docking identifies alpha-amyrin as a potent inhibitor, displaying a strong binding affinity of -8.6 kcal/mol. Comprehensive analyses, including ADMET predictions, PASS analysis, and SwissTargetPrediction, affirm alpha-amyrin's drug-like properties and diverse biological activities. Cytotoxicity assays on HEK-293 cells confirm its safety, and fluorescence-based inhibition assays provide empirical evidence of its inhibitory potency on TLR2 enzymatic activity. Further validations in HUVECs show a significant decrease in TLR2 mRNA expression (p<0.01) and activity (p<0.05) upon alpha-amyrin treatment. In conclusion, this integrative study positions alpha-amyrin as a promising therapeutic candidate for TLR2 inhibition, emphasizing its potential in combating bacterial infections with safety and efficacy.

Prevalence of Obesity and Associated Dietary Habits among Medical Students at King Khalid University, Southwestern Saudi Arabia.

Background and Objectives: Healthy eating is a crucial approach to improving overall health, encompassing a well-balanced diet of natural and fresh foods, plenty of fruits and vegetables, and foods rich in minerals and vitamins. This study aimed to assess the prevalence of obesity and associated dietary habits among medical students at King Khalid University, Aseer, Saudi Arabia. Materials and Methods: This observational cross-sectional study was conducted through face-to-face interviews. A structured predesigned questionnaire was used to collect data. Results: A total of 540 medical students were included; 43.3% of participants were aged 20-22 years, 24.8% were in the 3rd year, and 82.0% had an average income level. Of them, 21.9% were overweight and 14.6% were obese. There was a significant association between obesity and grade (p = 0.004). Significant differences were observed between males and females in adding sugar to beverages, the frequency of eating out, cooking meat, and drinking water (p < 0.05). The predictors of obesity were being male (OR = 3.5, 95% CI [1.6-7.8], p = 0.002), age (OR = 1.8, 95% CI [1.1-3.0, p = 0.019], being at grade 2 (OR = 38.8, 95% CI [4.0-375.8], p = 0.002), having grilled meat (OR = 0.42, 95% CI, [0.20-0.99], p = 0.048), using artificial sweeteners [OR = 0.24, 95% CI [0.08-0.73], p = 0.012], and drinking sparkling bottled water (OR 8.6, 95% CI [1.2 333-63.8], p = 0.034). Conclusions: The study revealed a high prevalence of obesity and overweight among medical students of both sexes. It recommends education on healthy eating habits, balanced nutrition, and regular physical activity, as well as gender-specific health initiatives, nutritional counseling, and the inclusion of physical activity.

Prevalence and factors associated with gastroesophageal reflux disease among primary health care attendants at Abha city, southwestern Saudi Arabia.

BACKGROUND: Gastroesophageal reflux disease (GERD) is an abnormal reflux of the gastric content into the esophagus. In Saudi Arabia the GERD prevalence is not recently well studied. OBJECTIVE: To investigate the prevalence of gastroesophageal reflux disease and associated factors among attendants of primary health care centers (PHCCs) at Abha city, Saudi Arabia. METHOD: A descriptive cross- sectional study was performed using GerdQ as diagnostic tool for the GERD. The GerdQ consisted of six questions. Four questions were about the positive GERD predictors. The other two questions were about the negative GERD predictors. The scoring of GerdQ relies on the frequency of GERD symptoms during the last seven days. Using stratified random sample technique a representative sample was slected from the study PHCCs taking into conmsideration the relative catchment population in each center among adult males and females attending the selected PHCCs for any reason. RESULTS: The present study included 320 persons. The study showed a prevalence of GERD of 67.8%. The prevalence of GERD with high impact on daily life (HIDL) was found to be 50%. By multiple logistic regression (enter method) only four significant independent factors associated with GERD were identified; being unmarried (aOR = 1.85, 95% CI:1.02-3.23); smoking (aOR = 2.11, 95% CI: 1.41-5.98), fast food intake (OR = 1.28, 95% CI:1.01-1.71), and subjective perception of stress (OR = 3.0, 95% CI:1.68-5.26). CONCLUSIONS: GERD is a public health problem among adults in the region. Community level awareness programs are recommended. Healthcare providers must be aware of community perceptions and practices.

Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia.

BACKGROUND: The purpose was to measure the prevalence and related risk factors of low back pain (LBP) among health care workers (HCWs) at different levels of health care in southwestern Saudi Arabia. METHODS: A cross-sectional study using a self-administered questionnaire was conducted among HCWs providing primary, secondary and tertiary health care services in the Aseer region, southwestern Saudi Arabia. The questionnaire collected data regarding having LBP in the past 12 months, socio-demographics, work conditions and history of chronic diseases, regular physical exercise and overexertional back trauma. Univariate and multivariable logistic regression analyses were performed. RESULTS: Out of 740 participants, the overall prevalence of LBP in the past 12 months amounted to73.9% (95% CI: 70.7-77.0). The prevalence of LBP with neurological symptoms reached 50.0%. The prevalence of LBP necessitating medications and or physiotherapy was 40.5%, while the prevalence of LBP requiring medical consultation was 20%. Using multivariable logistic regression, the following risk factors were identified: working in secondary and tertiary hospitals (aOR = 1.32, 95% CI:1.01-1.76), increased BMI (aOR = 1.10, 95% CI:1.01-3.65), and positive history of overexertional back trauma (aOR = 11.52, 95% CI:4.14-32.08). On the other hand, practising regular physical exercise was a significant protective factor (aOR = 0.61, 95% CI: 0.42-0.89). CONCLUSIONS: LBP is a common problem among HCWs. Many preventable risk factors have been identified, including exertional back trauma, increased BMI and lack of regular physical exercise. Occupational health and safety programmes to build ergonomically safe working conditions and encourage regular physical exercise are needed.

Awareness of stroke among patients attending primary healthcare services in Abha, Southwestern Saudi Arabia.

OBJECTIVE: To examine the awareness about major symptoms, risk factors, and response to stroke among the population in Abha, Southwestern Kingdom of Saudi Arabia. Improving stroke-related knowledge may advance stroke prevention and reduce pretreatment delay and disabilities. METHODS: We conducted a cross-sectional study among a representative sample of primary healthcare adult patients between January-May 2016 and used a validated Arabic questionnaire to evaluate the participants` awareness about stroke. RESULTS: The study involved 1472 adults. Only 63.6% and 43.7% of participants correctly recognized thrombosis and hemorrhage as types of stroke. Commonly identified risk factors were hypertension (55.8%), dyslipidemia (45.8%), and smoking (41.9%). Sudden severe headache (54.1%), dizziness (51.0%), and difficulty in speaking (44.3%) were the most frequently recognized symptoms. The most frequently reported correct responses to stroke were contacting a doctor (73.0%), going to the hospital (67.2%), and calling an ambulance (52.4%). Improper responses to stroke (ignoring the condition or self-prescription) were noted in 18.8% of participants. Logistic regression revealed that physicians, nurses, friends and relatives as a source of knowledge were significantly associated with a lower insufficient knowledge of stroke symptoms and risk factors. On the other hand, women, persons above 40 years old, and married persons were significantly more prone to have insufficient knowledge about a proper response to stroke. CONCLUSION: Our study revealed a notable deficit of knowledge about warning symptoms, risk factors, and proper response to stroke. Health education strategies to improve stroke awareness are required and could potentially prevent and improve the outcome of stroke.

Hepatitis C virus infection in southwestern Saudi Arabia: Are we still in the plateau phase?

The aim was to study the seroprevalence of Hepatitis C virus (HCV) infection and related risk factors in Aseer region in southwestern Saudi Arabia, the region known to be of the highest endemicity of viral hepatitis. In a cross-sectional study, all participants were interviewed using structured questionnaire. HCV infection was diagnosed using fourth-generation ELISA. All positive and equivocal HCV serology results were further confirmed by using a qualitative confirmatory RT-PCR. The study enrolled 10,234 participants. A seroprevalence of 2.2% (95%CI: 1.9-2.5%) was found. In multivariate logistic regression analysis, the study showed that males had significantly more risk to become seropositive for HCV (aOR = 1.437, 95%CI: 1.071-1.927) compared to females. Similarly, participants having history of blood transfusion had more than two times the risk of becoming seropositive for HCV (aOR = 2.079, 95%CI: 1.037-4.149). HCV infection in the study area is still high in the plateau phase. It is recommended to have an active educational and media campaign about the risks of HCV infections. Workshops and training of qualified laboratory staff related to blood banking seem mandatory. J. Med. Virol. 89:867-871, 2017. © 2016 Wiley Periodicals, Inc.

Iodine-deficiency disorders in the Aseer region, south-western Saudi Arabia: 20 years after the national survey and universal salt iodization.

OBJECTIVE: To study (i) the current prevalence of iodine-deficiency disorders among schoolchildren in south-western Saudi Arabia after universal salt iodization and (ii) the iodine content of table salts and water. DESIGN: Cross-sectional study on a stratified proportional allocation sample of children. Thyroid gland enlargement was assessed clinically and by ultrasound scanning. Urine, table salt and water samples were taken to measure iodine content. Settings The Aseer region, south-western Saudi Arabia. SUBJECTS: Schoolchildren aged 8-10 years. RESULTS: The study included 3046 schoolchildren. The total goitre rate amounted to 24·0 %. Prevalence of enlarged thyroid by ultrasound was 22·7 %. The median urinary iodine concentration of the study sample amounted to 17·0 µg/l. The iodine content of table salt ranged from 0 to 112 mg/kg; 22·5 % of the table salt samples were below the recommended iodine content (15 mg/kg) set by WHO. The total goitre rate increased significantly from 19·8 % among children using table salt with iodine content ≥15 mg/kg to reach 48·5 % among children using table salt with 0 mg iodine/kg. Analysis of water samples taken from schools showed that the majority of water samples (78·8 %) had an iodine content of 0 µg/l. CONCLUSIONS: The study documented that 18 years after the national study, and after more than a decade of universal salt iodization in Saudi Arabia, the problem of iodine-deficiency disorders is still endemic in the Aseer region. Efforts should focus on fostering advocacy and communication and ensuring the availability of adequately iodized salt.

Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: the need for national guidelines for health students.

BACKGROUND: The objectives of the study were to study the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among health college students (HS) and health care workers (HCWs) in the Najran Region of south-western Saudi Arabia and to study the students' knowledge of occupational exposure to blood-borne viral infections. METHODS: A cross-sectional study of a representative sample of 300 HS and 300 HCWs was conducted. RESULTS: An overall seroprevalence of HBV of 1.7% and 8.7% was found among HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of HCWs lack anti-HBs and are susceptible to HBV infection. An overall seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs, respectively. The present study indicates poor knowledge among HS and moderate knowledge among HCWs regarding occupationally transmitted blood-borne diseases, safe injection practices, and standard precautions to prevent occupationally transmitted blood-borne infections. CONCLUSION: It is mandatory to develop a structured program to raise awareness among HS, and current health colleges' curricula should be upgraded to address these issues early. The HS should be considered new recruits to health services in terms of their initial screening for blood-borne infections and vaccination against HBV. The development of a novel continuing medical education and pre-employment awareness program for HCWs is recommended to address the following: blood-borne diseases transmitted occupationally, standard precautions to prevent occupationally transmitted blood borne infections, and safe injection practices.

Major placenta previa among patients with and without previous cesarean section: Maternal characteristics, outcomes and risk factors.

OBJECTIVES: To compare maternal characteristics and outcomes among patients having major placenta previa (PP) with and without previous cesarean section (CS). And to determine if previous CS alone is a risk factor for associated adverse maternal outcomes in these patients. MATERIALS AND METHODS: This is a retrospective analysis including two groups of major PP patients, with previous CS (n = 184) and without CS (n = 115); who were admitted to Abha Maternity and Children's Hospital over the last ten-years (January 2012-December 2021), Aseer region, Saudi Arabia. RESULTS: Compared to those without previous CS, major PP patients with previous CS had significantly advanced ages with higher mean numbers of gravidity and parity, but significantly less rates of previous uterine surgery and IVF pregnancies. Moreover, they were more likely to acquire higher rates of adverse maternal outcomes. In the same way, these patients had an increased Odds Ratios of cesarean hysterectomy (OR of 20.462), urinary tract injuries (OR of 12.361), associated PAS (OR of 4.375), moderate/ heavy intra-operative bleeding (OR of 2.153) and the need for transfusion of 3+ units of packed RBCs (OR of 1.849). CONCLUSION: (1) Patients with combined existence of major PP and previous CS had significantly higher rates of adverse maternal outcomes (2) Alone, prior CS in major PP patients increased the Odds Ratios of cesarean hysterectomy, urinary tract injuries, diagnosis of PAS, excessive intra-operative bleeding and repeated packed RBCs transfusions. (3) Among our PP patients with previous CS, the increased rate and OR of PAS diagnosis could in-part explain the adverse maternal outcomes.

Breast cancer knowledge and related behaviors among women in Abha City, southwestern Saudi Arabia.

Breast cancer is the most common malignancy among women in Saudi Arabia. A cross-sectional study was conducted on 1,092 women attending urban primary health care centers in Abha City southwestern Saudi Arabia about breast cancer knowledge, attitudes, and related practices. Only 22.0% heard about mammography, and 41.5% heard about breast self-examination (BSE). More than half of the women in the study identified changes occurring in case of breast cancer and identified risk factors. Only 8.3% were examined by clinical breast examination (CBE), 6.2% were examined by mammography, and 29.7% performed BSE. The study points to the insufficient knowledge of women and the low practice of BSE, CBE, and mammography. Public awareness should be enhanced by all available means including mass media, schools, social gatherings, and waiting areas in primary health care centers. There is an urgent need for continuing medical education programs for health care workers in the region concerning breast cancer.

Placenta accreta spectrum in major placenta previa diagnosed only by MRI: incidence, risk factors, and maternal morbidity.

BACKGROUND: Antenatal assessment of maternal risk factors and imaging evaluation can help in diagnosis and treatment of placenta accreta spectrum (PAS) in major placenta previa (PP). Recent evidence suggests that magnetic resonance imaging (MRI) could complement ultrasonography (US) in the PAS diagnosis. OBJECTIVES: Evaluate the incidence, risk factors, and maternal morbidity related to the MRI diagnosis of PAS in major PP. DESIGN: A 10-year retrospective cohort study. SETTING: Tertiary care hospital. PATIENTS AND METHODS: We report on patients with major PP who had cesarean delivery in Abha Maternity and Children's Hospital (AMCH) over a 10-year period (2012-2021). They were evaluated with ultrasonography (US) and color Doppler for evidence of PAS. Antenatal MRI was ordered either to confirm the diagnosis (if equivocal US) or to assess the depth of invasion/extra-uterine extension (if definitive US). MAIN OUTCOME MEASURES: Risk factors for PAS in major PP and maternal complications. SAMPLE SIZE: 299 patients RESULTS: Among 299 patients, MRI confirmed the PAS diagnosis in 91/299 (30.5%) patients. The independent risk factors for MRI diagnosis of PAS in major PP included only repeated cesarean sections and advanced maternal age. The commonest maternal morbidity in major PP with PAS was significantly excessive intraoperative bleeding. CONCLUSION: MRI may be a valuable adjunct in the evaluation of PAS in major PP; as a complement, but not substitute US. MRI may be suitable in major PP/PAS patients who are older and have repeated cesarean deliveries with equivocal results or deep/extra-uterine extension on US. LIMITATION: Single center, small sample size, lack of complete histopathological diagnosis. CONFLICT OF INTEREST: None.

Incidence, risk factors, and maternal outcomes of major degree placenta previa: A 10-year retrospective analysis.

OBJECTIVES: To determine the incidence, risk factors, and maternal outcomes of "major degree" placenta previa (PP)/placenta accreta spectrum (PAS) in Abha Maternity and Children's Hospital, Abha, Saudi Arabia. Secondly, to compare our findings to those of previous studies on PP/PAS in Saudi Arabia. METHODS: This is a retrospective study that included 299 patients diagnosed with major degree PP/PAS and admitted to Abha Maternity and Children's Hospital, Abha, Saudi Arabia, within 10 years (January 2012-December 2021). Also, we compared our results to the outcomes of PP/PAS patients in 6 previous Saudi studies. RESULTS: The total number of deliveries was 54,341; PP minor and major degrees were diagnosed in 376 (0.69%) patients. Of them, 299 patients had PP major degree (79.5%). The pattern of main risk factors for major PP/PAS included: elder age, high parity, and previous cesarean deliveries. Nearly 30.5% had evidence of PAS on antenatal MRI (n=91). Approximately 68.5% (n=205) of patients were delivered <37 weeks. Of 299 patients, 29 (9.7%)patients had emergency cesarean hysterectomy. The maternal mortality rate was 0.3% (n=1). Generally, in many aspects, our results are comparable to similar Saudi studies on PP/PAS. CONCLUSION: Major degree of PP/PAS is associated with high maternal morbidity but rare mortality. Over 30 years, our patients' obstetric characteristics did not change, including both elder age and high parity. A substantial increase in the rate of cesarean deliveries is a leading cause of major PP/PAS.

Specific aeroallergen sensitization associated with current rhinitis among adults in southwestern Saudi Arabia.

Data about allergic sensitization to rhinitis among adults are limited. The objectives were to explore the prevalence of current rhinitis (CR) and associated specific allergen sensitizations in southwestern Saudi Arabia. A cross-sectional study was conducted on 969 adults in southwestern regions of Saudi Arabia, namely Aseer, Jazan, and Al Baha. From each region, 5 primary health care centers were chosen. The validated Arabic Version of the International Study of Asthma and Allergies in Childhood questionnaire was used. Total immunoglobulin E (IgE) enzyme-linked immunosorbent assay, cytokine enzyme-linked immunosorbent assay (interleukin [IL]-4, IL-10, IL-13, and interferon-γ), aeroallergen-specific IgE immunoassay (a panel of 30 common aeroallergens; 9 indoor and 21 outdoors), and eosinophilic count were assessed. A prevalence of CR of 35.8% (95% confidence interval: 32.8%-38.9%) was found. Regarding outdoor aeroallergens, Mesquite-positive IgE antibodies were higher among CR adults (odds ratio = 1.52, 95% confidence interval: 1.02-2.21) compared to those without CR. The same significant pattern was found with Chenopodium, Ragweed, Pigweed, Russian thistle, Bermuda grass, Timothy grass, and Rye. All indoor aeroallergens were not significantly associated with CR. Total IgE and eosinophil count were significantly higher among adults with CR. In conclusion, CR in southwestern regions of Saudi Arabia is common and of significant public health importance. Aeroallergens that associate with adult sensitization to CR tend to be of the outdoor variety particularly the herbaceous grass and their pollens. The magnitude of CR and its association with exposure to outdoor aeroallergens should be taken into account by health policy decision makers, clinicians, and medical practitioners when diagnosing and treating related conditions.

Increased mental stress among undergraduate medical students in south-western Saudi Arabia during the COVID-19 pandemic.

Background: The COVID-19 pandemic has disrupted the daily life and academic trajectory of many students. The objectives of this study were to evaluate the effect of the pandemic on perceived stress levels among medical students. Methods: Comparative pre-pandemic and pandemic surveys were conducted among samples of undergraduate medical students. Students responded to a questionnaire including personal and academic data, and Cohen's Perceived Stress Scale (PSS). Results: Overall, the prevalence of high perceived stress during the pandemic (20.6%) was significantly higher (p = 0.001) than pre-pandemic (11.6%). A multivariable analysis revealed that the independent factors associated with high perceived stress were: participation in the study during the pandemic (aOR = 1.79, 95% CI: 1.22-2.63), female sex (aOR = 1.74, 95% CI: 1.23-2.47), younger age (aOR = 1.62, 95% CI: 1.04-2.55) and lower family income (aOR = 1.50, 95% CI: 1.12-2.03). PSS score was negatively correlated with increasing age, family income, and academic level. PSS score was positively correlated with: worries about the possible disruption of education or exams, excessive news exposure, worries about the possibility of COVID-19 infection, and the effects of mandatory isolation and social distancing. Conclusion: The COVID-19 pandemic increased the level of stress among medical students. Female students, younger students, and those in lower academic grades are the most at risk of having high stress. Worries about possible academic disruptions due to the pandemic are significant stressors. The implementation of online stress management programs is recommended.

Angiopoietin-1 and endostatin levels in cord plasma predict the development of bronchopulmonary dysplasia in preterm infants.

OBJECTIVE: To determine whether angiopoietin-1 and endostatin levels in the cord blood could predict the subsequent development of bronchopulmonary dysplasia (BPD) in preterm infants. PATIENTS AND METHODS: A total of 102 preterm (gestational age ≤ 32 weeks) infants (28 infants developed BPD and 74 had no BPD) were enrolled in the study. Cord plasma levels of angiopoietin-1 and endostatin were measured by enzyme-linked immunosorbent assay. RESULTS: Preterm infants who subsequently developed BPD had significantly lower cord plasma levels of angiopoietin-1 than those who did not (p < 0.001). Our results showed that cord plasma levels of endostatin were significantly higher in infants with BPD than in those without (p < 0.001). In infants with BPD, angiopoietin-1 levels in cord plasma correlated negatively with endostatin (r = -0.48; p = 0.008). CONCLUSION: In preterm infants, low-angiopoietin-1 and high-endostatin levels in cord plasma at birth predict the subsequent development of BPD.

Cardiovascular risk factors among adolescent secondary school boys in Ahad Rufeida, southwestern Saudi Arabia.

A cross-sectional stratified sample of 1249 adolescent secondary school boys was studied. More than 25% of boys did not practice any physical exercise. More than half of the parents (54.5%) were consanguineous. High prevalence of parental history of hypertension, diabetes and high blood lipids was found. Smoking amounted to 11.8%. The prevalence of obesity was 23.3%. The study showed that 6.8% had a high systolic blood pressure and 13.0% (162) had high diastolic blood pressure. There is a need for a national programme to prevent and control cardiovascular risk factors among adolescents.

Bullying Prevalence among Secondary School Children in Khamis Mushait City, Southwestern Saudi Arabia.

Bullying is a type of behavior that involves frequent, hostile activities expected to harm another person physically, mentally, or emotionally. Bullying behavior uses force, pressure, or threats to maltreat, forcefully dominate, or terrify another individual. The aim of this study was to assess the bullying prevalence and related features among secondary school pupils in Khamis Mushait city, southwestern Saudi Arabia. A cross-sectional investigation was performed among governmental and private secondary schools in Khamis Mushait city. Data were gathered from the study pupils using a pre-structured questionnaire. Bullying was assessed using the school climate bullying survey. The study included 300 secondary school students (163 females and 137 males). The overall rate of bullying was 64.7% (95% CI 59.1-69.9). The most prevalent type of bullying was verbal (41.7%, 95% CI 36.0-47.5) followed by physical (17.0%, 95% CI 12.9-21.7), and social (6.0%, 95% CI 3.6-9.3). Males had more than two times greater probability of having been bullied than females (aOR = 2.522, 95% CI 1.408-4.518). Similarly, students in first-level grade classes had more than three times greater probability of being bullied victims than those in the higher classes, i.e., second- and third-level grade classes (aOR = 3.417, 95% CI 1.159-10.07). More than half of the students tell teachers when other students are being bullied (53.7%) and tell a teacher or staff member at the school if they are being harassed (53.6%); teachers are doing anything they can to help if they are told that a student is being bothered (58.7%), and teachers are making clear to students that bullying is not tolerated (52.3%). In conclusion, in the present study, we reported a high prevalence rate of bullying among secondary school pupils in Khamis Mushait city, southwestern Saudi Arabia. Concerted efforts among teachers and health care providers in the region should be mandatory to deal with the problem.

Risk Factors of the First-Time Stroke in the Southwest of Saudi Arabia: A Case-Control Study.

Worldwide, stroke is the second leading cause of death and a frequent cause of permanent disability. The objective was to identify the first-time stroke modifiable risk factors in the Aseer region, southwest Saudi Arabia. In a multicenter hospital-based case-control study design, all first stroke patients admitted to hospitals in the Aseer region were included consecutively over one year. Age, sex, and geographical residence-matched controls were selected and included in a ratio of 1:1. Data collected included altitude (low or high), nationality, marital status, educational level, family history of stroke, history of diabetes mellitus, history of systemic hypertension, high cholesterol level, current smoking, obesity, and regular exercise practice. The study included 1249 first-time stroke patients and 1249 age, sex, and residence-matched controls. Hypertension, diabetes mellitus, obesity, and high cholesterol were significantly highly prevalent among cases (57.7%, 49.4%, 42.0%, 29.4%, respectively) compared to controls (31.8%, 25.9%, 30.8%, 12.1%, respectively). Practicing regular exercise was significantly highly prevalent among controls (29.9%) compared to cases (13.1%). Multivariable logistic regression analysis revealed that systemic hypertension (adjusted odds ratio (aOR) = 2.12, 95%CI: 1.74-2.57), diabetes mellitus (aOR = 1.73, 95%CI: 1.41-2.21), obesity (aOR = 1.95, 95%CI: 1.61-2.28) and high cholesterol (aOR = 1.64, 95%CI: 1.28-2.10) were significant risk factors, while regular exercise practice was a significant protective factor (aOR = 0.12, 95%CI: 0.05-0.26) for stroke. Hypertension, diabetes mellitus, obesity, and high cholesterol are major risk factors for stroke in the Aseer region of southwest Saudi Arabia. The protective role of regular physical activity in reducing the risk of stroke is evident. The observed higher prevalence of potentially modifiable risk factors among stroke cases encourages an urgent need to develop and implement a national program to control these factors.

Prevalence and correlates of university students' perceived stress in southwestern Saudi Arabia.

ABSTRACT: The university period can be stressful for most students. It may be due to exposure to various stressors. Objectives: To establish the prevalence and factors associated with high perceived stress among university undergraduates in south-western Saudi Arabia.A self-administered survey was conducted among a representative sample of King Khalid University students through a cross-sectional study. Data obtained included socio-economic, academic characteristics, and grade point average (GPA) scores. Stress was assessed using the Perceived Stress Scale.This study included 2467 students. The average Perceived Stress Scale score was 19.13 ±â€Š6.56, which was notably higher (P = .02) among health care undergraduates (19.45 ±â€Š6.49) compared to others (18.85 ±â€Š6.61). High perceived stress prevalence rate was 12.7% (13.6% in health care institutions and 12.0% in non-healthcare institutions). Multivariable analysis revealed that high perceived stress was considerably greater among females (adjusted odds ratio [aOR] = 2.35, 95% confidence interval:167-3.30), smokers (aOR = 1.65), those with an unsatisfactory income (aOR = 3.10), and healthcare students (aOR=1.33). In contrast, it was negatively associated with the GPA score (aOR= 0.77).High perceived stress is a substantial problem among university students. Female students and healthcare students are at a greater risk. High stress is correlated with smoking, lower GPA scores, and perceived insufficient family income.