Background: Cupping is a cultural/religious treatment modality in Saudi Arabia that has been recently regulated by the Ministry of Health. The objective was to determine the prevalence of cupping use, its predictors, and related beliefs among patients attending a primary care center. Methods: Observational cross-sectional study was conducted between January and July 2019 among patients attending Alwazarat healthcare center in Riyadh, Saudi Arabia. The data were collected using a self-completed questionnaire. Results: A total of 386 patients were included. Approximately 68.3% of the patients were females, and 41.8% were aged between 26 and 35 years. About 34.2% of the patients had cupping therapy before. Cupping use was higher in older age (P < 0.001), males (P = 0.002), and specific occupations (P < 0.001). The most frequent health problems treated were headache (40.5%), lethargy (13.0%), diabetes (10.7%), and hypertension (9.9%). Most (82.4%) of patients believed that the cupping they used was beneficial. Approximately 27.9% of the patients had cupping done in non-specialized centers, and 50% were not sure about infection control practices. Cupping was associated with the following encouraging factors; religious beliefs (79.8%), previous experience with relatives and friends (74.0%), culture and habits (57.8%), information in social media, and multimedia (52.9%). In multivariate logistic regression analysis, only age >35 years and previous experience of relatives and friends were independent predictors of cupping use. Conclusions: Cupping is a popular therapeutic modality among patients seeking primary care services in Riyadh, Saudi Arabia. Authorities are required to continue reviewing the standards of cupping clinics to ensure their license and patient safety.
Vitamin D deficiency has been associated with the risk for immune-mediated inflammatory reactions in various respiratory infections. Our study investigated the association between vitamin D deficiency and coronavirus disease 2019 (COVID-19) patients' outcomes. We included 545 patients who were admitted to a tertiary center in Jeddah, Saudi Arabia from March 2020 to July 2021 with a vitamin D serum test result at the time of infection or prior to disease onset. The data were extracted retrospectively using a data collection sheet. Our primary outcomes were intensive care unit (ICU) admission and in-hospital mortality. The cut-off values for vitamin D were <25, 25-49, and 50-250 for deficient, suboptimal, and optimal levels respectively. Our result revealed that there is no association between vitamin D serum levels deficiency and ICU admission (OR=1.08, p=0.75) or in-hospital mortality (OR=1.74, p=0.97). ICU admission and in-hospital mortality percentages in patients with vitamin D deficiency were 14.1% and 6.4%, respectively. In comparison, percentages for patients with optimal levels were 16.67% and 6.15% for ICU admission and in-hospital mortality, respectively. Smoking was not associated with ICU admission (p=0.05) or in-hospital mortality (p=0.38). Our study does not support a relationship between vitamin D deficiency and COVID-19 patients' outcomes. Future studies should be directed toward conducting randomized clinical trials to determine whether vitamin D has an effective role in reducing COVID-19 severity.
