Anxiety and Depression and Associated Risk Factors among Outpatients with Systemic Lupus Erythematosus: Eastern Province, Saudi Arabia.

BACKGROUND: Although mood disorders are prevalent among systemic lupus erythematosus (SLE) patients, they are usually underrecognized. This study aimed to estimate the prevalence of anxiety and depression among Saudi SLE patients. METHODS: This cross-sectional study was conducted among SLE patients from July 2022 to June 2023 in the Eastern Province of Saudi Arabia. A self-reported questionnaire was used to collect the data through validated tools including the Hamilton Anxiety Rating Scale-A and the Beck Depression Inventory score. RESULTS: There were 133 females (91.7%) and 12 males (8.3%) included in this study. Based on the HAM-A score, 45.5% of participants had an anxiety disorder, and according to the BDI score, 46.2% had a depression disorder. Anxiety and depression were significantly associated with a longer duration of SLE, unemployment status, smoking, and the presence of comorbidities. Moreover, the present study found a significant association between depression and male gender. CONCLUSION: This study found that Saudi SLE patients have a high prevalence of both anxiety and depression. Therefore, SLE patients should be screened for neuropsychiatric disorders during routine follow-ups and managed as early as possible.

Naringenin ameliorates Cyclophosphamide-induced nephrotoxicity in experimental model.

Cyclophosphamide (CP) is widely described in the management of several nonneoplastic and neoplastic disorders. Renal damage is the most reported toxic effect of CP in clinical practice. Our study aimed to evaluate the effect of Naringenin (NG) in attenuating renal damage induced by CP in an experimental model. A total of 32 rats were divided into four groups (n = 8): negative control: rats fed on a basal diet, positive control: rats injected intraperitoneally with CP 50 mg/kg of body weight/day, NG 100: rats treated with NG 100 mg/kg/day body orally with concomitant administration of CP as described before, and NG 200: rats treated with NG 200 mg/kg/day body orally daily + CP. At the end of the experimental protocol (21 days), blood creatinine and urea levels were measured. The antioxidant activities and lipid peroxidation products were measured in the renal tissues as indicators of oxidative damage. Histopathological examination and immunohistochemistry staining were also performed on renal tissues. Coadministration of NG along with CP significantly (p < 0.001) improved the renal function and antioxidant capacities compared with positive control animals. Furthermore, histopathological, and immunological examination of renal tissue confirmed the protective effect of NG against CP-induced nephrotoxicity. The current study showed that NG has the potential to protect CP-induced renal damage, which may be beneficial for further studies and the design of NG analogs to be useful in clinical practice against CP-induced nephrotoxicity.

Synergistic Effects of Nigella sativa and Exercise on Diabetic Profiles: A Systematic Review.

Individually, Nigella sativa (NS) and physical training interventions have been shown to be effective preventive and therapeutic strategies for diabetes mellitus. However, the effect of these in combination on bioindicators of diabetes has not yet been evaluated; there is little information available in the literature. A systematic review was therefore performed to assess any mutually potentiating impacts of NS and physical training interventions in diabetic subjects. A search was performed on this topic in the PubMed, CINAHL, Google Scholar and Web of Science databases for randomised, quasi-randomised or non-randomised controlled trials, studies with factorial or single-cohort pre-post designs, case series as well as case reports. The search terms encompassed various combinations of the following: "exercise", "training", "physical activity", "NS", "treadmill", "swimming", "Thymoquinone", "Nigellone", "caraway oil" and "black seeds". Two reviewers screened the abstracts of 202 identified publications according to predetermined inclusion criteria-i.e. papers published from 2009 onwards in the English language, studies on human or animal subjects, and the assessment of diabetic bioindicators following the combined administration of NS and exercise regimens in comparison with just one of these interventions or against controls. Despite the rich data available regarding the effect of both interventions separately, two human studies and two animal studies were ultimately included in the review. However, the benefit of combined administration of NS and exercise regimens on glycemic and lipidemic control was much more obvious compared to exercise alone. In conclusion, these findings suggested that combined administration of NS and exercise regimens could be used as an effective adjuvant for oral antidiabetic drugs in diabetes control.

Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

There is evidence that increasing the consumption of water containing magnesium can improve glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). This trial was undertaken with the objective of evaluating the effect of adding different concentrations of magnesium chloride to the desalinated drinking water on the glycemic, metabolic, and insulin resistance parameters among patients with T2DM. A randomized cross-sectional controlled clinical trial was conducted to evaluate the effects of adding magnesium chloride supplement to desalinated drinking water consumed by patients with T2DM on the glycemic and metabolic parameters and indicators of insulin sensitivity. The total number of patients with T2DM who successfully completed the trial is 102. Patients were randomly allocated into three groups: the first group received bottled water without added magnesium (0 mg/L) (Group A, n = 37); the second group received bottled water with a low level of magnesium (20 mg/L) (Group B, n = 33); and the third group received drinking water with a high level of magnesium (50 mg/L) (Group C, n = 32). The daily consumption of elemental magnesium for a period of 3 months resulted in significant improvement in HbA1C (8.0 vs 8.2%, p = 0.04), insulin level (7.5 vs 9.9 µIU/mL, p = 0.03), and homeostasis model assessment-estimated insulin resistance (HOMA.IR) (2.5 vs 2.9, p = 0.002) in group C. However, there was no significant improvement in fasting blood glucose (FBS) level or lipid profile. The results of this study suggest that oral magnesium supplementation at the given dose of 50 mg/L daily added to drinking water could improve long-term glycemic control indicators and reduce insulin resistance in patients with T2DM.

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.

Alterations in manganese level in the biological samples of young obese Saudi women.

OBJECTIVES: This study aims to evaluate the changes in serum manganese levels in the nails of women with obesity. METHODS: A cross-sectional study was conducted between 2018 and 2019 at Imam Abdulrahman Bin Faisal University, KSA. It was conducted in a convenience sample of 30 women with obesity and 40 without obesity. We obtained biological samples of nails from the participants and analysed these samples using a plasma atomic emission spectrometer to estimate the levels of manganese. A standard questionnaire containing items related to demographic features, such as address, age, education, and marital status, was used. In addition, the data on the usual consumption of water, milk, and soft drinks during a day or week, eating habits, and other health information were included in the questionnaire. RESULTS: The results of this study show that manganese levels are significantly lower (p < 0.001) in the group with obesity at 0.34 ± 0.06 mg/kg than in the group without obesity at 0.62 ± 0.02 mg/kg. Regular sports activity in a week and consumption of fruit, vegetables, fish, meat, and water are significant predictors of the levels of manganese in the body. CONCLUSION: The study demonstrates a significant difference in the levels of manganese in the nails of obese participants compared to non-obese participants. Further studies are needed to determine whether Saudi women are at risk for manganese deficiency.

Potential cause affecting bone quality in Saudi Arabia: New insights.

BACKGROUND: Osteoporosis (OP) is a silent systemic disease characterized by decrements in bone mineral density (BMD) and bone microstructure. This study aimed to determine the status of bone quality as well as to investigate the relationship between the glycaemic; lipid; bone profiles; and the BMD. METHODS: A retrospective study was conducted at KFHU, Al Khobar, Saudi Arabia analysis of patients who underwent BMD testing between the periods of 2016 to 2018. Based on the T scores, patients were classified as follows: normal (>-1.0), osteopenic (-1.0 to -2.5), or osteoporotic (≤-2.5). Details about medical and demographic information as well as metabolic and bone profiles (fasting blood glucose [FBG], glycated haemoglobin [HbA1c], cholesterol [Chol], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALP], vitamin D 25OHD [Vit D]) were extracted from the medical records system. RESULTS: Out of 4838 extracted profiles, there were 4196 females (85.1%). The mean glycaemic variables of patients showed an abnormal profile (FBG 118 ± 49 and HbA1c 6.6 ± 2). The mean T score showed that the majority of patients had either osteopenic (40%) or osteoporotic (24%) changed. Significant increase in mean HbA1c (7.6 ± 1.7) was obvious among the osteopenic patients when judged against the normal (7.5 ± 1.6; P < 0.033) and osteoporotic (7.4 ± 1.8; P < 0.037). Meanwhile, the mean serum ALP was significantly lower (81 ± 26) in the normal group than in the osteopenic (86 ± 33; P < 0.006) and osteoporotic groups (90 ± 40; P < 0.001). Finally, a linear, logistic regression analysis was found that Ca and ALP levels were significant predictors. CONCLUSION: This study finds that the main cause that affects bone quality in Saudi Arabia is diabetes mellitus and/or its related metabolic alteration. These results suggest that bone health is clinically significant and should be carefully assessed in diabetes patients.

Assessment of Self-Management Care and Glycated Hemoglobin Levels Among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study From the Kingdom of Saudi Arabia.

The prevalence of type 2 diabetes mellitus (T2DM) is increasing every year, along with its health and economic burden/impact. Achieving glycemic control remains challenging, and only 9-15% of diabetic patients manage to reach the optimal level. A few strategies have been found to improve diabetic control, including self-management care (SMC). This study aimed to explore the relationship between patient characteristics, SMC, and glycated hemoglobin (HbA1c) levels, as an indicator of optimal glycemic control. This was a cross-sectional study of 200 participants conducted at the King Fahd University Hospital (KFUH) in Saudi Arabia. A pre-structured questionnaire including sociodemographic data and aspects of diabetes self-management was distributed among patients at KFUH and the Family and Community Medicine Center (FAMCO) of Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia. HbA1c data were extracted from patients' records. Unfortunately, the majority of the participants (65%) were found to have poor glycemic control. Glucose management was better in patients having T2DM for more than five years (mean: 4.01; p<0.05). In addition, an income of less than 5,000 Saudi Riyals (SR) was associated with lower physical activity (mean: 2.95; p<0.05). The level of blood sugar was uncontrolled among the majority of surveyed patients. Our study found variables associated with SMC and HbA1c levels, which might help to guide future initiatives aiming to enhance the care of patients with T2DM.

Effects of Green Brazilian Propolis Alcohol Extract on Nociceptive Pain Models in Rats.

Pain is one of the most common symptoms encountered in the medical practice. None of the management procedures used currently offer a complete relief for patients suffering from nociceptive pain. New treatment strategies for pain management are needed. Propolis has been used in traditional medicine to relieve various types of pain. The aim of the current study was to investigate the potential effects of the green Brazilian propolis alcohol extract in vivo on the nociceptive and inflammatory pain models in rats. Rats were distributed into three random groups (n = 6); Group I: control group received normal saline intraperitoneally (i.p.); Group II: treated with green Brazilian propolis alcohol extract (P50 mg/kg i.p.); Group III: treated with P100 mg/kg i.p. After sixty minutes, 50 µL of 5% formalin was injected subcutaneously into the dorsal surface of the right hind paw. The nociceptive response was identified by counting the number of flinches of the injected paw. The number of flinches was counted for the period of 0-5 min (early phase; neurogenic) and 10-60 min (late phase; inflammatory). Thermal hyperalgesia was assessed using three-paw withdrawal latency measurement with ten minutes intervals using a planter analgesic meter. Abdominal writhe (contraction) was induced by i.p. injection of acetic acid (1 mL of 2%). The results showed that green Brazilian propolis alcohol extract caused a significant inhibition of acetic acid-induced pain and significantly increased the pain threshold against infrared and formalin tests. The promising antinociceptive and anti-inflammatory properties of propolis and/or its active constituents as natural compounds in the present study indicates that it merits further studies in pain.

Propolis Modulates Inflammatory Mediators and Improves Histopathology in Male Rats with L-arginine-induced Acute Pancreatitis.

OBJECTIVES: This study aimed to determine the effects of propolis on immune mediators and tissue histopathology in rats with L-arginine-induced acute pancreatitis (AP). METHODS: This study was conducted at Imam Abdulrahman Bin Faisal University, Dammam, Saudia Arabia between September and November 2017. A total of 24 male albino Wistar rats were divided into three equal groups. Group one was the negative control, group two was the positive control (L-arginine-induced AP) and group three received treatment (L-arginineinduced AP and propolis). The rats in group three were treated with 100 mg/kg propolis for seven days after AP induction. Pancreatic tissue was evaluated histologically and levels of interleukin (IL)-6, IL-22 and IL-1ß and tumour necrosis factor-alpha (TNF-α) were measured. RESULTS: Propolis reduced the quanitity of proinflammatory molecules (TNF-α, IL-1ß and IL-6) in group three compared to group two, significantly increased the overall anti-inflammatory effect of IL-22 (P <0.005) and reduced interstitial inflammation and neutrophil cell infiltration of the pancreatic tissues. CONCLUSION: Propolis may exert a therapeutic effect in AP. Further studies are required to demonstrate the mechanisms of propolis in AP.

Effects of potentially modifiable risk factors on the health of adults in the Eastern Province of KSA.

OBJECTIVES: The purpose of this study was to investigate the association between selected major modifiable risk factors including life style habits, household income and smoking on health. METHODS: This cross-sectional study was conducted during 2015-2016 among 104 healthy men aged 38 ± 8 years. The data were collected using a self-administered questionnaire that enquired about clinical information about blood pressure and body mass index. Venous blood samples were taken to assess the fasting blood glucose (FBG), lipid profile, high density lipoprotein and triglyceride. RESULTS: Current smoking status and consumed energy drinks were significantly positive risk factors for increased systolic blood pressure and FBG, respectively. Participants with monthly income of more than 10,000 Saudi Riyals showed significantly lower diastolic pressure than those with lower income. However, there was a significant decrease in body weight among those who consumed vegetables. CONCLUSION: This study highlights the effect of major modifiable risk factors on health. There is a great need for improving and enhancing a healthy lifestyle behaviour.

Impact of students' use of technology on their learning achievements in physiology courses at the University of Dammam.

OBJECTIVE: This study was conducted to investigate the possible relationship between students' use of technology and their achievements in physiology courses at five health colleges of the University of Dammam. METHODS: This study was conducted on 231 students studying physiology during their 2nd year at one of five health colleges (Medicine, Dental, Clinical Pharmacy, Applied Medical Sciences, and Nursing). An online survey was sent to the students regarding their use of technology and the devices they use. The Pearson correlation coefficient and descriptive statistics were implemented to study the frequency of, and relationship between, technology and learning achievement in physiology courses. RESULTS: This study observed a significant relationship between students' use of technology and their achievements in health colleges. The study also demonstrated that the most-used devices are laptops (50%) and phones (42%) followed by tablets (7%) and desktop computers (0.5%). This paper reports on the results of the survey, documenting what was revealed regarding how technology is used among students at the health colleges, as well as the important benefits on their achievements during physiology courses. CONCLUSIONS: Technology usage might produce comparatively more significant increases in academic achievement than would non-usage. Further research is warranted to examine its effects.

Descriptive study on the knowledge, attitudes and practices regarding the diabetic foot.

OBJECTIVES: The aim of this study is to assess the knowledge, attitudes, practices and risk factors influencing diabetic foot ulcers among diabetes patients attending a diabetic clinic in a Saudi hospital. METHODS: In this cross-sectional study, a random sample of 229 participants was selected from the diabetic clinic of the outpatient department of King Fahd Hospital of the University of Dammam during January to March 2015. A pre-tested structured questionnaire was administered to the diabetes patients to obtain information regarding the outcome variables. RESULTS: The results showed that diabetic foot ulcers were observed among 26% of diabetic patients. Concerning knowledge of the diabetic foot, the majority of participants had good education and favourable attitudes towards diabetic foot care. Interestingly, the results demonstrated that despite these characteristics, a high percentage of the participants ignored very important information and instructions before buying new shoes. CONCLUSION: All diabetic patients with diabetes mellitus should be educated regarding diabetic foot complications and the characteristic specifications of diabetic shoes. However, levels of knowledge, attitudes and practices should be improved. This improvement could be achieved by an awareness programme for the early detection and care of diabetic foot problems in KSA.