Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection: a systematic review and network meta-analysis.

PURPOSE: Fosfomycin has been used more frequently in managing uncomplicated urinary tract infections (UTIs) due to decreased compliance and increased multidrug-resistant bacteria. The aim of this network meta-analysis was to assess the efficacy of Fosfomycin compared to Nitrofurantoin, Trimethoprim-Sulfamethoxazole (TMP-SMX), and Ciprofloxacin in terms of clinical and microbiological cure alongside with other measurements. MATERIALS AND METHODS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). We included randomized control trials (RCTs) with uncomplicated UTI patients who received Fosfomycin, Nitrofurantoin, TMP-SMX, or Ciprofloxacin and reported the clinical or microbiological cure. We used Cochrane Risk of Bias Assessment Tool to assess the included studies' quality. R-software was used for all statistical analysis. We ranked all antibiotics using the netrank function which yielded P scores. Frequentist network meta-analysis was used to assess the efficacy of all outcomes. RESULTS: We included 13 RCTs with a total number of 3856 patients that showed Fosfomycin ranked the highest among the other antibiotics with respect to clinical cure (P-score = 0.99) and microbiological cure (P-score = 0.99) while Ciprofloxacin ranked the lowest (P-score = 0.11 and 0.02, respectively). Moreover, Ciprofloxacin yielded the highest relapse rate (P-score = 1), whereas TMP-SMX had the lowest relapse rate (P-score = 0.07). As for the adverse events, Ciprofloxacin demonstrated the highest adverse events as opposed to Fosfomycin (P-score = 0.98 and 0.05, respectively). CONCLUSION: The network meta-analysis demonstrated that Fosfomycin is the most effective antibiotic in treating uncomplicated UTIs with respect to clinical cure, microbiological cure, and adverse events profile.

Awareness of Constipation and Its Complications Among the General Population of Saudi Arabia.

BACKGROUND: Constipation is a common gastrointestinal issue with significant economic implications. Its prevalence varies globally, and it can have acute or chronic forms with primary or secondary causes. The pathophysiology of constipation is influenced by various factors. While previous studies have reported varying levels of awareness of constipation and its complications in different regions of Saudi Arabia, no comprehensive research has assessed such awareness among the general population. This study, thus, aimed to assess awareness of constipation and its complications among the public in Saudi Arabia. METHODOLOGY: A descriptive cross-sectional study was conducted in Saudi Arabia on individuals aged 18 and above, excluding healthcare workers. Data were collected using a validated survey distributed online between September 2023 and November 2023. RESULTS: A total of 1,139 participants were included in the study, predominantly female 739 (64.9%), and most of the participants 595 (52.2%) aged between 19 and 30 years, The majority of participants 850 (74.6%) had bachelor's degree. Regarding the source of medical information, 312 (27.4%) of the participants stated that they obtained medical information from social media. Additionally, 811 (71.2%) of participants reported experiencing constipation. Overall, 847 (74.4%) of participants demonstrated a good level of awareness of constipation, while 292 (25.6%) had a poor level of awareness. Significant associations were found between awareness level and age, city of residence, and occupation. CONCLUSION: Most adults in Saudi Arabia have a high level of awareness of constipation and its complications.

Retraction: Extensive Pulmonary Embolism Following Mild COVID-19 Pneumonia.

[This retracts the article DOI: 10.7759/cureus.21436.].

Retraction: Sylvian Fissure Lipoma: An Unusual Etiology of Seizures in Adults.

[This retracts the article DOI: 10.7759/cureus.21407.].

Assorted kerosene-based nanofluid across a dual-zone vertical annulus with electroosmosis.

The goal of this numerical simulation is to visualize the electroosmotic flow of immiscible fluids through a porous medium in vertical annular microtubes. The inner region (Region I) is filled with an electrically conducting hybrid nanofluid while an electrically conducting Jeffrey fluid is flowing in the second region (Region II). The chosen nanofluid is kerosene-based and the nanoparticles (Fe3O4-TiO2) are of a spherical shape. A strong zeta potential is taken into account and the electroosmotic velocity in the two layers is considered too. The annular microtubes are subjected to an external magnetic field and an electric field. The linked nonlinear governing equations with initial, interface and boundary conditions are solved using the finite difference method. The wall zeta potential and EDL thickness on the electric potential distribution, the velocity profile, the volumetric flow rate and the heat transfer are investigated versus the parameters under consideration. Graphs have been used to describe the numerical results of numerous emerging factors. It has been noticed that the temperature is the least for the clear fluid than the that of the non-clear one. Due to the fact that oil-based nanofluids are utilized to improve the stability and thermophysical characteristics of nanofluids when they are subjected to high temperatures, the proposed study presents a mathematical assessment that is sought to be useful in oil-based nanoflows' applications.

Acute paracetamol toxicity-induced inflammatory and oxidative effects are relieved by Aleppo galls: a novel experimental study.

BACKGROUND: Paracetamol (acetaminophen) is an over-the-counter non-steroidal anti-inflammatory drug that may cause acute toxic overdosage particularly in neuropsychiatric patients. Paracetamol is also very commonly prescribed as an analgesic and antipyretic agent. Paracetamol toxicity causes decreased reduced glutathione and oxidative tissue damage. Aleppo galls is a promising natural remedy exerting antioxidant and tissue-protective effects that may combat acetaminophen-induced oxidative tissue damage. METHODOLOGY: Biochemical and toxicological effects of a toxic dose of paracetamol (250 mg/kg) were investigated for three consecutive days versus the tissue-protective effects of Aleppo galls. Eighteen white albino mice were randomly allocated in this study and divided into three experimental groups (six mice per group): negative control (received intraperitoneal sterile water injection), paracetamol toxicity group (received intraperitoneal paracetamol injection) and the third group (received paracetamol injection at 250 mg/kg/day together with oral Aleppo galls treatment at 250 mg/kg/day for 3 consecutive days). All mice were sacrificed by the end of the study. RESULTS: Our data revealed that paracetamol toxicity exerted significant oxidative stress damaging effects (high serum malondialdehyde, decreased serum catalase and decreased total antioxidant capacity), and significant inflammatory effects (high serum IL-6) and significant tissue-damaging effects (high serum LDH). Aleppo galls treatment significantly protected against acetaminophen toxicity-induced oxidative stress effects (P<0.001), inflammatory effects (P<0.001) and tissue-damaging effects (P<0.001). CONCLUSION: Aleppo galls are promising for future drug therapeutics and for the synthesis of natural remedies for treating paracetamol toxicity. We recommend formulating Aleppo galls extract as a pharmaceutical nutrition and to be given to those who need to take large doses of paracetamol.

Aleppo galls alleviate paracetamol-induced hepatotoxicity and tissue damage: an experimental study.

BACKGROUND: Acute paracetamol toxicity is a common and potentially life-threatening emergency causing liver failure that may necessitate liver transplantation. Unfortunately, current therapies are still defective. OBJECTIVES: To investigate the protective effects exerted by Aleppo galls (Quercus infectoria Olivier) extract against acute paracetamol toxicity in mice. METHODOLOGY: Eighteen mice were divided into three experimental groups, each included six mice in each group. The groups included: negative control group, paracetamol toxicity group that received an acute toxic intraperitoneal dose of paracetamol (250 mg/kg) for four consecutive days, and treatment group (received 250 mg/kg paracetamol followed few hours later by Aleppo galls extract for the same duration). Animals were anaesthetized using ether anaesthesia. Animals were sacrificed by decapitation and blood samples were drawn. Paracetamol toxicity effects versus Aleppo galls protection were evaluated on liver function tests, liver histology, serum cholesterol and serum triglycerides. RESULTS: Acute paracetamol toxicity caused significantly elevated serum transaminases (ALT and AST), decreased serum albumin, and increased serum cholesterol and triglycerides. Aleppo galls extract exerted significant protective effects and restored near normal serum levels of the previously-mentioned parameters. Upon histopathological evaluation, mice in the control group showed normal hepatic architecture with preserved hepatic cords and sinuses. Acute paracetamol toxicity induced peripheral zonal degeneration with focal necrosis of the hepatic tissue. The hepatocytes showed cytoplasmic vacuolation with indistinct cell borders. Central hepatic venules were congested. Administration of Aleppo galls extract reduced the tissue damaging effects induced by paracetamol toxicity with only minimal residual degenerative changes that were observed with absent necrosis. CONCLUSION: Quercus infectoria Olivier (Aleppo galls) is a promising source of phytochemicals and future therapeutics.

Radiofrequency thermoablation of the peripheral branches of trigeminal nerve versus the Gasserian ganglion for treating idiopathic trigeminal neuralgia: A systematic review and meta-analysis.

BACKGROUND: Trigeminal neuralgia is characterized by pain at the distribution of one or more of the trigeminal nerve branches and is usually treated with anti-epileptic medication. When first line treatment fails, patients receive other treatment modalities including radiofrequency thermoablation (RFT) of the Gasserian ganglion and peripheral branches of the trigeminal nerve. The aim of this study is to compare RFT of the Gasserian ganglion and peripheral branches of trigeminal nerve in terms of efficacy and rate of complications. METHODS: This was a systematic review and meta-analysis that searched Medline, Cochrane Central Register of Controlled Trials, and Embase using Medical Subject Headings and the references of the enrolled studies with no restriction on date. We included only RCTs that compared the RFT of the Gasserian ganglion and peripheral branches of trigeminal nerve with one of the following outcomes: pain scales, immediate effective rate, recurrence rate, and complications. RESULTS: Five articles were eligible for our review and showed that there was no difference between RFT of the peripheral nerves and the Gasserian ganglion in terms of pain scores. There was a non-significant trend for RFT of the peripheral nerve to have higher immediate effect rates and higher recurrence rates. RFT of the Gasserian ganglion group was associated with masticatory weakness, while the other group was associated with facial swelling and numbness of V2. CONCLUSION: RFT of the peripheral branches is a safe and effective method to treat idiopathic trigeminal neuralgia but leads to a higher recurrence rate when compared with RFT of the Gasserian ganglion.

Attitudes of Patients with Chronic Diseases toward Management eHealth Applications Systems in Post-COVID-19 Times.

Introduction: There has been an increase in the adoption of eHealth technologies and applications by health consumers globally because of the restrictions imposed due to the COVID-19 pandemic in the last two years. The sudden change in the users' attitudes toward eHealth adoption needs to be critically evaluated and understood, as it can be the stepping stone toward rapid digitalization of healthcare operations in Saudi Arabia as a part of Vision 2030. Purpose: The purpose of this study was to evaluate the attitudes of the patients with chronic diseases toward eHealth applications in post-COVID times. Methods: A cross-sectional study design was adopted using the online questionnaire as a data collection instrument. All the health consumers using eHealth services aged above 18 years and living in Saudi Arabia were included in the survey. The survey was conducted for 3 weeks, resulting in a final sample of 234 participants. Results: Overall, 73.8% of the participants stated that they adopted eHealth only out of necessity, while 37.3% stated that they adopted it because no other services were available. Only 10.3% stated that they adopted eHealth out of interest. In relation to the future use of eHealth, 51.5% of the participants stated that they would definitely not use eHealth applications, and 33.6% stated that they would probably them once the pandemic ends. Only 4.4% of the participants stated that they would very much probably, and 10.5% stated they would probably not use eHealth applications once the pandemic ends. a significant difference in opinions in relation to the future adoption of eHealth applications was observed among the male and female participants, and also between the age groups of younger (age <35 years) and older (age ≥35 years) participants. Conclusions: For the change in attitudes (increased adoption of eHealth) to be sustained, policymakers need to develop relevant strategies promoting the use of eHealth in Saudi Arabia.

Sylvian Fissure Lipoma: An Unusual Etiology of Seizures in Adults.

Seizure is a prevalent symptom and is an important neurological complaint in the emergency department. Patients with first-time seizures require a thorough evaluation to determine the possible etiologies and identify any causative pathology. Further, neuroimaging studies are vital to identifying the structural culprits. We report the case of a 35-year-old man who was brought to the emergency department with abnormal repetitive shaking movements that were witnessed by his spouse. Before the event, he became dizzy and fell to the ground. During the episode, he was not aware of his surrounding. He developed uprolling of his eyes and had frothy secretions from the mouth. On physical examination, the patient was drowsy but fully oriented. There were no signs of focal neurological deficit. Routine laboratory investigations, including hematological and biochemical profiles, yielded normal results. He was referred to undergo magnetic resonance imaging of the brain. The scan demonstrated the presence of a well-circumscribed lesion in the left Sylvian fissure with high signal intensity on T1- and T2-weighted image with suppression on the fat-suppressed sequence and no post-contrast enhancement. The radiological impression was of Sylvian fissure lipoma. The lesion was successfully resected surgically and the patient had an uneventful recovery with no complaints at the follow-up visits. Sylvian fissure lipoma is among the rarest locations of intracranial lipoma. Despite this, physicians should remember this lesion when they encounter a brain lesion with high signal intensity on T1- and T2-weighted images. While the majority of cases are incidental, an intracranial lipoma can be an etiology of first-time seizures in adults.

Extensive Pulmonary Embolism Following Mild COVID-19 Pneumonia.

The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and predominantly manifests with respiratory symptoms. However, it may have a wide range of complications, including hematological complications. Several studies demonstrated that patients with COVID-19 exhibit a wide range of complex abnormalities of the coagulation system. We report the case of a 22-year-old man who presented to our emergency department with a cough and fever for one week. His vital signs were normal. Since the patient was young and mildly symptomatic, he was offered the option of home isolation for seven days. Two weeks later, the patient presented to the emergency department complaining of sudden shortness of breath that was associated with chest pain. The oxygen saturation was 92% on room air. The patient underwent computed tomography pulmonary angiography. The scan showed a centric filling defect in the main right and left pulmonary arteries representing pulmonary embolism. Further, the scan showed a thrombus in the inferior vena cava that was the source of bilateral pulmonary embolism. The patient was admitted to the intensive care unit. He received full anticoagulation with heparin. After recovery, he underwent a thrombophilia screen, which yielded normal findings. The present case demonstrated that thromboembolic events may develop even after the recovery from mild COVID-19 pneumonia. In the appropriate clinical settings, physicians should maintain a high index of suspicion of coagulopathy in any patient with recent COVID-19 pneumonia. Further studies are needed to determine the indication and duration of the thromboprophylaxis following the recovery from COVID-19.

Prevalence of Behavioral Addictions and Their Relationship With Stress and Anxiety Among Medical Students in Saudi Arabia: A Cross-Sectional Study.

Behavioral addiction is identified as any compulsive, repeated, and persistent behavior that leads to significant and functionally impairing harm or distress. The aim of this study is to determine the prevalence of internet, video-gaming, and pornography addictions among medical students in Western region. In addition, we intend to investigate the relationship between these behavioral addictions with stress and anxiety. Our study was a cross-sectional study with a sample size of 225. The study participants were medical students in their 3rd, 4th, and 5th academic years from five different medical colleges in Western region. The questionnaire included demographics and adapted five different pre-validated scales: Young's Internet Addiction Test - Short Version (IAT-SV), Internet Gaming Disorder Scale 9 - Short Form (IGDS9-SF), (PPC scale), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder 7-item scale (GAD-7). The IAT-SV scale showed: 71 (31.6%) of the participants had normal internet usage, 51 (22.7%) participants showed problematic usage, and 103 (45.8%) used the internet pathologically. The IGDS9-SF scale had observed the following values: 220 participants (97.8%) were non-disordered, and 5 participants (2.2%) were found to be disordered. Statistical analysis showed a highly significant association between stress and problematic pornography consumption (P < 0.01), and internet addiction (P <0.001). Moreover, there was a significant association between anxiety and internet gaming disorder (P < 0.01). This study showed high prevalence of internet addiction and low prevalence of internet gaming disorder. Also, it gave more understanding to a possible association between these behavioral addictions with stress and anxiety.

Cross Sectional E-Health Evaluation Study for Telemedicine and M-Health Approaches in Monitoring COVID-19 Patients with Chronic Obstructive Pulmonary Disease (COPD).

Monitoring COVID-19 patients with COPD has become one of the major tasks in preventing transmission and delivering emergency healthcare services after vaccination in case of any issues. Most COVID-19-affected patients are suggested to self-quarantine at home or in institutionalized quarantine centers. In such cases, it is essential to provide remote healthcare services. For remote healthcare monitoring, two approaches are being considered in this study, which include mHealth and Telehealth. A mixed-methods approach is adopted, where survey questionnaires are used for collecting information from 108 patients and semi-structured interviews are used with seven physicians regarding mHealth and Telehealth approaches. Survey results indicated that mHealth is rated to be slightly more effective than Telehealth, and interview results indicated that Telehealth is identified to be slightly more effective than mHealth in relation to parameters including usefulness, ease of use and learnability, interface and interaction quality, reliability, and satisfaction. However, both physicians and patients opined that both mHealth and Telehealth have a promising future with increasing adoption. Based on the findings, it can be concluded that both mHealth and Telehealth are considered to be effective in delivering remote care for COPD patients infected with COVID-19 at home. Implications of the study findings are discussed.

Pulmonary Alveolar Microlithiasis and Rheumatoid Arthritis: A Case Report and Review of the Literature.

Pulmonary alveolar microlithiasis is a rare autosomal recessive condition that is characterized by the formation of excessive calcium phosphate microliths in the alveoli. Most patients are diagnosed in adulthood due to the slow progression of the disease. Children with this disease are asymptomatic, and changes in the lung parenchyma are usually discovered incidentally. The diagnosis is made by the combination of a positive chest imaging and histological examination. Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by chronic seropositive symmetrical inflammatory polyarthritis with numerous extra-articular manifestations. It targets the lining of the synovial membranes, frequently affects females more than males, and is treated with the disease-modifying antirheumatic drugs (DMARDs). If left untreated, it leads to increased morbidity, mortality, and socioeconomic burdens. In this case, we report a 19-year-old young man who presented with clinical and radiographic features of PAM associated with RA.

Applying eHealth for Pandemic Management in Saudi Arabia in the Context of COVID-19: Survey Study and Framework Proposal.

BACKGROUND: The increased frequency of epidemics such as Middle East respiratory syndrome, severe acute respiratory syndrome, Ebola virus, and Zika virus has created stress on health care management and operations as well as on relevant stakeholders. In addition, the recent COVID-19 outbreak has been creating challenges for various countries and their respective health care organizations in managing and controlling the pandemic. One of the most important observations during the recent outbreak is the lack of effective eHealth frameworks for managing and controlling pandemics. OBJECTIVE: The aims of this study are to review the current National eHealth Strategy of Saudi Arabia and to propose an integrated eHealth framework that can be effective for managing health care operations and services during pandemics. METHODS: A questionnaire-based survey was administered to 316 health care professionals to review the current national eHealth framework of Saudi Arabia and identify the objectives, factors, and components that are key for managing and controlling pandemics. Purposive sampling was used to collect responses from diverse experts, including physicians, technical experts, nurses, administrative experts, and pharmacists. The survey was administered at five hospitals in Saudi Arabia by forwarding the survey link using a web-based portal. A sample population of 350 was achieved, which was filtered to exclude incomplete and ineligible samples, giving a sample of 316 participants. RESULTS: Of the 316 participants, 187 (59.2%) found the current eHealth framework to be ineffective, and more than 50% of the total participants stated that the framework lacked some essential components and objectives. Additional components and objectives focusing on using eHealth for managing information, creating awareness, increasing accessibility and reachability, promoting self-management and self-collaboration, promoting electronic services, and extensive stakeholder engagement were considered to be the most important factors by more than 80% of the total participants. CONCLUSIONS: Managing pandemics requires an effective and efficient eHealth framework that can be used to manage various health care services by integrating different eHealth components and collaborating with all stakeholders.

Prevalence and correlates of anaemia in adolescents in Riyadh city, Kingdom of Saudi Arabia.

OBJECTIVE: To determine the prevalence and correlates of anaemia in male and female adolescents in Riyadh, Kingdom of Saudi Arabia. DESIGN: A cross-sectional community-based study. SETTING: Five primary health-care centres in Riyadh. SUBJECTS: We invited 203 male and 292 female adolescents aged 13-18 years for interview, anthropometric measurements and complete blood count. Blood Hb was measured with a Coulter Cellular Analysis System using the light scattering method. RESULTS: Using the WHO cut-off of Hb<12 g/dl, 16·7 % (n 34) of males and 34·2 % (n 100) of females were suffering from anaemia. Mean Hb in males and females was 13·5 (sd 1·4) and 12·3 (sd 1·2) g/dl, respectively. Values for mean cell volume, mean cell Hb, mean corpuscular Hb concentration and red cell distribution width in male and female adolescents were 77·8 (sd 6·2) v. 76·4 (sd 10·3) µm(3), 26·1 (sd 2·7) v. 25·5 (sd 2·6) pg, 32·7 (sd 2·4) v. 32·2 (sd 2·6) g/dl and 13·9 (sd 1·4) v. 13·6 (sd 1·3) %, respectively. Multivariate logistic regression revealed that a positive family history of Fe-deficiency anaemia (OR=4·7; 95 % CI 1·7, 12·2), infrequent intake (OR=3·7; 95 % CI 1·3, 10·0) and never intake of fresh juices (OR=3·5; 95 % CI 1·4, 9·5) and being 13-14 years of age (OR=3·1; 95 % CI 1·2, 9·3) were significantly associated with anaemia in male adolescents; whereas in females, family history of Fe-deficiency anaemia (OR=3·4; 95 % CI 1·5, 7·6), being overweight (OR=3·0; 95 % CI 1·4, 6·1), no intake of fresh juices (OR=2·6; 95 % CI 1·4, 5·1), living in an apartment (OR=2·0; 95 % CI 1·1, 3·8) and living in a small house (OR=2·5; 95 % CI 1·2, 5·3) were significantly associated with anaemia. CONCLUSIONS: Anaemia is more prevalent among Saudi female adolescents as compared with males. Important factors like positive family history of Fe-deficiency anaemia, overweight, lack of fresh juice intake and low socio-economic status are significantly associated with anaemia in adolescents.

Prevalence of anemia and associated factors in child bearing age women in riyadh, saudi arabia.

Objective. To determine the prevalence and risk factors for anemia in child bearing age women in Riyadh, Saudi Arabia. Design. Cross-sectional survey was conducted using two-stage cluster sampling. 25 clusters (primary health care centers (PHCC)) were identified from all over Riyadh, and 45-50 households were randomly selected from each cluster. Eligible women were invited to PHCC for questionnaire filling, anthropometric measurements, and complete blood count. Blood hemoglobin was measured with Coulter Cellular Analysis System using light scatter method. Setting. PHCC. Subjects. 969 (68%) women out of 1429 women were included in the analysis. Results. Mean hemoglobin was 12.35 (±1.80) g/dL, 95% CI 12.24-12.46 with interquartile range of 1.9. Anemia (Hb <12 g/dL) was present in 40% (390) women. Mean (±SD) for MCH, MCV, MCHC, and RDW was 79.21 (±12.17) fL, 26.37 (±6.21) pg, 32.36 (±4.91) g/dL, and 14.84 (±4.65)%, respectively. Multivariate logistic regression revealed that having family history of iron deficiency anemia (OR 2.91, 95% CI 1.78-4.76) and infrequent intake of meat (OR 1.54, 95%CI 1.15-2.05) were associated with increased risk of anemia, whereas increasing body mass index (OR 0.95, 95% CI 0.92-0.97) was associated with reduced risk of anemia. Conclusion. Women should be educated about proper diet and reproductive issues in order to reduce the prevalence of anemia in Saudi Arabia.

Tourist satisfaction with primary health care services in aseer region.

OBJECTIVE: The objective of this study was to assess the satisfaction of tourists who utilized health care services of five selected primary health care centers in Abha, Aseer region of Saudi Arabia in the summer of the year 2000. METHODS: This study was conducted during July of 2000 in five primary health care centers (PHCCs) in Aseer region, Saudi Arabia. Self-administered questionnaire designed by the investigators was distributed to all tourists who fulfilled the following criteria: aged above 15 years, can read and write and has intent on participating voluntarily. The questionnaire concerned satisfaction with different health care services delivered by the PHCCs and suggestions for the improvement of the services. Data was entered and analyzed using SPSS. RESULTS: A total of 413 tourists fulfilled the selected criteria. The mean age of the participants was 29.2 years; 81.4% were males, 37.3% were highly educated and 32.7% came from western province. PHCCs services were accessible to 87% and the working hours at PHCCs were suitable for 88.6% of the tourists. More than three-quarters of the visitors came for cure. Satisfaction with the different health services on a 5-point scale ranged from 4.63 points for availability of medications to 4.85 points for cooperation of treating doctors. Seventeen suggestions and comments were reported by 26% of the participants. Most of these suggestions and comments were about providing an adequate number of female doctors and medications. CONCLUSION: This study revealed that most of the tourists who utilized the selected PHCCs in Aseer region were satisfied with most of the different PHCCs services. However, many tourists gave valid suggestions and comments which should be considered for the improvement of the quality of care in these PHCCs in the future.