HPV Vaccine Knowledge and Hesitancy Among Health Colleges' Students at a Saudi University.

Introduction: Human papillomavirus (HPV) infection is a widespread sexually transmitted infection linked to various types of cancer. Although vaccination against HPV is available, global HPV vaccination rates remain low. Aim: This study aimed to evaluate the awareness and knowledge of the HPV vaccine and to identify predictors associated with vaccine hesitancy among health college students at King Saud University, Saudi Arabia. Methods: A cross-sectional survey was distributed during December 2022 to students enrolled in health colleges. The survey link was randomly distributed via social media platforms and in-person interactions. The number of participants was 405 including both males and females. The data was analyzed using the Statistical Package for Social Sciences (SPSS). The correct response rate for all knowledge items was calculated, and they were stratified by gender and college. The association of vaccine hesitancy with sociodemographic characteristics was examined using logistic regression analysis. Results: The study found that approximately half of the students (49.9%) were aware of the HPV vaccine. However, only a small percentage of students answered all to all HPV knowledge items correctly. Additionally, only a small proportion (5.2%) reported receiving the vaccine. The overall HPV vaccine hesitancy was 59.1% (43.9% for female and 75.9% for male). The most common reasons for vaccine hesitancy was not knowing enough about it. Males were two times more likely than females to believe that they did not need the HPV vaccine. The odds for HPV vaccine hesitancy were greater among males and younger age groups compared to females and older age groups. Conclusion: This study underscores the importance of implementing university-wide interventions and educational campaigns to enhance awareness and knowledge of the HPV vaccine.

Prescription opioid misuse in relation to addiction susceptibility among women at a Saudi university.

Objectives: The trends of prescription opioid misuse are understudied in Arab populations, let alone among university students. Additionally, little is known about the psychological traits that increase susceptibility for such behaviors in this region. Thus, this study aimed to assess the prevalence of prescription opioid misuse and its association with addiction susceptibility, as measured by the Substance Abuse Risk Profile Scale (SURPS). Methods: We sampled university students from King Saud University's women's campus. Data on prescription opioid misuse, SURPS traits, and demographic characteristics were collected using an electronic self-administered survey. Results: Lifetime prescription opioid misuse was 48.5%, while past-month misuse was 28.9%. On average, SURPS subscale scores for impulsivity (mean = 11.6; SD = 2.8) hopelessness (mean = 12.3; SD = 3.5), sensation seeking (mean = 16.4; SD = 3.8), and anxiety sensitivity (mean = 14.6; SD = 2.6). Anxiety sensitivity composite scores significantly differed between students reporting misuse and those who did not. Moreover, the odds for prescription opioid misuse increased by 7% for every 1 unit increase in anxiety sensitivity (AOR = 1.07; 95% CI = 1.00, 1.14), when controlling for other SURPS measures and student characteristics. Conclusion: The prevalence of prescription opioid misuse in our study is higher than what is reported in global student populations. This may reflect unmonitored availability of controlled substances and unsupervised medical prescriptions. Additionally, high levels of anxiety sensitivity may be driving such misuse. Further surveillance of prescription drug misuse among university students and motivators for such behavior is needed for planning prevention and control interventions.

Is the Frequency of Postpartum Breastfeeding Counseling Associated with Exclusive Breastfeeding at Six Months? An Analytical Cross-Sectional Study.

Breastfeeding counseling is an essential public health tool in postpartum maternal and infant health. In this study, we aimed to explore the relationship between the frequency of postpartum breastfeeding counseling and the type of feeding outcome at six months. The study design was an analytical, cross-sectional study on mothers of 6-24-month-old children living in Riyadh, Saudi Arabia. We conducted an analysis with descriptive statistics as well as logistic regression models. The findings from our study can be summarized in the following points: First, only 31.9% of the women in our study received postnatal breastfeeding counseling in the first six months after delivery, with the majority receiving fewer than four sessions. Second, there seemed to be a drop in exclusive breastfeeding with time: from 35.3% in the first two months to 29.7% in the second two months and then 20.7% in the final two months. Third, previous exclusive breastfeeding increased the odds of exclusive breastfeeding in the proceeding delivery. Finally, exposure to one or more postnatal breastfeeding counseling sessions increased the odds of exclusive or predominant breastfeeding in the first six months. This study helps to guide decision makers in planning maternal child health services and relevant community-based efforts.

Harnessing Machine Learning in Early COVID-19 Detection and Prognosis: A Comprehensive Systematic Review.

During the early phase of the COVID-19 pandemic, reverse transcriptase-polymerase chain reaction (RT-PCR) testing faced limitations, prompting the exploration of machine learning (ML) alternatives for diagnosis and prognosis. Providing a comprehensive appraisal of such decision support systems and their use in COVID-19 management can aid the medical community in making informed decisions during the risk assessment of their patients, especially in low-resource settings. Therefore, the objective of this study was to systematically review the studies that predicted the diagnosis of COVID-19 or the severity of the disease using ML. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), we conducted a literature search of MEDLINE (OVID), Scopus, EMBASE, and IEEE Xplore from January 1 to June 31, 2020. The outcomes were COVID-19 diagnosis or prognostic measures such as death, need for mechanical ventilation, admission, and acute respiratory distress syndrome. We included peer-reviewed observational studies, clinical trials, research letters, case series, and reports. We extracted data about the study's country, setting, sample size, data source, dataset, diagnostic or prognostic outcomes, prediction measures, type of ML model, and measures of diagnostic accuracy. Bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with the number CRD42020197109. The final records included for data extraction were 66. Forty-three (64%) studies used secondary data. The majority of studies were from Chinese authors (30%). Most of the literature (79%) relied on chest imaging for prediction, while the remainder used various laboratory indicators, including hematological, biochemical, and immunological markers. Thirteen studies explored predicting COVID-19 severity, while the rest predicted diagnosis. Seventy percent of the articles used deep learning models, while 30% used traditional ML algorithms. Most studies reported high sensitivity, specificity, and accuracy for the ML models (exceeding 90%). The overall concern about the risk of bias was "unclear" in 56% of the studies. This was mainly due to concerns about selection bias. ML may help identify COVID-19 patients in the early phase of the pandemic, particularly in the context of chest imaging. Although these studies reflect that these ML models exhibit high accuracy, the novelty of these models and the biases in dataset selection make using them as a replacement for the clinicians' cognitive decision-making questionable. Continued research is needed to enhance the robustness and reliability of ML systems in COVID-19 diagnosis and prognosis.

Current and future prospective of pharmaceutical manufacturing in Saudi Arabia.

This observational descriptive study that was carried out with the objective of exploring the contribution of the local pharmaceutical industry to the Saudi drug security. Using a drug formulary provided from the Saudi Food and Drug Authority, containing all registered pharmaceutical products available in Saudi Arabia, we extracted information about drug class, drug type, country and place of manufacturing, shelf-life and price. Results showed that the majority of drugs in the market are manufactured in Europe (43.86%), followed by Saudi Arabia (22.55%), China and India (20.47%), Americas (10.24%), and other nations (2.61%). Most of the manufactured drugs were prescription drugs (90.62%). In this work, the local pharmaceutical industry with the highest percentage of contribution to local drug security was Pharmaceutical Solution Industries (PSI), representing the 5% of the items available in the Saudi market. The second highest percentage was 4% by TABUK Pharmaceutical Manufacturing CO., followed by SPIMACO (3%), JAMJOOM pharmaceutical company (2%), Riyadh pharma (2%), and Jazeera pharmaceutical industries (2%). In addition, results from this study provide information about the most essential pharmaceutical products that needs to be nationally manufactured or increased in production in order to rise the contribution of local pharmaceutical industries in Saudi drug security. Unfortunately, the small contribution of the Saudi pharmaceutical industry in local drug security increases the burden on the Kingdom's annual budget due to the over-reliance on international pharmaceuticals.

Prevalence of fatigue functional and social impairment among patients with rheumatic diseases compared to patients without: A cross-sectional comparison.

Rheumatic diseases (RD) are chronic diseases that significantly affect the lives of patients. Assessing health outcomes through a patient-reported outcome measurement information system (PROMIS) is essential for RD management. Moreover, these tend to be less favorable among individuals than among the rest of the population. This study aimed to compare PROMIS between RD patients and other patients. This cross sectional study was conducted in the year 2021. Information about patients with RD was obtained from the RD registry at King Saud University Medical City. Patients without RD were recruited from family medicine clinics. Patients were contacted electronically through WhatsApp© to complete the PROMIS surveys. We compared the individual PROMIS scores between the 2 groups using linear regression, adjusting for sex, nationality, marital status, education level, employment, family history of RD, income, and chronic comorbidities. There were 1024 individuals (512 with RD and 512 without RD). The most common RD was systemic lupus erythematosus (51.6%), followed by rheumatoid arthritis (44.3%). Individuals with RD reported significantly higher PROMIS T-scores for pain [ß = 6.2; 95% confidence interval (CI) = 4.76, 7.71] and fatigue (ß = 2.9; 95% CI = 1.37, 4.38) compared to those without RD. Moreover, RD individuals reported lower physical functioning (ß = -5.4; 95% CI = -6.50, -4.24) and social interaction (ß = -4.5; 95% CI = -5.73, -3.20). Patients with RD in Saudi Arabia, particularly those with systemic lupus erythematosus and rheumatoid arthritis, have significantly greater impairment in physical functioning and social interaction and report higher levels of fatigue and pain. Addressing and ameliorating these negative outcomes is necessary to improve quality of life.

Awareness of Human Papillomavirus among Male and Female University Students in Saudi Arabia.

BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted infection globally. Investigating HPV awareness can reduce the burden of HPV-related cancers. AIMS: (1) Assessing HPV awareness and knowledge among health college students at King Saud University, (2) comparing these outcomes across sociodemographic characteristics. METHODS: A cross-sectional survey study was conducted from November to December 2022 and included 403 health college students. Associations of HPV awareness and knowledge with sociodemographic characteristics were assessed using logistic regression analysis and linear regression analysis, respectively. RESULTS: Only 60% of students were aware of HPV, with awareness higher among females, although their knowledge scores were comparable to males. The odds of awareness of HPV were greater among medical students compared to other colleges and among students belonging to older age groups compared to the younger age group (18-20). The odds of HPV awareness among hepatitis B vaccinated students were 2.10 times that among unvaccinated students (AOR = 2.10; 95% CI = 1.21, 3.64). CONCLUSIONS: The low level of HPV awareness among college students warrants the need for HPV educational campaigns to improve HPV awareness and to promote HPV vaccination in the community.

Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review.

BACKGROUND: Evidence suggests physicians have higher rates of mental distress than other professionals. Although multiple studies have been conducted among Saudi medical trainees to address this issue, no reviews assessed multiple psychological problems simultaneously. We aimed to examine the prevalence and trends of depression, anxiety, burnout and stress among Saudi medical trainees. METHODS: A systematic review was conducted searching PubMed/Medline, OVID, Scopus, PsychInfo, EBSCOhost and the Directory of Open Access Journals (DOAJ) for studies addressing depression, burnout, stress and anxiety among Saudi medical trainees, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Joanna Briggs Critical Appraisal Checklist was used to evaluate quality. The main findings were summarised in tables. RESULTS: We identified 57 records from 2001 to 2020. Overall (mild, moderate or severe) depression ranged from 28% to 70.6%, while stress ranged from 30.5% to 90.7%. Burnout was primarily assessed among residents with an overall prevalence reaching 85.5%. Overall anxiety ranged from 52.7% to 67%, and was only assessed among undergraduates. Higher levels of all four mental conditions were reported among females. CONCLUSION: This review suggests high prevalence of depression, stress, burnout and anxiety among medical trainees, with higher estimates for females compared to males.

Association of health and lifestyle factors with uterine fibroids among Saudi women: A case-control study.

Objectives: The objective of this study was to measure the association between uterine fibroids (UFs) and several risk factors (parity, miscarriage, diabetes, hypertension, physical activity, smoking, family history of UF and contraceptive pill use) among Saudi women. Methods: A case-control study was conducted in 478 women at two medical centers in Riyadh. Cases were confirmed by ultrasound. Demographic and risk factor information was collected from interviews and medical records. The prevalence of risk factors was calculated with 95% confidence interval (CI). Unconditional logistic regression analysis was used to measure the associations between UFs and the risk factors. Results: More than half the participants were obese. The average body mass index (BMI) was 31.2 (±6.81) for cases and 29.4 (±7.02) for controls. Women 40 years or older had four times the odds of UFs than women younger than 40 years (adjusted odds ratio [AOR] = 4.24, 95% CI = 2.63, 6.85). Having a family history of UFs was associated with 69% greater odds of UFs (AOR = 1.69, 95% CI = 1.02, 2.81). Being obese was associated with 74% greater odds of UFs (AOR = 1.74, 95% CI = 1.00, 2.59), whereas previous live births decreased the odds of UFs by 62% (AOR = 0.38, 95% CI = 0.19, 0.75). Conclusions: This study identified risk factors associated with UFs in the Saudi population. Age over 40 years, obesity and a family history of UFs are important risk factors for UF, whereas parity appears to be protective against UF development in Saudi women. Early recognition of these risk factors is important to prevent UF complications.

Prevalence of fibromyalgia in physicians in training: a cross-sectional study.

The prevalence of fibromyalgia (FM) in physicians in training (PIT) in Saudi Arabia is unknown. The aim of this study is to evaluate the prevalence of FM in PIT using different screening tools and factors associated with its development. We also aimed at evaluating the level of agreement and correlation between screening tools. This was a cross-sectional study conducted in a single academic institution. PIT were invited to fill three questionnaires: Fibromyalgia Rapid Screening tool (FirST), Fibromyalgia Survey Questionnaire (FSQ), and London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). A total of 182 PIT completed the questionnaire. They were predominantly males (57.1%), single (56.0%), and at resident level (86.7%). The median age was 28 (interquartile range = 4). The average number of house-calls/month was 3.2 (SD = 2.3). The prevalence of FM using the FirST, FSQ, and LFESSQ was 6.0%, 8.2%, and 11.6%, respectively. Six (3.3%) fulfilled the three criteria concurrently. After adjusting for different variables using the FSQ, PIT with family history of FM had 23.6 times the odds for testing positive (95% CI = 3.12, 178.37), and every extra house-call/month was associated with a 50% increase in the odds for testing positive for FM (95% CI = 1.00, 2.25). Percent agreement between tools was high (all > 86%). Results for kappa coefficient showed moderate agreement between FSQ scores and each of FirST and LFESSQ. There was poor agreement between FirST and LFESSQ. FM is prevalent among PIT. There is a high percent agreement and poor to moderate correlation between the screening tools used.

Self-reported substance use in Iraq: findings from the Iraqi National Household Survey of Alcohol and Drug Use, 2014.

AIMS: To estimate the prevalence of tobacco, alcohol and drug use in Iraq using data from the Iraqi National Household Survey of Alcohol and Drug Use (INHSAD). DESIGN: A cross-sectional survey was conducted using a multi-stage cluster sampling method. Trained surveyors conducted face-to-face household interviews. SETTING: Iraq, from April 2014 to December 2014. PARTICIPANTS: A total of 3200 adult, non-institutionalized Iraqi citizens residing across all 18 governorates of Iraq. MEASUREMENTS: We estimated weighted prevalence and 95% confidence intervals (CIs) for life-time, past-year and past-month use of a variety of substances (tobacco, alcohol, prescription drugs and illicit drugs). For each substance, we also estimated whether individuals knew people who currently use the substance. FINDINGS: Self-reported past-month tobacco use was 23.2% (95% CI = 21.40, 25.19). Past-month alcohol use was 3.2% (95% CI = 2.58, 3.93). Women reported significantly lower prevalence for both tobacco and alcohol use compared with men (P-value < 0.01 for both). Only 1.4% (95% CI = 0.67, 3.02) reported past-month non-medical use of any prescription drugs. None of the women reported using any illicit drugs, and only 0.2% (95% CI = 0.07, 0.49) of men reported using any illicit drugs in the past month. Approximately 90.5% (95% CI = 88.58, 92.11) knew someone who uses tobacco, 42.4% (95% CI = 39.53, 45.24) knew someone who drinks alcohol, 27.9% (95% CI = 25.53, 30.45) knew someone who uses medication outside a doctor's instructions and 9.2% (95% CI = 7.87, 10.75) knew someone who uses an illicit drug. CONCLUSIONS: Psychoactive drug use is generally low in Iraq, tobacco being highest at an estimated 23.2%. Iraqi women report significantly less substance use than Iraqi men, which may be related to cultural gender norms. Discrepancy between self-report and 'knowing someone who uses a substance' suggests under-reporting in this population.

Smoking among university students: a gender analysis.

The main objectives of this paper were to estimate the consumption patterns of tobacco use among King Saud University (KSU) undergraduate students; and investigate different risk factors which may contribute to tobacco use among female students. A representative sample (n=7550) of the total KSU undergraduate student population of 69,498 (males and females) was selected, stratified according to college and gender. A modified version of the WHO/CDC Global Youth Tobacco Survey (GYTS) questionnaire was used for data collection. Overall smoking prevalence among KSU students was estimated at 14.5%, prevalence among male students (32.7%), and females (5.9%). Independent risk factors for smoking among males were found to be: age, father's smoking habits, and "friends' smoking habits"; while among females were: sister's smoking habits and "friends' smoking habits." The findings of this study re-emphasize the significance of peer pressure on smoking among university students of both sexes; influence of family members, usually of same sex. We need to foster gender-sensitive tobacco prevention intervention programs, to prevent youngsters of both sexes from taking up such habit. We also need to raise awareness of girls and young women, of the consequences of smoking in general, water-pipe in specific, on their own health, that of their spouses, families, and off-springs, many of whom could develop chronic respiratory disorders, as passive smokers in the beginning/potential smokers themselves, later on. All such efforts should be backed and supported by strong governmental commitment, to ensure success of their implementation accordingly.