Physicians' Practices in Diabetic Nephropathy in Primary Healthcare Centers in Jazan City, Saudi Arabia, 2023.

Background and Objectives: Diabetes is one of the most common diseases dealt with by physicians in primary healthcare centers (PHCs). The disease is associated with macrovascular and microvascular complications, especially in those with long disease duration and uncontrolled diabetic nephropathy, which is one of the most common microvascular complications among diabetic patients. This investigation assessed the practices of physicians working at PHCs in terms of diabetic nephropathy screening, management, and referral. Materials and Methods: This study is a cross-sectional investigation targeting physicians working at PHCs in the Jazan region of Saudi Arabia between March and August of 2023. Data were collected via a self-administered questionnaire, which was distributed via online platforms. The questionnaire included sections measuring physicians' demographic data and associated factors regarding training, the availability of resources, and practices in diabetic nephropathy, including screening, management, and referral. Chi-squared tests were used to assess associations between the practices of physicians and the measured demographics. Result: A total of 234 physicians participated in the investigation. The median age of the participants was 35 years. The adherence level of practice toward diabetic nephropathy according to American Diabetes Association (ADA) guidelines ranged from 40 points (the highest adherence level of participants) to 19 points (the lowest adherence level of participants), with a median of 33 points. Higher adherence levels were noted among physicians in Saudi Arabia, physicians with higher education levels, physicians specializing as family physicians or diabetologists, physicians who reported attending online and on-site training at diabetic centers, physicians who reported continuous access to urine and serum creatinine tests, and physicians who reported continuous access to the American Diabetes Association guidelines (p < 0.05). Conclusions: There are several factors associated with the level of adherence in diabetic nephropathy practice, such as physicians' education level, specialty, training, and access to guidelines. The findings suggest the need for more training for PHC physicians in the care of patients affected by or at risk of diabetic nephropathy.

Trigeminal Neuralgia Secondary to Herpes Simplex Virus Type 1 Infection Treated With Oral Acyclovir.

Trigeminal neuralgia (TN) is characterized by episodic electric, shock-like facial pain. Though often idiopathic, herpes simplex virus type 1 (HSV-1) reactivation can rarely cause symptomatic TN. We report the case of a 30-year-old woman who developed oral HSV-1 lesions followed by right-sided TN pain. MRI of the brain did not reveal neurovascular compression. TN pain completely resolved with oral acyclovir treatment alone, without anticonvulsants. This highlights the importance of considering atypical etiologies such as HSV-1 reactivation in TN evaluation. Early antiviral therapy may treat underlying inflammation and provide sustained symptom relief in HSV-associated TN.

Does ChAdOx1-S and BNT162b2 heterologous prime-boost vaccination trigger higher rates of vaccine-related adverse events?

Background: There has been significant international interest in heterologous prime-boost COVID-19 vaccination. However, it is linked with different intensity and frequency of adverse events. This study aimed to assess the safety of ChAdOx1-S and BNT162b2 vaccines when given as heterologous prime-boost vaccination in Saudi Arabia. Methods: A cross-sectional study was conducted during the period October 2021 to March 2022. The study included two groups of people based on the type of vaccination regimen. The first group (heterologous) was subjected to different prime-boost vaccination schedules irrespective of the prime and boost vaccine types. The second group included people vaccinated with the same type of COVID-19 vaccine (homologous). Results: The overall sample included 334 participants. Those included in the heterologous group were at about 1.5 fold -increased risk for developing local and systemic adverse events compared to the homologous group. Fever, headache, and vomiting were significantly more frequent among the heterologous group compared to the homologous group (p-value<0.05). In both groups, more than half of the recorded adverse events were mild/moderate in severity. Conclusion: Heterologous prime-post vaccination is associated with a slightly increased risk for the development of local and systemic adverse events compared to the homologous regimen. However, most of these adverse events are mild/moderate in nature and recede within two days with no serious adverse events documented.

Analysis of patients' complaints in primary healthcare centres through the Mawid appl in Riyadh, Saudi Arabia; a cross-sectional study.

Introduction: The Saudi Ministry of Health launched a central appointment mobile application system (Mawid) that is linked to all primary healthcare (PHC) centres in the kingdom. The application allows patients to evaluate the healthcare services they receive. This study aimed to determine the frequency and nature of the complaints of patients visiting PHC centres through the Mawid application. Method: This cross-sectional study was conducted using 3-month secondary data from the Mawid application. The study included 3134 comments from 380,493 patients who visited 38 PHC centres in Riyadh and responded to the Mawid application evaluation questionnaire. Data were analysed using SPSS version 21. Results: Approximately 59.1% of the patients' comments were negative (patients' complaints); only 19%, positive; 8.40%, mixed; and 13.6%, unrelated. The patients' complaints (n=2969) were obtained from 380,493 patients within 3 months, yielding a complaint rate of 2.6 per 1000 attendances per month. The majority of the complaints (79.3%) were from patients visiting nonspecialised PHC centres. Approximately 59.1% of the complaints fell under the management domain; 23.6%, patient-staff relationship domain; and only 17.2%, clinical domain. Conclusion: Management and interpersonal problems constituted the main patients' complaints in the PHC centres in Saudi Arabia. Therefore, future studies must clarify the reasons contributing to these complaints. Increasing the number of physicians, providing staff training and continuous auditing are mandatory to improve patients' experiences in PHC centres.

Post-COVID-19 syndrome: nature of symptoms and associated factors.

Aim: Post-COVID-19 syndrome is defined as continuous symptoms related to SARS-CoV-2 infection, which can persist for several weeks or months. Previous studies identified risk factors associated with post-COVID-19 syndrome, including female sex, hypertension, and allergic respiratory diseases. This study aims to investigate the frequency of this syndrome among Arabic patients. Subject and methods: A cross-sectional study was conducted from March to August 2022. The study included 520 Arabic patients with confirmed COVID-19 diagnosis, who were asked about possible symptoms persisting for ≥28 days. Results: Twenty-five percent (25%) of the included patients developed post-COVID-19 syndrome. The most common recorded symptoms were cough (32%), anosmia (32%), fatigue (28%), headache (19%), muscle pain (19%), and shortness of breath (17%). It was found that female sex, hospitalization due to initial COVID-19 infection, and the presence of chronic diseases were significant risk factors for developing post-COVID-19 syndrome. Conclusion: The study recorded post-COVID-19 syndrome among 25% of Arabic participants. Initial COVID-19 hospitalization, initial symptomatic COVID-19, and female sex were significant risk factors for developing post-COVID-19 syndrome. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01802-3.

The Experience and Satisfaction of Physicians with Electronic Health Systems in Healthcare Establishments in Jazan, Saudi Arabia.

Purpose: The Saudi Ministry of Health's electronic health (e-health) initiative aims to promote the higher use of electronic medical records and has established multiple health applications to facilitate access to healthcare. The current investigation measured the satisfaction and experience of physicians concerning e-health systems and identified the factors associated with their satisfaction level. Methods: This study was a cross-sectional investigation targeting physicians working in primary healthcare centers and hospitals in the Jazan region of Saudi Arabia. Data were collected via a self-administered questionnaire between July and September 2022, which was distributed via online platforms. The questionnaire included sections measuring the physicians' demographic data and their experiences with e-health systems, including information technology (IT) support, training, software design, workload, physician and patient support, and data quality. Chi-square or Fisher's exact tests were used to assess associations between physicians' satisfaction levels and the measured demographics. Results: A total of 445 physicians participated in the current investigation. The median age of the participants was 27, and more than half (58.4%) were male. The median level of the satisfaction score was 4 and varied between -30 (indicating the lowest satisfaction level) and 23 (indicating the highest satisfaction level). Employment rank and work settings were statistically associated with the level of satisfaction (P values < 0.05). The participating physicians were overall satisfied with the e-health systems' impact on their clinical workflow and ability to reduce their work hours but were less satisfied with the training required to use these systems. Conclusion: A good overall satisfaction level with the established e-health systems in the Jazan region was detected. Senior physicians and physicians working in primary healthcare settings exhibited lower satisfaction levels, indicating a need for further investigations to identify the challenges of using e-health systems in these settings, especially among senior physicians.

COVID-19 vaccine acceptance: knowledge and beliefs.

Backgrounds: Vaccine acceptance varies across countries, generations, and the perceived personality of individuals. Investigating the knowledge, beliefs, and acceptability of COVID-19 vaccines among individuals is vital to ensuring adequate health system capacity and procedures and promoting the uptake of the vaccines. Results: A cross-sectional study was conducted from August 2021 to January 2022 in Saudi Arabia. The study included 281 residents to estimate their acceptance to receive COVID-19 vaccination. Around 70% of the included participants had a moderate to high COVID-19 vaccine acceptance rate during the data collection period. The risk increases to about two folds among undergraduates [OR 1.846 (1.034-3.296), p value = 0.036)] and increases to four folds among non-employed [OR 3.944 (2.310-6.737), p value = 0.001]. About 78% of participants with high and 44% with low COVID-19 vaccine acceptance (p value = 0.001) believed the vaccines were safe and effective. The belief that COVID-19 disease will be controlled within two years increased the risk for low vaccine acceptance by about two folds [OR 1.730 (1.035-2.891), p value = 0.035]. Good knowledge about COVID-19 vaccination significantly affected the acceptance rate (p value = 0.001). Conclusions: Several factors affect the intention of individuals to receive vaccines. Therefore, building good knowledge and health literacy through educational intervention programs, especially vaccine safety and effectiveness, is important for successful vaccination campaigns among the general population and ensuring control of the COVID-19 pandemic.

Protective Duration of ChAdOx1 and BNT162b2 Vaccines Against SARS-CoV-2 Infection.

BACKGROUND AND OBJECTIVE: A limited number of studies have addressed the protective duration of coronavirus disease 2019 (COVID-19) vaccines following primary and booster doses in Saudi Arabia. Therefore, this study aimed to evaluate the protective duration of primary and booster doses of BNT162b2 and ChAdOx1 COVID-19 vaccine batches in Saudi Arabia. METHODS: A cross-sectional study was conducted from 1 January to 31 December, 2021. The study included 53,354 people infected with severe acute respiratory syndrome coronavirus-2 2 weeks or more after receiving at least a primary vaccination of either the ChAdOx1 or BNT162b2 vaccine. RESULTS: The total median protective duration of both primary COVID-19 vaccinations was 134 days. Heterologous primary vaccination (ChAdOx1 followed by BNT162b2) showed a significantly higher median protective duration of 142 days. The results show that the total median protective duration of the first booster doses of COVID-19 vaccines was 57 days. ChAdOx1 batch code C1 was found to have the most extended protective duration of 173 days (range 163-192 days). CONCLUSIONS: The current study revealed that the median protective duration of ChAdOx1 and BNT162b2 COVID-19 primary vaccination regimens administered in Saudi Arabia in 2021 was 134 days and that heterologous primary vaccination (ChAdOx1→BNT162b2) exhibited a significantly higher protective duration than other vaccination regimens.

Prevalence and factors associated with Internet gaming disorder among adolescents in Saudi Arabia: A cross-sectional study.

This study aimed to assess the prevalence of internet gaming disorder (IGD) and its associated factors among a sample of adolescents in the Faifa governorate in the south of Saudi Arabia. This was a cross-sectional study targeting intermediate and secondary school adolescent students in the Faifa governorate. Multistage sampling was performed to reach the required sample, where 9 schools were randomly selected, followed by the distribution of the questionnaire to all students at all levels. IGD was assessed using a validated Arabic version of the 20-item IGD scale. A chi-square test was used to evaluate the presence of statistical differences between sample demographic data and IGD. Four hundred and fifty students participated in the current study, where 132 (29.3%) of them were classified as having IGD. The prevalence of IGD was associated with gender, year of study, maternal education status, and the number of hours spent online and playing with friends (P values 0.05). Analysis of the IDG items among the current sample indicated that most were at the conflict stage of IGD. The IGD level identified in our sample is high compared to the published literature. Faifa is a mountainous region and, due to its geographical nature, there are limited public entertainment areas. Adolescents tend to spend more time at home, where they may be more exposed to IGD. This suggests the need for strategies to ensure early identification of those at risk of IGD and to provide preventive and treatment options for these students.

Seroprevalence of antibodies to SARS-CoV-2 among blood donors in the early months of the pandemic in Saudi Arabia.

BACKGROUND: Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. OBJECTIVE: To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. METHODS: Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. RESULTS: The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. CONCLUSIONS: At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling.

Comorbidities and severity of coronavirus disease 2019 patients.

OBJECTIVES: To determine the association between comorbidities and the severity of the disease among COVID-19 patients. METHODS: We searched the Cochrane, Medline, Trip, and EMBASE databases from 2019. The review included all available studies of COVID-19 patients published in the English language and studied the clinical characteristics, comorbidities, and disease outcomes from the beginning of the pandemic.  Two authors extracted studies characteristics and the risk of bias. Odds ratio (OR) was used to analyze the data with 95% confidence interval (CI). RESULTS: The review included 1,885 COVID-19 patients from 7 observational studies with some degree of bias risk and substantial heterogeneity. A significant association was recorded between COVID-19 severity and the following variables: male (OR= 1.60, 95%CI= 1.05 - 2.43); current smoker (OR=2.06, 95%CI= 1.08 - 3.94); and the presence of comorbidities including hypertension (OR=2.05, 95%CI= 1.56 - 2.70), diabetes (OR=2.46, 95%CI= 1.53 - 3.96), coronary heart disease (OR=4.10, 95%CI= 2.36 - 7.12), chronic kidney disease (OR=4.06, 95%CI= 1.45 - 11.35), and cancer (OR=2.28, 95%CI= 1.08 - 4.81). CONCLUSIONS: Comorbidities among COVID-19 patients may contribute to increasing their susceptibility to severe illness. The identification of these potential risk factors could help reduce mortality by identifying patients with poor prognosis at an early stage.

Light-assisted removal of ear canal live insect-A noninvasive approach for first level responders.

Physicians, working in the primary care setting and/or emergency departments, encounter more often patients of any age group with foreign bodies in the external auditory canal (EAC) and urgent removal is crucial to avoid complications. The condition is more commonly managed on an urgent basis if the foreign body is a live insect that is more agonizing for the patient. Foreign body removal is quite challenging but an essential skill for first-level responders and different approaches, each with its own pros and cons, are used for EAC foreign bodies removal. Herein, we report two cases that were managed safely by a noninvasive approach by using light illumination of EAC in complete darkness. The approach, not reported in the available literature, can be used as first-level management before opting another alternative, in settings where otolaryngologist services are not readily available.