Public Perception in Saudi Arabia Toward Herpes Zoster and Its Vaccination: A Cross-Sectional Study.

Background Herpes zoster (HZ) or shingles, arises from the reactivation of the varicella zoster virus (VZV), mainly affecting older and immunocompromised individuals. Despite the efficacy of vaccines, vaccination rates in Saudi Arabia are low. Thus, this study aimed to assess the knowledge, attitude, and practice of the Saudi Arabian population toward HZ and its vaccination. Methods An observational cross-sectional study was carried out to evaluate the public perception in Saudi Arabia toward HZ and its vaccination, during the period from January to March 2024. Participants were selected using a non-probability, convenience sampling method, with recruitment facilitated through WhatsApp, a messaging app. Data has been analyzed using the statistical software Statistical Package for Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY). A p-value of <0.05 has been used to report the statistical significance. Results The study's demographic profile included 1237 participants, predominantly younger than 30 years (65.5%), with a female majority (65.7%). Public knowledge about HZ was limited, only 29.6% of participants recognized the risk of HZ post-chickenpox. More than half of the participants were not aware that the vaccine is provided by the Saudi Ministry of Health (MOH) for certain groups. However, over 75% are willing to receive the HZ vaccine upon physician recommendation. Conclusion This study shows a general lack of awareness about HZ and its vaccination in Saudi Arabia, including misconceptions about vaccination availability, recommendations, and the disease's complications. Gender differences in attitude and interest highlight the potential for tailored educational campaigns. Addressing these issues is essential for improving vaccination rates and mitigating HZ's impact.

Effect of a WhatsApp walking trial on daily steps among female Saudi Arabian university students.

Objective: Physical inactivity in Saudi women is high, even among young women (60% of university students are physically inactive). We aimed to investigate the effect of a physical activity intervention on daily walking among female students at a Saudi university. Methods: Two hundred and seven female students (mean age: 22.6 ± 1.3; body mass index: 24.6 ± 5.9) participated in a parallel-group randomized trial. The intervention group wore pedometers and received health-promotion messages for 12 weeks through WhatsApp®; the control group received a similar number of messages unrelated to health. Average daily steps and self-reported activity were assessed at baseline and after 3 months. Analysis followed an intention-to-treat approach. Group differences in average daily steps were assessed using a two (group) by 2 (time) ANOVA. F-tests for main effects and the interaction were evaluated; P < 0.05 was considered significant. Results: There was a significant group-by-time interaction, that is, the intervention group had a significantly higher change in daily steps compared to the control group (+576 vs. -525; F = 4.33, P = 0.04). Self-reported daily activity was not significantly different by group. Conclusions: The intervention was effective at improving the number of daily steps in young women. Future studies could test this intervention among other student groups.

10 years of experience in adopting, implementing and evaluating progress testing for Saudi medical students.

Objectives: The progress test (PT) is a comprehensive examination that is designed to match the knowledge acquisition necessary at graduation and monitors progress during the entire period of an undergraduate program. Qassim College of Medicine (QCM) began using the multi-institutional PT in the Kingdom of Saudi Arabia (KSA). This study aimed to determine if the PT can be utilized to assess the progress of medical students at different Saudi medical colleges with different educational approaches, as well as whether this testing modality could be accepted by other colleges. Methods: Beside the establishment of a PT committee, comprehensive blueprinting was crafted to sample 200 A-type multiple choice questions (MCQs) from different disciplines. The PT is a paper-and-pencil model and is answered in a 4-h period. All PT items followed a uniform design. Results: In total, 13 rounds of the progress test have been conducted. The number of participating colleges increased from three (with 285 students) in the first test (May 2012) to more than 20 (with >6000 students) in the ninth round (February 2017). The average % scores for first-year students ranged from 3.0% to 7.9% while the average scores for fifth-year students ranged from 34.0% to 43.0%. Conclusion: The conduction of this meticulously crafted test to evaluate knowledge achievement at medical graduation is a fruitful tool and helps to provide constructive feedback for test-takers and other stakeholders relating to their relative positions among other fellows at the national level.

Mucormycosis co-infection in COVID-19 patients: An update.

Mucormycosis (MCM) is a rare fungal disorder that has recently been increased in parallel with novel COVID-19 infection. MCM with COVID-19 is extremely lethal, particularly in immunocompromised individuals. The collection of available scientific information helps in the management of this co-infection, but still, the main question on COVID-19, whether it is occasional, participatory, concurrent, or coincidental needs to be addressed. Several case reports of these co-infections have been explained as causal associations, but the direct contribution in immunocompromised individuals remains to be explored completely. This review aims to provide an update that serves as a guide for the diagnosis and treatment of MCM patients' co-infection with COVID-19. The initial report has suggested that COVID-19 patients might be susceptible to developing invasive fungal infections by different species, including MCM as a co-infection. In spite of this, co-infection has been explored only in severe cases with common triangles: diabetes, diabetes ketoacidosis, and corticosteroids. Pathogenic mechanisms in the aggressiveness of MCM infection involves the reduction of phagocytic activity, attainable quantities of ferritin attributed with transferrin in diabetic ketoacidosis, and fungal heme oxygenase, which enhances iron absorption for its metabolism. Therefore, severe COVID-19 cases are associated with increased risk factors of invasive fungal co-infections. In addition, COVID-19 infection leads to reduction in cluster of differentiation, especially CD4+ and CD8+ T cell counts, which may be highly implicated in fungal co-infections. Thus, the progress in MCM management is dependent on a different strategy, including reduction or stopping of implicit predisposing factors, early intake of active antifungal drugs at appropriate doses, and complete elimination via surgical debridement of infected tissues.

Association of genetic polymorphisms in DNA repair genes ERCC2 Asp312Asn (rs1799793), ERCC2 Lys 751 Gln (rs13181), XRCC1 Arg399 Gln (rs25487) and XRCC3 Thr 241Met (rs861539) with the susceptibility of lung cancer in Saudi population.

This study demonstrated the association of polymorphisms in ERCC2 (Asp312Asn) rs1799793, ERCC2 (Lys751Gln) rs13181, XRCC1 (Arg399Gln) rs25487 and XRCC3(Thr241Met) rs861539 polymorphisms with a susceptibility of lung cancer (LC) onset in the Saudi population. The study was performed on 134 LC patients and 270 controls. The data revealed that there was no significant association of LC with subtype squamous cell carcinoma (SCC), small cell lung cancer (SCLC) and adenocarcinoma with the ERCC2 rs1799793 polymorphism. The data showed that the CC genotype for ERCC2 rs13181, the AA genotype for XRCC1 rs25487, and the genotype TT for XRCC3 rs861539 were significantly associated with SCC susceptibility (p < 0.05). Similarly, the CC genotype for ERCC2 rs13181 and the AA genotype for XRCC1 rs25487 were significantly associated with adenocarcinoma susceptibility (p < 0.05). Whereas, the TT genotype for XRCC3 rs861539 was significantly associated with SCLC susceptibility (p = 0.005). In total, significant association of LC susceptibility was found in the following combination models of recessive genotypes: AC heterozygous for ERCC2 rs13181 + AA homozygous for XRCC1 rs25487, CC homozygous for ERCC2 rs13181 + GA heterozygous for rs25487, CC homozygous for rs13181 + AA homozygous for XRCC1 rs25487, CC homozygous for ERCC2 rs13181 + TT homozygous for XRCC3 rs861539, GA heterozygous for XRCC1 rs25487 + CT heterozygous for XRCC3 rs861539, GA heterozygous for XRCC1 rs25487 + TT homozygous for XRCC3 rs861539, AA homozygous for XRCC1 rs25487 + CT heterozygous for XRCC3 rs861539, AA homozygous for XRCC1 rs25487+ TT homozygous for XRCC3 rs861539. These data clearly demonstrated that the combination of recessive genotypes may be associated with susceptibility of LC onset (p < 0.05). In short, the data indicated that DNA repair genes increase LC risk via gene-gene interaction rather than independent variants.

Thymoquinone provides structural protection of human hemoglobin against oxidative damage: Biochemical studies.

Hydroxyl radicals (OH.) are one of the most active reactive oxidants recognized for their deleterious effects to cause protein oxidative damage. Thymoquinone, a monoterpene molecule abundantly present in black cumin and known for its pharmacological activities, but its activity against the OH.-induced protein oxidative damage has never been explored. This study determined the therapeutic potential of thymoquinone against OH.-induced oxidative human hemoglobin damage. Novel data demonstrated that thymoquinone provides structural protection of hemoglobin against oxidative damage. Treatment of hemoglobin with OH. induces hypochromicity at 280 and 405 nm, whereas thymoquinone reversed these hypochromic effects. In addition, OH. cause significant reduction in tryptophan fluorescence, however thymoquinone also reversed these damaging effects. Thymoquinone also reduces OH.-induced hydrophobicity and also reduces OH.-induced carbonylation. Moreover, it also inhibits thermal stabilization of OH.-hemoglobin complex. SDS-PAGE of unmodified hemoglobin showed four bands, which disappeared upon OH. treatment and these changes were also retained by thymoquinone. In conclusion, this is the first study that shows the therapeutic potential of thymoquinone against OH.-induced oxidative damage in human hemoglobin.

Physicians based emergency medical services for the management of burn injuries in trauma centers of the center region of Saudi Arabia: evaluation of physicians' knowledge and experience.

BACKGROUND: Medical services at trauma centers regularly encounter severe burn patients but prehospital care of these patients in Saudi Arabia is comparatively unexplored. This study evaluates the knowledge and experience of physicians working in trauma centers of Qassim province of Saudi Arabia for the management of patients with burn injuries. METHODS: This is a cross sectional study performed on 204 physicians working in the trauma centers of Qassim province. Physicians' knowledge and experience were assessed via administration of validated questionnaires and the data were analyzed using SPSS software. RESULTS: Among total studied physicians, only 35.3% and 24.0% gave the right answer to the question on the diagnosis of burn skin in depth/extent for adults and pediatric patients, respectively. Importantly, 93.6% physicians responded correctly for first aid treatment. For the parkland concept, 62.2% responded correctly, however, only 22.5% understand the colloid fluid concept. The 74% physicians knew the methods of fluid revival for mass burn injuries and about half of studied physicians showed right knowledge for intubation for breathing for mass burn injuries. Only 47.5% physicians understand the concept of electrolyte disorder. CONCLUSIONS: This is the first study from the central region of Saudi Arabia that analyzed the knowledge and experience of physicians working in trauma centers for the management of patients with burn injuries. Overall data showed that ~60% physicians working in trauma centers have knowledge for handling the patients with burn injuries but the rest needed counseling, therefore proper training sessions for them are needed for management of burn patients.

Digitalization plan in medical education during COVID-19 lockdown.

BACKGROUND: The COVID-19 pandemic has enhanced the adoption of virtual learning after the urgent suspension of traditional teaching. Different online learning strategies were established to face this learning crisis. The present descriptive cross-sectional study was conducted to reveal the different digital procedures implemented by the College of Medicine at Qassim University for better student performance and achievement. METHODS: The switch into distance-based learning was managed by the digitalization committee. Multiple online workshops were conducted to the staff and students about the value and procedures of such a shift. New procedures for online problem-based learning (PBL) sessions were designed. Students' satisfaction was recorded regarding the efficiency of live streaming educational activities and online assessment. RESULTS: The students were satisfied with the overall shift into this collaborative e-learning environment and the new successful procedures of virtual PBL sessions. The digital learning tools facilitated the performance of the students and their peer sharing of knowledge. The role of informatics computer technologies was evident in promoting the students, research skills, and technical competencies. CONCLUSIONS: The present work elaborated on the procedures and privileges of the transformation into digitalized learning, particularly the PBL sessions, which were appreciated by the students and staff. It recommended the adoption of future online theoretical courses as well as the development of informatics computer technologies.

Job insecurity, fear of litigation, and mental health among expatriate nurses.

The objective was to assess whether job insecurity and fear of litigation were correlates of depression, anxiety, and stress among expatriate nurses in Saudi Arabia. The participants included 977 expatriate nurses working in Al-Qassim, Saudi Arabia who completed an online survey that assessed depression, anxiety, and stress (using DASS-21) as well as demography, lifestyle, and job characteristics. Mean age was 32 years and 60% of nurses were from India/Pakistan. Twenty-four percent of nurses reported job insecurity, and 18% reported a fear of litigation. Severe depression, anxiety, and stress were significantly higher among nurses who always felt insecure about their job (compared to never) and among those who always feared litigation (compared to never). We concluded that job insecurity and fear of litigation were significant correlates of severe depression, anxiety, and stress among expatriate nurses.

Bisphenol A modified DNA: A possible immunogenic stimulus for anti-DNA autoantibodies in systemic lupus erythematosus.

Anti-DNA antibodies are now considered as a universal diagnostic feature for the patients with systemic lupus erythematosus (SLE) but the mechanism(s) involved in the generation of these autoantibodies remains to be investigated. Bisphenol A (BPA) is a synthetic phenol extensively used in the manufacturing of polycarbonated plastics. Upon mixing in the diet, it causes several health hazards. This study was undertaken to investigate the contribution of BPA induced DNA damage in SLE patients. Human DNA was modified by BPA in-vitro and the binding characteristics of SLE circulating immunoglobulin Gs (SLE-IgGs) with BPA damaged DNA (BPA-DNA) were screened and compared with the IgGs from normal healthy humans (NH-IgGs). Immunogenicity of BPA-DNA was determined by immunisation in rabbits. DNA from SLE patients (SLE-DNA) or healthy humans (NH-DNA) were isolated and their binding specificity with rabbit anti-BPA-DNA-IgGs was studied. Treatment of human DNA with BPA caused extensive damaged. Circulating SLE-IgGs showed strong recognition of BPA-DNA. BPA-DNA induced high titre antibodies in rabbits. Rabbit anti-BPA-DNA-IgGs showed strong cross reaction with isolated DNA from SLE patients. In short, we concluded that the structural alterations in DNA by BPA, generate neo-epitopes that may be a factor responsible for the induction of anti-DNA autoantibodies in SLE.

Association of cumulative job dissatisfaction with depression, anxiety and stress among expatriate nurses in Saudi Arabia.

AIMS: We aimed to (a) determine the prevalence of depression, anxiety and stress among expatriate nurses in Saudi Arabia, and (b) assess how dissatisfaction with salary, workload and teamwork, individually and in combination, was associated with those conditions. BACKGROUND: Prevalence estimates for depression, anxiety and stress among nurses are higher than those in the general population. Available data on the mental health of expatriate nurses are limited. METHODS: Expatriate nurses (n = 977) from governmental hospitals completed an electronic survey on demography, lifestyle, job factors, depression, anxiety and stress (assessed with DASS-21 scale). Multinomial logistic regressions were used for analyses. RESULTS: Dissatisfaction with workload and teamwork was significantly associated with both mild/moderate and severe depression in adjusted models. Dissatisfaction with workload was significantly associated with both anxiety and stress, but teamwork was not. There was a significant dose-response relationship between the number of domains of dissatisfaction and depression, anxiety and stress (p for trend was < 0.001). CONCLUSIONS: Dissatisfaction with salary, workload and teamwork is associated with depression, anxiety and stress in expatriate nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital and nursing administrators should identify specific aspects related to workload and teamwork and offer solutions to reduce mental health distress among nurses.

Depression and anxiety among parents and caregivers of autistic spectral disorder children.

OBJECTIVE: To evaluate the presence of depression and anxiety in parents/caregivers of autistic spectral disorder (ASD) children, and to identify associated factors. METHODS: In this retrospective cohort study carried out between July and December 2011, parents/caregivers of at least one child diagnosed with an ASD (cases group), were recruited through the Saudi Charitable Society of Autism Families and the Autism Clinic in the Pediatric out-patient clinic in King Fahad National Guard Hospital, King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. The parents/caregivers of a normally developed child (control group) were recruited from the Well Child Clinic at King Abdulaziz Medical City, Riyadh. We used a self-reported questionnaire containing questions on demographic data, as well as the Arabic version of the hospital anxiety and depression scale. RESULTS: The study included 100 parents/caregivers, 50 cases and 50 controls. More than 50% of the control group was in the age group 26-30 years (56%), while 42% of cases were in the age group 31-35 years. Time lapsed since autism diagnosis was over 3 years in one-third of cases. Twenty-two percent of cases, and only 2% of control parents/caregivers had a history of psychiatric problems (p=0.002). Both the mean depression score, and the mean anxiety score was significantly higher among cases when compared with controls, p<0.001. CONCLUSION: Autism is associated with burden and stress for parents/caregivers of the affected child. The demands placed by the disability contribute to a higher overall incidence of depression and anxiety among parents/caregivers.