Consanguineous marriages, premarital screening, and genetic testing: a survey among Saudi university students.

Background: Marriage among cousins or close relatives, i.e., consanguinity, is prevalent in many parts of the world, especially the Muslim world. Across civilizations, cultural norms, religious beliefs, and economic factors affect consanguineous marriages (CMs); however, such marriages have social, genetic, and health repercussions. The present study investigated the university students' attitudes regarding CMs and factors influencing their attitudes at King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). Methods: This cross-sectional prospective study was conducted at KAU Jeddah in 2023. The questionnaire was distributed via electronic media (Emails, Facebook Messenger & WhatsApp). The convenience sampling technique was used to select participants, and descriptive and inferential statistics were used to analyze the data on SPSS-26. Results: A total of 1707 university students were part of the study (females, 1,198, 70.2%; males, 509, 29.8%). Almost half of the participants, 819 (48.0%), had parents with CMs. Most of the participants, 1,391 (81.5%), had CMs in the family. Half of the participants disagreed that parents consider marriage stable due to high compatibility and the same social relationship before and after marriage. About one-third of respondents said parents believe family marriage transmits cultural values and continuity and keeps wealth in the family. More than three-fourths of the participants stated that if marriage is arranged with first cousins, they will opt for genetic analysis (82.5%) and premarital counseling (85.2%). The personal attitudes of females (p < 0.001), undergraduate (p = 0.02), and health sciences students (p = 0.02) were more positive than their counterparts. Males (OR = 0.41; p < 0.001) and non-health sciences students (OR = 0.68; p = 0.01) were less likely to have significant positive attitudes than their counterparts. Among participants who had CM parents, males (OR = 0.397; p < 0.001) and non-health sciences students (OR = 0.60; p = 0.01) and urban residents (OR = 0.59; p = 0.01) had significantly lower odds of having a positive attitude than their counterparts. Conclusion: The practice of CMs is still prevalent in Saudi culture, with almost half of the participants having CM parents and the majority reporting these marriages in their families. Personal attitudes toward CMs were extremely positive. Most students prefer genetic testing and premarital counseling if marrying first cousins. Gender, faculty, parental income, and educational background influenced participants' attitudes.

Language Barriers in Understanding Healthcare Information: Arabic-Speaking Students' Comprehension of Diabetic Questionnaires in Arabic and English Languages.

Background Typically, disease-related information is available in English on the internet, and the bulk of medical research journals are likewise published in English. Therefore, in non-English-speaking countries, many people find it challenging to put that knowledge into practice. This study compared Arabic-speaking students' performance on a diabetic questionnaire presented in Arabic with their performance on the same questionnaire in English. Methodology The cross-sectional study was carried out at the King Abdulaziz University, Jeddah. Identical questionnaires in Arabic and English assessing knowledge, attitude, and practices (KAP) on diabetes mellitus (DM) were filled out by Arabic-speaking students. The English version was distributed to the same students four weeks after the Arabic version. A total of 507 students filled out the Arabic questionnaire, and four weeks later, they filled out the English version. Results Students' scores were significantly higher in the knowledge and attitudes domains (P < 0.001), with no significant difference observed in the practice domain on the Arabic language questionnaire compared to English. A gender-wise comparison showed that females had significantly higher knowledge scores in the Arabic and practice domains in the English questionnaires. According to the regression analysis, students were predicted to have good knowledge scores on the Arabic language questionnaire than on the English version (odds ratio [OR] = 4.537, P < 0.001). Similarly, students on the Arabic language questionnaire showed higher scores for positive attitudes (OR = 2.703, P < 0.001), and adequate preventative behavior (OR = 1.592, P < 0.001) than on the English version. Furthermore, being female is linked to having good knowledge scores (OR = 1.724, P < 0.001). Conclusions Results indicated that students' good knowledge, positive attitude, and adequate practice scores were associated with the Arabic language questionnaire than the English version. Our participants' KAP scores derived from an English language questionnaire were not up to the mark. There is a need to modify the school curriculum to increase students' English comprehension and command so they can perform better in professional courses.

Psychosocial, cultural, and academic challenges to Saudi Arabian students in Australia.

OBJECTIVES: This study investigated the perceptions of Saudi Arabian medical disciplines students undergoing training in various institutes of Australia regarding psychosocial, cultural, and academic challenges. METHODS: This cross-sectional study was from March 15 to June 15, 2019. Data were collected by an online questionnaire. It consisted of questions regarding demographic, psychosocial, cultural, and academic challenges. Two hundred nineteen students studying in Australia responded to our questionnaire. RESULTS: Of the total 219 students, 13(6.0%) were undergraduate, 167(76%) were postgraduate, and 39(18%) were Ph.D. students. For most students (171[79.2%]), Australia was the country of choice for studying. Most of them were satisfied with their academic performance and adjustment to the Australian way of living. Most of the students (180[82.2%]) showed satisfaction over the availability of fair chances of their religious practices in Australia. Few of them faced difficulties coping with the Australian climate (25[11.4%]), homesickness (59[26.9%]), and food and dietary sources (44[20.1%]). Students were overall satisfied with the student advisory system (156[71.2%]), university assessments (147[67.2%]), and available research facilities (170[77.6%]). Among participants, 77 (35.1%), 119(54.3%), and 23(10.5%) students indicated that they wished to stay in Australia only until completion of their studies, temporarily and permanently, respectively. CONCLUSIONS: Our findings showed that Saudi students in Australia had strong psychosocial well-being, cultural integration, and academic success. Most of them were satisfied and adjusted well to Australian culture.

Predictors of misconceptions, knowledge, attitudes, and practices of COVID-19 pandemic among a sample of Saudi population.

This study intends to explore the predictors of misconceptions, knowledge, attitudes, and practices concerning the COVID-19 pandemic among a sample of the Saudi population and we also assessed their approaches toward its overall impact. This online cross-sectional survey was conducted at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU) in Jeddah, Saudi Arabia (SA). Participants were approached via social media (SM), and 2006 participants (953 [47.5%] females and 1053 [52.5%] males) were included in this study. SM was the leading source of information for 43.9% of the study participants. Most of the participants had various misconceptions such as "females are more vulnerable to develop this infection, rinsing the nose with saline and sipping water every 15 minutes protects against Coronavirus, flu and pneumonia vaccines protect against this virus." About one-third of participants (31.7%) had self-reported disturbed social, mental, and psychological wellbeing due to the pandemic. Many participants became more religious during this pandemic. Two-thirds of the study participants (68.1%) had good knowledge scores. Attitudes were highly positive in 93.1%, and practice scores were adequate in 97.7% of the participants. Participants' educational status was a predictor of high knowledge scores. Male gender and divorced status were predictors of low practice scores, and aged 51-61 years, private-sector jobs, and student status were predictors of high practice scores. Being Saudi was a predictor of a positive attitude, while the male gender and divorced status were predictors of a negative attitude. Higher education was a predictor of good concepts, while the older age and businessmen were predictors of misconceptions. Overall, our study participants had good knowledge, positive attitudes, and good practices, but several myths were also prevalent. Being a PhD and a Saudi national predicted high knowledge scores and positive attitudes, respectively. A higher education level was a predictor of good concepts, and students, private-sector jobs, and aged 51-61 years were predictors of high practice scores. Study participants had good understanding of the effects of this pandemic.

Persistence of Reverse Transcription-Polymerase Chain Reaction (RT-PCR) Positivity in COVID-19 Recovered Patients: A Call for Revised Hospital Discharge Criteria.

In the world scenario, the advent of COVID-19 has halted every aspect of life. It influenced every field of life, including the economy, and revealed the inadequacies in all nations' healthcare systems, from the most developed to the underdeveloped countries. There is a debate about the timing of antibodies production and detection during the disease. What is the significance of reverse transcription-polymerase chain reaction (RT-PCR) viral ribonucleic acid (RNA) in symptom resolving period? In the present manuscript, we have evaluated these points.

Association of Dyslipidemia and Comorbidities with Risk Factors Among Diabetic Patients: A Retrospective Analysis.

PURPOSE: To find out the association of dyslipidemia and comorbidities with risk factors among type-2 diabetes mellitus (T2DM) patients attending King Abdulaziz University Hospital (KAUH) Jeddah, Saudi Arabia (SA). PATIENTS AND METHODS: Three hundred and twenty-five T2DM patients were enrolled from the electronic record of the KAUH. The patients' existing comorbidities and dyslipidemia correlation with demographic, clinical, and available laboratory data were sought. Statistical analysis was performed on SPSS-23. RESULTS: Of the total 325 T2DM patients with a mean age of 60.13±10.5 years [males 95 (29.23%) and females 230 (70.77%)] were included from the electronic record. Poor glycemic control was observed in 222 (68.31%) subjects (HbA1c > 7%), and 154 (47.39%) subjects had DM for more than ten years. Among our study subjects, 103 (31.69%) were hypertensive (HTN), 112 (34.46%) had ischemic heart disease (IHD), 45 (13.85%) were obese, 8(2.46%) had a stroke and 269 (82.77%) had dyslipidemia. Of the total 269 dyslipidemic patients,168 (62.45%) were on hypolipidemic treatment. On comparison of study variables according to dyslipidemia versus normal lipid levels, the lipid profile, including HDLc, LDLc, TC, and TG, revealed a highly significant difference (p-value <0.001) whereas many variables were not significantly different. HBA1c, FBG, and RBG were significantly higher in dyslipidemic subjects. Logistic regression analysis of risk factors and comorbidities in our patients revealed that age 60-69 years and 70-79 years had a significant association with comorbidities. Similarly, logistic regression analysis of risk factors and dyslipidemia in our patients revealed no statistically significant association. CONCLUSION: Our results observed that the comorbidities were associated with increasing age and common comorbidities were HTN, IHD, dyslipidemia. Our study has highlighted the current trends in T2DM symptomatology and comorbidities. Efficient management and control by early screening and developing healthy lifestyles in our patients can be very helpful in the prevention of all these highly morbid complications of this preventable disease.

Approaches Towards Professional Studies and Spare-time Activities Among Preclinical and Clinical Year Medical Students.

Objective This study aims at a recognition of the differences in the study habits, approach to teaching resources, and spare-time activities of medical students in the preclinical and clinical training periods at King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA). Methods Study sampling was carried out in 2017 at the Faculty of Medicine, KAU, Jeddah, SA. Students from both genders were included and further subdivided to preclinical (2nd and 3rd years) and clinical groups (4th, 5th, and 6th years). Students were asked to respond to an online questionnaire. SPSS-Version 21 (IBM Corp., Armonk, NY, US) was utilized for statistical analysis of the collected data, Results Of the 347/500 (response rate 69.4%) medical students, 85 (24.5%) were from the preclinical students (2nd and 3rd years), and 262 (64.5%) were enrolled in the clinical group (4th to 6th years of MBBS). The majority of students 330 (94.1%) were unmarried, only 17 of them, i.e., 4.9%, were married. Analysis of the data revealed that medical textbooks, essential versions of basic medical books, online resources, and online version of books were used more frequently by the clinical group as compared to the preclinical students. Teacher-provided lecture handouts and lecture notes taken during classes were being equally used by both groups. There was a significant difference in the opinion on the usefulness of different resources between both groups. Students faced difficulty in understanding the English language, observed more in the pre-clinical years as compared to relatively groomed clinical students. The preclinical group could not understand the teaching material in books due to a weaker understanding of the English language. Social media software was used for keeping both groups busy, but clinical students also used social media for academic purposes. More than half of the participants from the preclinical and almost one-third from the clinical years admitted that their teachers recommended them for relevant medical textbooks. An encouraging trend was observed in most preclinical group students: they found teaching modalities, such as problem-based learning (PBL) and other academic activities, as a trigger to promote book reading. Conclusion Our results show that the students in the clinical phase had a more methodical approach to professional studies and a difference in spare-time activities.

Impact of omega-3 fatty acids on calorie intake and certain anthropometric measurements in children with sickle cell disease in Saudi Arabia.

The nutritional status and growth in children with sickle cell disease is compromised due to intake of diet that is low in calories as well as deficient in nutrients. Growth stunting and a low body mass index have been observed in these children. Some children exhibit pica, which is an abnormal eating pattern by ingesting things other than food, like paper, wood etc. This also was found to correlate to lower hemoglobin values. Interventions with certain essential nutrients such as omega-3 fatty acids are known to benefit these children in terms of lowering their complications due to the disease. We therefore wished to see if omega-3 fatty acids exhibit positive effects on their nutritional intake and growth parameters too. Hence, we supplemented these children with omega-3 fatty acids for a period of six months. Both the male and female children with the disease significantly improved their calorific intake as well as body mass index. Also a lowering of pica status was distinctly observed.

Medical students' preferences towards learning resources and their study habits at King Abdulaziz University, Jeddah, Saudi Arabia.

OBJECTIVE: The purpose of the present study was to explore why our medical students are avoiding the study of professional textbooks. We conducted this study from 10th March to 15th May 2017 at the King Abdulaziz University (KAU), Jeddah, to investigate their preferences towards learning resources, their study habits and correlation of academic achievements as a result of these trends. A questionnaire was provided as a web link. The participants of the study included medical students and data was analyzed on SPSS-Version 21. RESULTS: A total of 347/500 medical students participated in the study. Among our participants, there were 123 (35.5%) males and 224 (64.6%) were females. Female students' spent most of their time reading textbooks as compared to males (P-value = 0.001). Males mostly preferred the lecture handouts provided by their teachers. One-third of students admitted that, due to lack of a good grasp of English, they do not readily understand textbooks and consequently 67 (19.3%) students' showed a lack of interest in textbooks. Majority of the males 103 (84%) spent twice a time (66 vs. 33%) watching television as compared to the females. WhatsApp and Facebook kept both the sexes busy in most of their spare time.

Undergraduate medical research in the Gulf Cooperation Council (GCC) countries: a descriptive study of the students' perspective.

OBJECTIVE: There is a lack of research-oriented physicians in several Arab countries and especially in Gulf region countries. In this context, it is important to explore medical students' perceptions and motivations towards research. The aim of the present study was to investigate research attitude, practices, and motivations among medical students from GCC countries. RESULTS: There were 228 students who participated in this study (male 88, females 140). Thirty-eight percent of the students were participating from Saudi Arabia, 20.6% from the UAE, 17.1% from Oman, 12.7% from Kuwait and 11.4% from Bahrain. Among participants, 43.0% had experience of funded research, and 53.1% had a contribution to research. The confidence of participants in their ability to interpret and to write a research paper was quite high (70.2%). The majority of the students (87.3%) believed that undergraduate students could conduct research and can present at conferences. Improving research skills, attaining research publication, and improvement in patient care were claimed as the top three motives for conducting research. The majority (75.0%) were compelled to research to facilitate their acceptance to a residency program and 63.6% due to compulsion for a research methodology course.

Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices.

OBJECTIVE: We aimed at finding out reliable parameter in the differentiation of iron deficiency anemia (IDA) and beta-thalassemia trait (ß-TT) in the adult population subjected to Saudi Arabian Premarital Screening Program. METHODS: A total of 620 adults (age range 21-36 years) reported during February 2012 to November 2012. Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin (Hb). All the selected subjects' samples were subjected to blood morphology, comparison of MCV, RBC count. Red Cell Distribution Width (RDW) was noted from the Coulter Report whereas Red Cell Distribution Width Index (RDWI) value was calculated for all the samples. RESULTS: A total of one hundred &thirty-five individuals with hypochromic microcytic anemia having normal hemoglobin F and hemoglobin A2 < 3.2% were inducted in the study. Ninety-three were diagnosed having IDA, whereas thirty-two were having ßTT. Ten individuals revealed other causes of anemia. The RBC count was higher, and MCV was much lower in ßTT as compared to IDA. Both groups were subjected to RDW and RDWI, however, RDWI which showed better sensitivity and specificity for ßTT. CONCLUSION: RDWI is a reliable and useful index for differentiation among IDA and ßTT, as compared to RDW.

Utilization of smart phones related medical applications among medical students at King Abdulaziz University, Jeddah: A cross-sectional study.

INTRODUCTION: The present study explored the utility, attitude, and trends regarding Smartphone related Medical Applications (Apps) among medical students of King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA) and their perceptions of the impact of Medical Apps in their training activities. SUBJECTS AND METHODS: This survey was conducted at the Faculty of Medicine, Jeddah, and Rabigh campuses, KAU, Jeddah, SA. All participants were medical students of 2nd to 6th year. The data was collected by using an anonymous questionnaire regarding the perception of medical students about Medical Apps on the smart devices and the purpose of installation of the Apps. Additionally examined was the use of different Medical Apps by the students to investigate the impact of Medical Apps on the clinical training/practice. Data was analyzed on SPSS 21. RESULTS: The opinion of 330/460 medical students from all academic years was included in the study with a response rate of 72%. There were 170 (51.5%) males and 160 (48.5%) females with a mean age of 21.26±1.86 years. Almost all participating students 320 (97%) were well aware of Medical Apps for smart devices and 89.1% had installed different applications on their smart devices. The main usage was for either revision of courses (62.4%) or for looking up of medical information (67.3%), followed by preparing for a presentation (34.5%) and getting the medical news (32.1%). Regarding the impact of Medical Apps, most of the students considered these helpful in clinical decision-making, assisting in differential diagnosis, allowing faster access to Evidence-Based Medical practice, saving time and others. The practical use of these Apps was found to be minimal in medical students. Around 73% were occasional users of Medical Apps, and only 27% were using Medical Apps at least once a day. CONCLUSION: The regular use of Medical Apps on mobile devices is not common among medical students of KAU.

Changing haematological parameters in dengue viral infections.

BACKGROUND: Dengue Fever is the most common arboviral disease in the world, and presents cyclically in tropical and subtropical regions of the world. The four serotypes of dengue virus, 1, 2, 3, and 4, form an antigenic subgroup of the flaviviruses (Group B arboviruses). Transmission to humans of any of these serotypes initiates a spectrum of host responses, from in apparent to severe and sometimes lethal infections. Complete Blood count (CBC) is an important part of the diagnostic workup of patients. Comparison of various finding in CBC including peripheral smear can help the physician in better management of the patient. MATERIAL AND METHODS: This cross sectional study was carried out on a series of suspected patients of Dengue viral infection reporting in Ittefaq Hospital (Trust). All were investigated for serological markers of acute infection. RESULTS: Out of 341 acute cases 166 (48.7%) were confirmed by IgM against Dengue virus. IgG anti-dengue was used on 200 suspected re-infected patients. Seventy-one (39.5%) were positive and 118 (59%) were negative. Among 245 confirmed dengue fever patients 43 (17.6%) were considered having dengue hemorrhagic fever on the basis of lab and clinical findings. Raised haematocrit, Leukopenia with relative Lymphocytosis and presence atypical lymphocytes along with plasmacytoid cells was consistent finding at presentation in both the patterns of disease, i.e., Dengue Haemorrhagic fever (DHF) and Dengue fever (DF). CONCLUSION: Changes in relative percentage of cells appear with improvement in the symptoms and recovery from the disease. These findings indicate that in the course of the disease, there are major shifts within cellular component of blood.

Sperm swim-up: a simple and effective technique of semen processing for intrauterine insemination.

OBJECTIVE: To study the impact of sperm swim up technique of seminal processing for the purpose of intrauterine insemination (IUI) in couples presenting with subfertility. METHODS: Hundred and twenty-one couples presenting with subfertility underwent 281 cycles of IUI in Combined Military Hospital Kharian, Lahore and PNS SHIFA Karachi from June 2002 to March 2005. Men had prior semen analysis to assess for parameters like those that total sperm count, morphology and progressive motility. Only those couples were enrolled in whom there was either no obvious cause or the male partner had some problem with the seminal counts/motility. In standard swim-up technique, after liquefaction, the semen sample was centrifuged and supernatant was discarded. Pellet was suspended in pre-warmed 2.5 ml of Ham's F-10 culture medium and thereafter centrifuged once more. The pellet was gently over-layered with medium in the tube which was sealed, inclined at 45 degrees and kept at 37 degrees C for 60-90 minutes in 5% CO2. A sterile Pasteur pipette was used to remove the supernatant containing actively motile sperms. The specimen was kept at 37 degrees C till dispatched to be inseminated. Data was analyzed by using SPSS version-10. Motility and morphology were used to present qualitative parameters and chi-square test was applied to assess the effectiveness of IUI in relation with these variables. RESULTS: Post swim-up semen parameters including total motile sperm count and motility were observed. There was a trend towards an increased sperm count, motility and pregnancy rate after the swim up procedure. CONCLUSION: Our findings suggest that sperm swim-up technique is an easy reliable and effective sperm processing method for insemination purposes.

Impact of intrauterine insemination as first line treatment of subfertility.

OBJECTIVE: To determine the success rate of intrauterine insemination (IUI) in couples presenting with subfertility following controlled ovarian hyperstimulation (COH) by the use of cost effective intrauterine catheter (insertion tube). METHODS: An experimental study was conducted at the Obstetric and Gynaecology Departments of Combined Military Hospital Kharian and PNS SHIFA Karachi in collaboration with the Department of Pathology from June 2002 to March 2005. A total of 89 couples were studied, out of which 28 couples presented with abnormal finding in the seminal fluid of husband whereas in 61 couples no identifiable cause could be detected. The mean age of women was 29 years and the duration of infertility was variable. All women had tubal patency confirmed before undergoing COH. IUI was performed at follicular maturity of 18-22 mm. Main outcome measures analyzed were pregnancy rate per cycle of IUI, miscarriage rate and ongoing pregnancy rate. Prognostic factors associated with successful outcome in IUI, such as maternal age and motile sperm count was also observed. For cost effective measures, we used the sterilized disposable insertion tube of the 'Copper-T 380 A' device for insemination of reated sperms into the uterine cavity. Chi-square test was applied to assess the effectiveness of IUI in relation with these variables. RESULTS: A total of 205 insemination cycles were performed resulting in achievement of pregnancy in 31 patients. Miscarriage occurred in 3 patients. Out of these 31 women who conceived, 21 (67.7%, p=0.003) were aged < 35 years with higher pregnancy rate per cycle (21 / 90 = 23.3%). CONCLUSION: Intrauterine insemination may be regarded as valuable procedure for couples presenting at younger age with lesser duration of infertility and unexplained subfertility.