The attitude and acceptability towards medical promotional tools and their influence on physicians' prescribing practices in Jordan and Iraq: a cross-sectional study.

BACKGROUND: Pharmaceutical companies spend more than one-third of their sales revenue on marketing and promotion directed toward healthcare professionals. There has been a focus on the relationship between healthcare professionals and the pharmaceutical industry in recent years. This study aims to explore the attitude toward and acceptability of medical promotional tools and their influence on physicians' prescribing practices in Jordan and Iraq. METHODS: A cross-sectional survey study was conducted to explore the influence of visits by medical representatives (MRs) and medical promotions on physicians' prescribing practices between June and October 2020 in Jordan and Iraq. Previously validated questionnaires were used. RESULTS: A total of 801 physicians completed the questionnaires. Face-to-face visits, followed by the dispensing of medical samples, were the two most common promotional methods used by MRs. 48% of participating physicians reported that they would accept the promotional marketing tools offered to them. MRs focused on the key selling points of their product during medical promotions, and 39.6% of the physicians reported that MRs had a negative attitude toward their competitors' products. 69.9% of the physicians reported that they would change their practice after participating in conferences or meetings. CONCLUSION: Medical promotional tools have a clear influence on physicians' prescribing practices in Jordan and Iraq. Therefore, medical promotion should be controlled and guided by clear and country-specific ethical guidelines. This will ensure safe medical promotion to physicians and optimise the healthcare practices provided to patients.

Epidemiology of depression and anxiety among undergraduate students.

AIMS: Depression and anxiety are the most common and prevalent mental health issues among undergraduate students. This study aimed to investigate the prevalence of anxiety and depression, their associated predictors, and to assess knowledge and use of antidepressant medications among university students in Jordan. METHODS: A cross-sectional survey-based study was conducted in Jordan among undergraduate students from all levels of study. Istilli et al's questionnaire, the PHQ-9 and generalised anxiety disorder (GAD) scales were used in this study to explore the study objectives. Logistic regression analysis was used to identify predictors of anxiety and depression. RESULTS: A total of 1582 undergraduate students participated in the study. Prevalence of depression was 22.3% (n = 330), with proportions of minimal, mild, moderate, moderately severe and severe depression to be 15.9%, 32.4%, 29.5%, 14.7% and 7.6%, respectively. Prevalence of anxiety was 15.8% (n = 173), with proportions of mild, moderate and severe anxiety to be 46.4%, 37.8% and 15.8%, respectively. Female students and those with low income (<500 JD) had higher depression mean scores compared with others. Females, arts and engineering students, divorced and those who have four or more children had higher anxiety mean scores compared with others. CONCLUSION: Findings of this study addressed the importance of taking serious measures and interventions to prevent the development of severe mental illness among university students.

Knowledge and awareness of the general population and healthcare providers about retinoblastoma: It is time to know the glow.

Retinoblastoma is the most frequent primary intraocular tumour in childhood. Early detection of retinoblastoma is the key to successful management with a higher chance of survival. This study aims to assess the knowledge of the general population and healthcare providers about retinoblastoma in term of presentation, risk factors, timing for diagnosis, and complications. A cross-sectional study using an online survey was conducted in three Arab countries (Jordan, Saudi Arabia, and Iraq) between 28 August and 16 September 2020. The questionnaire tool was constructed based on an extensive literature review to explore the study's aim and objectives. Logistic regression was used to identify predictors of better knowledge about retinoblastoma. A total of 3676 participants were involved in the study (Jordan = 2654, Saudi Arabia = 604, and Iraq = 418). The average retinoblastoma knowledge score for the whole study population was 6.25 (SD = 4.12) out of 21, representing 29.8% (out of the maximum possible total score). Participants aged above 50 years old, married individuals, those with a secondary education level, those who work as professionals in industry, those who have more than four children, and those who reported that they were not in direct contact with a large number of children were less likely to be knowledgeable about retinoblastoma presentation, risk factors, the timing for diagnosis, and complications (P < .05). Early detection is the cornerstone for decreasing morbidity and mortality among children with retinoblastoma. However, the awareness and knowledge about retinoblastoma are very limited in our study population. Efforts should be directed at increasing awareness of both the general population and healthcare providers regarding retinoblastoma. Policymakers are responsible for improving knowledge and awareness about retinoblastoma to facilitate early detection of the disease by conducting awareness campaigns in addition to improve screening skills of healthcare providers and providing them with proper screening and diagnostic tools.

Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study.

BACKGROUND: Identifying trends of hospital admissions for respiratory diseases is crucial for public health and research to guide future clinical improvements for better outcomes. This study aims to define the trends of respiratory disease-related hospital admissions (RRHA) in England and Wales between 1999 and 2019. METHODS: An ecological study was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data for respiratory diseases were extracted for the period between April 1999 and March 2019. The trend in hospital admissions was assessed using a Poisson model. RESULTS: Hospital admission rate increased by 104.7% [from 1535.05 (95% CI 1531.71-1538.38) in 1999 to 3142.83 (95% CI 3138.39-3147.26) in 2019 per 100,000 persons, trend test, p < 0.01]. The most common causes were influenza and pneumonia, chronic lower respiratory diseases, other acute lower respiratory infections, which accounted for 26.6%, 26.4%, and 14.9%, respectively. The age group 75 years and above accounted for 34.1% of the total number of hospital admissions. Males contributed to 50.5% of the total number of hospital admissions. Hospital admission rate in females increased by 119.8% [from 1442.18 (95% CI 1437.66-1446.70) in 1999 to 3169.38 (95% CI 3163.11-3175.64) in 2019 per 100,000 persons, trend test, p < 0.001]. Hospital admission rate increased by 92.9% in males [from 1633.25 (95% CI 1628.32-1638.17) in 1999 to 3149.78 (95% CI 3143.46-3156.09) in 2019 per 100,000 persons, trend test, p < 0.001]. CONCLUSION: During the study period, hospital admissions rate due to respiratory diseases increased sharply. The rates of hospital admissions were higher among males for the vast majority of respiratory diseases. Further observational studies are warranted to identify risk factors for these hospital admissions and to offer relevant interventions to mitigate the risk.

Prevalence and factors associated with smartphone addiction among medical students at King Abdulaziz University, Jeddah.

OBJECTIVE: To investigate smartphone addiction among medical students and to determine factors associated with smartphone addiction among sixth-year medical students at King Abdulaziz University, Jeddah. METHODS: This cross-sectional study was conducted on 203 sixth-year medical students at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, during July 2017. Data analysis was done using SPSS-20. RESULTS: The number of completed questionnaires received was181 out of 203, making a response rate of 89%. There were 87 male respondents (48.1%) and 94 female respondents (51.9%). The overall prevalence of smartphone addiction was 66 (36.5%). There is a statistically significant relationship between daily hours of smartphone usage and smartphone addiction (p<0.02). Out of 66 addicted students, 24 (55.8%) students reported using their smartphone more than five hours daily, 17(34.7%) students were using it 4 to 5 hours daily, 13 (27.7%) students were using it 2 to 3 hours daily and 12(28.6%) students were using it less than two hours daily. The study showed no statistically significant relationship between smartphone addiction and smoking statusor degree of obesity. There was a significant association between the total score on the smartphone addiction scale and daily usage hours (p-value<0.005). CONCLUSION: The overall prevalence of smartphone addiction was high among our study participants. The smartphone addiction was associated with daily hours of smartphone usage.

Knowledge and awareness of ocular allergy among Jeddah population.

Background: Ocular allergy is one of the common conditions that affects patients from different age groups. Public awareness about the disease is crucial for reducing the incidence of ocular allergy. Aim: The present study aims to evaluate the knowledge level of the general population in Jeddah, Saudi Arabia toward ocular allergy. Methodology: This is a cross-sectional study that included the distribution of an online survey to the public living in Jeddah. The survey included questions to identify common demographics, knowledge, and awareness about ocular allergy signs and symptoms, prevention and treatment, and sources of information. Statistical analysis included descriptive and comparative analysis using Chi-square test and one-way ANOVA test. SPSS version 26 was used for data analysis. Results: In total, 1207 responded to this survey and were included in the analysis. Among them, 71% were females, 36.8% were in the age group of 15-25 years, 74.9% had a bachelor's degree, 60.4% were non-medical specialists, 13.2% were from the faculty of medicine. More than half of the participants were aware that ocular allergy affects millions of people globally every year. It is one of the most common eye conditions, itching is the primary source of discomfort, 15%-20% of the world population have ocular allergy, the disease causes discomfort and pain within the eye caused by frequent rubbing of the eye, and that symptoms of ocular allergy include redness, itching, tearing, discharge, blurred vision, and photophobia. Further, 64.9% thought that avoiding the source of triggers can help prevent ocular allergy. Social media was the most common source of information among 19.3%. The average score was 15.6 ± 6.1 out of 27 points; 42.6% of the responders had fair knowledge (50%-75%) about ocular allergy. The age group of 15-25 years (P < 0.001), bachelor's degree holders (P = 0.013), and individuals with a medical background (P = 0.003) were associated with significantly higher mean scores. Males (P = 0.003), age group of 15-25 years (P = 0.024), individuals with a medical background (P < 0.001) had significantly good knowledge about ocular allergy. Conclusion: The knowledge level of the general population about ocular allergy in Jeddah, Saudi Arabia is fair and requires improvement.

Fatal disseminated pyogenic infection due to hypermucoviscous hypervirulent Klebsiella pneumoniae: A case report and literature review.

Hypervirulent Klebsiella pneumonia is becoming recognized globally and has been associated with serious sequelae including death. However, ethnicity and metastatic infections are characteristics for hypermucoviscous hypervirulent Klebsiella pneumoniae (hvKp) and should be rolled in/out by PCR and/or string test.

Chronic Vomiting and Weight Loss Due to Cecal Pinworm Infestation: A Case Report and Brief Literature Review.

Enterobius vermicularis (E. vermicularis), also called pinworm or threadworm, is a widespread parasitic infection that has infected approximately 40 million individuals in the United States. However, the infection is rarely seen in the adult population. An atypical presentation of Enterobius vermicularis (E. vermicularis) infection has been reported previously in children and infants. However, there are no previous reports of this infection among adults in the Middle East. We present a case of a 30-year-old Saudi male patient who presented with significant weight loss, diarrhea, and vomiting. A colonoscopy revealed E. vermicularis in the cecum. The patient received one dose of oral albendazole 400 mg and then a repeat dose in two weeks based on his colonoscopy findings. The patient was seen in an outpatient clinic and reported complete resolution of postprandial vomiting. Asking about risk factors if there is any contact with contamination is essential. In addition, colonoscopy and stool analysis may also be considered to confirm the diagnosis. However, future studies investigating the incidence and risk factors of this infection are warranted as similar studies reporting this infection in Saudi Arabia are limited. Proper diagnosis and treatment are also essential to prevent complications of the infection.

Hospital Admission Trends Due to Viral Infections Characterised by Skin and Mucous Membrane Lesions in the Past Two Decades in England and Wales: An Ecological Study.

OBJECTIVES: This study aimed to investigate the trends in hospital admissions due to viral infections characterized by skin and mucous membrane lesions in England and Wales between 1999 and 2019. METHODS: This is an ecological study using publicly available databases in England and Wales; the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data were collected for the period between April 1999 and March 2019. Hospital admissions due to viral infections characterized by skin and mucous membrane lesions were identified using the tenth version of the International Statistical Classification of Diseases system, diagnostic codes B00-B09. The trend in hospital admissions was assessed using a Poisson model. RESULTS: Hospital admissions for different causes increased by 51.9% (from 25.67 (95% CI 25.23-26.10) in 1999 to 38.98 (95% CI 38.48-39.48) in 2019 per 100,000 persons, trend test, p < 0.01). The most prevalent viral infections characterized by skin and mucous membrane lesions hospital admissions causes were zoster (herpes zoster), varicella (chickenpox), herpesviral (herpes simplex) infections, and viral warts, which accounted for 26.9%, 23.4%, 18.7%, and 17.6%, respectively. The age group below 15 years accounted for 43.2% of the total number of admissions. Females contributed to 50.5% of the total number of admissions. Hospital admission rate in males increased by 61.1% (from 25.21 (95% CI 24.59-25.82) in 1999 to 40.60 (95% CI 39.87-41.32) in 2019 per 100,000 persons). The increase in females was 43.2% (from 26.11 (95% CI 25.49-26.72) in 1999 to 37.40 (95% CI 36.70-38.09) in 2019 per 100,000 persons). CONCLUSION: Our study demonstrates an evident variation in hospital admission of viral infections characterized by skin and mucous membrane lesions based on age and gender. Efforts should be directed towards vaccinating high-risk groups, particularly the elderly and females. Moreover, efforts should be focused on vaccinating the young population against varicella, particularly females who are more susceptible to acquiring the infection. Further observational and epidemiological studies are needed to identify other factors associated with increased hospital admission rates.

Hospital Admissions Due to Ischemic Heart Diseases and Prescriptions of Cardiovascular Diseases Medications in England and Wales in the Past Two Decades.

OBJECTIVES: The aim of this study was to explore the trend of ischemic heart disease (IHD) admission and the prescriptions of IHD medications in England and Wales. METHODS: A secular trends study was conducted during the period of 1999 to 2019. We extracted hospital admission data for patients from all age groups from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Prescriptions of IHD medications were extracted from the Prescription Cost Analysis database from 2004 to 2019. The chi-squared test was used to assess the difference between the admission rates and the difference between IHD medication prescription rates. The trends in IHD-related hospital admission and IHD-related medication prescription were assessed using a Poisson model. The correlation between hospital admissions for IHD and its IHD medication-related prescriptions was assessed using the Pearson correlation coefficient. RESULTS: Our study detected a significant increase in the rate of cardiovascular disease (CVD) medication prescriptions in England and Wales, representing a rise in the CVD medications prescription rate of 41.8% (from 539,334.95 (95% CI = 539,286.30-539,383.59) in 2004 to 764,584.55 (95% CI = 764,545.55-764,623.56) in 2019 prescriptions per 100,000 persons), with a mean increase of 2.8% per year during the past 15 years. This increase was connected with a reduction in the IHD hospital admission rate by 15.4% (from 838.50 (95% CI = 836.05-840.94) in 2004 to 709.78 (95% CI = 707.65-711.92) in 2019 per 100,000 persons, trend test, p < 0.01), with a mean decrease of 1.02% per year during the past 15 years and by 5% (from 747.43 (95% CI = 745.09-749.77) in 1999 to 709.78 (95% CI = 707.65-711.92) in 2019 per 100,000 persons, trend test, p < 0.01) with a mean decrease of 0.25% per year during the past two decades in England and Wales. CONCLUSION: The rate of hospitalisation due to IHD has decreased in England and Wales during the past two decades. Hospitalisation due to IHD was strongly and negatively correlated with the increase in the rates of dispensing of IHD-related medications. Other factors contributing to this decline could be the increase in controlling IHD risk factors during the past few years. Future studies exploring other risk factors that are associated with IHD hospitalisation are warranted.

Awareness of diabetic retinopathy among people with diabetes in Jeddah, Saudi Arabia.

BACKGROUND: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and the foremost cause of blindness. This study aimed to assess the level of awareness of DR and its related risk factors among patients with DM in Jeddah, Saudi Arabia. METHODS: A cross-sectional study was conducted among patients with DM attending primary health care centers at the Ministry of Health in Jeddah. A structured, pretested, self-administered questionnaire was used to collect information on the sociodemographic and DM- and DR-related characteristics of the patients. RESULTS: A total of 377 patients were enrolled. About 82.6% of the patients were aware that DM can affect their eyes, and they listed physicians, ophthalmologists, television, and family members as common sources of information on the topic. About 36% of the patients reported that their doctors had not advised them about it. More than half responded that they did not feel their vision to be affected by DM. More than 58% had never been diagnosed with DR. About 35% did not go to their eye checkups, even though around 59% thought that DR could lead to blindness. Of the 64% of patients whose DM was well controlled, 11% and 25% listed surgery and laser treatment, respectively, as available treatment options for DR. The following factors were found to be significant in relation to the subjects' awareness that DM can affect their eyes: the patients' perception of their doctors' advice about DR; the experience of having their vision affected by DM; the knowledge that DR may lead to blindness; the practice of going to eye checkups. CONCLUSIONS: Despite having good awareness about DM and its effects on eyes, the patients exhibited a relative lack of awareness about DR. Considering the association of DR with DM, its increasing magnitude is a potential burden on the community and health systems.

Knowledge and Attitudes towards Complementary and Alternative Medicine among Senior Medical Students in King Abdulaziz University, Saudi Arabia.

Objectives. This study assessed the knowledge and attitudes regarding complementary and alternative medicine (CAM) in medical students in Saudi Arabia. Furthermore, it evaluated their views on the incorporation of CAM in their medical syllabus. Methods. The study was conducted by selecting a cross-sectional sample of senior medical students in the Faculty of Medicine. A validated and reliable self-administered questionnaire was used to explore the knowledge, attitude, and benefits of CAM. It was distributed to a sample of 273 students. Results. The study included 242 students, making the response rate 88.6%. Only two-thirds of students (62.4%) were aware of acupuncture principles and only 17.4% recognized that chiropractic is associated with pain management. The knowledge of common herbs such as St. John's Wort, Echinacea, and Ginkgo biloba was limited among the students. Older students had a positive CAM attitude compared to younger students (p = 0.027). Conclusion. Students attitudes toward CAM learning were encouraging regardless of their limited knowledge on the subject. A high percentage of students agreed that CAM in combination with conventional therapy is beneficial in treating unusual cases, but the choice of CAM should be based on evidence. Furthermore, medical students are still reluctant to have CAM practitioners in their referral network.