Arabian Population Research Articles

Outcomes of Selective Laser Trabeculoplasty as Primary Treatment for Ocular Hypertension and Mild Open Angle Glaucoma in the Saudi Arabian Population

Background: Selective laser trabeculoplasty (SLT) is a promising, minimally invasive, non-surgical procedure for lowering IOP in glaucoma patients. While various studies have established the efficacy of SLT in lowering IOP in glaucoma patients there are limited data on its outcomes as a primary treatment modality in the Saudi Arabian population. That’s why it is essential to understand the effectiveness of therapeutic interventions in specific populations to optimize treatment strategies. Methods:. A retrospective cohort design was used. 54 eyes of patients with ocular hypertension (OHT) or mild primary open-angle glaucoma (POAG) underwent SLT. IOP, medication use, and potential influencing factors were monitored over one year. Results: SLT significantly reduced IOP (p < 0.001 for all comparisons). The mean IOP decreased from 20.57 mmHg at baseline to 14.72 mmHg at one month (a 28.4% reduction) and remained substantially low during the year (15.39 mmHg at six months and 15.44 mmHg at one year). After SLT, the proportion of eyes achieving well-controlled IOP (<21 mmHg) significantly increased from 51.9% at baseline to 96.3% at one year (p < 0.001). This improvement was observed across all patient subgroups, including those with OHT, mild POAG, normal-tension glaucoma, and secondary glaucomas. Before SLT, all patients were medication-free. At one year, 74.1% remained medication-free, while 25.9% required one medication (p < 0.001). Greater IOP reduction was associated with a longer time since SLT, younger age, and diagnoses of mild POAG or normal tension glaucoma (all p < 0.05). Conclusion: SLT demonstrated significant and sustained IOP reduction in the Saudi Arabian population with OHT and mild POAG. It also led to a substantial decrease in medication use. These findings suggest SLT as a viable primary treatment option for this patient population, though further research is needed to explore long-term outcomes.

A Saudi Heart Association Position Statement on Cardiovascular Diseases and Diabetes Mellitus.

Cardiovascular disease (CVD) and diabetes mellitus are prominent public health concerns in Saudi Arabia owing to their increasingly high prevalence and burden. Based on this, the Saudi Heart Association (SHA) set out to develop an official position statement on CVD and diabetes mellitus, with a focus on the prevention and management of these conditions and relevant special populations in the context of Saudi Arabia. A multidisciplinary panel of experts met under the auspices of the SHA in a series of meetings to review and discuss available evidence on the prevention and management of comorbid CVD and diabetes mellitus. Specialized subcommittees reviewed the data and offered context-specific recommendations (taking into account Saudi population characteristics, local healthcare system, available resources and medical expertise), which were later approved by the full expert panel. The prevalence of diabetes mellitus and CVD is alarming in the Saudi Arabian population. Diabetes mellitus and CVD are interconnected on several levels, including cellular and molecular events as well as epigenetic and genetic mechanisms. Screening for CVD is a priority for patients with diabetes and concomitant risk factors. The expert panel also recommends aggressive management of high blood pressure and dyslipidemia in addition to lifestyle changes and achieving glycemic targets for the prevention of CVD in patients with diabetes. Some glucose-lowering drug classes, namely SGLT2-inhibitors and GLP-1 receptor agonists, offer significant benefits on the level of cardiovascular risk reduction and are thus a powerful addition to the clinical management armamentarium in CVD and diabetes. Special consideration is also advised for patient populations with distinct clinical presentation and needs, such as coronary artery disease, heart failure, and chronic kidney disease, among others.

Integrative Metagenomic Analyses Reveal Gut Microbiota-Derived Multiple Hits Connected to Development of Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with gut dysbiosis. To investigate the association between gut microbiota and T2DM in a Saudi Arabian population. We conducted a comparative analysis of fecal microbiota from 35 individuals, including both T2DM patients and healthy controls. 16S rRNA gene sequencing was employed to characterize the microbial community structure. Our findings revealed significant differences in microbial composition between the two groups. The T2DM group exhibited a higher abundance of Firmicutes and lower levels of Bacteroidetes compared to the healthy control group. At the genus level, T2DM patients showed a decrease in butyrate-producing bacteria such as Bacteroides and Akkermansia, while an increase in Ruminococcus and Prevotella was observed. Additionally, the T2DM group had a higher abundance of Faecalibacterium, Agathobacter, and Lachnospiraceae, along with a lower abundance of Bacteroides. These results suggest that alterations in gut microbiota composition may contribute to the development of T2DM in the Saudi Arabian population. Further large-scale studies are needed to validate these findings and explore potential therapeutic interventions targeting the gut microbiome.

Modeling the potential public health and economic impact of different COVID-19 vaccination strategies with an adapted vaccine in the Kingdom of Saudi Arabia

ABSTRACT Background The dynamic evolution of the virus causing COVID-19 necessitates the development of adapted vaccines to protect against emerging variants. Research design and methods A combined Markov-decision tree model estimated the outcomes of alternative vaccination strategies. The Saudi Arabian population was stratified into standard-risk and high-risk subpopulations, defined as either the population comprising individuals aged ≥ 65 years and individuals with at least one comorbidity. The model estimated the health and economic outcomes of vaccination based on age-specific inputs taken from published sources and national surveillance data. Results The vaccination strategy targeting the elderly and high-risk subpopulation (was estimated to prevent 156,694 cases 12,800 hospitalizations, and 2,919 deaths and result in cost savings of SAR 1,239 million in direct costs and SAR 4,145 million in indirect costs. These gains increased with the vaccination strategies additionally targeting other subpopulations. Compared to the base case (aged ≥65 and those at high-risk), expanding vaccination coverage to 75% of the standard-risk population prevented more cases (323%), hospitalizations (154%), and deaths (60%) and increased the direct (232%) and indirect (270%) cost savings. Conclusions The adoption of broad vaccination strategies using a vaccine adapted to the dominant variant in circulation would yield substantial benefits in Saudi Arabia.

Impact of Altitude on Erythrocyte Sedimentation Rate: A Cross-Sectional Study Using National Laboratory Data from Saudi Arabia.

The erythrocyte sedimentation rate (ESR) is a widely used haematological test that indirectly measures inflammation in the body. It is influenced by various factors, including age, sex, and physiological condition. Altitude is another critical factor due to its impact on red blood cell physiology and plasma protein composition. This study aims to evaluate how altitude influences ESR values in the Saudi Arabian population, considering demographic and clinical variables. This cross-sectional study analyzed data from 158,539 participants collected from 42 commercial laboratory branches across 13 administrative regions in Saudi Arabia from 1 January 2015 to 31 December 2022. Participants were categorized based on city altitude and demographic characteristics including body mass index (BMI), alanine transaminase (ALT), chronic kidney disease (CKD), glycated haemoglobin (HbA1c), and thyroid-stimulating hormone (TSH) level. Univariate and multivariate logistic regression models were used to assess the factors influencing elevated ESR. The study analyzed 158,539 participants, with an equal sex distribution (49.9%) and a mean age of 40 years. The adjusted model results showed a CKD prevalence of 3%, with a higher prevalence at lower altitudes (3.8% at 0-500 meters). ESR levels were significantly influenced by sex, age, altitude, and clinical measurements. Males were less likely to have elevated ESR than females (odds ratio (OR) = 0.470, 95% confidence interval (CI): 0.440-0.510, p < 0.001). Older age was a strong predictor of elevated ESR, with those aged 90+ at a fourfold higher risk (OR = 4.540, 95% CI: 1.410-14.548, p = 0.011). Higher altitude was associated with reduced ESR, with an odds ratio of 0.660 (95% CI: 0.560-0.769, p < 0.001) above 2000 meters. Altitude significantly impacts ESR values, highlighting the need for altitude-specific reference ranges to improve diagnostic accuracy in high-altitude regions. The results also emphasize the importance of considering demographic and clinical factors when interpreting ESR. These findings can guide clinicians in refining diagnostic algorithms and optimizing patient management strategies in diverse geographical settings.

Artificial Intelligence-based Assessment of Facial Symmetry Aesthetics of Saudi Arabian Population.

The purpose of this study is to investigate facial symmetry aesthetics (FSA) in the Saudi Arabian population using artificial intelligence (AI).Two hundred and ten people from a range of demographic backgrounds participated in an observational cross-sectional study that was done at a hospital. Standardized posed photos of the face and smile were taken using a Canon camera utilizing a stratified random sample approach. Webceph software (Korea) with AI was used to evaluate macro, micro, and tiny aesthetic factors. The data were analyzed using paired t-tests, post hoc Bonferroni testing, analysis of variance (ANOVA), and descriptive statistics. The computation of intraclass correlation coefficients (ICCs) was utilized to assess the dependability of AI evaluations.All variables had ICCs of more than 0.97, indicating exceptional dependability for the AI-based evaluations. Between the Class I and Class III malocclusion groups, there were significant variations in right mandibular body length (p < 0.001), with Class III patients exhibiting greater values. While no significant changes were identified for other characteristics, paired t-tests showed a significant divergence in mandibular body length between the right and left sides (p = 0.001). In Class III malocclusion, there was a significant preference for right deviation in the direction of mandibular deviation (p = 0.005). These results imply that AI is capable of accurately identifying some anatomical characteristics associated with face aesthetics, especially when it comes to differentiating between Class III malocclusions.In conclusion, the Saudi Arabian population's facial symmetry assessments via AI have demonstrated a high degree of reliability and consistency. Notably, the length of the mandible on the right side has emerged as a crucial feature in discriminating between malocclusion classes. The study emphasizes how AI might improve the accuracy of assessments of face aesthetics and our knowledge of facial features connected to malocclusion.

Prevalence, Occurrence, and Characteristics of Supernumerary Teeth Among the Saudi Arabian Population Using Panoramic Radiographs.

Supernumerary teeth numerical anomalies and the early diagnosis of supernumerary teeth is very important to avoid potential complications. The study aim was to determine the prevalence, occurrence, and characteristics of supernumerary teeth among the Arabian population. A retrospective radiographic study was performed using panoramic radiographs of patients attending a teaching hospital from January 2018 to December 2020. Only healthy patients with clear radiographs were included in the study, and patients with syndromes, cleft lip, and palate, and unclear radiographs were excluded from the study. The details include the patient's age and gender, supernumerary tooth number, location, orientation, and position. Only a single examiner was involved in the data collection and analysis. Overall, 38 (2%) patients were observed with 47 supernumerary teeth. Among them, 76% were males and 24% were females, with a mean age of 16.1 ± 9.7 years. Mesiodens (87%) are the common type of supernumerary tooth, and the majority of the supernumerary teeth were impacted (66%). The majority of the patients presented with a single supernumerary tooth, while 24% of the patients presented with two supernumerary teeth. Sixty percent of the supernumerary teeth were conical in morphology, followed by a tuberculate morphology. In the study population, most of the supernumerary teeth were normal in orientation. The prevalence of supernumerary teeth was 2%. Among them, the majority were observed at the anterior region of the maxillary arch with a conical shape of normal orientation. The gender-based comparison of location, orientation, morphology, eruption, and number of supernumerary teeth showed male predilection.

Effect of Salvadora persica chewing sticks on maxillary central incisors crown-root angulation in Western-Asian population &amp; correlation with Collum angle on 3D CBCT images

The main aim of the study was to identify the Collum angle classification for maxillary central incisors among individuals use vs not-use chewing sticks which could have beneficial role for immediate implant placement in respective individuals. Additionally, to identify the root-crown positioning and angulation in the Western Asian Saudi Arabian population for chewing sticks user’s vs non-users in order to develop guideline for the prosthetic procedures using Cone beam computed tompography (CBCT). A total number of 380 CBCT scans were included in the study for both of the groups based on the inclusion criterion of the patients reporting to the Dental OPD of Riyadh Elm University. The data was analyzed using 3D planner dental imaging software. Initially the teeth were classified based on root position in relation to facial plate of alveolar bone using Jung et al. classification. Additionally, the Collum angle and the root angulation of the maxillary central incisors was evaluated. The data was analyzed using one-way Anova with post-hoc Tuckey-Kramer test for pair-wise comparison. As per the Jung et al. classification, majority of the roots were observed with buccal placement. Based on the Collum angle classification majority of the maxillary central incisors were observed with facial placement (n=170), specially subtype I (n=78). But the root angulation was observed to be independent of Collum angle. Thus, it can be concluded, unlike root angulation, Collum angle has a correlation with root positioning. The angle for the individuals using chewing sticks of Salvadora Persica was similar to the individuals not using the miswak. Collum angle is correlated in all classified position of root. But the root angulation is independent of classification varies between miswak and non-miswak users.

Comparative evaluation of pain rating scales for dental pain among the Saudi population: A cross-sectional study.

Pain, being a subjective phenomenon, is perceived in different manner by individuals based on various factors including age and gender. Various scales are available in literature to assess and record the pain perceived by an individual. Comparison of commonly used pain perception scales among Saudi Arabian population is scarce. A cross-sectional observational study was conducted among 180 subjects who were belonging to 2 age groups namely 7 to 16 years (group 1; n = 90) and 51 to 60 years (group II; n = 90). Subjects with dental pain of pulpal origin were included by employing consecutive sampling. The included participants were asked to record the severity of pain using visual analogue scale (VAS) and Wong Baker facial pain rating scale (WBS) in a computer-generated random order. The data obtained was subjected to statistical analysis. t test was used to compare the pain score recorded using VAS and WBS among males and females. The correlation between VAS and WBS was also assessed. P value < 0.05 was considered statistically significant. All subjects who participated responded to both the pain perception scales. No difference was found between males and females in the pain perception recorded using VAS and WBS in both the groups. A strong positive correlation was found between VAS and WBS score which was found to be statistically significant in both the groups. Both VAS and WBS are reliable tool to record pain perception in both age groups. WBS is found to be easier and more convenient one.

Awareness and Knowledge of Glaucoma Among the Diabetic Population of Saudi Arabia: A Cross-Sectional Study.

Introduction Glaucoma, a leading cause of blindness, often progresses silently, leading to irreversible optic neuropathy. Diabetics are at higher risk of developing glaucoma. In Saudi Arabia, with a high prevalence of diabetes, limited research has focused on glaucoma awareness among diabetics. This study investigates the current status of glaucoma awareness and knowledge among the general and diabetic populations in Saudi Arabia. Methods A cross-sectional survey was conducted in March 2024 using a convenience sampling approach. An online questionnaire was distributed via social media and Google Forms, targeting Saudi Arabian residents, both diabetic and non-diabetic. The questionnaire, validated and translated into Arabic, included demographic questions and multiple-choice questions assessing glaucoma knowledge. A pilot study confirmed high internal consistency (Cronbach's alpha=0.840). The sample size was calculated to be 385 participants, ensuring a 95% confidence level and 5% margin of error. Results A total of 518 participants were surveyed, with 52.9% having diabetes. Most participants (74.3%) were unaware of the term "glaucoma," and only 11.8% had been diagnosed with the condition. Awareness was significantly higher among those who had undergone ocular examinations in the past year (64.7%). Knowledge levels varied, with 43.1% showing average knowledge, 30.3% weak knowledge, and 26.6% good knowledge. Significant associations were found between knowledge levels and factors such as diabetes status (p=0.0001), educational level (p=0.021), and sources of information, particularly medical staff (p=0.0001). Conclusion The study highlights a significant gap in glaucoma awareness and knowledge among the Saudi Arabian population, especially among diabetics. Increased educational efforts, particularly through medical staff, are crucial to improve glaucoma awareness and early detection, potentially reducing the burden of this disease. Further research should explore targeted interventions to enhance glaucoma knowledge among high-risk groups.

Lactose intolerance awareness among adults in Riyadh, Saudi Arabia

IntroductionLactose intolerance is a common medical condition characterized by malabsorption of lactose. Despite the considerable impact of lactose intolerance on affected persons, studies on its awareness are limited. The aim of study was to assess the awareness of lactose intolerance and its associated factors among the general population of Riyadh City, Saudi Arabia. The prevalence of lactose intolerance in the study population was also assessed. MethodsThis was a cross-sectional study conducted in Saudi Arabia. An online questionnaire, which included 15 questions on lactose intolerance awareness and the risk factors for lactose intolerance, was administered. The prevalence of lactose intolerance was assessed using a validated five-question screening tool. The student's t-test and analysis of variance were used to compare quantitative variables, whereas the chi-square test was used to determine the association between qualitative variables. ResultsA total of 2150 adult participants were included. The mean percentage of correct answers to questions regarding lactose intolerance awareness was 28.9 % (±21.9). Participants with a previous lactose intolerance diagnosis had the highest lactose intolerance knowledge scores (46.9 [±18.3]). Regarding the prevalence of lactose intolerance, 14.7 % of the participants responded that they were likely lactose intolerant, whereas 7.3 % reported that they were diagnosed with lactose intolerance by a physician. Results of the assessment performed using the screening tool, which had a sensitivity of 47 % in this study, showed that women were more likely to have lactose intolerance than men. In addition, women and younger participants had greater knowledge of lactose intolerance than men and older participants. ConclusionThe Saudi Arabian population has a low awareness of lactose intolerance. The findings of this study provide valuable information regarding level of lactose intolerance awareness among the Saudi population and can be used for the development of effective programs for increasing lactose intolerance awareness in Saudi Arabia.

Significant association between insulin-like growth factor 2 mRNA-binding protein 2, interleukin-6 polymorphisms, and type 2 diabetes mellitus

Background: The study aimed to detect the association between insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) and interleukin-6 (IL-6) polymorphisms among type 2 diabetes mellitus (T2DM). Materials and Methods: This study involved 500 individuals; 250 obese DM cases and 250 healthy controls. The polymerase chain reaction restriction fragment length polymorphism was used to identify the genotype of the IGF2BP2 gene for the small nucleoproteins rs4402960 (G&gt;T) and small nucleoproteins rs800795 (G&gt;C). Results: The results indicated that the mutant C-allele of the single nucleotide polymorphism (SNP) rs1800795 variant was highly significantly associated with the study group (P = 0.002). The occurrence of genotypes (C/G and C/C) versus normal G/G genotype of the IL-6 variant was highly significant (P = 0.004) in the study group (49.2% vs. 50.8%) compared to the control group (62% vs. 38%). Similar findings were observed in SNPs for the rs440960 variant, in which the T-allele indicated a highly significant relationship (P = 0.0001) with the study group; the frequency of G/G genotype versus both (T/T and G/T) genotypes was highly significant (P = 0.0001) in the case group (34% vs. 66%) than in the healthy control group (52% vs. 48%). Conclusion: The current study indicated that IGF2BP2 rs4402960 and IL-6 rs1800795 polymorphism were highly significantly associated with the increased risk of obese T2DM among the Saudi Arabian population and presented a genetic model to screen the high-risk individuals with further validations.

Investigation of Wright Blood Group Alleles and Genotypes in Malaria-Endemic Area in Southwestern Saudi Arabia.

Inherited blood disorders as well as malaria are prevalent in southwestern Saudi Arabia. Patients with specific hemoglobinopathies may require frequent blood transfusions. Accordingly, alloimmunization may occur if donors and recipients are incompatible. Therefore, examination of various blood group antigens to provide compatible blood units is essential. Two alleles of the Diego (DI) blood group system, DI*02.03 and DI*02.04 encode the Wright antigens; Wra and Wrb, respectively. Anti-Wra may lead to alloimmunization during transfusion and pregnancy. Furthermore, the Wrb antigen may involve in interaction between protein receptors for Plasmodium falciparum. This study aimed to investigate the allele/genotype frequencies of the Wright blood groups in southwestern Saudi blood donors regarding the blood transfusion and assessed the population of Jazan Province for susceptibility of Plasmodium falciparum invasion. One-hundred-fifty Saudi blood donors were enrolled to this study. DNA was extracted from the blood samples. Primer pairs were designed to capture a single nucleotide variation that distinguishes the Wright alleles. Polymerase chain reaction (PCR) was conducted and followed by standard sequencing. Among the 150 genotyped samples, the only observed allele was DI*02.04 (n = 150, 100%). Accordingly, the genotype prevalence of DI*02.04/DI*02.04 was accounted for (n = 150, 100%). This study demonstrated the allele frequencies of DI*02.03 and DI*02.04 of the DI blood group system in Saudi blood donors. The DI*02.04 allele was the only allele that was observed. Furthermore, the prevalence of the genotypes was determined and the only observed genotype was DI*02.04/DI*02.04. Interestingly, this study indicates that the Saudi Arabian population living in Jazan Province may be more susceptible to Plasmodium falciparum invasion. Moreover, adding the Wright alleles for the transfusion screening panel is not recommended.

Evaluating the Effectiveness of Ahmed Glaucoma Valve Implantation in Reducing Intraocular Pressure in Refractory Glaucoma in the Saudi Arabian Population at a Tertiary Care Centre

Objectives: To assess the efficacy of Ahmed glaucoma valve implantation (AGVI) in lowering intraocular pressure (IOP) in patients with refractory glaucoma. Methods: In this retrospective study, we analyzed the medical records of 60 patients who received AGVI for refractory glaucoma. Data collected included demographics, type of glaucoma, preoperative and postoperative IOP, number of glaucoma medications, and any surgical complications. Success was defined as achieving an IOP &lt;21 mmHg at the final follow-up visit. Results: At the final follow-up (mean duration of 11.6 months), AGVI achieved successful IOP control (IOP of &lt;21 mmHg) in 40 eyes (66.7%). The mean number of glaucoma medications decreased significantly from 2.95 preoperatively to 1.98 postoperatively (p &lt; 0.001). Neovascular glaucoma (NVG) had a lower success rate compared to other types of glaucoma. Prior glaucoma surgery was associated with a higher risk of failing to reach target IOP, although this trend was not statistically significant (p = 0.108). Conclusion: AGVI implantation effectively lowered IOP in patients with refractory glaucoma, especially in the short term. However, long-term success rates were lower, and NVG showed less favorable outcomes. AGVI is a valuable option for managing refractory glaucoma, but careful patient selection is essential. Further research is needed to evaluate long-term efficacy and refine treatment strategies.

Trigeminal Neuralgia in the Presence of a Vascular Loop and Response to Medical Management: Experience From Saudi Arabia.

Trigeminal neuralgia (TN) is a neurovascular disorder characterized by severe, episodic facial pain, often attributed to vascular compression of the trigeminal nerve. The commonly reported artery responsible for compression is the superior cerebellar artery. Additionally, the anterior inferior cerebellar artery is also noted as a potential contributor to vascular loop compression. These vascular structures can lead to nerve root atrophy or displacement, which is significant in the pathophysiology of TN. While extensively studied globally, the specific characteristics of TN in the Saudi Arabian population remain underexplored. The primary objective of this study is to evaluate the response to medical management in patients with TN and vascular loop compression. The study was conducted at King Fahad Specialist Hospital in Dammam, Saudi Arabia, from April to August 2023, and utilized a retrospective case series design to review medical reports of 13 patients diagnosed with TN and vascular loop compression. The primary objective was to evaluate the response to medical management in this specific patient population. In this study, we included 13 patients with TN, providing a comprehensive snapshot of the patient population under study, encompassing demographic characteristics, clinical presentations, treatment responses, and other relevant variables. The mean age of the patients in the study is 48.23 years, with a standard deviation of 11.7, and a range from 30 to 71 years. The main findings of this study underscore the positive response to medical management in patients with TN and vascular loop compression. All patients in the study responded positively to the treatment, indicating a favorable overall response rate. The time to respond varied, with the majority responding within three months (46.16%), followed by those responding within 12 months (38.46%). This study highlights the potential efficacy of non-surgical approaches in managing the debilitating facial pain associated with TN. The positive outcomes observed in response to medical management emphasize the need for further exploration and validation of non-surgical approaches in the context of TN with vascular loop compression. This finding contributes to the global understanding of TN and offers promise for improving patient quality of life in Saudi Arabia.

The Prevalence of Gastroesophageal Reflux Disease (GERD) in H. pylori-Positive and -Negative Patients.

The presence of Helicobacter pylori (H. pylori) infection can influence gastric acid production. While both gastroesophageal reflux disease (GERD) and H. pylori are highly prevalent in the Saudi Arabian population, the relationship between these two conditions remains uncertain. This study aims to assess the association between GERD and H. pylori. This was a cross-sectional study which included patients who underwent endoscopy with gastric biopsy to test for H. pylori. H. pylori status was assessed using histopathology. The GERD-Q questionnaire was used to ascertain the presence of GERD. Multivariate analysis was used to assess the relationship between H. pylori and GERD. A total of 352 participants were included, with a mean age of 45 years (±14.7) and 58% of them being female. 148 participants (42%) tested positive for H. pylori. 59 (39.9%) had GERD. GERD was identified in 39.9% of the H. pylori-positive group and 37.3% of the H. pylori-negative group. H. pylori was not significantly associated with GERD in the multivariate analysis (P = 0.726, OR = 1.089, 95% CI: 0.675 - 1.759). There was no association between H. pylori infection and GERD in this Saudi Arabian population.

Key Factors Driving Physiotherapy Use in Patients with Nonspecific Low Back Pain: Retrospective Clinical Data Analysis

Background/objectives: Understanding the factors that influence physiotherapy (PT) service use among patients with nonspecific lower back pain (LBP) is necessary to optimize treatment strategies, healthcare resource allocation, and the planning of value-based initiatives. We report factors that influence the number of PT visits per episode of care (defined as a referral from a physician) for an LBP population in Saudi Arabia, and compare them with patients experiencing their first and recurrent episodes of LBP. Methods: LBP patients were retrospectively enrolled from a clinical dataset derived from an outpatient PT clinic in Saudi Arabia. The primary outcome variable was the number of PT visits performed per episode of care. Multiple linear regression analysis was performed to examine the relationships between the numbers of PT visits per episode of care and independent variables. Results: The number of PT sessions per week (β 0.34, p &lt; 0.001), compliance with PT sessions (β 0.31, p &lt; 0.001), and pre-pain scores (β 0.29, p &lt; 0.001) explained 41.8% (adjusted R2 0.32) of the variance in the total number of PT visits per episode of care (p &lt; 0.001). Conclusions: Factors that might improve value-based care for LBP patients are reported. The more PT sessions per week, compliance with these sessions, and higher baseline pain scores predict a higher number of PT visits per episode of care among these patients. While reported for a Saudi Arabian population, there is no reason to believe that these findings do not apply internationally.

Awareness of Interventional Radiology and The Associated Radiation Exposure Risk Among The Public Population and Primary Care Physicians in Saudi Arabia

Introduction: The imperative for healthcare professionals to possess a comprehensive understanding of radiation doses and the associated risks of the diagnostic imaging processes they recommend is underscored by the evolving landscape of medical diagnostics and treatment. Interventional radiology (IR) plays a crucial role in modern medicine, offering minimally invasive alternatives to traditional surgery. However, public and healthcare practitioner awareness of IR and its associated radiation risks remains inadequately explored, particularly in regions like Saudi Arabia. Purpose: This study aimed to evaluate the awareness of interventional radiology (IR) and the associated risks of radiological procedures among the general public and healthcare practitioners in Saudi Arabia, identify knowledge gaps, and inform future educational initiatives. Methods: Participants undergoing radiological procedures were selected using a random sampling technique, with stratification based on gender, age, nationality, and education level. The survey, conducted in Saudi Arabia, comprised 48 questions in yes-or-no and multiple-choice formats, covering demographic information, comprehension of interventional radiology, and awareness of radiation exposure risks. Results: Out of 625 respondents, 62.7% had no prior knowledge of IR, and 94.2% had never undergone IR procedures. A significant proportion (55%) lacked information about the radiation exposure associated with IR, and 57.9% perceived risks from radiation in imaging devices. In the post-educational video, 88.2% favoured IR over traditional treatment methods, with 57.8% expressing a willingness to undergo IR procedures in the future. Conclusion: The study reveals a substantial lack of awareness and knowledge about interventional radiology and radiation risks among the Saudi Arabian population and healthcare practitioners. There is a critical need to enhance public and professional understanding of IR to ensure informed decision-making and patient consent, necessitating targeted educational programs to bridge these knowledge gaps.

Prevalence and Association of Obesity, Depression, and Psychological Stress Among the Population of Saudi Arabia

Background: Obesity, stress, and depression are widespread global issues that have a significant impact on people's personal and public health. Studies reveal that the incidence of anxiety and sadness is significantly higher in obese people. Purpose: This study aimed to find ‏the prevalence and association of obesity, depression, and psychological stress among the population of Saudi Arabia. Methods: A cross-sectional study involving the society in general Saudi Arabian population that was conducted. A self-administered questionnaire is disseminated to the populace through an online platform. Results: About 72.1 percent of the 1075 respondents were female, while 52.6 percent were between the ages of 21 and 30. The proportion of obese individuals amounted to 20.6%. In contrast to melancholy (39.4%), psychological tension was present at a prevalence of 77.8%. A statistically significant correlation was observed between stress and depression; however, no such correlation was found between depression and overweight or obesity. Conclusion: Our study indicates that, contrary to what the literature suggests, numerous stressors rather than melancholy may be the cause of obesity rather than a risk factor for the condition. Further investigation is required to ascertain the correlation between psychological tension, obesity, and melancholy.

HLA Genetic Variants in COVID-19 Susceptibility: Assessing Diversity in Indian and Global Populations

Background: The rapid spread of the SARS-CoV-2 virus has had a global impact on various ethnic groups. In order to assess the genetic predisposition of the Indian population towards COVID-19, a comparative analysis was conducted using the Human Leukocyte Antigen (HLA) to investigate the frequencies of polymorphisms directly or potentially associated with COVID-19 susceptibility, severity, immune response, and fatal outcomes in comparison to other major populations. Objectives: The objective of this study is to evaluate the genetic predisposition of the Indian population to COVID-19 by analyzing the frequencies and associations of Human Leukocyte Antigen (HLA) polymorphisms. In addition, by delineating the role of specific HLA variants in the Indian context, the study seeks to enhance our understanding of genetic factors influencing COVID-19 impact and contribute to personalized approaches for disease management and prevention across diverse ethnic groups. Methods: We collected allelic information for DRB1 gene from 653 populations globally, as documented in The Allele Frequency Net Database (AFND). Data on COVID-19 susceptibility, severity, mortality, and protective factors were obtained from a previous global study. This study aimed to compare the specific frequencies of HLA-DRB1* in different ethnic groups, including other Indian populations with COVID-19-associated alleles and protective factors. Results: HLA-DRB1*01 was identified as a significant determinant of COVID-19 susceptibility among patients in 28 states of Mexico, whereas DRB1*08 in Saudi Arabian populations, DRB1*09:01 in Japanese populations, and DRB1*15:01 in Italian populations also showed this association. Likewise, DRB1*04 in the Iranian population played a role in disease severity, and DRB1*08 in the Italian population was associated with mortality in COVID-19 patients. In addition, alleles DRB1*01:01 and DRB1*04:01 were found to exhibit a protective role in Northeast England, whereas DRB1*04 demonstrated protective effects in Saudi Arabian populations. Conclusion: The involvement of HLA in COVID-19 requires further investigation, and epidemiological studies should focus on HLA profiles as determinants of the host immune system. Prolonged homozygosity in particular genomic regions could potentially increase susceptibility to COVID-19 infection. Therefore, prudent management strategies are recommended for this pandemic in isolated communities in India and worldwide.