Aseer Region Research Articles

Uveitis as a Predictor for Myocardial Infarction in Patients with Behçet's Disease, Multi Centric Cohort Study from Aseer Region, Saudi Arabia

Introduction: Behçet's disease (BD) is a chronic, multisystem inflammatory disorder characterized by a diverse array of clinical manifestations, including recurrent oral and genital ulcers, ocular inflammation, skin lesions, and joint problems. Its presentation varies, requiring tailored diagnosis and management. Methods: Retrospective cohort study, though review of medical charts and data for patients who meet the diagnostic criteria for BD actively receiving care in rheumatology clinics. The primary objective was to investigate the correlation between uveitis and Myocardial infarction in this population. Results: This study included a total of 111 patients. Approximately 33% of the patients exhibited positive CRP levels. Approximately 10% (11 patients) of the subjects were diagnosed with uveitis. Notably, the majority of individuals with uveitis were males. Three patients with uveitis had arthritis, none of whom presented with gastrointestinal tract (GIT) Complaints. Remarkably, none of the patients diagnosed with uveitis had a documented history of myocardial infarction (MI). Conclusion: In our cohort, those with a history of MI did not have a documented history of uveitis. Larger, prospective studies are needed to evaluate the associations between MI and uveitis in a BD population.

Awareness of Hypoglycemic Episodes Among Patients With Type 2 Diabetes Mellitus in Aseer Region, Saudi Arabia: A Cross-Sectional Study in 2024

Awareness of Hypoglycemic Episodes Among Patients With Type 2 Diabetes Mellitus in Aseer Region, Saudi Arabia: A Cross-Sectional Study in 2024

Efficiency of night shifts in Primary Healthcare Centers, Aseer Region, Saudi Arabia: Data envelopment analysis

BACKGROUND: Efficient allocation of healthcare resources is essential for meeting the increasing demand for healthcare services. This study aimed at exploring the performance of both one- and two-shift Primary Healthcare Centers (PHCCs) and examining the efficiency of healthcare centers to discover how efficiency is affected by the levels of resource allocation and staffing. MATERIALS AND METHODS: The study was conducted at 31 PHCCs assigned to cover extended hours, from 4:00 PM to 8:00 AM during May-October 2023. Study employed a quantitative approach and the data envelopment analysis technique to assess the efficiency of PHCCs, specifically focusing on night shift performance. Data were collected through interviews and surveys with primary healthcare staff including 99 doctors, 119 nurses, and 139 support staff using structured questionnaire. The DEA technique was utilized to measure the relative efficiency of the PHCCs by comparing the inputs and outputs. RESULTS: Out of 31 PHCCs, 45.2% run two shifts. Over the reported period, a total of 126,619 patient visits were recorded; 81.7% came to the two-shift PHCCs and 18.3% to the one-shift PHCCs. On average, each two-shift PHCC received approximately 161 visits/ shift, and the one-shift received 123 visits. Upper respiratory tract infections accounted for 30% of morbidities and chronic diseases for more than 20%. The performance of the two-shifts PHCCs revealed varying levels of efficiency with a score of 1.00 for the most efficient PHCC and 0.31 for the least efficient PHCC. CONCLUSION: This study underscores the importance of data-driven decision-making for healthcare administrators. Ongoing assessments and benchmarking are essential for continuously improving the quality of healthcare service and optimizing utilization of resources. Future research in this field can further explore the factors that contribute to healthcare efficiency and provide deeper insights into healthcare resource management and optimization of service delivery.

JAK2 Mutation Assessment in Thrombotic Events at Unusual Anatomical Sites: Insights from a High-Altitude Cohort.

Thrombosis stands as a significant contributor to both morbidity and mortality in individuals afflicted with myeloproliferative neoplasms. This retrospective study investigated the association between JAK2 mutations and venous thrombosis at unusual sites, and in young individuals with ischemic stroke, residing at high altitudes in the Aseer region, Saudi Arabia. Data were collected from two high-altitude referral hospitals over three years (2020-2022). Records of all JAK2 mutation tests were reviewed. Those requested as part of evaluation of thrombosis events, without known myeloproliferative neoplasms (MPNs) were analysed. Among the 208 JAK2 tests, 40 (19.2%) were linked to thrombotic event evaluations. The cohort, with a median age of 41, included 17 (42.7%) males and 23 females, with 57.5% having completely normal complete blood counts (CBC). Thrombotic events were divided between splanchnic vein thrombosis (36.6%) and cerebral thrombosis (34.1%), while the remaining cases involved unprovoked deep vein thromboses/pulmonary embolisms and portal vein thrombosis. Only 2 (5%) participants tested positive for JAK2 mutations: a 17-year-old male diagnosed concurrently with polycythemia vera after renal vein thrombosis and a 31-year-old woman with hepatic vein thrombosis and a normal CBC. This study reveals that JAK2 mutations are infrequently found in high-altitude patients with unprovoked DVT, PE, or atypical thrombosis. While JAK2 testing is notably relevant for splanchnic vein thrombosis, its routine use for other thrombotic events, particularly with normal CBC results, remains uncertain. Given the study's limitations, further prospective research with larger cohorts is needed to refine guidelines for JAK2 mutation testing in various thrombotic contexts.

Prevalence of gastrointestinal manifestations among diabetic patients in the Aseer region: A cross-sectional study.

Diabetes mellitus (DM) has a systemic consequence, influencing many systems of the body, including metabolic functions. This study aimed to determine the prevalence of gastrointestinal complications among patients with type 2 DM in the Asser region of Saudi Arabia, identify sources of information, and investigate the association of these symptoms with disease duration and glycated hemoglobin. This cross-sectional study was conducted between November 13 and December 27, 2023. The questionnaire collected demographic data including age, sex, education, employment, income, and nationality, and 16 questions (5 points for each symptom) about the frequency of gastrointestinal symptoms in the past 3 months. The total score was 80, participants were categorized based on their total scores into 2 groups: those scoring 40 or below, and those scoring above 40. A total of 230 patients were included in this study, their median age was 32.0 (24.00) years, 60% were men, 63.9% were married, 38.7% earned between 5000 and 10,000 Saudi Riyal/month, 85.2% did not work in the medical field, 39.1% held university degrees, 54.8% did not have health insurance, 70.4% did not smoke, 35.7% worked in government jobs, 63% lived in urban areas, 95.2% were Saudi and 53.5% had only DM. More than half of the respondents, 57.4%, relied on doctors for information about DM. Dysmotility symptoms were common: dyspepsia affected 26.5% often and 5.7% always; early satiety impacted 24.3% often and 5.2% always; and bloating affected 28.3% often and 10.9% always. Constipation/diarrhea were a common complaint, with 23.5% of patients experiencing them often and an additional 4.8% reporting it always. Stool consistency also varied widely, with 21.7% experiencing lumpy or hardened stool. Health insurance status and having chronic diseases showed significant association with the severity of symptoms. Duration of diabetes and glycated hemoglobin were associated with the frequency of the symptoms. Gastrointestinal symptoms are common among diabetic patients in Aseer. The frequency of symptoms is associated with glycemic control, duration of diabetes, and health insurance status. These findings highlight the need for improved management and support for better gastrointestinal health in diabetes.

Knowledge and willingness to donate kidney for transplantation among general population in Saudi Arabia

IntroductionKidney transplantation is the preferred treatment for end-stage renal disease (ESRD), offering a superior quality of life and extended survival compared to other renal replacement therapies. As the number of ESRD patients grows, so does the demand for organ transplants. The prevalence of ESRD is anticipated to escalate further due to the rising rates of diabetes mellitus (DM), hypertension (HTN), and obesity. Organ donation, particularly from living donors, remains the main source of transplants in the region, despite the notable underutilization of potential deceased donors’ organs. The objective of this research is to assess the level of knowledge, attitudes, and willingness to donate kidneys among the general population, a pivotal step in addressing the organ shortage crisis.MethodsThis cross-sectional study was conducted in the Aseer region of Saudi Arabia using a previously validated questionnaire. The questionnaire collected demographic data and insights into general attitudes, knowledge, and beliefs about organ donation. Logistic regression was used to identify predictors of knowledge and willingness to donate.ResultsThe study involved 705 participants, predominantly young adults with a high level of education. Awareness of kidney donation was high, and knowledge about donation was broad, especially regarding religious permissibility and awareness of the donor registry. However, only 25% expressed willingness to donate their kidneys, and a 4% were already registered as donors. Furthermore, higher educational level was not associated with higher odds of knowledge or willingness to donate.ConclusionDespite the considerable awareness, actual donor registration rates were low, highlighting the necessity for targeted educational interventions and a deeper understanding of the cultural and socioeconomic barriers that exist.

Resistance Pattern of Klebsiella pneumoniae in Aseer Region, Saudi Arabia: A Ten-Year Hospital-Based Study.

Background and Objectives: The frequency of multidrug-resistant Klebsiella pneumoniae (MDRKP) has dramatically increased worldwide in recent decades, posing an urgent threat to public health. The aim of this study was to assess the extent of K. pneumoniae in the Aseer region and explore the corresponding antimicrobial resistance profile over the last ten years. Materials and Methods: A record-based retrospective study was conducted in a tertiary hospital during the period of 2013 to 2022. The study targeted laboratory samples taken from patients admitted to the hospital and sent for K. pneumoniae culturing. We included only samples taken from the patient and confirmed by the lab. Data were extracted using a pre-structured data extraction sheet to avoid data-collection bias and confirm the inter-rater precision. Statistical Package for Social Sciences (SPSS) version 26 was employed for statistical analysis. All relationships were tested using Pearson X2 test for categorical data or chi-square for linear trend for resistance rate over years. Results: We obtained 3921 samples of isolated K. pneumoniae out of 28,420 bacterial samples. The isolation rate began at 11.3% in 2013, decreased to 6.1% in 2016, and then increased to a peak of 16.3% in 2021, before slightly decreasing to 12.8% in 2022. In total, 23.7% of K. pneumoniae samples were identified in urine samples, 19% in sputum samples, 14% in wound samples, and 11.7% in blood samples. The overall antibiotic resistance rate of K. pneumoniae from 2013 to 2022 showed a significant increase, particularly during 2020 and 2021, before decreasing again in 2022. The resistance rate decreased from 22.2% in 2013 to 18.6% in 2016 and increased to 54.6% and 56.4% during 2020 and 2021, respectively (p = 0.039). Conclusions: We observed a significant shift in K. pneumoniae resistance for some antibiotics during the study period, highlighting the urgent need for enhanced antimicrobial stewardship and infection-control measures.

Prevalence and Determinants of Exclusive Breastfeeding Among Mothers of Children Aged 6-24 Months in the Aseer Region.

Background Exclusive breastfeeding (EBF) is crucial for infant and maternal health, providing optimal nutrition and immune protection for infants while reducing maternal postpartum depression and cancer risk. However, global trends show an early cessation of breastfeeding and the introduction of other foods. This study aims to determine the prevalence and factors influencing EBF among mothers in the Aseer region of Saudi Arabia. Methodology A cross-sectional study using a multistage cluster sampling approach was conducted from January to March 2024 in primary healthcare centers across the Aseer region. Participants included mothers of children aged 6-24 months attending primary healthcare centers for immunizations or routine check-ups. A pretested structured questionnaire, developed after an extensive literature review and expert consultation, was used to interview consenting participants. The questionnaire covered sociodemographic data, obstetric and medical history, child data, EBF practices, maternal knowledge and perception of breastfeeding, counseling about breastfeeding, antenatal care, breastfeeding support, and barriers and motivators of EBF. Results A total of 1,008 eligible mothers were included. Only 131 (13%) fulfilled the World Health Organization criteria for EBF. Moreover, 257 (25.5%) mothers initiated breastfeeding within the first hour after delivery, and 387 (38.4%) exclusively breastfed for six months or more. EBF was less frequent among mothers with higher education (8%, n = 2) compared to those with lower education (23%, n = 23, p = 0.017). EBF was also less frequent among mothers who delivered via cesarean section (7.9%, n = 28) compared to those who had a vaginal delivery (15.8%, n = 103, p = 0.001). Conversely, EBF was more common among mothers with more than five pregnancies (15.8%, n = 45) compared to those with one to two pregnancies (9.4%, n = 37, p = 0.023). EBF was also more common among mothers who had breastfed more than four children (16.7%, n = 39) compared to those who had not (12.1%, n = 49, p = 0.048). Finally, EBF was more common among mothers without postpartum complications (13.4%, n = 131) or whose infants had no birth complications (13.4%, n = 128) compared to their respective counterparts (p = 0.029 and p = 0.048, respectively). Conclusions This study found a low prevalence of EBF in the Aseer region, despite high maternal knowledge and positive perceptions. Factors such as low education, medical barriers, unemployment, and high parity were associated with increased EBF rates. Interventions should focus on improving workplace support and increasing maternal awareness of EBF recommendations.

Evaluating Burn First Aid Knowledge, Practices, and Confidence Levels Among the General Population in Aseer, Saudi Arabia.

Background and objectives Burns represents a significant public health issue globally and in Saudi Arabia, disproportionately affecting vulnerable groups. Prompt, evidence-based first aid improves outcomes. This study assessed burn first aid understanding, self-assurance, and information sources among Aseer Region residents. Methods A cross-sectional online survey was distributed to 386 individuals using a validated questionnaire, assessing understanding via a 10-item scale and confidence through Likert scales. Associations between variables were examined statistically. Results Most participants (85%; n=330) demonstrated poor first-aid comprehension, and only (1%; n=2) exhibited excellent knowledge. A history of burn exposure correlated with higher knowledge (p=0.039). The Internet was the primary information source (48%; n= 185). Confidence in assisting burn victims was generally low. Conclusions Significant gaps in foundational burn first aid knowledge were identified, necessitating targeted educational interventions disseminated via multiple modalities to strengthen emergency response and optimize outcomes in this region.

A cross-sectional study on the self-management of asthma and asthma control among adult asthmatic patients in the Aseer region, KSA

Proper management of asthma is crucial for maintaining control over the disease and has a significant impact on the patient’s overall condition. The purpose of this study was to determine the extent of self-management and the level of Asthma control in the patients from the Aseer region of Saudi Arabia, as well as to investigate determinants of illness control. A study was conducted using quantitative cross-sectional methods. Researchers utilised a web-based, self-administered structured questionnaire to gather data. The questionnaire included three sections: a socio-demographic section, an Asthma Self-Management Questionnaire (ASMQ), and Asthma Control Test (ACT). An analysis using the chi-square test was conducted to determine if there was a notable connection between the socio-demographic characteristics of the participants and the level of asthma control. A total of 305 responses were collected. The average score for the Asthma Self-Management Questionnaire was 5.72, which corresponds to 40.9%. Based on the scores from the Asthma Control Test, it was found that 60 patients (20.0%) had asthma that was not under control, 94 (30.0%) had asthma that was partially controlled, and 151 (50.0%) had asthma that was well controlled. Factors such as gender, non-smoking status, and having asthma for over 10 years (p ˂0.05) were found to be strongly correlated with improved disease control. Significant gaps were found in patients’ awareness of the most important and critical aspects concerning the condition, medications, and preventative actions that limit asthma aggravation. To address the current situation, hospitals and clinics must make substantial efforts.

Knowledge of Diabetes Mellitus and Practices Regarding Lifestyle Factors and Diabetes Management in a General Adult Population of Aseer Region, Saudi Arabia.

Many studies report a lack of public awareness of the risk factors and complications of Diabetes Mellitus. Adequate glycemic control is crucial in preventing or delaying the onset of type 2 diabetes complications, and medication adherence is one of the key factors in achieving this goal. This study aimed to measure the knowledge about diabetes mellitus and practices regarding lifestyle factors and diabetes management in the study population in the Aseer region, of Saudi Arabia. A descriptive cross-sectional survey was conducted in Abha, a city in the Aseer region of Saudi Arabia. The general population of 18 years of age and above, who were residing in the study area during the period of study, ie, January 2023 to June 2023, were included. The questionnaire was distributed through social media and e-mail for data collection. The descriptive variables were presented using frequency, percentage, and graphs. Pearson's chi-square test was used at a 5% level of significance. Multivariate tests were applied to further explore the findings of univariate analysis. The data were analyzed using SPSS version 20.0. Out of the total 348 participants, a higher proportion was males (56.3%). About 78.7% of the participants were ever diagnosed with diabetes mellitus and 21.3% were never diagnosed with diabetes mellitus. Nearly 31.6% knew that the major cause of diabetes mellitus was obesity and 31.3% knew that it was a hereditary disease. About 42.2% of respondents exercised regularly and 27.6% were smokers. Adherence to prescribed anti-diabetic medications was seen in 63.2% of the respondents. Self-alterations in the timing and dose of prescribed anti-diabetic drugswere seen in 36.5% and 34.8%, respectively. About 60.1% had a moderate level of self-rated knowledge about Diabetes Mellitus, and 27.6% and 12.4% had good and poor self-rated knowledge levels of Diabetes mellitus, respectively. On multivariate analysis, the age group 60-69 years had significant variations as compared to the other age groups on DM, bachelor's degree holders had significant variations as compared to other education variables, being married had significant differences as compared to those unmarried, those employed had significant variations as compared to the other occupation categories, and smokers had a significant impact on DM as compared to non-smokers. Findings indicated less number of respondents exercised regularly, low adherence to prescribed anti-diabetic medications and low levels of self-rated knowledge of diabetes mellitus. Enhancing the patients' knowledge of diabetes mellitus and improving their self-management and adherence to its medications is necessary through public health education.

Social Media Use and Sleep Quality Among Secondary School Students in Aseer Region: A Cross-Sectional Study.

Use of different social media platforms has increased radically over the past decade, emerging as an important part of adolescents and young people's everyday life. This might exert potential adverse effects on sleep quality and daytime performance of young adults. To assess the relation between use of social media platforms and sleep quality among public secondary school students. A cross-sectional study was conducted on 961 students in Aseer region, Saudi Arabia. Students were asked to fill in a structured interview questionnaire covering personal data, pattern of social media use, sleep quality using The Pittsburgh Sleep Quality Index (PSQI) and their mental health status using the depression, anxiety and stress scale (DASS-21). Students' ages ranged from 15 to 20 years with a mean age of 16.7 ± 2.1 years old. A total of 570 (59.3%) students were females. Tiktok (80%), Snapchat (77.9%), Instagram (63.8%) and YouTube (58.8%) were the most reported platforms used. Regarding their sleep quality, 34.7% of students were poor sleepers. TikTok use (OR 1.33, 95% CI 1.01-1.77), hours spent on social media (OR 1.26, 95% CI 1.16-1.37) and having moderate to severe depressive symptoms (OR 1.69, 95% CI 1.19-2.40) were significant independent predictors of poor sleep among the studied sample. The present study emphasized the association between prolonged use of social media and poor sleep quality among Saudi adolescents. Awareness and behavioral change strategies and activities concerning the drawbacks of poor sleep and proper use of social media are urgently called for to control mental and physical health consequences of poor sleep and social media addiction.

Behçet's Disease Current Therapies: MTX- Imuran and Long-term Effect of VIT D and Colchicine (Multi Centric Cohort Study from Aseer Region, Saudi Arabia)

Background: Behçet's disease (BD) is a rare, chronic inflammatory disorder that recurs over time, impacting multiple systems, positioning it at the intersection of autoimmune and auto-inflammatory syndromes. BD is a unique clinical entity known for its diverse manifestations with recurring oral ulcers are the most common, followed by genital ulcers. This article aims to explore and emphasize the diverse medication approaches for treating our patients with Behçet's disease. Methods: A comprehensive retrospective analysis was conducted on medical records and data of patients under active care in rheumatology clinics, all of whom had a confirmed diagnosis of Behçet's disease looking for their different treatment options. We defined organ involvement severity to Mild (one organ), Moderate (2 organs) and sever is 3 and more organ involvement. Results: 111 patients, evenly distributed by gender, we analyzed therapy effects on Behçet's disease. Azathioprine and methotrexate users (54 and 13 patients, respectively) were typically aged 21-60. Colchicine use (78 patients) showed consistent results, with similar organ involvement severity. Comparatively, Vitamin D use (55 patients) showed similar age and gender distribution, with a quarter exhibiting severe organ involvement. However, neurological, gastrointestinal, and pulmonary symptoms showed no significant differences across these groups. Conclusion: In our study, we observed more sever disease in people taking MTX compared to Imuran. We also observed no morbidity or mortality benefit of vitamin D. Collaboration across disciplines is crucial for personalized treatment, considering organ involvement, age, gender, symptom intensity, and disease duration. Larger, prospective studies are needed to compare different Conventional Disease modifying agent and to consider mortality benefits of Colchicine in BD.

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis.

Eustachian tube dysfunction (ETD) affects a significant portion of the population, manifesting symptoms that impact the quality of life. Despite the prevalence of ETD, there remains a notable gap in comprehensive studies exploring the condition's dynamics within specific demographic contexts, particularly within Saudi Arabia. This study aimed to assess the prevalence and severity of ETD across different demographic groups, to evaluate the efficacy of various treatment modalities, and to identify key predictors of treatment response in a Saudi Arabian cohort. A cross-sectional study was conducted from June 2022 to May 2023 in tertiary care hospitals in the Aseer region, Saudi Arabia. Participants included adults diagnosed with ETD, assessed through clinical symptoms, otoscopic examinations, audiometric evaluations, tympanometry, and the ETDQ-7 questionnaire. The study incorporated advanced diagnostics such as nasopharyngoscopy and pressure equalization tube function tests and involved 154 participants, revealing significant variations in ETD severity, with the 46-60 age group exhibiting the highest mean ETDQ-7 score of 4.85, and urban residents displaying lower severity scores compared to rural counterparts. Pharmacological interventions were most effective, achieving the highest symptom relief and audiological improvement rates of 87.78%. Multivariate regression highlighted age, geographic location, and treatment modality as key predictors of treatment efficacy, with notable interaction effects between climate conditions and treatment types influencing outcomes. The findings underscore the heterogeneity in ETD presentation and the differential efficacy of treatment modalities.

Endoscopy of Low BMI Patients Compared to Normal BMI Patients: A Study From the Aseer Region, Saudi Arabia.

Gastrointestinal (GI) endoscopies are essential for detecting and treating various digestive tract problems. While typically safe, these treatments can entail the risk of severe adverse events (SAEs), especially in individuals with a low body mass index (BMI).The current study aimed to evaluate whether post-endoscopy SAEs are more common in patients with low BMI and find risk factors for serious adverse outcomes in Saudi Arabian patientsfrom Khamis Mushait, Aseer region, Saudi Arabia. The data of 398 adult patients with abdominal endoscopies between April and November 2023 were analyzed. Patients were divided into two groups: low BMI (BMI ≤ 18.5) and control (18.5 ≤ BMI ≤ 30). They were matched for age, gender, comorbidities, endoscopy type, and other pertinent characteristics. Low-BMI patients (Group I, n = 108) were substantially younger and had lower levels of albumin and total protein than the control group (Group II, n = 209). Comorbidities varied between groups, with diabetes mellitus more prevalent in Group II and inflammatory bowel disease (IBD) more commonplace in Group I. Treatment options also differed, with Group I receiving more biological treatments, steroids, and feeding tubes. Endoscopic procedures and indications were comparable among groups, with no significant variations in post-endoscopy complications. The endoscopy results varied from gastritis to colon malignancy, with no SAEs recorded in either group. Unlike earlier findings, this study found no higher incidence of SAEs in low-BMI individuals having abdominal endoscopy. This might be because of the restricted guidelines of different medical authorities, including clear informed consent that illustrates any risks, benefits, alternatives, sedation plan, and potential diagnostic or therapeutic interventions. Also, professional endoscopists and consultants who ensure adequate visualization of the GI mucosa, using mucosal cleansing and insufflation as necessary, should avoid any risk of abdominal hemorrhage. These findings highlight the significance of personalized risk assessment and pre-procedural optimization, including nutritional assistance, in this patient population. More prospective research with larger sample sizes is needed to validate these findings and create targeted techniques for improving outcomes in individuals with a low BMI having endoscopic operations.

Prediction of Diabetes and Prediabetes among the Saudi Population Using a Non-Invasive Tool (AUSDRISK).

Background and Objectives: Screening for type 2 diabetes mellitus (DM2) aims to identify asymptomatic individuals who may be at a higher risk, allowing proactive interventions. The objective of this study was to predict the incidence of DM2 and prediabetes in the Saudi population over the next five years. Materials and Methods: The study was conducted in the Aseer region through August 2023 using a cross-sectional survey for data collection. A multistage stratified random sampling technique was adopted, and data were collected through face-to-face interviews using the validated Arabic version of the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Results: In total, 652 individuals were included in the study. Their mean age was 32.0 ± 12.0 years; 53.8% were male, 89.6% were from urban areas, and 55.8% were single. There were statistically significant differences between males and females in AUSDRISK items, including age, history of high blood glucose, use of medications for high blood pressure, smoking, physical activity, and measurements of waist circumference (p < 0.05). Based on AUSDRISK scores, 46.2% of the included participants were predicted to develop impaired glucose tolerance within the coming five years (65.8% among females vs. 23.6%), and 21.9% were predicted to develop DM2 (35.6% among males vs. 6.0% among females); this difference was statistically significant (p = 0.0001). Conclusions: Urgent public health action is required to prevent the increasing epidemic of DM2 in Saudi Arabia.

Hypertension clinical pathway: Experience of Aseer region, Saudi Arabia.

Hypertension (HTN) is a common chronic health problem with many complications and high morbidity rates. This study aimed to describe the HTN pathway, to assess the performance of screening and registration programs, to explore the challenges and suggest solutions for those challenges. This study was conducted in primary care centers in the Aseer region, Saudi Arabia, at the end of 2022. The study consisted of three parts namely: Screening for HTN, registration of known hypertensive patients and opinions of representatives of Primary Healthcare Centers (PHCs) on challenges to the implementation of HTN pathway and suggestions for overcoming these challenges. Three Google forms were developed by the investigators to achieve the objectives of this study. The first two forms were completed by doctors and nurses at each PHC and reviewed by the leader of HTN pathway, and the third form completed by a representative of each PHC. SPSS version 26 was used for data management and analysis. Chi-square test was used to determine association between categorical variables; binary logistic regression analysis was performed to determine the correlates of being hypertensive and having good control of HTN. A total of 159,243 individuals were screened for HTN, 55% of whom were females and 94% were Saudis. The prevalence of HTN was 13%; 70% were overweight or obese and 14% had diabetes. The total registered number of patients was 55,628; 50% had good HTN control. Major challenges were inadequate health coaches, care coordinators, laboratory and radiology facilities, lack of coordination with hospitals, and ineffective appointment system. This study revealed that the current HTN pathway was successful with regard to screening and registration of patients with HTN. Many challenges need an executive plan with SMART objectives to optimize the care for HTN patients in the region.

Major placenta previa among patients with and without previous cesarean section: Maternal characteristics, outcomes and risk factors

ObjectivesTo compare maternal characteristics and outcomes among patients having major placenta previa (PP) with and without previous cesarean section (CS). And to determine if previous CS alone is a risk factor for associated adverse maternal outcomes in these patients. Materials and methodsThis is a retrospective analysis including two groups of major PP patients, with previous CS (n = 184) and without CS (n = 115); who were admitted to Abha Maternity and Children's Hospital over the last ten-years (January 2012–December 2021), Aseer region, Saudi Arabia. ResultsCompared to those without previous CS, major PP patients with previous CS had significantly advanced ages with higher mean numbers of gravidity and parity, but significantly less rates of previous uterine surgery and IVF pregnancies. Moreover, they were more likely to acquire higher rates of adverse maternal outcomes. In the same way, these patients had an increased Odds Ratios of cesarean hysterectomy (OR of 20.462), urinary tract injuries (OR of 12.361), associated PAS (OR of 4.375), moderate/ heavy intra-operative bleeding (OR of 2.153) and the need for transfusion of 3+ units of packed RBCs (OR of 1.849). Conclusion(1) Patients with combined existence of major PP and previous CS had significantly higher rates of adverse maternal outcomes (2) Alone, prior CS in major PP patients increased the Odds Ratios of cesarean hysterectomy, urinary tract injuries, diagnosis of PAS, excessive intra-operative bleeding and repeated packed RBCs transfusions. (3) Among our PP patients with previous CS, the increased rate and OR of PAS diagnosis could in-part explain the adverse maternal outcomes.

Awareness and knowledge of sun exposure and use of sunscreen among adults in Aseer region, Saudi Arabia

BackgroundExcessive sun exposure and inadequate sunscreen use can lead to skin cancer and other harmful effects on the skin, eyes, and immune system. PurposeThis observational cross-sectional study aimed to assess awareness and knowledge of sun exposure and sunscreen use among adults in the Aseer region, Saudi Arabia. This study also focused on evaluating the risks of skin cancer and participants’ sun-protective attitudes and practices. MethodsA population-based cross-sectional study was conducted among adults in the Aseer region, Saudi Arabia. Data were collected using a questionnaire from November 2022 to January 2023 that assessed participants’ knowledge, practices, and beliefs regarding sun exposure and sunscreen use. A total of 400 participants were selected for the study. Approval for the study was granted by the Local Research Ethics Committee of the University of Bisha, Saudi Arabia. ResultsThe results revealed that (59.8 %) of the participants were female, while (40.3 %) were male. Regarding age, the majority fell within the 26–35 age range (37.5 %), with (16.0 %) of participants using sunscreen regularly, with a total of (74.0 %) of participants using sunscreen. Men exhibited a higher prevalence of negative attitudes towards sun protection, while women demonstrated more favourable sun protection practices. In addition, (1.25 %) of the participants had skin cancer in the past; (81.0 %) of participants agreed that skin cancer could cause death, while (19.0 %) were unsure of the effects of skin cancer. Moreover, the results indicated that sun exposure had a significant positive effect on awareness levels (p < 0.05), indicating that increased sun exposure was associated with higher awareness of the harmful effects of the sun. Additionally, awareness level significantly positively affected sunscreen use (p < 0.01), suggesting that individuals with higher awareness were more likely to use sunscreen. ConclusionThere was an average awareness of sun exposure and its detrimental effects. In addition, a significant portion of the population demonstrates proactive measures to minimize sunlight exposure. However, sunscreen usage among Saudi adults was low despite having knowledge and awareness. Future research must enhance sun protection practices and reduce sun-related skin damage in the Aseer region.

Cultural Courtesies: Decoding Politeness Formulas in the Aseer Dialect of Arabic

This study analyzes politeness formulas within the Aseer dialect of Arabic, employing Conceptual Metaphor Theory and the Embodiment Hypothesis as theoretical frameworks. With a dataset encompassing a total of 300 formulas, comprising 210 related to body parts and 90 linked to devotion formulas, the research unravel the conceptual metaphors and metonymies inherent in these expressions. The study elucidates the cultural alignment of these formulas and their consistency with societal norms, contributing to the preservation of oral heritage in the Aseer region. The findings highlight how human beings utilize metaphor metonymy to embody abstract ideas, emphasizing the cultural significance of these politeness formulas and their connection to the physical and cultural experiences of the Aseer community. The outcomes of the study do not only enhance our understanding of politeness formulas but also pave the way for cross-dialect and cross-linguistic comparisons and applications in various fields, such as cross-cultural pragmatics, ethnographic studies, semantic mapping, and cultural preservation.