Makkah City Research Articles

Cross-Sectional Assessment of Chronic Kidney Disease Awareness Among the General Population in Makkah

Objectives: A growing global health concern is chronic kidney disease (CKD), which isprevalent in Saudi Arabia as well. In this research, we aimed to assess the knowledge,Perception, and Attitude toward Chronic Kidney Disease among the General Populationin Makkah, Saudi Arabia.Methods: In Makkah City, Saudi Arabia, a cross-sectional survey was carried out in2023. A random sample of the general population aged 18 to 60 was given an onlinequestionnaire; individuals with CKD and healthcare professionals were not included.Results: The study's findings showed that 73.6% of participants had little or noawareness of chronic kidney disease (CKD), suggesting that the public had a poorcomprehension of the condition. Being young, unmarried, and having a family history ofrenal disease were all positively correlated with higher awareness levels.Conclusion: The study emphasizes the urgent need for public health measures, such aseducation and awareness campaigns, to raise public understanding of chronic kidneydisease (CKD) in Makkah, Saudi Arabia.Keywords: Chronic Kidney Disease (CKD), Makkah, Online questionnaire, Survey,Public awareness.

Increased Activation Markers of Adaptive Immunity in Patients with Severe COVID-19.

Introduction: COVID-19 is a pandemic disease and is widespread over the world. This disease shows a 5.1% mortality. The understanding of the disease has expanded rapidly in many areas, including virological, epidemiological, clinical, and management dimensions. To better understand the inflammatory and immune profiles that impact the pathogenesis and development of severe COVID-19 symptoms, further studies are essential. This research aims to explore the inflammatory and adaptive immune responses associated with COVID-19, considering factors such as genetic diversity and environmental exposure among Saudi patients. The goal is to determine if patients with severe COVID-19 exhibit different disease phenotypes. Materials and Methods: This case-control study includes 115 participants (healthy and with COVID-19 infection), 55 of which had confirmed cases of COVID-19 in intensive care units (ICUs) at different hospitals in Makkah City, Saudi Arabia. Whole blood samples were collected from June to September 2021 for cellular analyses, and inflammation marker data were collected from hospital records. The expression of activation markers on B (CD27 and CD38) and T cells (CD27 and HLA-DR) was obtained using the flow cytometry technique. Also, serum was collected for cytokine measurements, including IL-6, INF-γ, and TNF- α. Results: The results indicated that lymphopenia and excessive T cell activation were more prevalent in severe cases than in healthy individuals. Furthermore, the results revealed that severe COVID-19 patients had an increased frequency of CD19+ B cells, with changes in B cell subsets. The current study implies impairment and changes in the phenotype of adaptive cells (including T and B cells), with an increase in HLA-DR molecules and inflammation markers with pro-inflammatory cytokines in severe COVID-19 cases. Conclusions: The current study implies impairment and changes in the phenotype of adaptive cells (including T and B cells), with an increase in HLA-DR molecules and inflammation markers in severe COVID-19 cases, which could be targeted for therapeutic interventions. This might be a valuable approach for the diagnosis and treatment of severe COVID-19 cases.

Maternal perceptions and awareness regarding developmental dysplasia of the hip in children among mothers and pregnant women in Makkah City, Saudi Arabia.

Developmental dysplasia of the hip (DDH) is a spectrum of disorders that develop in utero, involving the femoral head and acetabular cup development, ranging from dysplasia to dislocation. The prevalence of DDH in Saudi Arabia is 10.46 per 1000 live births. However, the late presentation of DDH in Saudi Arabia is around 30%, believed to be significantly due to a lack of awareness of the disease among mothers and pregnant women. This study aimed to measure maternal perceptions and awareness regarding DDH in children among mothers and pregnant women in Makkah City, Saudi Arabia. In total, 406 women participated in an electronic survey. The survey questions were adapted from previously published research, and the questionnaire was available in Arabic. The age distribution of the participants ranged from below 20 to over 50 years, with the largest group being 31-40 years old. Most of the participants had a university-level education (61.1%). The overall assessment showed a predominance of poor knowledge (41.1%), followed by good knowledge (34.7%), and then medium knowledge (24.1%). The present study revealed significant knowledge gaps and barriers to the early detection and intervention of DDH among Makkah City mothers and pregnant women. The findings underscore the need for targeted educational campaigns, increased access to screening programs, and heightened healthcare provider knowledge to improve DDH's perception and awareness. Future interventions should focus on addressing these gaps and promoting early detection and intervention strategies to minimize the long-term consequences of DDH.

Predictors of medication regimen complexity and its impact on hemoglobin a1c in type 2 diabetes patients: a retrospective analysis in ambulatory care in Makkah City.

Type 2 diabetes mellitus (T2DM) is a widespread chronic disease that poses a significant management challenge due to the complexity of the associated medication regimens, which can have a considerable impact on patient outcomes. Explore the complexity level of diabetes medications among patients with T2DM and to identify the predictors of medication regimen complexity (MRC) and its correlation with hemoglobin A1C (HbA1c) levels. Retrospective, cross-sectional study. An ambulatory care setting of a tertiary hospital in Makkah City, Saudi Arabia. Patients with T2DM referred to the diabetic clinic were identified and assessed for eligibility. The data were collected from patient electronic medical records between October 2022 and September 2023. The MRC Index was used to evaluate the complexity of the patients' medication regimens. MRC index scores and HbA1c levels. 353 records of patients with T2DM. The analysis revealed that 61.8% (n=218) of patients had high MRC, with the dosing frequency contributing significantly to their MRC (mean=3.9, SD=1.9). Having polypharmacy and longstanding T2DM were predictors of high MRC (odds ratios=4.9 and 2.6, respectively; P≤.01). Additionally, there was an inverse association between the patients' diabetes-specific MRC index scores and their glycemic control (odds ratios=0.2, P<.001). The study findings highlight the importance of considering MRC in managing T2DM. Simplifying medication regimens and optimizing medication management strategies can improve patient outcomes. Further research is needed to explore interventions to reduce MRC and enhance diabetes management in this population. Retrospective study design measuring the MRC at a diabetes-specific level.

Generative Artificial Intelligence as a Source of Inspiration for a Modern and Authentic Architectural Identity of Residential Building Facades in Makkah City

Generative Artificial Intelligence as a Source of Inspiration for a Modern and Authentic Architectural Identity of Residential Building Facades in Makkah City

Electronic device usage among preschool children and its association with mental health status in Saudi Arabian kindergartens.

To estimate the prevalence of electronic device usage and its association with mental health status among preschool children aged 3-6 years. A cross-sectional study was conducted among preschool children aged 3-6 years in kindergartens in Makkah city in 2023-2024, using an electronic questionnaire. An Arabic version of the Strengths and Difficulties Questionnaire was used to assess mental health. We recruited a total of 399 children. The prevalence of electronic device usage was 91.5%. The number of hours spent using electronic devices ranged from 0 to 12 hour (h)/day, with a mean of 3.1h/day. We found a significant positive correlation between the number of hours spent using electronic devices and emotional problems (r=0.200, p<0.001), conduct problems (r=0.149, p=0.003), hyperactivity (r=0.279, p<0.001), peer problems (r=0.104, p=0.038), and total difficulty scores (r=0.263, p<0.001). We also found a significant negative correlation between the number of hours spent using electronic devices and the prosocial score (r= -0.128, p=0.011), and most of the included children had scores within the "close to average" category across all scales of mental health status. There was a high prevalence of electronic device usage among preschool children, which exceeded the recommended time limit. A significant correlation was observed between electronic device use and mental health scores. Further longitudinal studies are required to understand the nature of this association and its implications for child development.

Knowledge of Narcolepsy Among Physicians in Makkah Region, Saudi Arabia: A Cross-Sectional Study.

Background Narcolepsy is a chronic sleep disorder that is characterized by excessive daytime sleepiness and cataplexy. It has been increasingly diagnosed over the years, impacting productivity and employment rates. Awareness of healthcare providers is crucial for the early identification and management of this condition. Objectives This study assessed physicians' knowledge of narcolepsy in the Makkah region of Saudi Arabia. Method This cross-sectional study was conducted from February to November 2023. An online self-administered questionnaire has been used to target physicians working in the Makkah region of Saudi Arabia. The utilized questionnaire assessed demographic and professional data as well as the participants' knowledge of narcolepsy. Statistical analysis was performed using RStudio (R version 4.3.1.). Statistical differences in knowledge were assessed using Pearson's chi-squared and Fisher's exact tests. Factors associated with knowledge of narcolepsy were investigated through univariable and multivariable regression analyses expressed using beta coefficients and 95% confidence intervals (95% CIs). Statistical significance was considered at p < 0.05. Results A total of 226 physicians participated in this study. Male physicians (54.4%, n = 123), practicing in governmental hospitals (77.9%, n = 176) and residing in Makkah City (43.4%, n = 98) were predominant. Non-surgical specialties represented 73.5% (n = 166) of the sample. Around 81% (n = 184) of the participants were aware of narcolepsy, with a significant difference according to professional status (p = 0.045). The majority of physicians have correctly identified narcolepsy as a sleep disorder (78.3%, n = 177), but only 32.3% (n = 73) have identified its typical onset age group and recognized that there are two types of narcolepsy. Almost half of the respondents indicated a lack of knowledge about the diagnostic criteria for narcolepsy in the DSM-5 (52.2%, n = 118). Only 27.4% (n = 62) recognized the correct diagnostic criteria. Half of the sample (51.3%, n = 116) recognized the use of multiple sleep latency tests for the diagnosis. For factors associated with higher participants' knowledge, non-surgical specialties showed significantly higher knowledge scores compared to surgical specialties (beta = 0.91, 95% CI, 0.13 to 1.7, p = 0.024). Conclusion This study has revealed a significant lack of knowledge about narcolepsy among physicians inMakkah region. This raises concerns about the timely identification, proper understanding, and accurate diagnosis of patients with narcolepsy. Adequate understanding of narcolepsy is crucial to avoid its misdiagnosis or delays in receiving appropriate treatment and support, ultimately impacting their quality of life.

Prevalence of Varicose Veins Among Surgeons: A Cross-Sectional Study.

Background Extended periods of standing, obesity, female sex, and older age are risk factors associated with a higher probability of developing varicose veins (VV). This study aimed to determine the prevalence of VV among surgeons in public hospitals inMakkah, Saudi Arabia, and to identify the risk factors associated with this condition. Methodology This is a descriptive cross-sectional study based on a validated online questionnaire distributed via hospital WhatsApp(Meta Platforms Inc., Menlo Park, CA) groups conducted between January and June 2024. The inclusion criteria of this study were surgeons of both sexes and any age group working in the selected hospitals in Makkah City, who agreed to participate in the study. The exclusion criteria were any other healthcare workers from outside the surgical field. We included 192 participants, and Epi Info software (Centers for Disease Control and Prevention, Atlanta, GA) was used to calculate the sample size. The data were collected, reviewed, and then fed into IBM SPSS Statistics software for Windows version 21 (IBM Corp., Armonk, NY). Every participant filled out a consent form. The university ethics committee of Umm Al-Qura University, Makkah, granted ethical permission. Result This study comprised 192 surgeons in Makkah hospitals. Twenty-eight surgeons were either diagnosed with VV or had signs of VV. Varicose veins were detected among 50% of thoracic surgeons, 42.9% of pediatric surgeons, and 26.3% of orthopedic surgeons. The most reported risk factors were a family history of VV (17%), hypertension (16%), and diabetes mellitus (14%). Surgeons aged 40 years or older had a higher prevalence of VV than younger ones. Also, 55.6% of obese surgeons had VV compared to 7.8% of others with average weight. Conclusion We found that VV is a common problem, particularly among individuals with predisposing factors, such as long standing hours, smoking, pregnancy, and obesity. We found that surgeons specializing in thoracic and pediatric specialties and female surgeons were more likely to be affected by VV. Preventive measures, such as avoiding prolonged standing, wearing compression stockings, and maintaining a healthy lifestyle, are recommended.

Biological studies of the activity of Manuka honey against Carbapenem-resistant Enterobacterales (CRE) bacteria.

To evaluate the potency of Manuka honey UMF +15 against Carbapenem-resistant Enterobacterales (CRE). Bacterial resistance is a worldwide problem that is increasing year by year, especially Carbapenem resistance. Alternatives to antibiotics are needed to both reduce costs, and to reduce the spread of antibiotic resistance, with the ultimate goal of saving lives. The efficacy of Manuka honey UMF +15 was tested by 2 methods; Well diffusion assay and minimum bactericidal concentration (MBC) against twenty Carbapenem-resistant isolates which collected from Makkah city hospitals during three months of study from 1st of September 2023 up to 1st of December 2023. The growth of all isolates of Carbapenem-resistant Enterobacterales (CRE) was severely inhibited by low concentrations of Manuka honey, affecting 25% of isolates at 15% and 75% of isolates at 18% of Manuka honey. In addition, using the honey at different concentrations in a well diffusion assay resulted, as expected, in a variable zone diameter, ranging from large zones(14mm) to small zones (2mm) according to the concentration of the honey. This study shows the remarkable antibacterial activity of Manuka honey and suggests that this natural remedy might be used in the future as an alternative treatment option against Carbapenem-resistant Enterobacterales (CRE); however, further clinical trials should be performed to corroborate our initial findings.

Frequency and Amount of Caffeine Consumption and Its Effects on Sleep Quality Among the General Population in Makkah City, Saudi Arabia, in 2024.

Caffeine is a commonly consumed psychoactive substance with potential effects on sleep quality. However, few studies have examined this relationship in the general population of Makkah, Saudi Arabia. To investigate the impact of caffeine consumption on sleep quality and identify demographic factors associated with caffeine intake and sleep quality in Makkah's general population. This cross-sectional study used a convenient sampling approach to recruit 390 individuals residing in Makkah. Data were collected via a Google Forms questionnaire distributed through various social media platforms. Caffeine intake and sleep quality were assessed using a validated questionnaire adapted for Saudi Arabia and the Pittsburgh Sleep Quality Index (PSQI), respectively. The median total daily caffeine intake was 324.20 mg, with 43.1% of participants consuming more than the suggested cutoff of 400 mg daily. There were significant positive correlations between PSQI and total caffeine consumption in the morning, evening, and overall daily consumption. The results also indicated significant relationships between demographic factors, such as marital status, educational level, income, and BMI groups, and caffeine consumption. Caffeine intake was found to be high among the general population of Makkah, with a significant portion consuming more than the suggested daily limit. There was a significant positive correlation between caffeine consumption and poor sleep quality. Additionally, demographic factors such as marital status, educational level, income, and BMI groups were found to be associated with caffeine consumption.

Screening of overactive bladder syndrome and its relation with insomnia: A public health experience.

Overactive bladder (OAB) syndromes are a vital global issue linked to sleep disturbances and insomnia. This survey explores the relationship between these health burden issues and their risk factors. A survey-based study was conducted among Makkah city citizens' in April 2023. A standardized tool of OAB symptom score and Insomnia Severity Index was used to screen participants. The collected data were statistically analyzed using SPSS. Overall, 529 participants were enrolled in this survey with mean = 37.3 and standard deviation = 13.7. Most participants had mild OAB 74.67%, while insomnia represents no clinically significant subtype among the majority 55.39%. About 25.33% of participants had clinical OAB (moderate and severe), while approximately 44.61% had insomnia. Similarly, participants with the mild subtype of OAB show a significant correlation with no clinically significant subtype of insomnia (P ˃ 0.001). Furthermore, participants with moderate OAB were statistically associated with subthreshold insomnia (P ˃ 0.001). Medical attention and public awareness are mandatory for the early detection of OAB and insomnia.

The Prevalence and Predictors of Dietary Patterns Consumption among Population Living in Makkah City, Saudi Arabia: A Cross-Sectional Study

The Prevalence and Predictors of Dietary Patterns Consumption among Population Living in Makkah City, Saudi Arabia: A Cross-Sectional Study

Prevalence and Determinants of Routine Childhood Vaccination Hesitancy in Makkah, Saudi Arabia.

Vaccines are among the most important inventions of the last century; they contribute significantly to preventing infectious diseases. In 2019, the World Health Organization (WHO) recognized vaccine hesitancy as one of the top ten threats. This study aimed to estimate the prevalence and determinants of routine childhood vaccine hesitancy among parents in Makkah City in 2023 using the Parent Attitude about Childhood Vaccine (PACV) survey. A cross-sectional study was conducted from October to December 2023 among parents of children aged six years or younger who attended primary healthcare centers (PHCC) in Makkah City using a stratified sampling technique. Data were collected using an electronic self-administered questionnaire, and the Arabic PACV Cronbach's alpha was 0.79. A total of 246 parents participated in the study. Over half of the participants were males (56.5%), and the mean age was 36 ± 7.2. Parents who scored 50% or more were considered hesitant. The study identified approximately 3% of parents as hesitant. The only significant association toward hesitancy status was age; younger parents were less hesitant than older parents, P-value < 0.006. The other variables, such as gender, educational level, marital status, employment status, household income, number of children, and having a child with chronic disease, were not significantly associated with vaccine hesitation. Though the overall parental hesitation rate is low, several questions received more hesitant responses than non-hesitant responses. Therefore, we recommend raising awareness through healthcare providers focusing on educating parents and correcting misconceptions about the safety and efficacy of vaccines.

Impact of Depression on Irritable Bowel Syndrome (IBS)-Associated Gastrointestinal Symptoms: A Cross-Sectional Study in Makkah City, Saudi Arabia.

Background Irritable bowel syndrome (IBS) is a functional gastrointestinal chronic disorder associated with symptoms such as abdominal pain, diarrhea, and constipation. One of the factors that could affect the pathogenesis of IBS is depression, a common psychological disorder that causes social and physical disability and affects productivity. A number of Saudi teachers were found to have depression, which was linked with multiple risk factors including chronic illnesses. However, there is limited data that exhibits the association between IBS and depression, specifically. Therefore, our study aims to determine the impact of depression on IBS-associated gastrointestinal symptoms in Makkah City schools, Saudi Arabia. Methods In this cross-sectional study, we used two validated scales and translated them into Arabic and then we distributed them to our targeted population. Our sample size was determined to be 383 but we succeeded in recruiting 477 participants in our study. Data were statistically analyzed using the statistical software Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corp., Armonk, NY). Results Generally, participants who demonstrated mild levels of Patient Health Questionnaire-9 (PHQ-9) depression scale corresponded significantly with minimal/mild and moderate levels of Gastrointestinal Symptom Rating Scale-IBS (GSRS-IBS) scores (n = 85 and 76, respectively; p ˂ 0.001), while participants who scored moderately on the PHQ-9 depression scale corresponded significantly with a severe level of GSRS-IBS scores (n = 29; p ˂ 0.001). Conclusion Our study found a significant association between different levels of depression and IBS among participants with a positive history of IBS. Further studies about the prevalence of IBS, depression, and the nature of their relationship are strongly recommended, in addition to the necessity of a suicide risk assessment for those with severe depression.

Development of hydrological based physical model for nutrients transport simulation: case study of Makkah city, Saudi Arabia

Development of hydrological based physical model for nutrients transport simulation: case study of Makkah city, Saudi Arabia

Attitude of Dental Students Toward Rubber Dam Application: A Cross-Sectional Study.

Introduction The rubber dam (RD) system is globally recognized as an indispensable component of dental treatments, ensuring the highest standards of care. The use of RD isolation profoundly impacts the clinical aspects of dental procedures. The aim of this study was to assess the attitudes of dental students toward the use of RD, with an emphasis on evaluating the factors influencing its use among students at Umm Al-Qura University in Makkah city, Kingdom of Saudi Arabia. Methods An online questionnaire was distributed to a population sample of 203 undergraduate dental students in their clinical years at Umm Al-Qura University. Questions covered various aspects, including the frequency of RD use, perceptions of its effectiveness, and prospective intentions for its future use, as well as factors influencing these attitudes. Statistical analysis was performed using SPSS software Version 26 (IBM Corp., Armonk, NY, USA). In addition, the chi-square test and Fisher-Freeman-Halton exact test were used for the comparison of the data at a significance level of p<0.05. Results The questionnaire was completed by 191 participants, with a response rate of 95.5%. Of the students, 189 (99%) used RD during operative procedures for adhesive restorations. Furthermore, 157 (82.2%) students agreed that proper isolation cannot be achieved without RD application. All the advantages of RD application were recognized by 165 (85.9%) of the students. Notably, there was a significant association between the factors limiting the RD application and the students' academic year (p<0.05), with senior students reporting fewer limitations. Responses indicated that 163 (85.3%) of the students received satisfactory training for RD and 165 (86.4%) students had a high intention to continue using RD following graduation. Conclusion Within the limitations of this study, it can be concluded that the results presented a positive attitude toward RD use. However, there is a continued necessity to enhance education and advocate consistent RD application for improved patient care and clinical outcomes.

The Assessment of Diabetic Ketoacidosis Awareness Among Diabetic Patients and Their Caregivers in Makkah, Saudi Arabia: A Cross-Sectional Study.

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM). It occurs due to a decrease in the level of insulin and an increase in the level of glucose in the blood, which makes cells unable to use glucose as an energy source and begin to break fat into ketones; an overload of ketones levels in the blood can lead to DKA.The aim of the study is to assess awareness of DKA among diabetic patients and their caregivers in Makkah City, Saudi Arabia. This study is a cross-sectional study collected through an online questionnaire of diabetic patients and their caregivers in Makkah City. A self-reported questionnaire designed in Arabic and English through the use of Google Forms, it distributed electronically via social media to the target population with the objectives of the survey. A total of 400 participants were included, 73%of them were males, while 27%were females. A 9%of the participants have been diagnosed with DKA. A high awareness level about DKA was found in 32.5%of participants, while 67.5%had a poor awareness level. Factors associated with a high level of awareness towards DKA are young age, being single, students and having a previous DKA diagnosis. Regarding our participants who have poor awareness of DKA, further education for diabetic patients and their caregivers about DKA is crucial to prevent life-threatening complications, and improve quality of life for these patients.

Malaria during COVID-19 Travel Restrictions in Makkah, Saudi Arabia.

Malaria is a parasitic infection that may result in an acute, life-threatening illness. It is a major public health problem in the tropical world. The disease is caused by the parasites of the genus Plasmodium and is transmitted by female Anopheles mosquitoes. Saudi Arabia is in the elimination phase of malaria control. Several parts of Saudi Arabia report cases of imported malaria among travelers and visitors. The city of Makkah in Saudi Arabia has a population of about 2.3 million. Moreover, over 6 million religious visitors from different parts of the world visit Makkah annually. During the COVID-19 outbreak, travel restrictions were enforced in Makkah to contain the spread of COVID-19. We compare the total reported cases of malaria in Makkah before, during, and after COVID-19 travel restrictions in this retrospective cross-sectional study. Data on demographics, clinical data, and laboratory parameters were collected from the medical records of the Ministry of Health, Saudi Arabia. The annual malaria incidence rates in Makkah were 29.13/million people (2018), 37.82/million people (2019), 15.65/million people (2020), 12.61/million people (2021), and 48.69/million people (2022). Most of the malaria cases in Makkah were caused by Plasmodium falciparum, followed by P. vivax. Sudan, Nigeria, Yamen, Pakistan, and India are the top five countries contributing to malaria cases in Makkah. Weekly malaria case analyses revealed that COVID-19-related travel restrictions resulted in zero malaria cases in Makkah, indicating the magnitude of the travel-related malaria burden in the city.

The Prevalence of Tooth Wear and Their Associated Etiologies Among Adult Subjects Visiting Umm Al-Qura University Dental Clinic in Makkah City, Saudi Arabia.

In the past two decades, changing trends in socioeconomic status, dietary habits, and individual lifestyles of individuals have led to the emergence of tooth wear as an oral health problem. The present study aimed to investigate the prevalence and the associated etiologies of tooth wear in a convenience sample of adult patients visiting outpatient clinics of the Faculty of Dentistry at Umm Al-Qura University. This cross-sectional study was conducted on adult patients (18-40 years old) visiting outpatient clinics of the Faculty of Dentistry, Umm Al-Qura University. Two trained examiners visually assessed patients' tooth wear using Smith and Knight's Tooth Wear Index (TWI). Following the clinical examination, patients completed a self-administered questionnaire detailing risk factors such as the frequency of intake of acidic food and medicines, general health, chewing habits, dietary factors, and oral health-associated preventive behaviors. The resulting collected data were tabulated and statistically analyzed using Statistical Product and Service Solutions (SPSS, version 21; IBM SPSS Statistics for Windows, Armonk, NY). The total prevalence of tooth wear was 74%, and the recorded mean wear score (TWI) was 0.380 ± 0.386; anterior teeth exhibited greater wear than posterior teeth. Numerous associations were recorded between tooth wear and the tested variables in demographics, habits, diet, and medications, but most of them were not statistically significant. When toothbrushing habits were explored, the only factors to played a significant role in abrading the tooth structure were the type of brush bristles used (P-value = 0.026) and the frequency of brush renewal (P = 0.043). Patients who frequently ate citrus fruits and other acidic foods recorded high wear scores (0.509 ± 0.311 and 0.508 ± 0.402, respectively), although the difference was not statistically significant. When chewing occurred on both sides of the mouth, less tooth wear was recorded than if chewing was on the right or left side only (0.371 ± 0.260, 0.422 ± 0.273, and 0.520 ± 0.419, respectively). The study data support an association between tooth wear and patient occupation, use of hard-bristled and new toothbrushes, eating of citrus and other acidic food, and chewing on one side, as all of these factors increased the risk of tooth wear.

Sustainable Plasma Gasification Treatment of Plastic Waste: Evaluating Environmental, Economic, and Strategic Dimensions.

The conversion of waste to energy is an essential process in the Middle East, especially in Saudi Arabia, where it plays a crucial role in waste management. The annual analysis of the decomposition hazards of the landfills in the city of Makkah showed that they ranged from 168,000 Mg in 1994 to 297,000 Mg in 2022. The emission costs of pollution ranged from 4 million in 1994 to 7 million in 2022. The number of gas emissions of plastic waste accumulating in the analyzed landfill has increased from 128,000 Mg in 1994 to 227,000 Mg in 2022. The thermal plasmas used were produced by air plasma torches, which are an essential part of plasma reactors. The operational characteristics of air plasma torches were investigated at a flow rate of 10-30 g/s, including current-voltage characteristics, applied power, applied flow rate, average temperatures of the exiting plasma jet ranging from 15,000 to 19,000 K, average velocity of the exiting plasma jet (1677.3-2763.2) m/s, wavelength of the emitted radiation ranging from 153 to 193 nm, and the corresponding beam lengths ranging from 400 to 450 mm. The proposed plasma gasification is the greenest method for processing plastic waste in the light of ecological, economic, and strategic visions with an amount of recovered pyrolysis oil in the year 2022 of 3.17 × 105 tons with an equivalent energy of 12.55 × 109 MJ, with an output efficiency value equal to 81%. A roadmap for the economic and environmental visions was introduced, where the economic return on investment (ROR%) was 80%, the payback period (PBP) was 1.2 years, and the gross profit reached 129%.