Umm Al-Qura University Research Articles

Prevalence of Primary Dysmenorrhea and Its Effect on the Quality of Life Among Female Students at Umm Al-Qura University

Prevalence of Primary Dysmenorrhea and Its Effect on the Quality of Life Among Female Students at Umm Al-Qura University

Knowledge and Attitudes Regarding the Inappropriate Use of Proton Pump Inhibitors Among Students of Umm Al-Qura University in Saudi Arabia: A Cross-Sectional Study

Knowledge and Attitudes Regarding the Inappropriate Use of Proton Pump Inhibitors Among Students of Umm Al-Qura University in Saudi Arabia: A Cross-Sectional Study

Patterns of mandibular third molar impaction and its relationship with distal caries in the adjacent mandibular second molars: A retrospective study

BackgroundImpacted third molars can cause significant challenges for dental health. While many of these impacted teeth remain asymptomatic, they can lead to dental caries. ObjectiveTo investigate the patterns of mandibular third molar impaction and its relationship with the occurrence of caries in the adjacent mandibular second molars. Materials and MethodsThis study assessed the dental panoramic radiographs of 1591 participants who visited the Department of Oral and Maxillofacial Surgery at the Dental Teaching Hospital at Umm Al-Qura University between 2022 and 2024. The presence of distal caries in the adjacent mandibular second molars was assessed and compared across the different impaction patterns, considering both age and gender. ResultsThe results showed that 29.22 % of the patients had impacted mandibular third molars. The most common patterns of impacted mandibular third molar angulation were mesioangular in the females and horizontal in the males. The majority of these impacted third molars were level A and class I (as per the Pell and Gregory classification).One hundred and eighty-three (39.35 %) of the impacted mandibular third molars had associated carious lesions, with 89 showing distal caries in the adjacent mandibular second molar and 18 showing caries in the third molar itself. The carious lesions were most commonly found in cases of mesioangular, level A, and class I impaction patterns (p < 0.05). ConclusionThe findings of this study shed light to the high prevalence of carious lesions associated with impacted mandibular third molar, especially in cases of mesioangular, level A, and class I impaction patterns. These findings highlight the importance of careful monitoring of impacted third molars to prevent the development of caries in the adjacent teeth.

Evaluation of depression and anxiety behaviors among medical field students in Umm Al-Qura University during Covid-19 outbreak, Saudi Arabia.

Evaluation of depression and anxiety behaviors among medical field students in Umm Al-Qura University during Covid-19 outbreak, Saudi Arabia.

Assessing Medical Students' Understanding of Do-Not-Resuscitate (DNR) Orders.

The evolution of medical directives surrounding cardiopulmonary resuscitation (CPR) has led to the prominence of do-not-resuscitate (DNR) orders. These orders aim to respect patient autonomy and ensure dignified end-of-life care. While regulations in the United States emphasize patient choice and comprehensive discussions, Saudi Arabia's approach to DNR orders integrates Islamic principles alongside expert medical judgment. This study aimed to assess the awareness and comprehension of DNR orders among medical students at Umm Al-Qura University, Makkah, Saudi Arabia. This study employed a cross-sectional design at Umm Al-Qura University in 2023. Convenience sampling yielded a sample of 145 participants, encompassing medical students from all years (first-sixth) and medical interns. A self-administered online questionnaire assessed participants' knowledge, beliefs, and attitudes regarding DNR orders. The questionnaire specifically addressed their familiarity with DNR orders, their understanding of the Islamic perspective on DNR, and the factors influencing their attitudes toward DNR. Results: The majority of respondents (62%) were familiar with the term "DNR," but only 52% correctly defined it. Social media was the primary source of information about DNR for most respondents (56%). A significant portion of respondents (60.7%) agreed with the concept of DNR, and 54% had personal experience with the term. Patient dignity (54%), religious concerns (66.7%), and legal concerns (60.7%) were identified as important factors in DNR decisions. A majority of respondents (67%) agreed that it is acceptable to discontinue life support for DNR patients, and 49.3% believed that organ donation should be encouraged among patient families. The study found that as medical students progressed through their training (from pre-clinical to clinical years and internship), their acceptance and understanding of DNR orders generally increased. The study found that medical students possess some basic familiarity with DNR orders, but there is considerable room for advancement in their comprehension and acceptance of the topic. Addressing these knowledge gaps may lead to improved patient outcomes. The findings also underscore the need to equip future physicians with a comprehensive understanding of DNR orders, their ethical ramifications, and effective communication strategies for engaging with patients and their families.

Brain Death Knowledge and Attitudes Among Fourth-Year Medical Students at Umm Al-Qura University.

Background Despite clear definitions of brain death, students and medical professionals may have varying understandings. This study investigated the knowledge and attitudes of medical students regarding brain death. Methods A cross-sectional survey was administered to 142 fourth-year medical students at Umm Al-Qura University. The survey used single-choice and Likert scale questions to assess knowledge of brain death definition, diagnosis procedures, and student attitudes. Prior to administration, the questionnaire underwent content validation by experts in medicine, ethics, and public health. Results A significant proportion of students lacked knowledge of the legal definition of brain death in Saudi Arabia (26.1%), brain death diagnostic procedures (43.7%), and prerequisites for declaring brain death (38%). While some students expressed confidence in diagnosing brain death, concerns about misdiagnosis were also present. Conclusion Fourth-year medical students in this study demonstrated significant knowledge gaps regarding brain death. Medical education programs may need to be revised to provide more comprehensive training on brain death and its implications. Additionally, public awareness campaigns could improve understanding and facilitate informed decision-making about organ donation. Further research, including multicenter studies, is warranted to confirm these findings and guide educational interventions.

In Vitro Evaluation of Cytotoxicity of Moringa oleifera Hydroalcoholic Leaf Extract on Human Gingival Fibroblasts

Background. The market for wound healing biomaterials is a rapidly growing industry globally. Moringa oleifera Lam. (MO) is a plant that has gained attention for its benefit in buccal mouthwashes and antiseptic products. This study aimed to assess the cytotoxic potential of MO hydroalcoholic extract on human primary gingival fibroblasts. Methods. The gingival tissue was collected from a healthy adult male at Umm Al-Qura University Dental Teaching Hospital. Gingival fibroblasts were isolated and cultured in Dulbecco’s Modified Eagle Medium (DMEM). MO leaves were dried, powdered, and extracted with 80% ethanol. Various concentrations of MO alcohol extract were used to assess the cell viability of gingival fibroblasts using the MTT assay. Results. The gingival fibroblasts treated with higher concentrations of MO hydroalcoholic extract (10, 5, and 2.5 mg/ml) showed significant morphological changes, including cytoplasm swelling, ruptured cells, nuclear changes, and apoptotic bodies. At these concentrations, cell viability decreased sharply. However, at a lower concentration of 2.5 mg/ml, the cells showed better viability. MO alcohol extract at concentrations of 1.25 mg/ml or lower did not have cytotoxic effects on fibroblasts, with cell viability comparable to that of the control. Conclusions. MO alcohol extract at concentrations of 1.25 mg/ml or lower is not cytotoxic and does not induce dystrophic changes in morphology. Further research is needed to understand MO’s impact on oral health and to assess its potential use in oral care products in vivo.

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.

The effect of educational animation compared to leaflets on patients’ knowledge regarding root canal treatment: a randomized controlled trial

BackgroundIncorporating video as a tool for education offers a multitude of advantages. However, it is unknown what is the best educational tool to use for increasing public awareness, consequently reducing fear about root canal treatment. For this reason, this study aimed to compare the effectiveness of educational animation and leaflets as delivery methods for providing information on root canal treatment to patients and to assess their ability to retain the information.MethodsOne hundred fifty adult volunteers were recruited via social media and Umm Al-Qura University Dental Hospital to participate in this randomized control trial study. The volunteers were divided into the study group (SG) and the control group (CG). The SG was provided with information through animations created by the research team, while the CG received the same information through a leaflet. Pre-intervention (T1), immediate post-intervention (T2), and one-month post-intervention (T3) validated questionnaires were completed by the participants to assess the changes in their knowledge. To evaluate the impact of the information delivery method, the knowledge scores of T2 and T3 were compared to T1 within each group using Paired T-tests. Additionally, the study compared the knowledge scores of the two groups using unpaired T-tests. The significance level was set at a P-value of less than 0.05.ResultsA significant improvement in endodontic therapy knowledge among the participants in both groups (T1 compared to T2 in the same group) was noted (P < 0.050). However, when comparing T2 between groups, no significant difference was found in delivering the information and improving the knowledge (P = 0.080). Still, the mean differences between T1 and T2, as well as T1 and T3, were greater (P < 0.050) in the SG than in the CG. Furthermore, the total knowledge score in the SG at T3 was significantly higher than the CG.ConclusionBoth educational animation and leaflets are practical tools to increase patients’ awareness about root canal treatment. However, educational videos are more effective than leaflets in delivering and retaining information about root canal treatment.Trial registrationThis study was retrospectively registered as a randomized control trial at the ISRCTN registry with the document number ISRCTN18413241, 15/05/2023.

The severity of dry eye symptoms and risk factors among university students in Saudi Arabia: a cross-sectional study

Dry eye syndrome (DES) is a tear film disorder caused by increased tear evaporation or decreased production. The heavy workload on the eye and the increased usage of digital screens may decrease blink frequency, leading to an increased evaporation rate and an upsurge in the incidence and severity of DES. This study aims to assess the severity of DES symptoms and the risk factors among university students. A cross-sectional study was conducted at Umm AlQura University to evaluate the severity of DES among students and explore its potential association with digital screen use. Validated questionnaires were used to assess the severity of DES and digital screen usage. The study included 457 participants, of which 13% had symptoms suggestive of severe DES. Furthermore, multiple risk factors had a significant association with the severity of DES, including gender, use of monitor filters, monitor and room brightness, and smoking habits. DES symptoms were prevalent among university students, particularly female students. Although there was no significant association with the duration of screen usage and collage distribution. Other factors however, such as the usage of screen monitors and the brightness of both the monitor and the room, were significantly associated with the severity of DES symptoms.

The Relative Contribution of the Emotional Suppression in Predicting Chronic Fatigue Syndrome among Female Students of Umm Al-Qura University at Makkah Al Mukarramah

This study aims to determine the level of implementing the strategy of the emotional suppression by Umm Al Qura University female students, to know the prevalence rate of the chronic fatigue syndrome among female students of Umm Al Qura University, to know the relationship between the use of the emotional suppression strategy and the feeling of the chronic fatigue syndrome, and to know the differences between female students of Umm Al Qura University in using the strategy of the emotional suppression and the Chronic fatigue syndrome according to marital status and age, revealing the possibility of predicting the feeling of the chronic fatigue syndrome through the scores achieved by Umm Al Qura University female students on the scale of the emotional suppression prepared by Al-Khairi and Taleb (2017), and the chronic fatigue scale prepared by Abdul Khaleq and Al Dheeb (2006) Using the descriptive, predictive method . The study was applied to a Random sample of (417) female students at Umm Al Qura University in Makkah Al Mukaromah. The results revealed that the level of emotional suppression among Umm Al Qura University female students is higher than the average. The prevalence of the chronic fatigue syndrome is less than the average, while the prevalence of the chronic fatigue according to the used test (the median) ranged between (47.4-48.4%) among university female students for the dimensions and the total score. The value of the correlation coefficient between the students' scores on the emotional suppression scale and their scores on the chronic fatigue syndrome scale was positive and indicative Moreover, the results showed that the emotional suppression predicted the chronic fatigue syndrome by (19%).

Competitive Intelligence at Umm Al-Qura University from the Viewpoint of Faculty Members

The current study aims to introduce the availability degree of the competitive intelligence dimensions (Planning and Focus - Collecting Data - Analysis - Publishing) at Umm Al-Qura University from the viewpoint of faculty members and reveal statistically significant differences between the averages of faculty members’ responses in the availability degree of competitive intelligence dimensions due to variables (Gender - Academic Degree - Number of Experience Years). The study has adopted the descriptive survey approach, and the necessary data was collected from the study sample using a questionnaire that was applied to a sample of (797) faculty members at Umm Al-Qura University. The study reached the following prominent findings: The availability of competitive intelligence dimensions (Planning and Focus - Collecting Data - Analysis - Publishing) at Umm Al-Qura University from the viewpoint of faculty members was moderate. The study concluded that there are no statistically significant differences between the averages of the study sample’s responses in determining the availability degree of competitive intelligence dimensions due to the variable (Gender), and they appeared for the variables (Academic Degree and Number of Experience Years).

Factors for Developing Digital Skills among Faculty Members at the College of Education at Umm Al-Qura University

The study aimed to assess the digital skills of faculty members at the College of Education, Umm Al-Qura University, and identify factors influencing these skills. It also investigated whether there were statistically significant differences in digital skills based on gender, years of experience, and the number of digital skills courses. The results showed that overall digital skills were at a moderate level. Some skills, like word processing and presentation software, were high, while others, such as using certain educational platforms and programming, were lower. Faculty members believed that factors like IT support, the university's approach to technology, and training influenced their digital skills. Female faculty members had higher digital skills, and those with more experience or courses had better digital skills. The study recommended increasing the focus on enhancing faculty digital skills through technology integration and training.

Attitudes of Linguistic Theses for Postgraduate Students in the College of Arabic Language at Umm Al-Qura University in Makkah. Since the beginning of the Twenty-First Century: 2000-2018 CE/(1420 AH-1440 AH) A Type of Statistical Bibliometric Study

Attitudes of Linguistic Theses for Postgraduate Students in the College of Arabic Language at Umm Al-Qura University in Makkah. Since the beginning of the Twenty-First Century: 2000-2018 CE/(1420 AH-1440 AH) A Type of Statistical Bibliometric Study

Exploring Undergraduate Students' Perspectives on Endodontic Treatment: A Cross-Sectional Study in Makkah.

Background Students at two universities in Saudi Arabia found endodontics or root canal treatment (RCT) difficult due to challenges in the procedures. Until now, there has been no evidence that Umm Al-Qura University students face difficulties when performing RCT. Therefore, this study aims to explore students' perceptions of the critical steps in RCT. Methods A survey was conducted among 146 dental students at Umm Al-Qura University, Makkah, Saudi Arabia to assess their perceptions and challenges during RCT. Demographic information was collected in the first section, while the second section focused on identifying difficulties encountered during endodontic treatment stages. All participants provided signed electronic consent, and the study was approved by the university's institutional review board. Chi-squared tests were used to analyze the results. Results In a survey of 123 students, 94 (76.2%) found the endodontic specialty acceptable compared to other dental specialties (P < 0.001). Eighty-eight (71.5%) found RCT on the molars difficult (P < 0.001). Most students, 104 (84.6%), chose to have more clinical training to improve their clinical endodontic skills, and 77 (62.6%) chose to increase the number of instructors per student in the clinic (P < 0.05). Difficulties in performing RCT on premolars and during root canal obturation were statistically correlated with the academic year of the student (P < 0.05). Conclusion Dental students often struggle when performing RCT on molars. Some difficulties during RCT are correlated with the academic year of the student. Finally, from the students' perspective, improving endodontic skills involves providing better clinical training opportunities and increasing instructor-to-student ratios.

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 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.

Factors Influencing the Preference of Medical Students at Umm Al-Qura University for Otorhinolaryngology-Head and Neck Surgery as a Future Specialty: A Cross-Sectional Study.

Otorhinolaryngology (ORL) specialists treat patients of different ages, ranging from elderly patients with head and neck tumors to neonates with respiratory problems. No studies have been conducted to explore the factors that affect the preference for ORL among Umm Al-Qura University students. We aimed to investigate factors and motivators influencing medical students at Umm Al-Qura University in Makkah, Saudi Arabia, who choose to pursue a career in ORL-head and neck surgery. This cross-sectional study was conducted over two months in 2023 among 439 students in the pre-clinical, clinical, and internship years of the Faculty of Medicine at Umm Al-Qura University, Saudi Arabia.We shared a Google Forms questionnaire(Google, Inc., Mountain View, CA) and explored factors associated with interest in ear, nose, and throat (ENT) as a future specialty.We used Pearson's chi-squaretest to arrive at the results. A total of 339 (77.2%) participants were female. Participants were evenly divided between pre-clinical years (213 (48.5%)) and clinical years (207 (47.2%)), with a smaller percentage in the internship category (19 (4.3%)). ORL involvement was reported in 159 (36.2%) of the participants. The surgical specialty of ORL focuses mostly on conditions affecting the head, neck, nose, and ears. Since students found this specialty fascinating, we recommend that senior doctors make a greater effort to enlighten doctors-in-training about this field of expertise through lectures and campaigns at hospitals and universities.

Measuring the impact of dental service quality on revisit intention using an extended SERVQUAL model.

The pursuit of quality services can lead to both service enhancement and increased motivation to visit dental centers for oral health treatment. The purpose of this study is to investigate the effect of dental center service quality factors on revisit intention among adult patients by applying an extended service quality model (SERVQUAL). This cross-sectional study was conducted between September and November 2023 in the outpatient waiting areas and clinical settings of Umm Al-Qura University Dental Teaching Hospital (UQU-DTH). A sample of 355 patients was invited by the convenience sampling method. The data was collected through a validated Arabic version of the extended SERVQUAL questionnaire. A hierarchical regression analysis was used to assess the incremental effects of the extended SERVQUAL factors on the intention of patients to revisit the UQU-DTH while controlling for demographic variables. Cronbach alpha was used to examine the internal consistency of each model factor. A total of 330 completed responses were received, with a 93% response rate. The findings indicated that demographic variables such as age and level of education contribute to some extent but become negligible when the extended SERVQUAL factors are included in the model. Moreover, the extended SERVQUAL model factors substantially improved the model. Three factors were found to positively and significantly affect the revisit intention, namely, "staff-related factors," "cost-effectiveness," and "responsiveness." Overall, the model explained 65.6% of the variance in the revisit intention (R2 = 0.656, p < 0.001). The findings present a unique model that may be used to better understand the factors that influence patients' intentions to revisit dental centers in an educational setting. Additionally, it identified elements that dental center quality management needs to prioritize and address.

The Association Between Caffeine Consumption and Academic Success in Makkah Region, Saudi Arabia.

Theconsumption ofcaffeinated beverages has increased significantly, particularly, among young adults. They usecaffeinated drinks foravariety of reasons. The most popularreason is to enhancemental alertness by improving brain function, wakefulness, and productivity. Thehigh prevalence rate of caffeinated drinks among young adults may affect theiracademic performance level. Adescriptive cross-sectional study based on an electronic questionnaire via Google Forms, conducted in February 2022 after the biomedical ethics committee obtained the ethical approval at Umm Al-QuraUniversity (UQU), College of Medicine, Makkah, Saudi Arabia,the sample size was593 medical students inMakkah region. Atotal number of 593 medical students participated in this study, most of the medical students who participated (47.20%) had average GPA of 85%-95%. The largest number of medical students (45.30%) consume only one cup of caffeinated beverages per day. We reported no association between caffeinated beverages consumption and academic performance. Our studydemonstrates thatcaffeinated beverages are a popular practice among medical college students. Majorityof the medical students in Makkah region consume coffee as the most popular drink, while energy drinks are considered to be the least consumed drink,but energy drinks are easilyaffordable and available. Therefore, primary prevention of excessive consumption of caffeine is essential.